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Hossain MS, Das S, Gazi MA, Alam MA, Haque NMS, Mahfuz M, Ahmed T, Damman CJ. Association of faecal pH with childhood stunting: Results from a cross-sectional study. BMJ Paediatr Open 2019; 3:e000549. [PMID: 31646200 PMCID: PMC6782033 DOI: 10.1136/bmjpo-2019-000549] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/19/2019] [Accepted: 08/21/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Gut microbiota plays an important role in the growth of children. The gut of children with optimum growth is enriched in certain species, especially Bifidobacteria and Clostridia. Bifidobacteria and commensal Clostridia both contribute to formation of acidic stool, and an elevated faecal pH indicates reduction of these species in the gut. The purpose of the study was to investigate the association of faecal pH with childhood stunting. METHODS In this cross-sectional study, 100 children with length-for-age Z score (LAZ) <-1 aged between 12 and 18 months were enrolled from the ongoing Bangladesh Environmental Enteric Dysfunction study conducted in Dhaka, Bangladesh. LAZ was measured by anthropometry and data on factors affecting linear growth were recorded. Faecal pH measurement was done using pH metre on freshly collected non-diarrhoeal faecal samples following standard procedure. Multiple quantile regression was done to quantify the relation between faecal pH and LAZ scores. RESULTS The mean LAZ and faecal pH of the children were -2.12±0.80 and 5.84±1.11, respectively. Pearson correlation analysis showed a statistically significant negative correlation between stool pH and the LAZ scores (p<0.01). After inclusion of other factors affecting linear growth into the regression model, a statistically significant inverse association was observed between faecal pH and LAZ score (p<0.01). CONCLUSION Elevated faecal pH was found to have a significant association with stunted growth. As an indicator of gut microbiota status, faecal pH might have emerged as a possible indirect determinant of childhood stunting. TRIAL REGISTRATION NUMBER NCT02812615.
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Affiliation(s)
- Md. Shabab Hossain
- Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | - Subhasish Das
- Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | - Md. Amran Gazi
- Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | - Md. Ashraful Alam
- Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | - Nur Muhammad Shahedul Haque
- Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | - Mustafa Mahfuz
- Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | - Chris J Damman
- Division of Gastroenterology, University of Washington, Seattle, Washington, USA
- Bill and Melinda Gates Foundation, Seattle, Washington, USA
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Vindigni SM, Taylor J, Quilter LAS, Hyun TS, Liu C, Rosinski SL, Rakita RM, Fredricks DN, Damman CJ. Tropheryma whipplei infection (Whipple's disease) in a patient after liver transplantation. Transpl Infect Dis 2016; 18:617-24. [PMID: 27258480 DOI: 10.1111/tid.12562] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 02/05/2016] [Accepted: 04/03/2016] [Indexed: 01/01/2023]
Abstract
Whipple's disease (WD) is a rare infection caused by the bacterium Tropheryma whipplei that can affect multiple organs and most commonly occurs in the immunocompetent host. Only 3 cases of WD have been reported in the setting of immunosuppression for organ transplantation. Here, we report the first case of WD, to our knowledge, in a patient after liver transplantation with comorbid graft-versus-host-disease. We discuss the diagnostic challenges in this setting and the value of electron microscopy and in situ hybridization methods for confirming the infection. WD may be under-diagnosed in immunosuppressed transplant patients because the disease can present with atypical clinical and histological features that suggest other conditions.
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Affiliation(s)
- S M Vindigni
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - J Taylor
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - L A S Quilter
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - T S Hyun
- Department of Pathology, University of Washington, Seattle, Washington, USA.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - C Liu
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - S L Rosinski
- Seattle Cancer Care Alliance, Seattle, Washington, USA
| | - R M Rakita
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - D N Fredricks
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - C J Damman
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington, USA.,Gastroenterology/Hepatology Section, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
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Abstract
This review details potential mechanisms linking gut dysbiosis to metabolic dysfunction, including lipopolysaccharide, bile acids, short chain fatty acids, gut hormones, and branched-chain amino acids.
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Affiliation(s)
- Kristina M Utzschneider
- Division of Metabolism, Endocrinology and Nutrition (K.M.U.), Department of Medicine, VA Puget Sound Health Care System and the University of Washington, Seattle, Washington; Division of Public Health Sciences (M.K.), Fred Hutchinson Cancer Research Center, and the Department of Epidemiology, University of Washington, Seattle, Washington; Division of Gastroenterology (C.J.D.), Department of Medicine, University of Washington, Seattle, Washington; and Division of Public Health Sciences (M.H.), Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Mario Kratz
- Division of Metabolism, Endocrinology and Nutrition (K.M.U.), Department of Medicine, VA Puget Sound Health Care System and the University of Washington, Seattle, Washington; Division of Public Health Sciences (M.K.), Fred Hutchinson Cancer Research Center, and the Department of Epidemiology, University of Washington, Seattle, Washington; Division of Gastroenterology (C.J.D.), Department of Medicine, University of Washington, Seattle, Washington; and Division of Public Health Sciences (M.H.), Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Chris J Damman
- Division of Metabolism, Endocrinology and Nutrition (K.M.U.), Department of Medicine, VA Puget Sound Health Care System and the University of Washington, Seattle, Washington; Division of Public Health Sciences (M.K.), Fred Hutchinson Cancer Research Center, and the Department of Epidemiology, University of Washington, Seattle, Washington; Division of Gastroenterology (C.J.D.), Department of Medicine, University of Washington, Seattle, Washington; and Division of Public Health Sciences (M.H.), Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Meredith Hullar
- Division of Metabolism, Endocrinology and Nutrition (K.M.U.), Department of Medicine, VA Puget Sound Health Care System and the University of Washington, Seattle, Washington; Division of Public Health Sciences (M.K.), Fred Hutchinson Cancer Research Center, and the Department of Epidemiology, University of Washington, Seattle, Washington; Division of Gastroenterology (C.J.D.), Department of Medicine, University of Washington, Seattle, Washington; and Division of Public Health Sciences (M.H.), Fred Hutchinson Cancer Research Center, Seattle, Washington
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Abstract
The conserved cp32 plasmid family of Borrelia burgdorferi was recently shown to be packaged into a bacteriophage particle (C. H. Eggers and D. S. Samuels, J. Bacteriol. 181:7308-7313, 1999). This plasmid encodes BlyA, a 7.4-kDa membrane-interactive protein, and BlyB, an accessory protein, which were previously proposed to comprise a hemolysis system. Our genetic and biochemical evidence suggests that this hypothesis is incorrect and that BlyA and BlyB function instead as a prophage-encoded holin or holin-like system for this newly described bacteriophage. An Escherichia coli mutant containing the blyAB locus that was defective for the normally cryptic host hemolysin SheA was found to be nonhemolytic, suggesting that induction of sheA by blyAB expression was responsible for the hemolytic activity observed previously. Analysis of the structural features of BlyA indicated greater structural similarity to bacteriophage-encoded holins than to hemolysins. Consistent with holin characteristics, subcellular localization studies with E. coli and B. burgdorferi indicated that BlyA is solely membrane associated and that BlyB is a soluble protein. Furthermore, BlyA exhibited a holin-like function by promoting the endolysin-dependent lysis of an induced lambda lysogen that was defective in the holin gene. Finally, induction of the cp32 prophage in B. burgdorferi dramatically stimulated blyAB expression. Our results provide the first evidence of a prophage-encoded holin within Borrelia.
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Affiliation(s)
- C J Damman
- Department of Molecular Biology and Biochemistry, Wesleyan University, Middletown, Connecticut 06459, USA
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Eggers CH, Casjens S, Hayes SF, Garon CF, Damman CJ, Oliver DB, Samuels DS. Bacteriophages of spirochetes. J Mol Microbiol Biotechnol 2000; 2:365-73. [PMID: 11075907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
Historically, a number of bacteriophage-like particles have been observed in association with members of the bacterial order Spirochetales, the spirochetes. In the last decade, several spirochete bacteriophages have been isolated and characterized at the molecular level. We have recently characterized a bacteriophage of the Lyme disease agent, Borrelia burgdorferi, which we have designated phiBB-1. Here we review the history of the association between the spirochetes and their bacteriophages, with a particular emphasis on phiBB-1 and its prophage, the 32-kb circular plasmid family of B. burgdorferi.
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Affiliation(s)
- C H Eggers
- Division of Biological Sciences, The University of Montana, Missoula 59812, USA
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