QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Related articles in J. Nutr. Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Campbell, D. I. Articles by Lunn, P. G. Search for Related Content PubMed PubMed Citation Articles by Campbell, D. I. Articles by Lunn, P. G.

---

Community and International Nutrition

Growth Faltering in Rural Gambian Infants Is Associated with Impaired Small Intestinal Barrier Function, Leading to Endotoxemia and Systemic Inflammation

D. I. Campbell^*,, M. Elia^*,** and P. G. Lunn^*,,1

^* Medical Research Council, Keneba, The Gambia; Royal Victoria Infirmary, Newcastle-Upon-Tyne, UK; ^** Department of Clinical Nutrition and Metabolism, Institute of Human Nutrition, Southampton General Hospital, UK; and Department of Biological Anthropology, University of Cambridge, UK

¹To whom correspondence should be addressed. E-mail: pgl21{at}cam.ac.uk.

Growth faltering of rural Gambian infants is associated with a chronic inflammatory enteropathy of the mucosa of the small intestine that may impair both digestive/absorptive and barrier functions. The aim of this study was to determine whether the enteropathy was associated with a compromised barrier function that allowed translocation of antigenic macromolecules from the gut lumen into the body, with subsequent systemic immunostimulation, resulting in growth retardation. Rural Gambian infants were studied longitudinally at regular intervals between 8 and 64 wk of age. On each study day, each child was medically examined, anthropometric measurements were made, a blood sample was taken and an intestinal permeability test performed. Evidence of chronic immunostimulation was provided by abnormally elevated white blood cell, lymphocyte and platelet counts, and frequently raised plasma concentration of C-reactive protein. Intestinal permeability was abnormal and associated with impaired growth (r = -0.41, P < 0.001). Plasma concentrations of endotoxin and immunoglobulin (Ig)G-endotoxin core antibody were also elevated and related to both growth (r = -0.30, P < 0.02; r = -0.64, P < 0.0001, respectively) and measures of mucosal enteropathy. Plasma IgG, IgA and IgM levels increased rapidly with age toward adult concentrations. Raised values were related to poor growth but also to measures of mucosal enteropathy and the endotoxin antibody titer. The interrelationships among these variables and growth suggested that they were all part of the same growth-retarding mechanism. These data are consistent with the hypothesis of translocation of immunogenic lumenal macromolecules across a compromised gut mucosa, leading to stimulation of systemic immune/inflammatory processes and subsequent growth impairment.

KEY WORDS: • infant growth • intestinal permeability • endotoxin • inflammation • enteropathy

Related articles in J. Nutr.:

Environmental Contamination and Chronic Inflammation Influence Human Growth Potential

Noel W. Solomons
J. Nutr. 2003 133: 1237. [Full Text]  

This article has been cited by other articles:

				B. K. Ritchie, D. R. Brewster, G. P. Davidson, C. D. Tran, Y. McNeil, J. S. Hawkes, and R. N. Butler 13C-Sucrose Breath Test: Novel Use of a Noninvasive Biomarker of Environmental Gut Health Pediatrics, August 1, 2009; 124(2): 620 - 626. [Abstract] [Full Text] [PDF]

				P. C Turner, A. C Collinson, Y. B. Cheung, Y. Gong, A. J Hall, A. M Prentice, and C. P Wild Aflatoxin exposure in utero causes growth faltering in Gambian infants Int. J. Epidemiol., October 1, 2007; 36(5): 1119 - 1125. [Abstract] [Full Text] [PDF]

				E. A Williams, M. Elia, and P. G Lunn A double-blind, placebo-controlled, glutamine-supplementation trial in growth-faltering Gambian infants Am. J. Clinical Nutrition, August 1, 2007; 86(2): 421 - 427. [Abstract] [Full Text] [PDF]

				S. Gratz, Q. K. Wu, H. El-Nezami, R. O. Juvonen, H. Mykkanen, and P. C. Turner Lactobacillus rhamnosus Strain GG Reduces Aflatoxin B1 Transport, Metabolism, and Toxicity in Caco-2 Cells Appl. Envir. Microbiol., June 15, 2007; 73(12): 3958 - 3964. [Abstract] [Full Text] [PDF]

				X.-Y. Sheng, K M. Hambidge, X.-X. Zhu, J.-X. Ni, K. B Bailey, R. S Gibson, and N. F Krebs Major variables of zinc homeostasis in Chinese toddlers. Am. J. Clinical Nutrition, August 1, 2006; 84(2): 389 - 394. [Abstract] [Full Text] [PDF]

				B. Ntab, K. B. Simondon, J. Milet, B. Cisse, C. Sokhna, D. Boulanger, and F. Simondon A Young Child Feeding Index Is Not Associated with Either Height-for-Age or Height Velocity in Rural Senegalese Children J. Nutr., March 1, 2005; 135(3): 457 - 464. [Abstract] [Full Text] [PDF]

				N. W. Solomons Environmental Contamination and Chronic Inflammation Influence Human Growth Potential J. Nutr., May 1, 2003; 133(5): 1237 - 1237. [Full Text] [PDF]