ABSTRACT
A child's diet contains nutrients and other substances that influence intestinal health. The present study aimed to evaluate the relations between complementary feeding, intestinal barrier function and environmental enteropathy (EE) in infants. Data from 233 children were obtained from the Brazilian site of the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project cohort study. Habitual dietary intake from complementary feeding was estimated using seven 24-h dietary recalls, from 9 to 15 months of age. Intestinal barrier function was assessed using the lactulose-mannitol test (L-M), and EE was determined as a composite measure using faecal biomarkers concentrations - α-1-antitrypsin, myeloperoxidase (MPO) and neopterin (NEO) at 15 months of age. The nutrient adequacies explored the associations between dietary intake and the intestinal biomarkers. Children showed adequate nutrient intakes (with the exception of fibre), impaired intestinal barrier function and intestinal inflammation. There was a negative correlation between energy adequacy and L-M (ρ = -0·19, P < 0·05) and between folate adequacy and NEO concentrations (ρ = -0·21, P < 0·01). In addition, there was a positive correlation between thiamine adequacy and MPO concentration (ρ = 0·22, P < 0·01) and between Ca adequacy and NEO concentration (ρ = 0·23; P < 0·01). Multiple linear regression models showed that energy intakes were inversely associated with intestinal barrier function (ß = -0·19, P = 0·02), and fibre intake was inversely associated with the EE scores (ß = -0·20, P = 0·04). Findings suggest that dietary intake from complementary feeding is associated with decreased intestinal barrier function and EE in children.
Subject(s)
Diet/standards , Enteritis/etiology , Infant Nutritional Physiological Phenomena , Intestines/physiology , Brazil/epidemiology , Breast Feeding , Cohort Studies , Enteritis/epidemiology , Female , Humans , Infant , Male , Nutritional StatusABSTRACT
Enterotoxigenic Escherichia coli (ETEC) is a major cause of traveler's diarrhea as well as of endemic diarrhea and stunting in children in developing areas. However, a small-mammal model has been badly needed to better understand and assess mechanisms, vaccines, and interventions. We report a murine model of ETEC diarrhea, weight loss, and enteropathy and investigate the role of zinc in the outcomes. ETEC strains producing heat-labile toxins (LT) and heat-stable toxins (ST) that were given to weaned C57BL/6 mice after antibiotic disruption of normal microbiota caused growth impairment, watery diarrhea, heavy stool shedding, and mild to moderate intestinal inflammation, the latter being worse with zinc deficiency. Zinc treatment promoted growth in zinc-deficient infected mice, and subinhibitory levels of zinc reduced expression of ETEC virulence genes cfa1, cexE, sta2, and degP but not of eltA in vitro Zinc supplementation increased shedding and the ileal burden of wild-type (WT) ETEC but decreased shedding and the tissue burden of LT knockout (LTKO) ETEC. LTKO ETEC-infected mice had delayed disease onset and also had less inflammation by fecal myeloperoxidase (MPO) assessment. These findings provide a new murine model of ETEC infection that can help elucidate mechanisms of growth, diarrhea, and inflammatory responses as well as potential vaccines and interventions.
Subject(s)
Bacterial Toxins/metabolism , Diarrhea/physiopathology , Enterotoxigenic Escherichia coli/metabolism , Escherichia coli Infections/physiopathology , Zinc/metabolism , Animals , Diarrhea/microbiology , Disease Models, Animal , Mice , Mice, Inbred C57BLABSTRACT
The purpose of this study was to determine the precise role of angiotensin subtype-1 (AT1) and -2 (AT2) receptors and the mechanisms by which they act to alter fluid transport in the rat jejunum. In rats on normal sodium intake, ANG II at low dose stimulated net jejunal fluid absorption, whereas at a high dose the peptide inhibited absorption. Low-dose ANG II-stimulated fluid absorption was blocked completely by the specific AT2 receptor antagonist PD-123319 (PD) but was unchanged by the AT1 receptor antagonist losartan (Los). The AT2 receptor agonist CGP-42112A, caused an inversely dose-dependent increase in fluid absorption, which also was totally prevented by PD but was unaltered by Los. Conversely, high-dose ANG II inhibition of absorption was blocked by Los but not by PD. In animals receiving normal sodium intake, neither Los nor PD alone altered fluid absorption. In sodium-restricted animals, however, Los alone increased absorption and PD alone inhibited absorption. In rats on normal sodium intake, low-dose ANG II increased jejunal interstitial and luminal (loop) fluid concentrations of cGMP. These increases in cGMP were blocked with PD but not with Los. 8-Bromoguanosine-3',5'-cyclic monophosphate administered via the mesenteric artery or the submucosal interstitial space markedly increased absorption, but it inhibited absorption when administered into the loop. High-dose ANG II decreased jejunal interstitial and loop fluid cAMP and increased PGE2. The increase in PGE2 was blocked by Los but not by PD. The data demonstrate that ANG II mediates jejunal sodium and water absorption by an action at the AT2 receptor involving cGMP formation. The data also show that ANG II inhibits absorption via the AT1 receptor by a mechanism that is both negatively coupled to cAMP and increases jejunal PGE2 production.
Subject(s)
Angiotensin II/pharmacology , Intestinal Absorption/physiology , Intestinal Mucosa/physiology , Jejunum/physiology , Receptors, Angiotensin/physiology , Water , Adrenergic alpha-1 Receptor Antagonists , Angiotensin Receptor Antagonists , Animals , Cyclic AMP/metabolism , Cyclic GMP/analogs & derivatives , Cyclic GMP/metabolism , Cyclic GMP/pharmacology , Diet, Sodium-Restricted , Dinoprostone/metabolism , Dose-Response Relationship, Drug , Guanethidine/pharmacology , Homeostasis , Imidazoles/pharmacology , Intestinal Absorption/drug effects , Intestinal Mucosa/drug effects , Jejunum/drug effects , Kinetics , Losartan/pharmacology , Male , Mesenteric Arteries/drug effects , Mesenteric Arteries/physiology , Oligopeptides/pharmacology , Prazosin/pharmacology , Pyridines/pharmacology , Rats , Rats, Wistar , Receptor, Angiotensin, Type 1 , Receptor, Angiotensin, Type 2 , Receptors, Angiotensin/agonists , Time FactorsABSTRACT
The mean +/- SEM duration of diarrheal episodes decreased from 7.1 +/- 2.2 days to 4.3 +/- 0.9 days (P < 0.05) while the incidence of diarrheal episodes remained steady (2.2 +/- 0.3 versus 2.4 +/- 0.5 episodes; P = not significant) between two three-month periods before and after the oral administration of a single large age-adjusted dose of vitamin A among children at historical risk for persistent diarrhea in an impoverished Brazilian community.
Subject(s)
Diarrhea, Infantile/prevention & control , Vitamin A/administration & dosage , Administration, Oral , Brazil/epidemiology , Diarrhea, Infantile/epidemiology , Humans , Incidence , Infant , Longitudinal Studies , Risk Factors , Seasons , Time FactorsABSTRACT
PIP: A review of data on the morbidity and mortality caused by persistent diarrhea (more than 14 days' duration) was undertaken from studies in several geographic areas, including Bangladesh, Brazil, Ethiopia, India, Indonesia, and Peru, over the last 3 decades. An estimated 3-5 billion diarrheal illnesses and 5-10 million diarrhea-related deaths occur annually among 3 billion people in Africa, Asia, and Latin America. Mostly the 338 million to 1 billion episodes and 4.6 million deaths annually. A study from India showed that the incidence of persistent diarrhea was greater in the age group 0-11 months (31 episodes/100 child-years) than at age 12-23 months (9 episodes/100 child years) or 24-35 months (6 episodes/100 child-year). Similar results were obtained in periurban Peru, periurban northeastern Brazil, and rural guatemala. Diarrhea is believed to precipitate and exacerbate malnutrition while malnutrition predisposes to diarrhea. 2 studies in both Bangladesh and Peru indicate that the risk of developing diarrhea inversely parallels delayed-type hypersensitivity reactions to standard skin-test antigens. In a cohort of 175 children under 5 years of age over a 28-month period in an urban slum in northeastern Brazil the children had an average of 11 episodes/year and spent 82 days/year with diarrhea. The leading potential pathogens seen with persistent diarrhea in some areas are enteroaggregative E. coli and Cryptosporidium. Other pathogens include Shigella, Salmonella, enteropathogenic (LA (local)) E. coli, and variably Giardia lamblia. Recent nutritional management promotes breast feeding, dietary supplementation with vitamin A, zinc, iron, folate, and vitamin B 12, and improved oral rehydration solutions with glucose polymers (such as rice starch) and possibly neutral amino acids (such as alanine or glycine) and glutamine.^ieng
Subject(s)
Developing Countries , Diarrhea/epidemiology , Child, Preschool , Chronic Disease , Diarrhea/etiology , Diarrhea/physiopathology , Diarrhea/therapy , Fluid Therapy , Humans , Infant , Morbidity , Nutritional Status , Risk FactorsABSTRACT
The bacteriologic and clinical effects of early antibiotic treatment of Campylobacter jejuni enteritis were studied. Erythromycin rapidly eliminated C. jejuni from stools, whereas trimethoprim-sulfamethoxazole did not. Despite its bacteriologic effectiveness, erythromycin did not reduce the duration or severity of diarrhea, abdominal pain, or other symptoms.
Subject(s)
Campylobacter Infections/drug therapy , Enteritis/drug therapy , Erythromycin/therapeutic use , Sulfamethoxazole/therapeutic use , Trimethoprim/therapeutic use , Adult , Campylobacter Infections/microbiology , Campylobacter fetus/drug effects , Child , Drug Combinations/pharmacology , Drug Combinations/therapeutic use , Enteritis/microbiology , Erythromycin/pharmacology , Feces/microbiology , Female , Humans , Male , Microbial Sensitivity Tests , Sulfamethoxazole/pharmacology , Time Factors , Trimethoprim/pharmacology , Trimethoprim, Sulfamethoxazole Drug CombinationABSTRACT
Milk specimens, 75 from cows immunized against cholera toxin and 35 from a human population in which enterotoxigenic Escherichia coli and rotaviral infections are endemic, were collected as paired filter paper and frozen whole milk samples. Each pair was tested for antibody activity against heat-labile E. coli and Vibrio cholerae enterotoxins. Additionally, 12 of the 35 paired human milk samples stored as frozen whole milk and dried on filter paper were tested for anti-rotavirus immunoglobulin A. Anti-enterotoxin and anti-rotavirus immunoglobulin A titers in milk dried on filter paper compared favorably with those of their frozen whole milk pairs. Filter paper samples offered considerable advantages for field collection, transportation, and storage over frozen liquid samples.