Association of intestinal pathogens with faecal markers of environmental enteric dysfunction among slum‐dwelling children in the first 2 years of life in Bangladesh

Fahim, Shah Mohammad; Das, Subhasish; Gazi, Md. Amran; Mahfuz, Mustafa; Ahmed, Tahmeed

doi:10.1111/tmi.13141

Cited by 41 publications

(43 citation statements)

References 52 publications

(68 reference statements)

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“…The worst symptoms of Giardia infection are associated with damage to the absorptive small intestine mucosa, along with an impaired intestinal immunity that contributes to chronic infection. Recently published data from children in Bangladesh suggested a correlation between giardiasis and increased the risk of intestinal permeability as well as an immune defect (35,37,38). Although an observation by Scott et al showed that small intestinal gut permeability increased of Giardia infected mice without any morphological damage to the intestinal mucosa, which is independent of T-cell and is secondary to reorganization of cytoskeletal F-actin and tight-junction ZO-1 protein (70).…”

Section: Discussion and Perspectivementioning

confidence: 99%

“…Additionally an observational study of Bangladeshi infants of an urban area indicated giardiasis was associated with the intestinal barrier disruption (38). Furthermore, another prospective longitudinal study con rmed that giardiasis was signi cantly associated with concentrations of fecal myeloperoxidase (MPO) and alpha-1-anti-trypsin (AAT) in children under the age of 2 and was also signi cantly associated with score of environmental enteric dysfunction (EED) (37). Most of these studies showed evidence that giardiasis was associated with intestinal permeability.…”

Section: Giardiasis and Poor Child Growthmentioning

confidence: 97%

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A systematic review of human giardiasis in Bangladesh: public health perspective

Hossain¹,

Rashid²,

Noor³

et al. 2020

Preprint

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Background: Giardiasis identified as a leading cause of gastrointestinal pathogen in young children worldwide, is also common in Bangladesh. There has been an emerging evidence of an association between giardiasis and child growth. This systematic review focuses only on Bangladeshi children. Prevalence of giardiasis with its adverse health effects and the advancement of diagnosis has been reviewed.Methods: A broad review of literature, electronic databases, and books within the time frame of 1970 and 2019 has been searched. Data published on giardiasis prevalence, outcomes (child growth, intestinal permeability, and diarrhea) and advances of diagnosis in Bangladesh has been searched.Results: Both assemblages A and B genotypes of Giardia lamblia are responsible for human giardiasis in Bangladesh. Recent studies on Bangladeshi children suggested Giardia species infections has an adverse impact on poor child growth which have further characterized associations with altered gut epithelial barrier dysfunction, as well as diarrhea. Indeed emerging evidence indicates the key consequence of Giardia colonization is nutrient malabsorption. Conclusions: In Bangladesh giardiasis remains a major public health concern, especially in children age <5 years but is considered as a neglected disease. In order to reduce the burden of giardiasis in developing countries such as Bangladesh, more focus is require to include this disease in public health policies.

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Section: Discussion and Perspectivementioning

confidence: 99%

Section: Giardiasis and Poor Child Growthmentioning

confidence: 97%

A systematic review of human giardiasis in Bangladesh: public health perspective

Hossain¹,

Rashid²,

Noor³

et al. 2020

Preprint

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“…Environmental Enteric Dysfunction (EED), an asymptomatic small intestinal pathology, has been implicated in linear growth failure of children less than two years of age [14,22]. EED is characterized by persistent immune activation, gut inflammation and altered intestinal permeability resulting from chronic exposure to intestinal pathogens and frequent enteric infections [23][24][25]. The overall negative impact of EED on child growth and development, especially in their early years of life, is now well established [22,26].…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

Helicobacter pylori infection is associated with fecal biomarkers of environmental enteric dysfunction but not with the nutritional status of children living in Bangladesh

et al. 2020

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Background Because Helicobacter pylori (H. pylori) infection and Environmental Enteric Dysfunction (EED) follow a similar mode of transmission, there can be a complex interplay between H. pylori infection and EED, both of which can influence childhood growth. We sought to investigate the factors associated with H. pylori infection and identify its relationship with the fecal biomarkers of EED including Myeloperoxidase (MPO), Neopterin (NEO), Calprotectin, Reg1B and Alpha-1 antitrypsin (AAT), and nutritional status of the children. Methodology Data from an ongoing community-based nutrition intervention study was used for this analysis. Total 319 children aged between 12-18 months were evaluated at enrolment and at the end of a 90-day nutrition intervention. Multivariable linear regression with generalized estimating equations was done to examine the association of H. pylori infection with stool biomarker of EED and nutritional status of the children.

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“…Myeloperoxidase (MPO), a marker of neutrophil activity in intestinal mucosa, and lipocalin-2 (LCN-2), a glycoprotein upregulated in tissue damage under infection conditions, have been considered as biomarkers of environmental enteric dysfunction, including EPEC, in children [35][36][37][38]. To ensure that our EPEC infection model mimics the alterations of these biomarkers as observed in children, we measured MPO and LCN-2 in the ileal and colonic tissues, as well as in cecal contents and stools.…”

Section: Epec Infection Promotes Acute Intestinal Tissue Damage and Imentioning

confidence: 99%

EnteropathogenicEscherichia coli(EPEC) Infection Induces Diarrhea, Intestinal Damage, Metabolic Alterations and Increased Intestinal Permeability in a Murine Model

Ledwaba

Costa

Bolick

et al. 2020

Preprint

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Enteropathogenic E. coli (EPEC) are recognized as one of the leading bacterial causes of infantile diarrhea worldwide. Weaned C57BL/6 mice pretreated with antibiotics were challenged orally with wild-type EPEC or escN mutant (lacking type 3 secretion system) to determine colonization, inflammatory responses and clinical outcomes during infection. Antibiotic disruption of intestinal microbiota enabled efficient colonization by wild-type EPEC resulting in growth impairment and diarrhea. Increase in inflammatory biomarkers, chemokines, cellular recruitment and pro-inflammatory cytokines were observed in intestinal tissues.Metabolomic changes were also observed in EPEC infected mice with changes in TCA cycle intermediates, increased creatine excretion and shifts in gut microbial metabolite levels. In addition, by 7 days after infection, although weights were recovering, EPEC-infected mice had increased intestinal permeability and decreased colonic claudin-1 levels. The escN mutant colonized the mice, but had no weight changes or increased inflammatory biomarkers, showing the importance of the T3SS in EPEC virulence in this model. In conclusion, a murine infection model treated with antibiotics has been developed to mimic many clinical outcomes seen in children with EPEC infection and to examine potential roles of selected virulence traits. This model can help in further understanding mechanisms involved in the pathogenesis of EPEC infections and potential outcomes and thus assist in the development of potential preventive or therapeutic interventions.

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Association of intestinal pathogens with faecal markers of environmental enteric dysfunction among slum‐dwelling children in the first 2 years of life in Bangladesh

Cited by 41 publications

References 52 publications

A systematic review of human giardiasis in Bangladesh: public health perspective

A systematic review of human giardiasis in Bangladesh: public health perspective

Helicobacter pylori infection is associated with fecal biomarkers of environmental enteric dysfunction but not with the nutritional status of children living in Bangladesh

EnteropathogenicEscherichia coli(EPEC) Infection Induces Diarrhea, Intestinal Damage, Metabolic Alterations and Increased Intestinal Permeability in a Murine Model

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