Scientists Find Treatment for Gut Damage Affecting Up to 7 Million Children

Scientists have uncovered several promising treatment strategies for a condition affecting millions of children worldwide.

Environmental enteric dysfunction (EED) is a gut disorder affecting the small intestines. The condition is associated with inflammation, poor nutrient absorption and stunted growth in children.

“EED affects roughly 5 to 7 million children in low- and mid-income countries,” Ta-Chiang Liu, an associate professor in the Department of Pathology and Immunology at Washington University in St. Louis, told Newsweek.

The acquired condition is thought to be caused by malnutrition, although exactly which nutrients are involved is still unclear.

In a recent study published in the journal Science Translational Medicine, Liu and his colleagues assessed 15 children from Zambia with EED and identified a host of physiological changes associated with the condition. Among these were a loss of cells in the small intestine that play an essential role in the immune system, increased production of bile acid (digestive juices that promote the absorption of fats) and low levels of an essential molecule in energy metabolism called NAD+.

To examine potential treatments for EED, the team was able to re-create these physiological conditions inside mice by feeding them a low-protein diet. “Our manuscript shows that dietary protein is directly responsible for many of the gut pathology seen in children with EED,” Liu said.

However, there may be a genetic component too. “Our manuscript also found that a substantial number of EED children who do not respond to nutritional therapies carry mutations in the genes involved in making NAD+ in the body,” Liu said. “So those carriers when exposed to protein-insufficient diets are most likely to develop refractory [stubborn] EED.”

To mimic this genetic disposition in mice, the team removed the gene encoding an essential enzyme in the production of NAD+ from the mouse’s genome.

By studying these mouse models, the team found that supplementation with dietary protein and NAD+, as well as reducing the production of bile acids, was able to reverse the effects of this lab-induced EED.

More research is needed to confirm the efficacy of this approach in humans, but the team’s results offer hope to the millions of children suffering from this condition.

“We propose to use combinations of protein, a bile acid reducing drug—FDA approved for high cholesterolemia patients—and NAD+-boosting supplements for EED therapies,” Liu said. “We think the findings may [also] be relevant to other malnutrition-associated gut damage.”

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