Serum anti-flagellin and anti-lipopolysaccharide immunoglobulins as predictors of linear growth faltering in Pakistani infants at risk for environmental enteric dysfunction
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Author
Syed, Sana
Iqbal, Najeeha T.
Sadiq, Kamran
Ma, Jennie Z.
Akhund, Tauseef
Xin, Wenjun
Moore, Sean R.
Liu, Enju
Qureshi, Shahida
Gosselin, Kerri
Gewirtz, Andrew
Ali, S. Asad
Note: Order does not necessarily reflect citation order of authors.
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https://doi.org/10.1371/journal.pone.0193768Metadata
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Syed, S., N. T. Iqbal, K. Sadiq, J. Z. Ma, T. Akhund, W. Xin, S. R. Moore, et al. 2018. “Serum anti-flagellin and anti-lipopolysaccharide immunoglobulins as predictors of linear growth faltering in Pakistani infants at risk for environmental enteric dysfunction.” PLoS ONE 13 (3): e0193768. doi:10.1371/journal.pone.0193768. http://dx.doi.org/10.1371/journal.pone.0193768.Abstract
Background: Environmental Enteric Dysfunction (EED) in children from low-income countries has been linked to linear growth declines. There is a critical need to identify sensitive and early EED biomarkers. Objective: Determine whether levels of antibodies against bacterial components flagellin (flic) and lipopolysaccharide (LPS) predict poor growth. Design/Methods In a prospective birth cohort of 380 children in rural Pakistan blood and stool samples were obtained at ages 6 and 9 months. Linear mixed effects models were used to examine longitudinal associations between quartiles of anti-flic and anti-LPS antibodies and changes in LAZ, WAZ and WLZ scores. Spearman’s correlations were measured between anti-flic and anti-LPS immunoglobulins with measures of systemic/enteric inflammation and intestinal regeneration. Results: Anti-LPS IgA correlated significantly with CRP, AGP and Reg1 serum at 6mo and with MPO at 9mo. In multivariate analysis at 6mo of age, higher anti-LPS IgA levels predicted greater declines in LAZ scores over subsequent 18mo (comparing highest to lowest quartile, β (SE) change in LAZ score/year = -0.313 (0.125), p-value = 0.013). Anti-flic Ig A in the two highest quartiles measured at 9mo of age had declines in LAZ of -0.269 (0.126), p = 0.033; and -0.306 (0.129), p = 0.018 respectively, during the subsequent 18mo of life, compared to those in the lowest quartile of anti-flic IgA. Conclusions and relevance Elevated anti-flic IgA and anti-LPS IgA antibodies at 6 and 9mo, predict declines in linear growth. Systemic and enteric inflammation correlated with anti-LPS IgA provides mechanistic considerations for potential future interventions.Other Sources
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839587/pdf/Terms of Use
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