High dose multiple micronutrient supplementation improves villous morphology in environmental enteropathy without HIV enteropathy: Results from a double-blind randomised placebo controlled trial in Zambian adults

BMC Gastroenterology

Volumn 14, Issue 1, 2014, Pages

  Louis Auguste, John ^a   Greenwald, Stephen ^a   Simuyandi, Michelo ^b   Soko, Rose ^b   Banda, Rose ^b   Kelly, Paul ^a,b  

^a QUEEN MARY UNIVERSITY OF LONDON   (United Kingdom)

^b UNIVERSITY OF ZAMBIA   (Zambia)

Author keywords

Enteropathy; Histopathology; HIV related gastrointestinal disease; Micronutrients; Nutrition

Indexed keywords

IMMUNACE; MULTIPLE MICRONUTRIENT; PLACEBO; TRACE ELEMENT; TYPHOID VACCINE; UNCLASSIFIED DRUG;

ADULT; ARTICLE; CLINICAL ARTICLE; DRUG MEGADOSE; ENTEROPATHY; ENVIRONMENTAL ENTEROPATHY; FEMALE; HISTOPATHOLOGY; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; HUMAN TISSUE; INTESTINE CRYPT; INTESTINE VILLUS; MALE; MORPHOLOGY; RANDOMIZED CONTROLLED TRIAL (TOPIC); SMALL INTESTINE; TREATMENT OUTCOME; UNSPECIFIED SIDE EFFECT; ZAMBIA;

ADULT; DIETARY SUPPLEMENTS; DOUBLE-BLIND METHOD; ENVIRONMENT; FEMALE; HIV INFECTIONS; HUMANS; INTESTINAL DISEASES; INTESTINAL MUCOSA; JEJUNUM; MALE; MICRONUTRIENTS; MIDDLE AGED; YOUNG ADULT; ZAMBIA;

EID: 84892543655     PISSN: None     EISSN: 1471230X     Source Type: Journal    
DOI: 10.1186/1471-230X-14-15     Document Type: Article

References (33)

1. Humphrey JH. Child undernutrition, tropical enteropathy, toilets, and handwashing. Lancet 2009, 374:1032-1035. 10.1016/S0140-6736(09)60950-8, 19766883.
2. Kelly P, Menzies I, Crane R, Zulu I, Nickols C, Feakins R, Mwansa J, Mudenda V, Katubulushi M, Greenwald S, Farthing M. Responses of small intestinal architecture and function over time to environmental factors in a tropical population. Am J Trop Med Hyg 2004, 70:412-419.
3. Veitch AM, Kelly P, Zulu IS, Segal I, Farthing MJ. Tropical enteropathy: a T-cell-mediated crypt hyperplastic enteropathy. Eur J Gastroenterol Hepatol 2001, 13:1175-1181. 10.1097/00042737-200110000-00009, 11711773.
4. Campbell DI, Elia M, Lunn PG. Growth faltering in rural Gambian infants is associated with impaired small intestinal barrier function, leading to endotoxemia and systemic inflammation. J Nutr 2003, 133:1332-1338.
5. Levine MM. Immunogenicity and efficacy of oral vaccines in developing countries: lessons from a live cholera vaccine. BMC Biol 2010, 8:129. 10.1186/1741-7007-8-129, 2958895, 20920375.
6. Prendergast A, Kelly P. Enteropathies in the developing world: neglected effects on global health. Am J Trop Med Hyg 2012, 86:756-763. 10.4269/ajtmh.2012.11-0743, 3335677, 22556071.
7. Paiardini M, Frank I, Pandrea I, Apetrei C, Silvestri G. Mucosal immune dysfunction in AIDS pathogenesis. AIDS Rev 2008, 10:36-46.
8. Trehan I, Shulman RJ, Ou C-N, Maleta K, Manary MJ. A randomized, double-blind, placebo-controlled trial of rifaximin, a nonabsorbable antibiotic, in the treatment of tropical enteropathy. Am J Gastroenterol 2009, 104:2326-2333. 10.1038/ajg.2009.270, 2758482, 19491826.
9. Galpin L, Manary MJ, Fleming K, Ou C-N, Ashorn P, Shulman RJ. Effect of lactobacillus GG on intestinal integrity in Malawian children at risk of tropical enteropathy. Am J Clin Nutr 2005, 82:1040-1045.
10. Williams EA, Elia M, Lunn PG. A double-blind, placebo-controlled, glutamine-supplementation trial in growth-faltering Gambian infants. Am J Clin Nutr 2007, 86:421-427.
11. Van der Merwe LF, Moore SE, Fulford AJ, Halliday KE, Drammeh S, Young S, Prentice AM. Long-chain PUFA supplementation in rural African infants: a randomized controlled trial of effects on gut integrity, growth, and cognitive development. Am J Clin Nutr 2013, 97:45-57. 10.3945/ajcn.112.042267, 3522138, 23221579.
12. Kelly P, Katubulushi M, Todd J, Banda R, Yambayamba V, Fwoloshi M, Zulu I, Kafwembe E, Yavwa F, Sanderson IR, Tomkins A. Micronutrient supplementation has limited effects on intestinal infectious disease and mortality in a Zambian population of mixed HIV status: a cluster randomized trial. Am J Clin Nutr 2008, 88:1010-1017. 2777266, 18842788.
13. Lukacik M, Thomas RL, Aranda JV. A meta-analysis of the effects of oral zinc in the treatment of acute and persistent diarrhea. Pediatrics 2008, 121:326-336. 10.1542/peds.2007-0921, 18245424.
14. Ghana VAST, Team S. Vitamin a supplementation in northern Ghana: effects on clinic attendances, hospital admissions, and child mortality. Ghana VAST Study Team. Lancet 1993, 342:7-12. 10.1016/0140-6736(93)91879-Q, 8100345.
15. Dhaliwal W, Shawa T, Khanam M, Jagatiya P, Simuyandi M, Ndulo N, Bevins CL, Sanderson IR, Kelly P. Intestinal antimicrobial gene expression: impact of micronutrients in malnourished adults during a randomized trial. J Infect Dis 2010, 202:971-978. 10.1086/655903, 3374852, 20695797.
16. Forrester JE, Sztam KA. Micronutrients in HIV/AIDS: is there evidence to change the WHO 2003 recommendations?. Am J Clin Nutr 2011, 94:1683S-1689S. 10.3945/ajcn.111.011999, 3226021, 22089440.
17. Semba RD, Tang AM. Micronutrients and the pathogenesis of human immunodeficiency virus infection. Br J Nutr 1999, 81:181-189. 10.1017/S0007114599000379, 10434844.
18. Irlam JH, Visser MM, Rollins NN, Siegfried N. Micronutrient supplementation in children and adults with HIV infection. Cochrane Database Syst Rev 2010, John Wiley & Sons, Ltd.
19. Baum MK, Campa A, Lai S, Sales Martinez S, Tsalaile L, Burns P, Farahani M, Li Y, van Widenfelt E, Page JB, Bussmann H, Fawzi WW, Moyo S, Makhema J, Thior I, Essex M, Marlink R. Effect of micronutrient supplementation on disease progression in asymptomatic, antiretroviral-naive, HIV-infected adults in Botswana: a randomized clinical trial. JAMA J Am Med Assoc 2013, 310:2154-2163.
20. Sazawal S, Black RE, Ramsan M, Chwaya HM, Stoltzfus RJ, Dutta A, Dhingra U, Kabole I, Deb S, Othman MK, Kabole FM. Effects of routine prophylactic supplementation with iron and folic acid on admission to hospital and mortality in preschool children in a high malaria transmission setting: community-based, randomised, placebo-controlled trial. Lancet 2006, 367:133-143. 10.1016/S0140-6736(06)67962-2, 16413877.
21. Department of Health - Committee on Medical Aspects of Food Policy Dietary Reference Values for Food Energy and Nutrients for the United Kingdom: Report of the Panel on Dietary Reference Values of the Committee on Medical Aspects of Food Policy 1991, 41. London: HMSO, Report on Health and Social Subjects, Department of Health - Committee on Medical Aspects of Food Policy.
22. Banda R, Yambayamba V, Lalusha BD, Sinkala E, Kapulu MC, Kelly P. Safety of live, attenuated oral vaccines in HIV-infected Zambian adults: oral vaccines in HIV. Vaccine 2012, 30:5656-5660. 10.1016/j.vaccine.2012.06.079, 3778926, 22789509.
23. Ferreira RC, Forsyth LE, Richman PI, Wells C, Spencer J, MacDonald TT. Changes in the rate of crypt epithelial cell proliferation and mucosal morphology induced by a T-cell-mediated response in human small intestine. Gastroenterology 1990, 98(5 Pt 1):1255-1263.
24. Lionetti P, Breese E, Braegger CP, Murch SH, Taylor J, MacDonald TT. T-cell activation can induce either mucosal destruction or adaptation in cultured human fetal small intestine. Gastroenterology 1993, 105:373-381.
25. MacDonald TT, Ferguson A. Hypersensitivity reactions in the small intestine. 2. Effects of allograft rejection on mucosal architecture and lymphoid cell infiltrate. Gut 1976, 17:81-91. 10.1136/gut.17.2.81, 1411080, 1083353.
26. Mowat AM, Felstein MV. Experimental studies of immunologically mediated enteropathy. V. Destructive enteropathy during an acute graft-versus-host reaction in adult BDF1 mice. Clin Exp Immunol 1990, 79:279-284. 10.1111/j.1365-2249.1990.tb05191.x, 1534741, 2138068.
27. Mowat AM, Felstein MV, Borland A, Parrott DM. Experimental studies of immunologically mediated enteropathy. Development of cell mediated immunity and intestinal pathology during a graft-versus-host reaction in irradiated mice. Gut 1988, 29:949-956. 10.1136/gut.29.7.949, 1433779, 3294125.
28. Fox J, Peters B, Prakash M, Arribas J, Hill A, Moecklinghoff C. Improvement in vitamin D deficiency following antiretroviral regime change: Results from the MONET trial. AIDS Res Hum Retroviruses 2011, 27:29-34. 10.1089/aid.2010.0081, 20854196.
29. Loignon M, Brodeur H, Deschênes S, Phaneuf D, Bhat PV, Toma E. Combination antiretroviral therapy and chronic HIV infection affect serum retinoid concentrations: longitudinal and cross-sectional assessments. AIDS Res Ther 2012, 9:3. 10.1186/1742-6405-9-3, 3305370, 22296672.
30. Ross AC. Vitamin A and retinoic acid in T cell-related immunity. Am J Clin Nutr 2012, 96:1166S-1172S. 10.3945/ajcn.112.034637, 3471201, 23053562.
31. Gentschew L, Ferguson LR. Role of nutrition and microbiota in susceptibility to inflammatory bowel diseases. Mol Nutr Food Res 2012, 56:524-535. 10.1002/mnfr.201100630, 22495981.
32. Hughes S, Kelly P. Interactions of malnutrition and immune impairment, with specific reference to immunity against parasites. Parasite Immunol 2006, 28:577-588. 1636690, 17042929.
33. Chuttani HK, Jain K, Misra RC. Small bowel in typhoid fever. Gut 1971, 12:709-712. 10.1136/gut.12.9.709, 1411789, 4999718.