ArticleProceedings of the National Academy of Sciences of the United States of America2022
Stunted children display ectopic small intestinal colonization by oral bacteria, which cause lipid malabsorption in experimental models.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed, 43 citations in OpenAlex.
- Salivary Microbiome Differences in Stunted and Healthy Children: A Metagenomic Analysis.European journal of dentistry · 2026Article
- Beyond malaria prevention: sulfadoxine-pyrimethamine treatment in pregnancy selectively remodels the maternal gut microbiome to increase gestational weight gain and improve birthweight.medRxiv : the preprint server for health sciences · 2026Article
- Segmented filamentous bacteria are worldwide human gut commensals.Nature communications · 2026Article
- Socioeconomic and nutritional determinants outweigh gut microbiota influence on neurodevelopment in young children from Antananarivo, Madagascar.Scientific reports · 2026Article
- Oral microbiota-driven immune modulation along the oral-gut axis: from local signals to systemic inflammation.NPJ biofilms and microbiomes · 2026Review
- Small intestinal microbiome, the underrated maestro of SIMO disease.FEMS microbiology reviews · 2026Review
- Effects of intergenerational transmission of small intestinal bacteria cultured from stunted Bangladeshi children with enteropathy.bioRxiv : the preprint server for biology · 2025Article
- Bile acid dysmetabolism in Bangladeshi infants associated with poor linear growth, enteric inflammation, and small intestine bacterial overgrowth.World journal of gastroenterology · 2025Article
- One Health, One Microbiome.Microbiome · 2025Review
- A newborn derived monoclonal IgM antibody selectively modulates microbial metabolism in the gut.Nature communications · 2025Article
- Impact of prenatal drought exposures on under-5 childhood stunting in 32 low-and-middle-income countries: a global analysis using demographic and health survey.Environmental health : a global access science source · 2025Article
- Article
- Delving the depths of 'terra incognita' in the human intestine - the small intestinal microbiota.Nature reviews. Gastroenterology & hepatology · 2025Review
- The forgotten link: how the oral microbiome shapes childhood growth and development.Frontiers in oral health · 2025Review
- Small Intestinal Bacterial Overgrowth and Childhood Malnutrition: A Comprehensive Review of Available Evidence.Nutrients · 2024Review
- Current Understanding ofCurrent tropical medicine reports · 2024Article
- Small Intestine Bacterial Overgrowth is associated with increased Campylobacter and epithelial injury in duodenal biopsies of Bangladeshi children.PLoS neglected tropical diseases · 2024Article
- Ectopic colonization by oral bacteria as an emerging theme in health and disease.FEMS microbiology reviews · 2024Review
- Novel gastrointestinal tools (GI Tools) for evaluating gut functional capacity in adults with environmental enteropathy in Zambia and Zimbabwe: A cross-sectional study protocol.F1000Research · 2024Article
- Gut microbiomes of agropastoral children from the Adadle region of Ethiopia reflect their unique dietary habits.Scientific reports · 2023Article
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Authors and funding
22 authors at 7 institutions in 7 countries.
Funding
Abstract
Environmental enteric dysfunction (EED) is an inflammatory syndrome postulated to contribute to stunted child growth and to be associated with intestinal dysbiosis and nutrient malabsorption. However, the small intestinal contributions to EED remain poorly understood. This study aimed to assess changes in the proximal and distal intestinal microbiota in the context of stunting and EED and to test for a causal role of these bacterial isolates in the underlying pathophysiology. We performed a cross-sectional study in two African countries recruiting roughly 1,000 children aged 2 to 5 years and assessed the microbiota in the stomach, duodenum, and feces. Upper gastrointestinal samples were obtained from stunted children and stratified according to stunting severity. Fecal samples were collected. We then investigated the role of clinical isolates in EED pathophysiology using tissue culture and animal models. We find that small intestinal bacterial overgrowth (SIBO) is extremely common (>80%) in stunted children. SIBO is frequently characterized by an overgrowth of oral bacteria, leading to increased permeability and inflammation and to replacement of classical small intestinal strains. These duodenal bacterial isolates decrease lipid absorption in both cultured enterocytes and mice, providing a mechanism by which they may exacerbate EED and stunting. Further, we find a specific fecal signature associated with the EED markers fecal calprotectin and alpha-antitrypsin. Our study shows a causal implication of ectopic colonization of oral bacterial isolated from the small intestine in nutrient malabsorption and gut leakiness in vitro. These findings have important therapeutic implications for modulating the microbiota through microbiota-targeted interventions.
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