Stunting is preceded by intestinal mucosal damage and microbiome changes and is associated with systemic inflammation in a cohort of Peruvian infants

Mara Zambruni, Theresa J. Ochoa, Anoma Somasunderam, Miguel M. Cabada, Maria L. Morales, Makedonka Mitreva, Bruce A. Rosa, Gonzalo J. Acosta, Natalia I. Vigo, Maribel Riveros, Sara Arango, David Durand, Maitreyee N. Berends, Peter Melby, Netanya S. Utay

Research output: Contribution to journalArticle

Abstract

Stunting, defined as height-for-age Z score equal to or lower than −2, is associated with increased childhood mortality, cognitive impairment, and chronic diseases. The aim of the study was to investigate the relationship between linear growth, intestinal damage, and systemic inflammation in infants at risk of stunting. We followed up 78 infants aged 5-12 months living in rural areas of Peru for 6 months. Blood samples for biomarkers of intestinal damage (intestinal fatty-acid-binding protein [I-FABP] and zonulin) and systemic inflammation (interleukin-1β, interleukin-6, tumor necrosis factor α [TNF-α], soluble CD14, and lipopolysaccharide-binding protein [LBP]) and fecal samples for microbiome analysis were collected at baseline and closure of the study. The children's growth and health status were monitored through biweekly home visits by trained staff. Twenty-one percent of the children became stunted: compared with non-stunted children, they had worse nutritional parameters and higher levels of serum I-FABP at baseline. The likelihood of becoming stunted was strongly associated with an increase in sCD14 over time; LBP and TNF-α showed a trend toward increase in stunted children but not in controls. The fecal microbiota composition of stunted children had an increased beta diversity compared with that of healthy controls throughout the study. The relative abundance of Ruminococcus 1 and 2, Clostridium sensu stricto, and Collinsella increased in children becoming stunted but not in controls, whereas Providencia abundance decreased. In conclusion, stunting in our population was preceded by an increase in markers of enterocyte turnover and differences in the fecal microbiota and was associated with increasing levels of systemic inflammation markers.

Original languageEnglish (US)
Pages (from-to)1009-1017
Number of pages9
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume101
Issue number5
DOIs
StatePublished - Jan 1 2019

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Growth Disorders
Microbiota
Inflammation
Fatty Acid-Binding Proteins
Ruminococcus
Providencia
House Calls
Peru
Clostridium
Enterocytes
Growth
Interleukin-1
Health Status
Blood Proteins
Interleukin-6
Chronic Disease
Tumor Necrosis Factor-alpha
Biomarkers
Mortality
Population

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases

Cite this

Stunting is preceded by intestinal mucosal damage and microbiome changes and is associated with systemic inflammation in a cohort of Peruvian infants. / Zambruni, Mara; Ochoa, Theresa J.; Somasunderam, Anoma; Cabada, Miguel M.; Morales, Maria L.; Mitreva, Makedonka; Rosa, Bruce A.; Acosta, Gonzalo J.; Vigo, Natalia I.; Riveros, Maribel; Arango, Sara; Durand, David; Berends, Maitreyee N.; Melby, Peter; Utay, Netanya S.

In: American Journal of Tropical Medicine and Hygiene, Vol. 101, No. 5, 01.01.2019, p. 1009-1017.

Research output: Contribution to journalArticle

Zambruni, M, Ochoa, TJ, Somasunderam, A, Cabada, MM, Morales, ML, Mitreva, M, Rosa, BA, Acosta, GJ, Vigo, NI, Riveros, M, Arango, S, Durand, D, Berends, MN, Melby, P & Utay, NS 2019, 'Stunting is preceded by intestinal mucosal damage and microbiome changes and is associated with systemic inflammation in a cohort of Peruvian infants', American Journal of Tropical Medicine and Hygiene, vol. 101, no. 5, pp. 1009-1017. https://doi.org/10.4269/ajtmh.18-0975
Zambruni, Mara ; Ochoa, Theresa J. ; Somasunderam, Anoma ; Cabada, Miguel M. ; Morales, Maria L. ; Mitreva, Makedonka ; Rosa, Bruce A. ; Acosta, Gonzalo J. ; Vigo, Natalia I. ; Riveros, Maribel ; Arango, Sara ; Durand, David ; Berends, Maitreyee N. ; Melby, Peter ; Utay, Netanya S. / Stunting is preceded by intestinal mucosal damage and microbiome changes and is associated with systemic inflammation in a cohort of Peruvian infants. In: American Journal of Tropical Medicine and Hygiene. 2019 ; Vol. 101, No. 5. pp. 1009-1017.
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abstract = "Stunting, defined as height-for-age Z score equal to or lower than −2, is associated with increased childhood mortality, cognitive impairment, and chronic diseases. The aim of the study was to investigate the relationship between linear growth, intestinal damage, and systemic inflammation in infants at risk of stunting. We followed up 78 infants aged 5-12 months living in rural areas of Peru for 6 months. Blood samples for biomarkers of intestinal damage (intestinal fatty-acid-binding protein [I-FABP] and zonulin) and systemic inflammation (interleukin-1β, interleukin-6, tumor necrosis factor α [TNF-α], soluble CD14, and lipopolysaccharide-binding protein [LBP]) and fecal samples for microbiome analysis were collected at baseline and closure of the study. The children's growth and health status were monitored through biweekly home visits by trained staff. Twenty-one percent of the children became stunted: compared with non-stunted children, they had worse nutritional parameters and higher levels of serum I-FABP at baseline. The likelihood of becoming stunted was strongly associated with an increase in sCD14 over time; LBP and TNF-α showed a trend toward increase in stunted children but not in controls. The fecal microbiota composition of stunted children had an increased beta diversity compared with that of healthy controls throughout the study. The relative abundance of Ruminococcus 1 and 2, Clostridium sensu stricto, and Collinsella increased in children becoming stunted but not in controls, whereas Providencia abundance decreased. In conclusion, stunting in our population was preceded by an increase in markers of enterocyte turnover and differences in the fecal microbiota and was associated with increasing levels of systemic inflammation markers.",
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T1 - Stunting is preceded by intestinal mucosal damage and microbiome changes and is associated with systemic inflammation in a cohort of Peruvian infants

AU - Zambruni, Mara

AU - Ochoa, Theresa J.

AU - Somasunderam, Anoma

AU - Cabada, Miguel M.

AU - Morales, Maria L.

AU - Mitreva, Makedonka

AU - Rosa, Bruce A.

AU - Acosta, Gonzalo J.

AU - Vigo, Natalia I.

AU - Riveros, Maribel

AU - Arango, Sara

AU - Durand, David

AU - Berends, Maitreyee N.

AU - Melby, Peter

AU - Utay, Netanya S.

PY - 2019/1/1

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N2 - Stunting, defined as height-for-age Z score equal to or lower than −2, is associated with increased childhood mortality, cognitive impairment, and chronic diseases. The aim of the study was to investigate the relationship between linear growth, intestinal damage, and systemic inflammation in infants at risk of stunting. We followed up 78 infants aged 5-12 months living in rural areas of Peru for 6 months. Blood samples for biomarkers of intestinal damage (intestinal fatty-acid-binding protein [I-FABP] and zonulin) and systemic inflammation (interleukin-1β, interleukin-6, tumor necrosis factor α [TNF-α], soluble CD14, and lipopolysaccharide-binding protein [LBP]) and fecal samples for microbiome analysis were collected at baseline and closure of the study. The children's growth and health status were monitored through biweekly home visits by trained staff. Twenty-one percent of the children became stunted: compared with non-stunted children, they had worse nutritional parameters and higher levels of serum I-FABP at baseline. The likelihood of becoming stunted was strongly associated with an increase in sCD14 over time; LBP and TNF-α showed a trend toward increase in stunted children but not in controls. The fecal microbiota composition of stunted children had an increased beta diversity compared with that of healthy controls throughout the study. The relative abundance of Ruminococcus 1 and 2, Clostridium sensu stricto, and Collinsella increased in children becoming stunted but not in controls, whereas Providencia abundance decreased. In conclusion, stunting in our population was preceded by an increase in markers of enterocyte turnover and differences in the fecal microbiota and was associated with increasing levels of systemic inflammation markers.

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