Fecal Markers of Environmental Enteric Dysfunction and their Relation to Faltering Growth in a Sample of Egyptian Children

Wakeel, Maged A. El; El-Kassas, Ghada M.; Ahmed, G; Ali, Walaa H.; Elsheikh, Eman Mohamed; El-Zayat, Salwa Refat; Fadl, Nevein N.; Kamel, Eman H.; Rabah, Thanaa M.

doi:10.3889/oamjms.2021.7029

“…Tumor necrotic factor is pro-inflammatory cytokine that produced from T lymphocytes, in EED, the ratio of TNF is increased in relation to other protective cytokines [3], [24]. It activates and drives differentiation of immune cells on infection [7]. It is one of the systemic inflammatory cytokines that detected with small intestine bacterial overgrowth in EED [34].…”

Section: Discussionmentioning

confidence: 99%

“…The histopathology emphasis that it is a disease of small bowel that involves flattened short villi with deep crypts, and lymphocytic infiltration, this structural change may lead to functional disturbances and decreased surface area for nutrient absorption and consequent malnutrition [6]. The underlying mechanism of pathology is interacting play between five main aspects: Intestinal inflammation, damage, repair, microbial translocation, permeability and absorption, and systemic inflammation [7].…”

Section: Introductionmentioning

confidence: 99%

“…Fecal and serum biomarkers of inflammation are available. However, no single biomarker or group of biomarkers has been thoroughly validated or documented to capture EED [7].…”

Section: Introductionmentioning

confidence: 99%

“…It is produced by B cells in response to repeated bacterial enteric infections. It measures antibodies against endotoxin lipopolysaccharide (LPS) of Gram-negative bacteria that have translocated across a leaky gut [2], [5], [7].…”

Section: Introductionmentioning

confidence: 99%

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Serum Biomarkers of Environmental Enteric Dysfunction and Growth Perspective in Egyptian Children

Wakeel¹,

El-Kassas

²

,

Hashem

³

et al. 2020

Open Access Maced J Med Sci

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1

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BACKGROUND: Environmental enteric dysfunction (EED) is a chronic subclinical condition, contributed to limited sources and poor countries. EED pathology is concerned with small intestine structure and function, which affect the macronutrients and micronutrients absorption with consequent growth faltering. AIM: This study aimed to evaluate some serum biomarkers involved in EED and determine their association with stunting and faltering growth in children; zonulin, endotoxin core antibody (EndoCAb), high-sensitive C-reactive protein (hsCRP), alpha-1-acid glycoprotein (AGP), and tumor necrosis factor (TNF), serum iron, and Vitamins A and D. PATIENTS AND METHODS: This case–control study enrolled 105 children aged from 1 to 10 years old, having weight-for-age z-scores and height-for-age z-scores (WAZ or HAZ) ranging from −1.5 to −2. They were compared with control group consisted of 100 children having WAZ or HAZ > −1 of matched age and sex. Assessment of serum markers levels of enteric dysfunction (zonulin and EndoCAb), markers of systemic inflammation (Hs CRP and AGP), along with serum micronutrients (vitamin A, vitamin D and iron) in children with malnutrition in comparison to controls. RESULTS: There was a highly significant decrease as regarding the anthropometric measurements; weight, height, BMI, and arm circumference. Moreover, significant increase in serum zonulin, EndoCAb, HsCRP, and AGP and highly significant decrease of serum Vitamin D and iron in cases group as compared to control group. Height Z score showed negative correlation with zonulin, HsCRP, and AGP and positive correlation with Vitamin D. Weight Z score showed negative correlation with zonulin, HsCRP, and AGP and positive correlation with Vitamin D and Vitamin A. Regression analysis noted increase of zonulin and α1AGP as high associative markers with height Z score affection, however, increase of zonulin was high associative markers with weight Z score affection. CONCLUSION: Faltering growth is associated with elevated serum systemic markers of intestinal inflammation (HsCRP and α1AGP). EED may be a cause of faltering growth.

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“…producing increased intestinal permeability [5]. EndoCAb is antibody released against the LPS of Gram-negative bacteria [7].…”

Section: Zonulin Affects Tight Junctions Between Enterocytesmentioning

confidence: 99%

Serum Biomarkers of Environmental Enteric Dysfunction and Growth Perspective in Egyptian Children

Wakeel¹,

El-Kassas²,

Hashem³

et al. 2021

Open Access Maced J Med Sci

Self Cite

View full text Add to dashboard Cite

BACKGROUND: Environmental enteric dysfunction (EED) is a chronic subclinical condition, contributed to limited sources and poor countries. EED pathology is concerned with small intestine structure and function, which affect the macronutrients and micronutrients absorption with consequent growth faltering. AIM: This study aimed to evaluate some serum biomarkers involved in EED and determine their association with stunting and faltering growth in children; zonulin, endotoxin core antibody (EndoCAb), high-sensitive C-reactive protein (hsCRP), alpha-1-acid glycoprotein (AGP), and tumor necrosis factor (TNF), serum iron, and Vitamins A and D. PATIENTS AND METHODS: This case–control study enrolled 105 children aged from 1 to 10 years old, having weight-for-age z-scores and height-for-age z-scores (WAZ or HAZ) ranging from −1.5 to −2. They were compared with control group consisted of 100 children having WAZ or HAZ > −1 of matched age and sex. Assessment of serum markers levels of enteric dysfunction (zonulin and EndoCAb), markers of systemic inflammation (Hs CRP and AGP), along with serum micronutrients (vitamin A, vitamin D and iron) in children with malnutrition in comparison to controls. RESULTS: There was a highly significant decrease as regarding the anthropometric measurements; weight, height, BMI, and arm circumference. Moreover, significant increase in serum zonulin, EndoCAb, HsCRP, and AGP and highly significant decrease of serum Vitamin D and iron in cases group as compared to control group. Height Z score showed negative correlation with zonulin, HsCRP, and AGP and positive correlation with Vitamin D. Weight Z score showed negative correlation with zonulin, HsCRP, and AGP and positive correlation with Vitamin D and Vitamin A. Regression analysis noted increase of zonulin and α1AGP as high associative markers with height Z score affection, however, increase of zonulin was high associative markers with weight Z score affection. CONCLUSION: Faltering growth is associated with elevated serum systemic markers of intestinal inflammation (HsCRP and α1AGP). EED may be a cause of faltering growth.

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Daily Complementary Feeding With Eggs Improves Fibroblast Growth Factor 21 in Infants

Nakiranda,

Malan,

Ricci

et al. 2024

Maternal & Child Nutrition

0

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This secondary analysis of the Eggcel‐growth study investigated the effect of daily egg intake for 6 months in infants aged 6–9 months on environmental enteric dysfunction (EED) biomarkers and the association of EED markers with growth faltering. A randomised controlled trial was conducted in Jouberton, South Africa, among 500 infants randomly assigned equally to either an intervention group receiving a daily chicken egg or a control group. Both groups were followed up for 6 months. Data on infant and maternal sociodemographic information and anthropometric status of infants were collected. EED and inflammatory markers were analysed using Q‐Plex Human EED (11‐Plex) assay. There was a significant reduction in fibroblast growth factor 21 (FGF21) concentration in the intervention group (B = −0.132; 95% CI −0.255, −0.010; p = 0.035). Baseline, insulin‐like growth factor 1 (IGF‐1) was positively associated with endpoint length‐for‐age z‐score (LAZ), weight‐for‐age z‐score (WAZ) and weight‐for‐length z‐score (WLZ) and there was an inverse relationship between baseline FGF21 and intestinal fatty acid‐binding protein (I‐FABP) with endpoint growth indicators. Baseline IGF‐1 was positively associated with reduced odds of wasting, stunting and being underweight (p < 0.001) and baseline FGF21 was associated with increased odds of stunting (p = 0.002), wasting (p = 0.031) and being underweight (p = 0.035). There was a 20% increased odds of stunting with baseline I‐FABP (p = 0.045) and a 30% increased odds of being underweight with baseline soluble CD14 (p = 0.039). Complementary feeding with eggs decreased growth hormone resistance (reduced FGF21 levels); however, FGF21 and I‐FABP levels were linked to increased growth faltering.Trial Registration: ClinicalTrials.gov: NCT05168085

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Fecal Markers of Environmental Enteric Dysfunction and their Relation to Faltering Growth in a Sample of Egyptian Children

Cited by 8 publications

References 26 publications

Serum Biomarkers of Environmental Enteric Dysfunction and Growth Perspective in Egyptian Children

Serum Biomarkers of Environmental Enteric Dysfunction and Growth Perspective in Egyptian Children

Serum Biomarkers of Environmental Enteric Dysfunction and Growth Perspective in Egyptian Children

Daily Complementary Feeding With Eggs Improves Fibroblast Growth Factor 21 in Infants

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