Starved Guts

Abstract

Malnutrition contributes significantly to death and illness worldwide and especially to the deaths of children younger than 5 years. The relation between intestinal changes in malnutrition and morbidity and mortality has not been well characterized; however, recent research indicates that the functional and morphologic changes of the intestine secondary to malnutrition itself contribute significantly to these negative clinical outcomes and may be potent targets of intervention. The aim of this review was to summarize current knowledge of experimental and clinically observed changes in the intestine from malnutrition preclinical models and human studies. Limited clinical studies have shown villous blunting, intestinal inflammation, and changes in the intestinal microbiome of malnourished children. In addition to these findings, experimental data using various animal models of malnutrition have found evidence of increased intestinal permeability, upregulated intestinal inflammation, and loss of goblet cells. More mechanistic studies are urgently needed to improve our understanding of malnutrition-related intestinal dysfunction and to identify potential novel targets for intervention.

A novel histological index for evaluation of environmental enteric dysfunction identifies geographic-specific features of enteropathy among children with suboptimal growth

“…Each parameter was given a numerical range of severity, with each numerical grade specifically defined. While the reproducibility between the three gastrointestinal pathologists in this study for grading the individual parameters varied, the overall score reproducibility was in the same range of interobserver reproducibility described for other accepted histology indices (overall kappa coefficient of 0.70), including those for grading inflammatory changes in ulcerative colitis (37) and due to H. pylori [52]. Thus, the performance of the histology index described here appears to conform to the general performance of histologic assessment of tissue pathology and is suitable for use in comparing cohorts with enteropathies, including EED.…”

“…This knowledge gap is in part attributable to the limited understanding of the histologic changes associated with this disorder and how they compare to other enteropathies including GSE, which shares features of an environmental trigger and villous blunting on histology [33]. While GSE has not been identified as a prevalent disorder in sub-Saharan Africa and South Asia (outside of India), enteropathy has been identified among children with SAM, especially kwashiorkor, in these settings [34][35][36][37][38].…”

The impact of malnutrition on childhood infections

“…Similarly, malnutrition is associated with small intestinal histological abnormalities, including villous blunting, reduction in mucus-secreting goblet cells and inflammation [ 31 ]. It is not yet clear if this is EED or a separate disease.…”

Cucurbitacin E Induces Autophagy-Involved Apoptosis in Intestinal Epithelial Cells

“…The structure and function of the intestinal mucosa may be impaired in the case of severe burns and trauma, critical illness, malnutrition, and severe infection or inflammation. This impairment leads to intestinal mucosal barrier dysfunction, intestinal bacterial translocation, and endotoxin invasion, which in turn induces or aggravates local intestinal or systemic inflammatory responses and even causes multiple organ dysfunction in severe cases (Attia et al, 2017;Delorme-Axford and Klionsky, 2018;He et al, 2019). Apoptosis is the process of active cell death and is regulated by free radicals.…”