Modifying gut integrity and microbiome in children with severe acute malnutrition using legume-based feeds (MIMBLE): A pilot trial.
Modifying gut integrity and microbiome in children with severe acute malnutrition using legume-based feeds (MIMBLE): A pilot trial.
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使用基于豆类的饲料（Mimble）：一项试验试验，在严重急性营养不良的儿童中修饰肠道完整性和微生物组。
DOI：
10.1016/j.xcrm.2021.100280
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发表时间：
2021-05-18
期刊：
影响因子：
--
通讯作者：
Maitland K
中科院分区：
文献类型：
--
作者：
Calder N;Walsh K;Olupot-Olupot P;Ssenyondo T;Muhindo R;Mpoya A;Brignardello J;Wang X;McKay E;Morrison D;Holmes E;Frost G;Maitland K
非洲儿童严重急性营养不良的病死率仍然很高。我们报告了一项在58名乌干达儿童中进行的3臂试点试验，将含有豇豆（CpF，n = 20）或菊粉（InF，n = 20）的针对胃肠功能紊乱的饲料与常规饲料（ConF，n = 18）进行比较。肠道渗透性（乳果糖：甘露醇比值1.19 ± SD 2.00）、炎症（粪便钙卫蛋白539.0 μg/g，四分位距[IQR] 904.8）和饱腹感（血浆多肽YY 62.6 pmol/l，IQR 110.3）的基线测量结果证实了胃肠道功能障碍。到第28天，在实现体重增加>5 g/kg/天的比例方面没有观察到差异（87%，92%，86%; p > 0.05），死亡率（16%，30%，17%; p > 0.05），或水肿消退（83%，54%，91%; p > 0.05）在CpF，InF，和ConF。从第1天起粪便细菌丰度降低仅在ConF中观察到（基于丰度的覆盖率估计值[ACE] 53.2）至第7天（ACE 40.8）（p = 0.025）。在CpF中，双歧杆菌相对丰度从第7天（5.8% ± 8.6%）至第28天（10.9% ± 8.7%）增加（校正p = 1.000）。富含豆类的饲料支持肠道功能和微生物组的各个方面。试验注册PACTR 201805003381361。住院患者喂养标准或豆类饲料导致相似的体重增加豆类饲料在第7天限制了肠道微生物群丰富度的减少微生物发酵被保留，这对肠道健康和完整性有影响。证明富含豆类的饲料在治疗儿童严重急性营养不良的死亡率和体重增加方面优于标准饲料。粪便细菌丰富度和短链脂肪酸浓度在抗生素给药期间得以保留，这对胃肠道健康和肠道屏障完整性的恢复具有意义。
Case fatality among African children with severe acute malnutrition remains high. We report a 3-arm pilot trial in 58 Ugandan children, comparing feeds targeting disordered gastrointestinal function containing cowpea (CpF, n = 20) or inulin (InF, n = 20) with conventional feeds (ConF, n = 18). Baseline measurements of gut permeability (lactulose:mannitol ratio 1.19 ± SD 2.00), inflammation (fecal calprotectin 539.0 μg/g, interquartile range [IQR] 904.8), and satiety (plasma polypeptide YY 62.6 pmol/l, IQR 110.3) confirm gastrointestinal dysfunction. By day 28, no differences are observable in proportion achieving weight gain >5 g/kg/day (87%, 92%, 86%; p > 0.05), mortality (16%, 30%, 17%; p > 0.05), or edema resolution (83%, 54%, 91%; p > 0.05) among CpF, InF, and ConF. Decreased fecal bacterial richness from day 1 (abundance-based coverage estimator [ACE] 53.2) to day 7 (ACE 40.8) is observed only in ConF (p = 0.025). Bifidobacterium relative abundance increases from day 7 (5.8% ± 8.6%) to day 28 (10.9% ± 8.7%) in CpF (corrected p = 1.000). Legume-enriched feeds support aspects of gut function and the microbiome. Trial registration PACTR201805003381361. Inpatient feeding with standard or legume-based feeds resulted in similar weight gain Legume feeds limited antibiotic-mediated decrease in gut microbiota richness at day 7 Microbial fermentation was preserved, which has implications for gut health and integrity Further testing of legume-enriched feeds in severe acute malnutrition is warranted Calder et al. demonstrate that legume-enriched feeds perform comparably to standard feeds in the treatment of severe acute childhood malnutrition for mortality and weight gain. Fecal bacterial richness and short-chain fatty acid concentration are preserved during antibiotic administration, which has implications for recovery of gastrointestinal health and gut-barrier integrity.
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影响因子：
3.6
作者：
Kane, Anne V.;Dinh, Duy M.;Ward, Honorine D.
通讯作者：
Ward, Honorine D.
影响因子：
3.7
作者：
Gachau, Susan;Irimu, Grace;English, Mike
通讯作者：
English, Mike
DOI：
10.1038/nrdp.2017.67
发表时间：
2017-09-21
期刊：
Nature reviews. Disease primers
影响因子：
--
作者：
Bhutta ZA;Berkley JA;Bandsma RHJ;Kerac M;Trehan I;Briend A
通讯作者：
Briend A
影响因子：
168.9
作者：
Black, Robert E.;Victora, Cesar G.;Uauy, Ricardo
通讯作者：
Uauy, Ricardo
影响因子：
8.8
作者：
Anyango, Joseph O.;de Kock, Henriette L.;Taylor, John R. N.
通讯作者：
Taylor, John R. N.