美国华盛顿大学医学院Jeffrey I. Gordon团队研究了针对营养不良儿童进行微生物导向食品干预的效果。2021年4月7日，该研究发表在《新英格兰医学杂志》上。

全世界有3000多万儿童患有中度急性营养不良。现有治疗效果有限，关于这种疾病的发病机制仍不清楚，但中度急性营养不良的儿童肠道微生物群发育紊乱。

在这项研究中，研究组在孟加拉国贫民窟招募了123名12至18个月、患有中度急性营养不良的婴儿，并向其提供了一种微生物群导向的补充食品原型（MDCF-2）或即用补充食品（RUSF）。每天补充两次，持续3个月，然后进行1个月的监测。

研究组分别在基线检查时、干预期间每2周和4个月时检测患儿的体重身长、体重年龄、身长年龄的z评分以及中上臂围值。比较这些相关表型在基线和3个月之间以及基线和4个月之间的变化率。研究组还检测了血浆中4977种蛋白质水平和粪便样本中209种细菌的水平。

共有118名幼儿（每个研究组59名）完成了干预。在整个研究过程中（包括1个月的随访），体重身高和体重年龄z评分的变化率与MDCF-2对生长的益处保持一致。接受MDCF-2与70个血浆蛋白和21个相关细菌类群的水平变化幅度有关，这些类群与体重身高z评分呈正相关。这些蛋白质包括骨生长和神经发育的介质。

该研究结果支持MDCF-2可作为中度急性营养不良幼儿的膳食补充剂。

附：英文原文

Title: A Microbiota-Directed Food Intervention for Undernourished Children

Author: Robert Y. Chen, B.S.,, Ishita Mostafa, B.D.S., M.P.H.,, Matthew C. Hibberd, Ph.D.,, Subhasish Das, M.B., B.S., M.P.H.,, Mustafa Mahfuz, M.B., B.S., M.P.H.,, Nurun N. Naila, M.B., B.S., M.P.H.,, M. Munirul Islam, M.B., B.S., Ph.D.,, Sayeeda Huq, M.B., B.S., M.P.H.,, M. Ashraful Alam, M.P.H.,, Mahabub U. Zaman, M.P.H.,, Arjun S. Raman, M.D., Ph.D.,, Daniel Webber, M.D., Ph.D.,, Cyrus Zhou, B.S.,, Vinaik Sundaresan, B.S.,, Kazi Ahsan, M.B., B.S., M.P.H.,, Martin F. Meier, B.S.,, Michael J. Barratt, Ph.D.,, Tahmeed Ahmed, M.B., B.S., Ph.D.,, and Jeffrey I. Gordon, M.D.

Issue&Volume: 2021-04-07

Abstract:

BACKGROUND

More than 30 million children worldwide have moderate acute malnutrition. Current treatments have limited effectiveness, and much remains unknown about the pathogenesis of this condition. Children with moderate acute malnutrition have perturbed development of their gut microbiota.

METHODS

In this study, we provided a microbiota-directed complementary food prototype (MDCF-2) or a ready-to-use supplementary food (RUSF) to 123 slum-dwelling Bangladeshi children with moderate acute malnutrition between the ages of 12 months and 18 months. The supplementation was given twice daily for 3 months, followed by 1 month of monitoring. We obtained weight-for-length, weight-for-age, and length-for-age z scores and mid–upper-arm circumference values at baseline and every 2 weeks during the intervention period and at 4 months. We compared the rate of change of these related phenotypes between baseline and 3 months and between baseline and 4 months. We also measured levels of 4977 proteins in plasma and 209 bacterial taxa in fecal samples.

RESULTS

A total of 118 children (59 in each study group) completed the intervention. The rates of change in the weight-for-length and weight-for-age z scores are consistent with a benefit of MDCF-2 on growth over the course of the study, including the 1-month follow-up. Receipt of MDCF-2 was linked to the magnitude of change in levels of 70 plasma proteins and of 21 associated bacterial taxa that were positively correlated with the weight-for-length z score (P<0.001 for comparisons of both protein and bacterial taxa). These proteins included mediators of bone growth and neurodevelopment.

CONCLUSIONS

These findings provide support for MDCF-2 as a dietary supplement for young children with moderate acute malnutrition and provide insight into mechanisms by which this targeted manipulation of microbiota components may be linked to growth.

DOI: 10.1056/NEJMoa2023294

Source: https://www.nejm.org/doi/full/10.1056/NEJMoa2023294