N Engl J Med 2020 07;383(4):321-333
From the Edison Family Center for Genome Sciences and Systems Biology (R.Y.C., V.L.K., M.C.H., J.G., B.D.L., K.A., E.K., J.S.-B., M.J.B., J.I.G.), the Center for Gut Microbiome and Nutrition Research (R.Y.C., V.L.K., M.C.H., J.G., K.A., M.J.B., J.I.G.), and the Department of Pathology and Immunology (V.L.K., M.J.B., J.I.G.), Washington University School of Medicine, St. Louis; the International Center for Diarrhoeal Disease Research, Bangladesh (S.D., M.S.H., M.M., S.M.F., M.A.G., R.H., S.A.S., R.N.M., T.A.), the Department of Pathology, Dr. Sirajul Islam Medical College (S.M.K.N.B.), and Sheikh Russel National Gastroliver Institute and Hospital (M.M.R.), Dhaka, Bangladesh; the A.A. Kharkevich Institute for Information Transmission Problems, Russian Academy of Sciences, Moscow (D.A.R., S.A.L.); and the Infectious and Inflammatory Disease Center, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA (D.A.R., S.A.L., A.L.O.).
Background: Environmental enteric dysfunction (EED) is an enigmatic disorder of the small intestine that is postulated to play a role in childhood undernutrition, a pressing global health problem. Defining the incidence of this disorder, its pathophysiological features, and its contribution to impaired linear and ponderal growth has been hampered by the difficulty in directly sampling the small intestinal mucosa and microbial community (microbiota).
Methods: In this study, among 110 young children (mean age, 18 months) with linear growth stunting who were living in an urban slum in Dhaka, Bangladesh, and had not benefited from a nutritional intervention, we performed endoscopy in 80 children who had biopsy-confirmed EED and available plasma and duodenal samples. Read More