Environmental, Metabolic, and Inflammatory Factors Converge in the Pathogenesis of Moderate Acute Malnutrition in Children: An Observational Cohort Study.
Environmental, Metabolic, and Inflammatory Factors Converge in the Pathogenesis of Moderate Acute Malnutrition in Children: An Observational Cohort Study.
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DOI：
10.4269/ajtmh.20-0963
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发表时间：
2021-03-22
期刊：
影响因子：
--
通讯作者：
Melby PC
中科院分区：
文献类型：
--
作者：
Patterson GT;Manthi D;Osuna F;Muia A;Olack B;Mbuchi M;Saldarriaga OA;Ouma L;Inziani M;Yu X;Otieno P;Melby PC
急性营养不良影响着全世界5000多万儿童。这些儿童因传染病患病和死亡的风险增加。然而，急性营养不良的发病机制以及感染风险增加和不良后果的机制尚不清楚。我们的目的是确定中度急性营养不良儿童（MAM）和健康对照（hc）之间炎症和炎症反应的差异，并寻找可能影响这种反应的环境、病理生理和代谢因素。在肯尼亚内罗毕对16名18-36个月的MAM和16名hc患儿进行了研究。在入组和采集样本前2周，所有儿童均无传染病症状（发烧、腹泻或咳嗽）。人口和健康数据由其主要照顾者提供。采集血液样本来测量各种生物标志物和对炎症刺激的反应。患有MAM的儿童更多地来自水污染、拥挤和收入来源不稳定的家庭。他们也有基础炎症、循环细菌脂多糖（LPS）、肠道损伤标志物的增加，以及对LPS的夸张的全血炎症反应。患有MAM的儿童的代谢变化导致血浆长链脂肪酸水平升高，而长链脂肪酸被发现有助于促炎状态。这些探索性发现表明，多种因素的融合促进了失调的炎症反应，并提出了一些机制假设，可以更好地了解MAM的发病机制。
Acute malnutrition affects more than 50 million children worldwide. These children are at an increased risk of morbidity and mortality from infectious disease. However, the pathogenesis of acute malnutrition and mechanisms underlying the increased risk and poor outcomes from infection are not well understood. Our objective was to identify differences in inflammation and inflammatory responses between children with moderate acute malnutrition (MAM) and healthy controls (HCs), and search for environmental, pathophysiological, and metabolic factors that may influence this response. Sixteen children with MAM and 16 HCs aged 18–36 months were studied in Nairobi, Kenya. None of the children had symptoms of an infectious disease (fever, diarrhea, or cough) in the 2 weeks before enrollment and sample collection. Demographic and health data were provided by their primary caregivers. Blood samples were collected to measure various biomarkers and the response to an inflammatory stimulus. Children with MAM were more frequently from households with contaminated water, crowding, and unstable income sources. They also had increases in basal inflammation, circulating bacterial lipopolysaccharide (LPS), markers of intestinal damage, and an exaggerated whole blood inflammatory response to LPS. Metabolic changes in children with MAM led to increased plasma levels of long-chain fatty acids, which were found to contribute to the pro-inflammatory state. These exploratory findings suggest convergence of multiple factors to promote dysregulated inflammatory responses and prompt several mechanistic hypotheses that can be pursued to better understand the pathogenesis of MAM.
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影响因子：
3.7
作者：
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通讯作者：
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影响因子：
120.7
作者：
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通讯作者：
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影响因子：
168.9
作者：
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通讯作者：
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影响因子：
7.1
作者：
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通讯作者：
Brown, Kenneth H.
影响因子：
7.1
作者：
Karakochuk, Crystal;van den Briel, Tina;Zlotkin, Stanley
通讯作者：
Zlotkin, Stanley