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儿童营养不良与肠道感染:一篇叙述性综述

Undernutrition and Intestinal Infections in Children: A Narrative Review.

作者信息

Carvalho Maria Clara da Cruz, Ribeiro Samilly Albuquerque, de Sousa Lélia Sales, Lima Aldo Ângelo Moreira, Maciel Bruna Leal Lima

机构信息

Graduate Program in Health Science, Center for Health Science, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil.

National Institute of Biomedicine of the Brazilian SemiArid, Faculty of Medicine, Federal University of Ceara, Fortaleza 60430-275, CE, Brazil.

出版信息

Nutrients. 2025 Apr 28;17(9):1479. doi: 10.3390/nu17091479.

Abstract

Undernutrition affects thousands of children under five years old worldwide, and various factors are related to its onset, among which we highlight enteric infections and gastrointestinal barrier dysfunction. The cycle of intestinal infections and undernutrition has long-term consequences, such as cognitive deficits, poor growth, and metabolic diseases in adulthood. This review explores factors linked to childhood undernutrition, focusing on intestinal infections and markers of intestinal permeability that affect child development. This narrative review was conducted using Medline/PubMed, Web of Science, and Scopus, from July 2024 to March 2025. Studies involving children under five years old and addressing undernutrition, intestinal infections, or intestinal permeability markers were included. Exclusion criteria comprised studies without therapeutic focus, and books, case reports, or academic theses. No language restrictions were applied, and registration on global platforms was not required. Overall, the studies reported a close relationship between enteric pathogens, diarrheal and non-diarrheal stools, and undernutrition. Among the pathogens most frequently found in the feces of malnourished children were , enterotoxigenic , enteroaggregative (EAEC), and . The studies also showed the relationship between gastrointestinal barrier function and undernutrition, with the deterioration of nutrient absorption and, consequently, repercussions on development, linear growth, and weight in children. Although the studies analyzed had different designs and heterogeneity in the age range of the studied children, it was possible to observe the relationship between the infection/undernutrition cycle. Future studies should optimize personalized nutrient-based therapies, assess long-term effects on gut health and growth, and explore the gut microbiome's role in enteric infection susceptibility and undernutrition.

摘要

营养不良影响着全球数以千计的五岁以下儿童,其发病与多种因素相关,其中我们重点关注肠道感染和胃肠屏障功能障碍。肠道感染与营养不良的循环会产生长期后果,如认知缺陷、生长发育不良以及成年后的代谢性疾病。本综述探讨了与儿童营养不良相关的因素,重点关注影响儿童发育的肠道感染和肠道通透性标志物。本叙述性综述于2024年7月至2025年3月使用Medline/PubMed、科学网和Scopus进行。纳入了涉及五岁以下儿童且探讨营养不良、肠道感染或肠道通透性标志物的研究。排除标准包括无治疗重点的研究、书籍、病例报告或学术论文。未设语言限制,也无需在全球平台注册。总体而言,研究报告了肠道病原体、腹泻和非腹泻粪便与营养不良之间的密切关系。在营养不良儿童粪便中最常发现的病原体有[具体病原体1]、产肠毒素性[具体病原体2]、肠集聚性[具体病原体3](EAEC)以及[具体病原体4]。研究还表明了胃肠屏障功能与营养不良之间的关系,即营养吸收恶化,进而对儿童的发育、线性生长和体重产生影响。尽管所分析的研究设计不同,且所研究儿童的年龄范围存在异质性,但仍有可能观察到感染/营养不良循环之间的关系。未来的研究应优化基于个性化营养的疗法,评估对肠道健康和生长的长期影响,并探索肠道微生物群在肠道感染易感性和营养不良中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/507d/12073655/aca636ceb6dd/nutrients-17-01479-g001.jpg

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