Longitudinal Analysis of the Intestinal Microbiota in Persistently Stunted Young Children in South India

Abstract

Stunting or reduced linear growth is very prevalent in low-income countries. Recent studies have demonstrated a causal relationship between alterations in the gut microbiome and moderate or severe acute malnutrition in children in these countries. However, there have been no primary longitudinal studies comparing the intestinal microbiota of persistently stunted children to that of non-stunted children in the same community. In this pilot study, we characterized gut microbial community composition and diversity of the fecal microbiota of 10 children with low birth weight and persistent stunting (cases) and 10 children with normal birth weight and no stunting (controls) from a birth cohort every 3 months up to 2 years of age in a slum community in south India. There was an increase in diversity indices (P <0.0001) with increasing age in all children. However, there were no differences in diversity indices or in the rates of their increase with increasing age between cases and controls. The percent relative abundance of the Bacteroidetes phylum was higher in stunted compared to control children at 12 months of age (P = 0.043). There was an increase in the relative abundance of this phylum with increasing age in all children (P = 0.0380) with no difference in the rate of increase between cases and controls. There was a decrease in the relative abundance of Proteobacteria (P = 0.0004) and Actinobacteria (P = 0.0489) with increasing age in cases. The microbiota of control children was enriched in probiotic species Bifidobacterium longum and Lactobacillus mucosae, whereas that of stunted children was enriched in inflammogenic taxa including those in the Desulfovibrio genus and Campylobacterales order. Larger, longitudinal studies on the compositional and functional maturation of the microbiome in children are needed.

Mechanisms of cross-talk between the diet, the intestinal microbiome, and the undernourished host

“…18 Although functional consequences are difficult to infer from phylum-level changes, fecal microbial communities from both undernourished cohorts included increased proportions of pathogenic taxa within Proteobacteria, including Enterobacter, Escherichia, Klebsiella, and Shigella, as confirmed elsewhere. 19,25 It should be noted that a similar pattern (increased proportions of Proteobacteria with decreased microbial diversity) is found in inflammatory bowel disease. 26 On the other hand, genera containing potentially beneficial organisms are depleted in the undernourished gut.…”

“…Roseburia, Faecalibacterium, and Butyrivibrio (important sources of butyrate for colonocytes), as well as Lactobacillus and Bifidobacterium (which can decrease inflammation, strengthen gut barrier function, inhibit pathogens, and mediate other beneficial effects under certain conditions), are deficient in stool from undernourished children. [18][19][20]25 Together, these data suggest that the characteristic fecal microbiota of the undernourished child contains decreased richness, increased relative abundance of genera containing pathogens, and loss of genera containing potentially beneficial organisms.…”

Keadaan Mikrobiota Saluran Cerna pada Anak Sekolah Dasar yang Mengalami Stunting di Lombok Barat

“…Diare berkaitan dengan kondisi bakteri patogen yang tinggi di dalam saluran cerna. Komposisi mikrobiota saluran cerna pada saat diare berubah menjadi lebih tinggi komposisi bakteri patogennya dibandingkan probiotik di dalam saluran cerna (Dinh et al 2016;Gough et al 2015) Diketahui bahwa setiap individu memiliki komposisi mikrobiota saluran cerna yang berbeda-beda. Faktor usia dan daerah tempat tinggal juga dapat menentukan komposisi mikrobiota saluran cerna ini.…”

“…Penelitian lain yang dilakukan pada anak di India bagian selatan menunjukkan bahwa anak sehat memiliki komposisi jumlah bakteri Bifidobacterium longum dan Lactobacillus mucosae yang lebih banyak dibanding anak stunting (Dinh et al 2016). Hasil tersebut belum dapat dibuktikan dalam penelitian ini, walaupun ada kecenderungan jumlah Bifidobacteria pada anak yang sehat juga lebih tinggi (8,22±0,79 log CFU/g) dibanding anak yang stunting (8,19±0,74 log CFU/g), namun hasilnya tidak signifikan (p>0,05).…”

“…Semakin buruk status gizi seorang anak, maka komposisi mikrobiota yang ada di dalam saluran cerna lebih banyak mikrobiota patogen (Ghosh et al 2014). Penelitian lain juga menunjukkan bahwa anak stunting, mikrobiota saluran cernanya kaya akan bakteri inflammogenic seperti genus Desulfovibrio dan ordo Campylobacterales (Dinh et al 2016).…”