Centre for Genomics & Child Health, Blizard Institute, Queen Mary University of London, London, United Kingdom; email:
Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom.
Annu Rev Nutr. 2023 Aug 21;43:327-353. doi: 10.1146/annurev-nutr-061121-091234. Epub 2023 May 19.
Childhood undernutrition is a major global health burden that is only partially resolved by nutritional interventions. Both chronic and acute forms of child undernutrition are characterized by derangements in multiple biological systems including metabolism, immunity, and endocrine systems. A growing body of evidence supports a role of the gut microbiome in mediating these pathways influencing early life growth. Observational studies report alterations in the gut microbiome of undernourished children, while preclinical studies suggest that this can trigger intestinal enteropathy, alter host metabolism, and disrupt immune-mediated resistance against enteropathogens, each of which contribute to poor early life growth. Here, we compile evidence from preclinical and clinical studies and describe the emerging pathophysiological pathways by which the early life gut microbiome influences host metabolism, immunity, intestinal function, endocrine regulation, and other pathways contributing to child undernutrition. We discuss emerging microbiome-directed therapies and consider future research directions to identify and target microbiome-sensitive pathways in child undernutrition.
儿童期营养不良是全球范围内的一个主要健康负担，仅通过营养干预措施并不能完全解决。慢性和急性形式的儿童营养不良都以代谢、免疫和内分泌系统等多个生物系统的紊乱为特征。越来越多的证据表明，肠道微生物组在介导这些影响生命早期生长的途径中发挥作用。观察性研究报告了营养不良儿童的肠道微生物组发生改变，而临床前研究表明，这可能会引发肠道肠病，改变宿主代谢，并破坏针对肠道病原体的免疫介导的抵抗力，这些都会导致生命早期生长不良。在这里，我们汇总了临床前和临床研究的证据，并描述了早期生命肠道微生物组影响宿主代谢、免疫、肠道功能、内分泌调节和其他导致儿童营养不良的途径的新兴病理生理学途径。我们讨论了新兴的基于微生物组的治疗方法，并考虑了未来的研究方向，以确定和针对儿童营养不良中微生物组敏感的途径。
