Gut microbiomes of Malawian twin pairs discordant for kwashiorkor.

TitleGut microbiomes of Malawian twin pairs discordant for kwashiorkor.
Publication TypeJournal Article
Year of Publication2013
AuthorsSmith MI, Yatsunenko T, Manary MJ, Trehan I, Mkakosya R, Cheng J, Kau AL, Rich SS, Concannon P, Mychaleckyj JC, Liu J, Houpt E, Li JV, Holmes E, Nicholson J, Knights D, Ursell LK, Knight R, Gordon JI
Date Published2013 Feb 1
KeywordsAmino Acids, Animals, Arachis hypogaea, Carbohydrate Metabolism, Child, Preschool, Diseases in Twins, Feces, Female, Gastrointestinal Tract, Germ-Free Life, Humans, Infant, Kwashiorkor, Longitudinal Studies, Malawi, Male, Metagenome, Mice, Mice, Inbred C57BL

Kwashiorkor, an enigmatic form of severe acute malnutrition, is the consequence of inadequate nutrient intake plus additional environmental insults. To investigate the role of the gut microbiome, we studied 317 Malawian twin pairs during the first 3 years of life. During this time, half of the twin pairs remained well nourished, whereas 43% became discordant, and 7% manifested concordance for acute malnutrition. Both children in twin pairs discordant for kwashiorkor were treated with a peanut-based, ready-to-use therapeutic food (RUTF). Time-series metagenomic studies revealed that RUTF produced a transient maturation of metabolic functions in kwashiorkor gut microbiomes that regressed when administration of RUTF was stopped. Previously frozen fecal communities from several discordant pairs were each transplanted into gnotobiotic mice. The combination of Malawian diet and kwashiorkor microbiome produced marked weight loss in recipient mice, accompanied by perturbations in amino acid, carbohydrate, and intermediary metabolism that were only transiently ameliorated with RUTF. These findings implicate the gut microbiome as a causal factor in kwashiorkor.

Alternate JournalScience
PubMed ID23363771