Impaired Barrier Function and Autoantibody Generation in Malnutrition Enteropathy in Zambia

Beatrice Amadi, Ellen Besa, Kanekwa Zyambo, Patrick Kaonga, John Louis-Auguste, Kanta Chandwe, Phillip I. Tarr, Donna M. Denno, James P. Nataro, William Alvis Faubion, Anne Sailer, Sunil Yeruva, Tricia Brantner, Joseph A Murray, Andrew J. Prendergast, Jerrold R. Turner, Paul Kelly

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Intestinal damage in malnutrition constitutes a threat to the survival of many thousands of children globally. We studied children in Lusaka, Zambia, with severe acute malnutrition (SAM) and persistent diarrhea using endoscopy, biopsy and analysis of markers and protective proteins in blood and intestinal secretions. We carried out parallel investigations in apparently healthy adults, and analyzed biomarkers only in apparently healthy children. Villus height and crypt depth did not differ in children with SAM and adult controls, but epithelial surface was reduced in children with SAM (median 445, interquartile range (IQR) 388, 562 μm per 100 μm muscularis mucosae) compared to adults (578, IQR 465,709; P = 0.004). Histological lesions and disruptions of claudin-4 and E-cadherin were most pronounced in children with SAM. Circulating lipopolysaccharide, a marker of bacterial translocation, was higher in malnourished children (251, IQR 110,460 EU/ml) than in healthy children (51, IQR 0,111; P = 0.0001). Other translocation markers showed similar patterns. Anti-Deamidated Gliadin Peptide IgG concentrations, although within the normal range, were higher in children with SAM (median 2.7 U/ml, IQR 1.5–8.6) than in adults (1.6, 1.4–2.1; P = 0.005), and were inversely correlated with villus height (ρ = − 0.79, n = 13, P = 0.001). Malnutrition enteropathy is associated with intestinal barrier failure and immune dysregulation.

Original languageEnglish (US)
Pages (from-to)191-199
Number of pages9
JournalEBioMedicine
Volume22
DOIs
StatePublished - Aug 1 2017

Fingerprint

Claudin-4
Zambia
Gliadin
Endoscopy
Biopsy
Biomarkers
Cadherins
Malnutrition
Autoantibodies
Lipopolysaccharides
Blood
Immunoglobulin G
Peptides
Proteins
Intestinal Secretions
Bacterial Translocation
Mucous Membrane
Blood Proteins
Diarrhea
Reference Values

Keywords

  • Autoantibodies
  • Enteropathy
  • Environmental enteric dysfunction
  • Glucagon-like peptide 2
  • HIV
  • Malnutrition
  • Microbial translocation
  • Tissue transglutaminase serology, deamidated gliadin peptide serology

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Amadi, B., Besa, E., Zyambo, K., Kaonga, P., Louis-Auguste, J., Chandwe, K., ... Kelly, P. (2017). Impaired Barrier Function and Autoantibody Generation in Malnutrition Enteropathy in Zambia. EBioMedicine, 22, 191-199. https://doi.org/10.1016/j.ebiom.2017.07.017

Impaired Barrier Function and Autoantibody Generation in Malnutrition Enteropathy in Zambia. / Amadi, Beatrice; Besa, Ellen; Zyambo, Kanekwa; Kaonga, Patrick; Louis-Auguste, John; Chandwe, Kanta; Tarr, Phillip I.; Denno, Donna M.; Nataro, James P.; Faubion, William Alvis; Sailer, Anne; Yeruva, Sunil; Brantner, Tricia; Murray, Joseph A; Prendergast, Andrew J.; Turner, Jerrold R.; Kelly, Paul.

In: EBioMedicine, Vol. 22, 01.08.2017, p. 191-199.

Research output: Contribution to journalArticle

Amadi, B, Besa, E, Zyambo, K, Kaonga, P, Louis-Auguste, J, Chandwe, K, Tarr, PI, Denno, DM, Nataro, JP, Faubion, WA, Sailer, A, Yeruva, S, Brantner, T, Murray, JA, Prendergast, AJ, Turner, JR & Kelly, P 2017, 'Impaired Barrier Function and Autoantibody Generation in Malnutrition Enteropathy in Zambia', EBioMedicine, vol. 22, pp. 191-199. https://doi.org/10.1016/j.ebiom.2017.07.017
Amadi B, Besa E, Zyambo K, Kaonga P, Louis-Auguste J, Chandwe K et al. Impaired Barrier Function and Autoantibody Generation in Malnutrition Enteropathy in Zambia. EBioMedicine. 2017 Aug 1;22:191-199. https://doi.org/10.1016/j.ebiom.2017.07.017
Amadi, Beatrice ; Besa, Ellen ; Zyambo, Kanekwa ; Kaonga, Patrick ; Louis-Auguste, John ; Chandwe, Kanta ; Tarr, Phillip I. ; Denno, Donna M. ; Nataro, James P. ; Faubion, William Alvis ; Sailer, Anne ; Yeruva, Sunil ; Brantner, Tricia ; Murray, Joseph A ; Prendergast, Andrew J. ; Turner, Jerrold R. ; Kelly, Paul. / Impaired Barrier Function and Autoantibody Generation in Malnutrition Enteropathy in Zambia. In: EBioMedicine. 2017 ; Vol. 22. pp. 191-199.
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