Environmental Enteropathy in Undernourished Pakistani Children: Clinical and Histomorphometric Analyses.
Environmental Enteropathy in Undernourished Pakistani Children: Clinical and Histomorphometric Analyses.
复制标题
DOI：
10.4269/ajtmh.17-0306
复制
发表时间：
2018-06
期刊：
影响因子：
--
通讯作者：
Ali SA
中科院分区：
文献类型：
--
作者：
Syed S;Yeruva S;Herrmann J;Sailer A;Sadiq K;Iqbal N;Kabir F;Ahmed K;Qureshi S;Moore SR;Turner J;Ali SA
尽管采取了营养干预措施，但生长迟缓被认为是潜在的环境肠病(EE)的继发性疾病，在居住在资源贫乏国家的婴儿中仍然普遍存在，而且特征仍然很差。从380名儿童的出生队列中，65名营养不良的婴儿接受了为期12周的即食治疗性食品(RUTF)的营养补充。11名对RUTF反应不足的儿童接受了十二指肠活检的上消化道内窥镜检查，并与美国、年龄匹配的健康、乳糜泻、非腹膜绒毛萎缩、非腹膜上皮内淋巴细胞增多症和移植物抗宿主病患者的标本进行了比较。在11名接受活检的儿童中，有10名(91%)发现EE，其中1名患有乳糜泻。形态计量学显示EE患者的绒毛与隐窝(V：C)比率低于健康和非腹腔淋巴细胞增多症患者。与健康对照组相比，环境肠病患者绒毛体积显著减少。EE组每100个上皮细胞平均CD3+细胞数、每1,000微米固有层CD3+细胞数和固有层CD20+B细胞集合体数量均高于其他组。我们的结果表明，EE的V：C比降低，但没有乳糜泻严重。环境性肠病上皮内和固有层T淋巴细胞增多症比乳糜泻更严重。固有层B和T淋巴细胞的增加提示非溶细胞性淋巴细胞活化可能是EE相对于乳糜泻的一个更显著的特征。这些结果为儿童EE和乳糜泻的共同但不同的组织学和免疫学特征提供了新的见解。
Despite nutrition interventions, stunting thought to be secondary to underlying environmental enteropathy (EE) remains pervasive among infants residing in resource-poor countries and remains poorly characterized. From a birth cohort of 380 children, 65 malnourished infants received 12 weeks of nutritional supplementation with ready-to-use therapeutic food (RUTF). Eleven children with insufficient response to RUTF underwent upper endoscopy with duodenal biopsies, which were compared with U.S., age-matched specimens for healthy, celiac disease, non-celiac villous atrophy, non-celiac intraepithelial lymphocytosis, and graft-versus-host disease patients. Of the 11 children biopsied, EE was found in 10 (91%) with one subject with celiac disease. Morphometry demonstrated decreased villus-to-crypt (V:C) ratios in EE relative to healthy and non-celiac lymphocytosis patients. Environmental enteropathy villus volumes were significantly decreased relative to healthy controls. In EE, average CD3+ cells per 100 epithelial cells and per 1,000 µm2 of lamina propria and the number of lamina propria CD20+ B-cell aggregates were increased relative to all other groups. Our results indicate that V:C ratios are reduced in EE but are less severe than in celiac disease. Environmental enteropathy intraepithelial and lamina propria T lymphocytosis is of greater magnitude than that in celiac disease. The increases in lamina propria B and T lymphocytes suggest that non-cytolytic lymphocytic activation may be a more prominent feature of EE relative to celiac disease. These results provide new insights into shared yet distinct histological and immunological features of EE and celiac disease in children.
登录
查看更多内容
影响因子：
3.8
作者：
Bartelt LA;Bolick DT;Kolling GL;Roche JK;Zaenker EI;Lara AM;Noronha FJ;Cowardin CA;Moore JH;Turner JR;Warren CA;Buck GA;Guerrant RL
通讯作者：
Guerrant RL
影响因子：
39.2
作者：
LINDENBAUM, J;GERSON, CD;KENT, TH
通讯作者：
KENT, TH
DOI：
10.1097/00005176-199102000-00010
发表时间：
1991-02-01
影响因子：
2.9
作者：
SULLIVAN, PB;MARSH, MN;NEALE, G
通讯作者：
NEALE, G
影响因子：
3.6
作者：
Goto, R;Panter-Brick, C;Tuladhar, NR
通讯作者：
Tuladhar, NR
影响因子：
11.8
作者：
Keusch, Gerald T.;Denno, Donna M.;Brewer, Thomas
通讯作者：
Brewer, Thomas