Biodesign Center for Health Through Microbiomes, Arizona State University, Tempe, Arizona, USA.
Center for Indigenous Health Research, Wuqu' Kawoq | Maya Health Alliance, Tecpan, Guatemala.
BMJ Paediatr Open. 2023 Apr;7(1). doi: 10.1136/bmjpo-2023-001960.
Aflatoxin B1 (AFB1) is a carcinogen produced by and which grow on maize. Given the high prevalence of child stunting (ie, impaired growth) and other nutritional disorders in low-income and middle-income countries, where maize is consumed, the role of aflatoxin exposure may be significant. Observational reports have demonstrated associations between aflatoxin exposure and impaired child growth; however, most have been cross-sectional and have not assessed seasonal variations in aflatoxin, food preparation and dynamic changes in growth. Biological mechanistic data on how aflatoxin may exert an impact on child growth is missing. This study incorporates a prospective cohort of children from rural Guatemala to assess (1) temporal associations between aflatoxin exposure and child growth and (2) possible mediation of the gut microbiome among aflatoxin exposure, inflammation and child growth.
We will prospectively evaluate aflatoxin exposure and height-for-age difference trajectories for 18 months in a cohort of 185 children aged 6-9 months at enrolment. We will assess aflatoxin exposure levels and biomarkers of gut and systemic inflammation. We will examine the faecal microbiome of each child and identify key species and metabolic pathways for differing AFB1 exposure levels and child growth trajectories. In parallel, we will use bioreactors, inoculated with faeces, to investigate the response of the gut microbiome to varying levels of AFB1 exposure. We will monitor key microbial metabolites and AFB1 biotransformation products to study nutrient metabolism and the impact of the gut microbiome on aflatoxin detoxification/metabolism. Finally, we will use path analysis to summarise the effect of aflatoxin exposure and the gut microbiome on child growth.
Ethics approval was obtained from Arizona State University Institutional Review Board (IRB; STUDY00016799) and Wuqu' Kawoq/Maya Health Alliance IRB (WK-2022-003). Findings will be disseminated in scientific presentations and peer-reviewed publications.
黄曲霉毒素 B1（AFB1）是一种由 和 产生的致癌物，它们生长在玉米上。考虑到在玉米消费的低收入和中等收入国家中儿童发育迟缓（即生长受损）和其他营养障碍的高患病率，黄曲霉毒素暴露的作用可能很重要。观察性报告表明，黄曲霉毒素暴露与儿童生长受损之间存在关联；然而，大多数报告都是横断面的，并没有评估黄曲霉毒素、食物准备和生长动态变化的季节性变化。关于黄曲霉毒素如何对儿童生长产生影响的生物学机制数据尚不清楚。本研究纳入了危地马拉农村的一个前瞻性队列，以评估（1）黄曲霉毒素暴露与儿童生长之间的时间关联，以及（2）肠道微生物组在黄曲霉毒素暴露、炎症和儿童生长之间可能的中介作用。
我们将前瞻性评估 185 名 6-9 个月大的入组儿童 18 个月的黄曲霉毒素暴露和身高年龄差异轨迹。我们将评估黄曲霉毒素暴露水平和肠道和全身炎症的生物标志物。我们将检查每个儿童的粪便微生物组，并确定关键物种和代谢途径，以区分不同的 AFB1 暴露水平和儿童生长轨迹。平行地，我们将使用生物反应器，接种粪便，研究肠道微生物组对不同 AFB1 暴露水平的反应。我们将监测关键微生物代谢物和 AFB1 生物转化产物，以研究营养代谢和肠道微生物组对黄曲霉毒素解毒/代谢的影响。最后，我们将使用路径分析总结黄曲霉毒素暴露和肠道微生物组对儿童生长的影响。
亚利桑那州立大学机构审查委员会（IRB；STUDY00016799）和 Wuqu' Kawoq/Maya 健康联盟 IRB（WK-2022-003）获得了伦理批准。研究结果将在科学演讲和同行评议的出版物中发表。
