Understanding the role of the gut in undernutrition: what can technology tell us?
Understanding the role of the gut in undernutrition: what can technology tell us?
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DOI：
10.1136/gutjnl-2020-323609
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发表时间：
2021-06-08
期刊：
影响因子：
24.5
通讯作者：
HUNGer Consortium
中科院分区：
文献类型：
--
作者：
Thompson AJ;Bourke CD;Robertson RC;Shivakumar N;Edwards CA;Preston T;Holmes E;Kelly P;Frost G;Morrison DJ;HUNGer Consortium
肠道功能在营养不良中的研究仍然很不足，尽管它在必需营养的消化，吸收和同化中发挥着关键作用。在肠道病原体负荷高的地区，肠道屏障功能的改变和随后的炎症反应是可观察到的，但仍然很难表征。环境性肠病（EE）-一种影响肠道形态和功能的疾病，其特征是绒毛变钝、炎症和通透性增加-被认为在线性生长受损（发育迟缓）和严重急性营养不良中发挥作用。然而，缺乏定量评估肠道功能能力的工具，阻碍了我们对营养不良肠道发病机制的理解和对肠道靶向治疗的评估，以加速营养恢复。在这里，我们调查了改善肠道功能评估的潜在解决方案的技术前景，重点关注可在低收入和中等收入国家（LMIC）的护理点部署的设备。我们评估了技术创新的潜力，以评估营养不良患者的肠道形态、功能、屏障完整性和免疫反应，并强调了目前最适合部署和开发的方法。这篇文章的重点是低收入国家的EE和营养不良，但其中许多技术也可能在监测其他肠道病变方面变得有用。
Gut function remains largely underinvestigated in undernutrition, despite its critical role in essential nutrient digestion, absorption and assimilation. In areas of high enteropathogen burden, alterations in gut barrier function and subsequent inflammatory effects are observable but remain poorly characterised. Environmental enteropathy (EE)—a condition that affects both gut morphology and function and is characterised by blunted villi, inflammation and increased permeability—is thought to play a role in impaired linear growth (stunting) and severe acute malnutrition. However, the lack of tools to quantitatively characterise gut functional capacity has hampered both our understanding of gut pathogenesis in undernutrition and evaluation of gut-targeted therapies to accelerate nutritional recovery. Here we survey the technology landscape for potential solutions to improve assessment of gut function, focussing on devices that could be deployed at point-of-care in low-income and middle-income countries (LMICs). We assess the potential for technological innovation to assess gut morphology, function, barrier integrity and immune response in undernutrition, and highlight the approaches that are currently most suitable for deployment and development. This article focuses on EE and undernutrition in LMICs, but many of these technologies may also become useful in monitoring of other gut pathologies.