一則對(duì)馬拉維的年幼雙胞胎的研究揭示,，一種叫做夸休可爾癥（kwashiorkor）的嚴(yán)重,、急性形式的營(yíng)養(yǎng)不良與某些腸道細(xì)菌有關(guān),，而不是僅僅與營(yíng)養(yǎng)有關(guān),。這些結(jié)果表明，對(duì)世界上某些營(yíng)養(yǎng)不良的兒童來(lái)說(shuō),，僅僅讓他們攝入更多的卡路里將不足以讓他們變得健康,。更令人樂(lè)觀的是，在一則相關(guān)的《觀點(diǎn)欄目》中,，David Relman寫(xiě)道,，這些發(fā)現(xiàn)“帶來(lái)了希望，即通過(guò)理解腸道微生物群在營(yíng)養(yǎng)不足中所扮演的作用,，我們可以設(shè)計(jì)新的受到生態(tài)學(xué)啟發(fā)的策略來(lái)糾正這一問(wèn)題,。”
不幸的是,，營(yíng)養(yǎng)不良在馬拉維是常見(jiàn)的，而夸休可爾癥的病兒除了消瘦外還會(huì)有水腫,、肝損害,、皮膚潰瘍及厭食癥等問(wèn)題。Michelle Smith及其同事對(duì)馬拉維的317對(duì)雙胞胎進(jìn)行了研究,，研究的時(shí)間為雙胞胎長(zhǎng)到3歲以前的這段時(shí)間,。在這一時(shí)期中，有一半的雙胞胎保持著良好的營(yíng)養(yǎng)狀態(tài),，而在其他的雙胞胎中,，他們中有一人或兩人出現(xiàn)了夸休可爾癥?；加性摷不嫉暮⒆蛹八麄兊碾p胞胎按照標(biāo)準(zhǔn)護(hù)理給予了以花生為基礎(chǔ)的治療性食療,。對(duì)他們腸道微生物群的隨著時(shí)間推移而做的研究揭示，嚴(yán)重營(yíng)養(yǎng)不良的孩子有著不同的微生物概貌,，而該微生物概貌在治療過(guò)程中會(huì)日趨與營(yíng)養(yǎng)狀態(tài)良好的孩子的微生物概貌相似,。然而，當(dāng)治療停止時(shí),，其微生物組合會(huì)回復(fù)至其較早前的狀態(tài),。為了做進(jìn)一步的調(diào)查，研究人員將每位健康及患病雙胞胎的糞便菌群轉(zhuǎn)移到無(wú)菌小鼠的體內(nèi),。那些接受了夸休可爾癥雙胞胎腸道微菌群的小鼠會(huì)像有這種腸道微菌群的人類一樣出現(xiàn)營(yíng)養(yǎng)不良的癥狀,。盡管夸休可爾癥患者的腸道微菌群一般在飲食治療時(shí)會(huì)成熟，但它會(huì)在恢復(fù)當(dāng)?shù)卮迩f飲食時(shí)又回復(fù)到夸休可爾癥時(shí)的狀態(tài),。代謝概貌的變化及異常硫代謝的跡象伴隨著這些微生物組成的改變,。（生物谷Bioon.com）
DOI: 10.1126/science.1229000
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Gut Microbiomes of Malawian Twin Pairs Discordant for Kwashiorkor
M.I. Smith; T. Yatsunenko; M.J. Manary; I. Trehan; J. Cheng; A.L. Kau; J.I. Gordon at Washington University in St. Louis in St. Louis, MO; M.J. Manary; I. Trehan at University of Malawi College of Medicine in Blantyre, Malawi; M.J. Manary at U.S. Department of Agriculture Children’s Nutrition Research Center in Houston, TX; M.J. Manary at Baylor College of Medicine in Houston, TX; R. Mkakosya at University of Malawi in Chichiri, Malawi; S.S. Rich; P. Concannon; J.C. Mychaleckyj; J. Liu; E. Houpt at University of Virginia in Charlottesville, VA; J.V. Li; E. Holmes; J. Nicholson at Imperial College London in London, UK; D. Knights; L.K. Ursell; R. Knight at University of Colorado in Boulder, CO; R. Knight at Howard Hughes Medical Institute in Boulder, CO; D. Knights at University of Minnesota in Minneapolis, MN; D. Knights at University of Minnesota in Saint Paul, MN.
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.
