Gut Bacteria Missing in Severe Acute Malnutrition, Can We Identify Potential Probiotics by Culturomics? (original) (raw)
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Malnutrition and Fragility: From Children to Elderly with Probiotics
The great economic and social disparities, as well as the climatic changes which have caused natural disasters and migration in numerous parts of the planet, have greatly contributed to the increase in malnutrition around the world. Moreover, as if that were not enough, the Declaration of Alma Ata to the Millennium Declaration (in order to reduce poverty and related pathologies such as malnutrition) have not presented satisfactory results yet. Therefore, this review will resume the scientific papers about malnutrition. One of the most serious expression of malnutrition is emaciation or Kwashiorkor, which affects the vulnerability of the individuals from childhood, in most cases, until old age. The keyword global malnutrition, will be linked to the use of probiotics as a preventive way to reduce vulnerability (in children) and frailty (frailty syndrome in the elderly). In this type of patients, there are a susceptibility to other pathologies, especially contracting infections as a result of malnutrition. If an adequate gut microbiota (ecological communities of commensal, symbiotic and pathogenic microorganisms found in the gastrointestinal tract) has been established since childhood, the response to Arch Clin Biomed Res 2020; 4 (6): 709-720
Gut Microbiomes of Indian Children of Varying Nutritional Status
PLoS ONE, 2014
Background: Malnutrition is a global health problem affecting more than 300 million pre-school children worldwide. It is one of the major health concerns in India since around 50% of children below the age of two suffer from various forms of malnutrition. The gut microbiome plays an important role in nutrient pre-processing, assimilation and energy harvest from food. Consequently, dysbiosis of the gut microbiota has been implicated in malnutrition.
Persistent gut microbiota immaturity in malnourished Bangladeshi children
2014
Therapeutic food interventions have reduced mortality in children with severe acute malnutrition (SAM), but incomplete restoration of healthy growth remains a major problem. The relationships between the type of nutritional intervention, the gut microbiota, and therapeutic responses are unclear. In the current study, bacterial species whose proportional representation define a healthy gut microbiota as it assembles during the first two postnatal years were identified by applying a machine-learning-based approach to 16S ribosomal RNA data sets generated from monthly faecal samples obtained from birth onwards in a cohort of children living in an urban slum of Dhaka, Bangladesh, who exhibited consistently healthy growth. These age-discriminatory bacterial species were incorporated into a model that computes a ‘relative microbiota maturity index’ and ‘microbiota-for-age Z-score’ that compare postnatal assembly (defined here as maturation) of a child’s faecal microbiota relative to healthy children of similar chronologic age. The model was applied to twins and triplets (to test for associations of these indices with genetic and environmental factors, including diarrhoea), children with SAM enrolled in a randomized trial of two food interventions, and children with moderate acute malnutrition. Our results indicate that SAM is associated with significant relative microbiota immaturity that is only partially ameliorated following two widely used nutritional interventions. Immaturity is also evident in less severe forms of malnutrition and correlates with anthropometric measurements. Microbiota maturity indices provide a microbial measure of human postnatal development, a way of classifying malnourished states, and a parameter for judging therapeutic efficacy. More prolonged interventions with existing or new therapeutic foods and/or addition of gut microbes may be needed to achieve enduring repair of gut microbiota immaturity in childhood malnutrition and improve clinical outcomes.
Scientific Reports, 2016
Severe acute malnutrition (SAM) is associated with inadequate diet, low levels of plasma antioxidants and gut microbiota alterations. The link between gut redox and microbial alterations, however, remains unexplored. By sequencing the gut microbiomes of 79 children of varying nutritional status from three centers in Senegal and Niger, we found a dramatic depletion of obligate anaerobes in malnutrition. This was confirmed in an individual patient data meta-analysis including 107 cases and 77 controls from 5 different African and Asian countries. Specifically, several species of the Bacteroidaceae, Eubacteriaceae, Lachnospiraceae and Ruminococceae families were consistently depleted while Enterococcus faecalis, Escherichia coli and Staphylococcus aureus were consistently enriched. Further analyses on our samples revealed increased fecal redox potential, decreased total bacterial number and dramatic Methanobrevibacter smithii depletion. Indeed, M. smithii was detected in more than half of the controls but in none of the cases. No causality was demonstrated but, based on our results, we propose a unifying theory linking microbiota specificity, lacking anaerobes and archaea, to low antioxidant nutrients, and lower food conversion. Malnutrition is estimated to cause 3 million child deaths annually or 45% of all child deaths 1 and reflects the first Millennium Development Goal 2. Severe acute malnutrition (SAM) is defined as a very low weight-for-height z-score (WHZ < −3 SD, corresponding to a weight below the average weight of healthy controls of the same height minus 3 standard deviations calculated according to World Health Organization (WHO) standards 3), a mid-upper-arm circumference (MUAC) of less than 115 mm in children aged 6-59 months, or bilateral nutritional edema 2. Its prevalence is estimated at 29 million children under 5 years of age 2,4. SAM has been associated with high mortality (10-30%) and increased risk of diarrhea, pneumonia and systemic infections including bacteremia with Staphylococcus aureus, Streptococcus, Salmonella, Klebsiella, and Escherichia coli. SAM is not only associated with inadequate quantitative intake of energy and protein but also with a qualitative lack of micronutrients. The diet is restricted to cooked but contaminated starchy foods (rice, millet, sorghum) and lacks milk, meat, leafy vegetables and fruits (mango, orange, guava), which are natural sources of micronutrients and dietary antioxidants (vitamins A, C, E) 5-8. This inadequate diet leads to low levels of antioxidants 9 ,
Effects of probiotic on gut microbiota in children with acute diarrhea: a pilot study
Paediatrica Indonesiana
Background Acute diarrhea is a common health problem in Indonesia. During acute diarrhea, changes in gut microbiota are marked by decrease beneficial microbes Bifidobacterium and Lactobacillus, and increased pathogenic bacteria Enterobacter and Clostridium. Such microbial imbalances are known as dysbiosis. Treatment with probiotics may help repair dysbiosis, quicken healing time, and decrease complications. Objective To assess for dysbiosis during acute diarrhea, and determine if it can be normalized by probiotic treatment. Methods This placebo-controlled, unblinded clinical trial was performed in Budhi Asih District Hospital, Jakarta, from January to March 2018. Twenty-four children age 6-24 months with acute diarrhea and 12 healthy children were enrolled. First fecal specimen was collected for all subjects and analyzed using non-culture real time PCR to count the population of Lactobacillus, Bifidobacterium, Enterobacter, Clostridium, and all bacteria. Children with diarrhea were ...
Cellular and Molecular Biology, 2020
The core objective was to evaluate the effect of probiotic fortification at three phases of formula milk administration in malnourished children. A dose related effect was determined in 30 severely acute malnourished children (6-59 months) in a double-blind, randomized design. According to the results, serum albumin levels, treatment T2 (6 billion cfu) has significantly increased albumin levels (3.7g/dL) and the effect of phase-III (Plumpy'nut) was found to be better. Results regarding sodium levels showing probiotic-dose have significant effect (P≤0.05) in phases as well. Moreover, the effect of T1 i.e. 3 billion cfu of probiotics has significantly reduced sodium levels (141.8mmol/L) vs. others and the effect of phase-II was better on reducing sodium levels. which is further confirmed in terms of reduced erythrocyte sedimentation rate levels at phase-III (29.566 vs. phase-II, 41.3 and phase-I, 46.533 mm/h). Conclusively, the effect of 6 billion cfu at phase-III was more effec...
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Figure 1. The cycle of malnutrition and enteric disease. This figure, adapted from Guerrant, et al. 2008, depicts the cyclical nature of the synergistic relationship between infection with enteric pathogens and the development of malnutrition (undernutrition). Around the outer circle are indicated the expected physiological effects on children. The arrow pointing from "malnutrition" indicates the resulting impairment of both physical and cognitive development observed in other studies during the first two years of life that may extend into adulthood. Potential interventions that may be capable of interrupting this "vicious cycle" are depicted by the lightning bolts.