Alterations in the histological features of the intestinal mucosa in malnourished adults of Bangladesh

Abstract

There is paucity of knowledge on the histological features of the intestinal mucosa in malnourished adults of Bangladesh. The purpose of the study was to explore the histological features of the intestinal mucosa in malnourished adults of Bangladesh and to compare the findings with their well-nourished counterparts. 64 adults (37 malnourished with body mass index, BMI < 18.5 kg/m2 and 27 controls with BMI > 18.5 kg/m2) from the Bangladesh Environmental Enteric Dysfunction (BEED) study, who underwent upper-gastrointestinal endoscopy, were selected for this study. With a view to address the association of environmental enteric dysfunction (EED) with malnutrition, upper-gastrointestinal endoscopy was performed and mucosal biopsies from the distal duodenum were studied for histopathology. Villous height, crypt depth, and presence of inflammatory infiltrates in lamina propria were investigated. Bivariate analysis was performed to quantify the relation between malnutrition and the histological features. About 95% adults, irrespective of nutritional status, were diagnosed to have chronic non-specific duodenitis on histopathology. Malnourished adults suffered significantly more from chronic active duodenitis compared to their well-nourished counterparts (p = 0.003). Malnourished adults also had significantly higher frequency of subtotal villous atrophy, crypt hyperplasia and marked cellular infiltration in the lamina propria than the healthy controls (p < 0.05).

Heat Stress-Mediated Activation of Immune–Inflammatory Pathways

“…In mammals and birds, this cell line folds along its path through the GIT to increase its contact surface and thus its absorptive power, generating villi (raised portions) and invaginations between villi, which are termed crypts. In vivo models for studying gut physiology have shown hyperplastic crypts combined with reduced villus area, suggesting rapid tissue adaptation to nutrient shortages [ 30 , 31 , 32 ]. Heat stress may affect the intestinal structure by shortening villus height and increasing crypt depth, with a consequent decrease in the villus:crypt ratio, as shown in poultry [ 19 , 20 , 24 , 25 , 33 ], rodents [ 21 , 27 ], and pigs [ 22 , 23 ] ( Table 1 ).…”

Alteration of stool pH and its association with biomarkers of gut enteropathy among slum-dwelling women of reproductive age in Bangladesh

“…The gold standard for the diagnosis of EED involves a biopsy of the intestinal tissue and confirmation by histopathology. The Bangladesh Environmental Enteric Dysfunction (BEED) study revealed that 95% of adults residing in slums, who are asymptomatic, exhibit chronic non-specific intestinal inflammation, a hallmark feature of EED [ 20 ]. However, collecting endoscopy-guided small intestinal biopsy samples from clinically asymptomatic adults for routine diagnosis of EED is technically infeasible and, in some instances, unethical [ 20 – 22 ].…”