McGrath Christine J, Arndt Michael B, Walson Judd L
Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas, USA.
PATH, Seattle, Washington, USA.
Horm Res Paediatr. 2017;88(1):111-117. doi: 10.1159/000471875. Epub 2017 May 9.
Despite global efforts to reduce childhood undernutrition, current interventions have had little impact on stunting and wasting, and the mechanisms underlying growth faltering are poorly understood. There is a clear need to distinguish populations of children most likely to benefit from any given intervention and to develop tools to monitor response to therapy prior to the development of morbid sequelae. In resource-limited settings, environmental enteric dysfunction (EED) is common among children, contributing to malnutrition and increasing childhood morbidity and mortality risk. In addition to EED, early alterations in the gut microbiota can adversely affect growth through nutrient malabsorption, altered metabolism, gut inflammation, and dysregulation of the growth hormone axis. We examined the evidence linking EED and the gut microbiome to growth faltering and explored novel biomarkers to identify subgroups of children at risk of malnutrition due to underlying pathology. These and other biomarkers could be used to identify specific groups of children at risk of malnutrition and monitor response to targeted interventions.
尽管全球致力于减少儿童营养不良现象，但目前的干预措施对发育迟缓及消瘦影响甚微，且生长发育迟缓背后的机制仍知之甚少。显然有必要区分最有可能从任何特定干预措施中受益的儿童群体，并开发工具，以便在出现病态后遗症之前监测对治疗的反应。在资源有限的环境中，环境肠道功能障碍（EED）在儿童中很常见，会导致营养不良，并增加儿童发病和死亡风险。除了EED，肠道微生物群的早期改变可通过营养吸收不良、代谢改变、肠道炎症以及生长激素轴失调对生长产生不利影响。我们研究了将EED和肠道微生物群与生长发育迟缓联系起来的证据，并探索了新的生物标志物，以识别因潜在病理而有营养不良风险的儿童亚组。这些生物标志物和其他生物标志物可用于识别有营养不良风险的特定儿童群体，并监测对靶向干预措施的反应。
