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Duodenal quantitative mucosal morphometry in children with environmental enteric dysfunction: a cross-sectional multicountry analysis.
Ehsan, Lubaina; Coomes, David; Kelly, Paul; Greene, Adam R; Ali, S Asad; Mulenga, Chola; Denno, Donna M; VanBuskirk, Kelley; Raghib, Muhammad Faraz; Mahfuz, Mustafa; Moore, Sean R; Hossain, Md Shabab; Ahmed, Tahmeed; Sullivan, Peter B; Moskaluk, Christopher A; Syed, Sana.
Afiliación
  • Ehsan L; Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Virginia, Charlottesville, VA, United States.
  • Coomes D; Department of Epidemiology, University of Washington, Seattle, WA, United States.
  • Kelly P; Blizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, United Kingdom.
  • Greene AR; Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Virginia, Charlottesville, VA, United States.
  • Ali SA; Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
  • Mulenga C; Tropical Gastroenterology and Nutrition Group, University of Zambia School of Medicine, Lusaka, Zambia.
  • Denno DM; Department of Pediatrics, University of Washington, Seattle, WA, United States.
  • VanBuskirk K; Department of Global Health, University of Washington, Seattle, WA, United States.
  • Raghib MF; Department of Pediatrics, University of Virginia, Charlottesville, VA, United States.
  • Mahfuz M; Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
  • Moore SR; Department of Pediatrics, University of Virginia, Charlottesville, VA, United States.
  • Hossain MS; Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
  • Ahmed T; Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
  • Sullivan PB; Department of Paediatrics, Children's Hospital, University of Oxford, Oxford, United Kingdom.
  • Moskaluk CA; Department of Pathology, University of Virginia, Charlottesville, VA, United States.
  • Syed S; Department of Pediatrics, University of Virginia, Charlottesville, VA, United States. Electronic address: ss8xj@virginia.edu.
Am J Clin Nutr ; 120 Suppl 1: S41-S50, 2024 Sep.
Article en En | MEDLINE | ID: mdl-38685382
ABSTRACT

BACKGROUND:

Environmental enteric dysfunction (EED), a chronic inflammatory condition of the small intestine, is an important driver of childhood malnutrition globally. Quantifying intestinal morphology in EED allows for exploration of its association with functional and disease outcomes.

OBJECTIVES:

We sought to define morphometric characteristics of childhood EED and determine whether morphology features were associated with disease pathophysiology.

METHODS:

Morphometric measurements and histology were assessed on duodenal biopsy slides for this cross-sectional study from children with EED in Bangladesh, Pakistan, and Zambia (n = 69), and those with no pathologic abnormality (NPA; n = 8) or celiac disease (n = 18) in North America. Immunohistochemistry was also conducted on 46, 8, and 18 biopsy slides, respectively. Linear mixed-effects regression models were used to reveal morphometric differences between EED compared with NPA or celiac disease and identify associations between morphometry and histology or immunohistochemistry among children with EED.

RESULTS:

In duodenal biopsies, median EED villus height (248 µm), crypt depth (299 µm), and villuscrypt (VC) ratio (0.9) values ranged between those of NPA (396 µm villus height; 246 µm crypt depth; 1.6 VC ratio) and celiac disease (208 µm villus height; 365 µm crypt depth; 0.5 VC ratio). Among EED biopsy slides, morphometric assessments were not associated with histologic parameters or immunohistochemical markers, other than pathologist-determined subjective semiquantitative villus architecture.

CONCLUSIONS:

Morphometric analysis of duodenal biopsy slides across geographies identified morphologic features of EED, specifically short villi, elongated crypts, and a smaller VC ratio relative to NPA slides, although not as severe as in celiac slides. Morphometry did not explain other EED features, suggesting that EED histopathologic processes may be operating independently of morphology. Although acknowledging the challenges with obtaining relevant tissue, these data form the basis for further assessments of the role of morphometry in EED.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Duodeno / Mucosa Intestinal Límite: Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: Africa / Asia Idioma: En Revista: Am J Clin Nutr Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Duodeno / Mucosa Intestinal Límite: Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: Africa / Asia Idioma: En Revista: Am J Clin Nutr Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos