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Proc Natl Acad Sci U S A. 2018 Sep 4;115(36):E8489-E8498. doi: 10.1073/pnas.1806573115. Epub 2018 Aug 20.

Stunted childhood growth is associated with decompartmentalization of the gastrointestinal tract and overgrowth of oropharyngeal taxa.

Author information

1
Unité de Pathogénie Microbienne Moléculaire, Institut Pasteur, 75015 Paris, France.
2
Unité INSERM 1202, Institut Pasteur, 75015 Paris, France.
3
Department of Botany, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
4
Department of Zoology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
5
Biodiversity Research Centre, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
6
Unité de Bactériologie Expérimentale, Institut Pasteur de Madagascar, BP 1274 Ambatofotsikely, 101 Antananarivo, Madagascar.
7
Laboratoires d'Analyses Médicales, Institut Pasteur de Bangui, BP 923 Bangui, Central African Republic.
8
Michael Smith Laboratories, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
9
Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, BP 4150, 101 Antananarivo, Madagascar.
10
Complexe Pédiatrique de Bangui, BP 923 Bangui, Central African Republic.
11
Unité d'Epidémiologie, Institut Pasteur de Bangui, BP 923 Bangui, Central African Republic.
12
Unité d'Epidémiologie et de Recherche Clinique, Institut Pasteur de Madagascar, BP 1274 Ambatofotsikely, 101 Antananarivo, Madagascar.
13
Unité de Pathogénie Microbienne Moléculaire, Institut Pasteur, 75015 Paris, France; philippe.sansonetti@pasteur.fr.
14
Chaire de Microbiologie et de Maladies Infectieuses, Collège de France, 75231 Paris, France.

Abstract

Linear growth delay (stunting) affects roughly 155 million children under the age of 5 years worldwide. Treatment has been limited by a lack of understanding of the underlying pathophysiological mechanisms. Stunting is most likely associated with changes in the microbial community of the small intestine, a compartment vital for digestion and nutrient absorption. Efforts to better understand the pathophysiology have been hampered by difficulty of access to small intestinal fluids. Here, we describe the microbial community found in the upper gastrointestinal tract of stunted children aged 2-5 y living in sub-Saharan Africa. We studied 46 duodenal and 57 gastric samples from stunted children, as well as 404 fecal samples from stunted and nonstunted children living in Bangui, Central African Republic, and in Antananarivo, Madagascar, using 16S Illumina Amplicon sequencing and semiquantitative culture methods. The vast majority of the stunted children showed small intestinal bacterial overgrowth dominated by bacteria that normally reside in the oropharyngeal cavity. There was an overrepresentation of oral bacteria in fecal samples of stunted children, opening the way for developing noninvasive diagnostic markers. In addition, Escherichia coli/Shigella sp. and Campylobacter sp. were found to be more prevalent in stunted children, while Clostridia, well-known butyrate producers, were reduced. Our data suggest that stunting is associated with a microbiome "decompartmentalization" of the gastrointestinal tract characterized by an increased presence of oropharyngeal bacteria from the stomach to the colon, hence challenging the current view of stunting arising solely as a consequence of small intestine overstimulation through recurrent infections by enteric pathogens.

KEYWORDS:

decompartmentalization; microbiota; oropharyngeal taxa; stunting; sub-Saharan Africa

PMID:
30126990
PMCID:
PMC6130352
[Available on 2019-03-04]
DOI:
10.1073/pnas.1806573115
[Indexed for MEDLINE]

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