Impaired Gut Microbial Community Development in Undernourished Children

Impaired Gut Microbial Community Development in Undernourished Children
Author: Sathish Subramanian
Publisher:
Total Pages: 156
Release: 2015
Genre: Electronic dissertations
ISBN:

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The healthy growth of children is typically considered from an anthropometric perspective: i.e. changes in height and weight over time. Another feature of postnatal development involves the acquisition of our microbial communities, the largest of which resides in our gut. Malnutrition (undernutrition) in children, and its severity, is defined by the degree to which their anthropometric scores deviate from median values established by a World Health Organization reference cohort of 8440 individuals living in six countries. Epidemiologic studies have shown that moderate to severe forms of acute undernutrition are not due to food insecurity alone. The human gut microbiota can be thought of as a microbial 'organ' that plays important roles in extracting and metabolizing food ingredients, providing metabolites to the host and shaping development of the immune system. The central hypotheses of my thesis are that this microbial organ undergoes definable stages in its development following birth, that features of its developmental program are shared across biologically unrelated individuals living in distinct geographic locales and representing distinctive cultural traditions, that this developmental program is disrupted in undernourished children, and that such disruption is not merely an effect of undernutrition but is causally related to it. My thesis consists of three parts. The first part is a 'Perspective' describing the hypotheses described above, and describing approaches that might be useful for linking the identification of bacterial taxa that define normal development of the gut microbiota during the first several years of postnatal life to (i) an analysis of how this developmental program may be linked to the risk for, or the expression of the manifestations of undernutrition, and (ii) how knowledge of complementary feeding practices could be applied to developing new ways to sponsor robust development of the microbiota in individuals where this program has already been perturbed. In the second part, I define normal gut microbiota development in unrelated children with healthy growth phenotypes who live in an urban slum of Dhaka, Bangladesh. I did so by applying a machine-learning method (Random Forests) to bacterial 16S rRNA datasets generated from fecal samples collected monthly from birth through 24 months of life. I identified a group of 'age-discriminatory' bacterial strains whose changing representation in gut microbiota over time provide a signature of the developmental biology of the gut microbial community. I used this Random Forests-derived model to create two metrics that define the state of maturation of a given child's microbiota relative his/her chronologic age; 'relative microbiota maturity index' and 'microbiota-for-age Z score'. Using these metrics, I found that children with severe acute malnutrition (SAM) have immature gut microbiota (i.e. the configuration of their gut communities is younger than expected based on their chronologic age) and that this immaturity is incompletely and only transiently improved by two commonly used therapeutic food interventions. In the third part, I expand my Random Forests-based modeling of gut microbiota development by studying members of birth cohorts living in India, South Africa, Peru, and Brazil; finding that features of microbiota development (age-discriminatory strains) are shared across populations representing diverse geographic locations and cultural traditions. I also present a preclinical model for identifying complementary foods that could be used to repair the persistent microbiota immaturity present in children with SAM. This model was created by (i) culturing nine age-discriminatory bacterial strains as well as seven SAM-associated strains from the fecal microbiota of Bangladeshi children, (ii) introducing these strains into germ-free mice, (iii) feeding the animals different sequences of a prototypic Bangladeshi diet supplemented with different combinations of commonly consumed complementary foods, and (iv) analyzing 16S rRNA datasets generated from the recipient animal's fecal microbiota in order to identify foods that promote the representation of age-indicative but not SAM-associated strains. A follow-up study in gnotobiotic mice of one of the lead complementary foods discovered from these analyses confirmed that it promotes microbiota maturation, as well as sponsoring an increase in butyrate levels and the representation of colonic regulatory T cells.

Microbiota-directed Therapeutic Foods for the Treatment of Childhood Undernutrition

Microbiota-directed Therapeutic Foods for the Treatment of Childhood Undernutrition
Author: Jeanette Gehrig
Publisher:
Total Pages: 221
Release: 2018
Genre: Electronic dissertations
ISBN:

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Undernutrition is the leading cause of child mortality worldwide. Moreover, children who survive periods of undernutrition suffer long-term consequences including stunted growth, greater susceptibility to infection, and cognitive deficiencies. Therefore, undernutrition is a substantial public health and economic burden that limits human potential in low-income countries. An increasing body of evidence posits that 'normal' gut community (microbiota) development is linked to healthy growth; however, therapeutic foods currently used to treat undernutrition were not designed considering the impact on the developing gut microbiota. We hypothesized that by treating undernourished children with microbiota-directed therapeutic foods to repair their gut microbiota immaturity, we could improve outcomes such as gut barrier function, immune function, metabolism, and growth.Here, I combined culture-independent V4-16S sequencing and machine learning to generate models of normal gut microbiota development for healthy birth cohorts from five low-income countries and reveal a shared program of microbiota assembly over the first two years of life that is independent of individuals' culture or geography. Applying these models to bacterial V4-16S datasets from Bangladeshi children treated for severe acute malnutrition (SAM) confirms the finding that children with undernutrition harbor immature microbial gut communities that are not repaired by existing therapeutic foods. 'Age-discriminatory' bacterial taxa identified in these models and taxa enriched in individuals with SAM were subsequently cultured from fecal samples from Bangladeshi children. Gnotobiotic mice were colonized with these sequenced bacterial strains and fed different combinations and sequences of Bangladeshi complementary food (CF) ingredients; the results revealed ingredients that could specifically increase the relative abundance of targeted age-discriminatory bacterial taxa. Lead ingredients from this screen were combined in a microbiota-directed complementary food (MDCF) prototype which, compared to an existing therapeutic food, selectively increased the abundance of targeted taxa and increased biomarkers of growth in gnotobiotic mice.To obtain a deeper understanding of the biological state of undernutrition, we performed proteomic and metabolomic analyses of plasma samples and characterized the gut microbial communities of Bangladeshi children treated for SAM and followed over the course of a 12- month study during which time many transitioned to a state of moderate acute malnutrition (MAM). There were significant correlations between plasma protein biomarkers of growth and immune function and age-discriminatory taxa in the gut microbiota of these children. MDCF prototypes were subsequently tested in gnotobiotic mice colonized with a representative post-SAM MAM microbiota and in gnotobiotic piglets colonized with a defined consortium of targeted age- and growth-discriminatory bacteria. The results revealed that these MDCF prototypes were able to increase the representation of targeted age- and growth-discriminatory taxa, alter their patterns of gene expression, improve gut barrier function in recipient mice, and increase growth in piglets. Finally, a randomized, double blind study was performed to test the effects of three MDCF formulations in Bangladeshi children with MAM. A lead MDCF changed the levels of biomarkers and mediators of growth, bone formation, neurodevelopment, and immune function toward a healthy state. These changes in the host proteome were accompanied by MDCF-induced changes in the configuration of the gut microbiota.

Disrupted Gut Microbiota Development and Childhood Undernutrition

Disrupted Gut Microbiota Development and Childhood Undernutrition
Author: Laura V. Blanton
Publisher:
Total Pages: 222
Release: 2016
Genre: Electronic dissertations
ISBN:

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Immediately following birth, there is a rapid and dynamic succession of microbes that colonize the human gut; this developmental program is largely completed within the first 24-30 months of postnatal life. This consortium of microbes, known as the gut microbiota, impacts metabolism of dietary components, maturation of the immune system including the gut mucosal barrier, and the ability of enteropathogens to establish themselves. Much remains unknown about this patterned bacterial progression within infants and children, and the extent to which gut microbiota maturation is directly related to healthy growth. Childhood undernutrition is a devastating global health problem. Not only is it a leading cause of childhood mortality, undernutrition has many long-term consequences, including stunting, neurodevelopmental abnormalities and immune dysfunction. Furthermore, current therapeutic interventions have limited efficacy in mitigating these sequelae. Recent studies have demonstrated that gut microbiota maturation is disrupted in undernourished children. My thesis tests the hypothesis that gut microbiota maturation not only serves as a biomarker of health status but is causally related to the growth and development of infants and children. Chapter one provides an overview of the human gut microbiota in the developing infant. Chapter two initially describes a bacterial V4-16S rRNA analysis of the fecal microbiota of healthy infants and children enrolled in a Malawian cohort; Random Forests-based modeling of the result- ing datasets yielded a sparse 25-taxa model of normal gut microbiota development. This model of gut microbiota maturation demonstrated that undernourished children have significantly immature, i.e., younger-looking, microbiota compared to their healthy chronologically age-matched counterparts. Moreover, the state of gut microbiota maturation at 12 months of age in members of a Malawian birth cohort was predictive of growth phenotypes (as de ned by anthropometry) at 18 months. Transplanting 19 microbiota from age-matched healthy or undernourished Malawian infants and children into recently weaned gnotobiotic mice fed a representative Malawian diet revealed that immature microbiota from undernourished children conferred impaired growth phenotypes (de ned by serial measurements of total weight and lean body mass) relative to mice colonized with mature microbiota from healthy donors. These differences were not associated with significant differences in food consumption. These transplantations also demonstrated differences in bone morphology and altered metabolic profiles in serum, liver, muscle, and brain. Random Forests modeling of V4-16S rRNA datasets generated from the fecal microbiota of recipient mice established that a subset of age-discriminatory taxa were growth-discriminatory. Furthermore, co-housing mice shortly after they had been colonized with either a mature microbiota from a healthy (H) 6-month-old Malawian infant or an immature microbiota from an 6-month-old severely stunt- ed/underweight (Un) infant revealed invasion of taxa from the mature microbiota into the immature microbiota with a concomitant prevention of impaired growth in Un cagemates. The principal invaders were age- and growth-discriminatory bacterial strains. Five of these invading strains were cultured and added to the Un microbiota prior to its transplantation to young germ-free mice. Two members of the consortium were able to establish themselves in mice harboring the Un microbiota; their presence ameliorated the growth faltering and metabolic phenotypes produced by the Un microbiota. The results of Chapter 2 provide evidence that gut microbiota composition is causally related to undernutrition. Chapter three addresses interactions between human milk oligosaccharides (HMOs) and the gut microbiota as related to host growth and metabolism. In the breast milk of 6-month postpartum mothers with severely stunted infants, sialylated HMOs were significantly less abundant than in the milk of mothers with healthy infants. To investigate this observation, germ-free mice were fed the representative Malawian diet, with or without purified sialylated bovine milk oligosaccharides (S-BMO), and colonized with a microbial consortium cultured from the fecal microbiota of a 6-month-old severely stunted Malawian infant. S-BMO supplementation conferred a microbiota-dependent increase in lean mass gain, altered bone morphology, and altered liver, muscle, and brain metabolic profiles that indicated an enhanced capacity for nutrient anabolism. These results were also observed in gnotobiotic pigs harboring the same microbes and fed the Malawian diet. The fourth and final chapter discusses future experiments designed to characterize the mechanisms by which microbiota immaturity could impact growth and metabolism, and how findings and concepts obtained from preclinical gnotobiotic animal models could be directly tested in clinical studies.

Nutrition and Growth

Nutrition and Growth
Author: B. Koletzko
Publisher: Karger Medical and Scientific Publishers
Total Pages: 202
Release: 2018-01-29
Genre: Family & Relationships
ISBN: 3318063053

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Adequate nutrition is a crucial component for child growth. Under- or malnutrition may not only affect present and future growth, but also a child's ability to develop skills. In this publication, specialists in nutrition and growth present some of the best studies from peer-reviewed journals published between July 2016 and June 2017. Each paper is briefly summarized and supplemented with editorial comments which evaluate the clinical importance of each article and discuss its application. This 'Yearbook' is an important tool for practicing physicians, including pediatricians, subspecialists in pediatric gastroenterology, metabolism and nutrition, and endocrinology. Nutritionists and dieticians, as well as other health professionals involved in the care of children, will also find this to be a useful resource.

Nutrition and Infectious Diseases

Nutrition and Infectious Diseases
Author: Debbie L. Humphries
Publisher: Springer Nature
Total Pages: 524
Release: 2020-12-10
Genre: Medical
ISBN: 3030569136

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This comprehensive and user-friendly volume focuses on the intersection between the fields of nutrition and infectious disease. It highlights the importance of nutritional status in infectious disease outcomes, and the need to recognize the role that nutrition plays in altering the risk of exposure and susceptibility to infection, the severity of the disease, and the effectiveness of treatment. Split into four parts, section one begins with a conceptual model linking nutritional status and infectious diseases, followed by primers on nutrition and immune function, that can serve as resources for students, researchers and practitioners. Section two provides accessible overviews of major categories of pathogens and is intended to be used as antecedents of pathogen-focused subsequent chapters, as well as to serve as discrete educational resources for students, researchers, and practitioners. The third section includes five in-depth case studies on specific infectious diseases where nutrition-infection interactions have been extensively explored: diarrheal and enteric disease, HIV and tuberculosis, arboviruses, malaria, and soil-transmitted helminths. The final section addresses cross-cutting topics such as drug-nutrient interactions, co-infections, and nutrition, infection, and climate change and then concludes by consolidating relevant clinical and public health approaches to addressing infection in the context of nutrition, and thus providing a sharp focus on the clinical relevance of the intersection between nutrition and infection Written by experts in the field, Nutrition and Infectious Diseases will be a go to resource and guide for immunologists, clinical pathologists, sociologists, epidemiologists, nutritionists, and all health care professionals managing and treating patients with infectious diseases.

Pocket Book of Hospital Care for Children

Pocket Book of Hospital Care for Children
Author: World Health Organization
Publisher: World Health Organization
Total Pages: 442
Release: 2013
Genre: Business & Economics
ISBN: 9241548371

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The Pocket Book is for use by doctors nurses and other health workers who are responsible for the care of young children at the first level referral hospitals. This second edition is based on evidence from several WHO updated and published clinical guidelines. It is for use in both inpatient and outpatient care in small hospitals with basic laboratory facilities and essential medicines. In some settings these guidelines can be used in any facilities where sick children are admitted for inpatient care. The Pocket Book is one of a series of documents and tools that support the Integrated Managem.

Sex and Gender Factors Affecting Metabolic Homeostasis, Diabetes and Obesity

Sex and Gender Factors Affecting Metabolic Homeostasis, Diabetes and Obesity
Author: Franck Mauvais-Jarvis
Publisher: Springer
Total Pages: 630
Release: 2017-12-08
Genre: Medical
ISBN: 3319701789

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The book provides a reference for years to come, written by world-renowned expert investigators studying sex differences, the role of sex hormones, the systems biology of sex, and the genetic contribution of sex chromosomes to metabolic homeostasis and diseases. In this volume, leaders of the pharmaceutical industry present their views on sex-specific drug discovery. Many of the authors presented at the Keystone Symposium on “Sex and gender factors affecting metabolic homeostasis, diabetes and obesity” to be held in March 2017 in Lake Tahoe, CA. This book will generate new knowledge and ideas on the importance of gender biology and medicine from a molecular standpoint to the population level and to provide the methods to study them. It is intended to be a catalyst leading to gender-specific treatments of metabolic diseases. There are fundamental aspects of metabolic homeostasis that are regulated differently in males and females, and influence both the development of diabetes and obesity and the response to pharmacological intervention. Still, most preclinical researchers avoid studying female rodents due to the added complexity of research plans. The consequence is a generation of data that risks being relevant to only half of the population. This is a timely moment to publish a book on sex differences in diseases as NIH leadership has asked scientists to consider sex as a biological variable in preclinical research, to ensure that women get the same benefit of medical research as men.

Bugs as Drugs

Bugs as Drugs
Author: Robert A. Britton
Publisher: John Wiley & Sons
Total Pages: 514
Release: 2020-07-02
Genre: Medical
ISBN: 1555819702

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Examining the enormous potential of microbiome manipulation to improve health Associations between the composition of the intestinal microbiome and many human diseases, including inflammatory bowel disease, cardiovascular disease, metabolic disorders, and cancer, have been elegantly described in the past decade. Now, whole-genome sequencing, bioinformatics, and precision gene-editing techniques are being combined with centuries-old therapies, such as fecal microbiota transplantation, to translate current research into new diagnostics and therapeutics to treat complex diseases. Bugs as Drugs provides a much-needed overview of microbes in therapies and will serve as an excellent resource for scientists and clinicians as they carry out research and clinical studies on investigating the roles the microbiota plays in health and disease. In Bugs as Drugs, editors Robert A. Britton and Patrice D. Cani have assembled a fascinating collection of reviews that chart the history, current efforts, and future prospects of using microorganisms to fight disease and improve health. Sections cover traditional uses of probiotics, next-generation microbial therapeutics, controlling infectious diseases, and indirect strategies for manipulating the host microbiome. Topics presented include: How well-established probiotics support and improve host health by improving the composition of the intestinal microbiota of the host and by modulating the host immune response. The use of gene editing and recombinant DNA techniques to create tailored probiotics and to characterize next-generation beneficial microbes. For example, engineering that improves the anti-inflammatory profile of probiotics can reduce the number of colonic polyps formed, and lactobacilli can be transformed into targeted delivery systems carrying therapeutic proteins or bioengineered bacteriophage. The association of specific microbiota composition with colorectal cancer, liver diseases, osteoporosis, and inflammatory bowel disease. The gut microbiota has been proposed to serve as an organ involved in regulation of inflammation, immune function, and energy homeostasis. Fecal microbiota transplantation as a promising treatment for numerous diseases beyond C. difficile infection. Practical considerations for using fecal microbiota transplantation are provided, while it is acknowledged that more high-quality evidence is needed to ascertain the importance of strain specificity in positive treatment outcomes. Because systems biology approaches and synthetic engineering of microbes are now high-throughput and cost-effective, a much wider range of therapeutic possibilities can be explored and vetted.

Human Microbiome

Human Microbiome
Author:
Publisher:
Total Pages: 0
Release: 2022
Genre:
ISBN:

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Systematic

Systematic
Author: James R. Valcourt
Publisher: Bloomsbury Publishing USA
Total Pages: 289
Release: 2017-02-07
Genre: Science
ISBN: 1632860317

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A brilliant young scientist introduces us to the fascinating field that is changing our understanding of how the body works and the way we can approach healing. SYSTEMATIC is the first book to introduce general readers to systems biology, which is improving medical treatments and our understanding of living things. In traditional bottom-up biology, a biologist might spend years studying how a single protein works, but systems biology studies how networks of those proteins work together--how they promote health and how to remedy the situation when the system isn't functioning properly. Breakthroughs in systems biology became possible only when powerful computer technology enabled researchers to process massive amounts of data to study complete systems, and has led to progress in the study of gene regulation and inheritance, cancer drugs personalized to an individual's genetically unique tumor, insights into how the brain works, and the discovery that the bacteria and other microbes that live in the gut may drive malnutrition and obesity. Systems biology is allowing us to understand more complex phenomena than ever before. In accessible prose, SYSTEMATIC sheds light not only on how systems within the body work, but also on how research is yielding new kinds of remedies that enhance and harness the body's own defenses.