# CHARACTERIZATION OF THE ROLE OF THE SMALL INTESTINAL MICROBIOTA IN THE PATHOGENESIS OF ENVIRONMENTAL ENTERIC DYSFUNCTION IN UNDERNOURISHED CHILDREN AND MOTHERS

> **NIH NIH F30** · WASHINGTON UNIVERSITY · 2022 · $32,686

## Abstract

ABSTRACT
Worldwide, one in five children under five years of age manifests undernutrition as impaired linear growth, or
stunting. Stunting, defined as having a length-for-age z-score (LAZ) < -2, is associated with poor developmental
outcomes, including impaired neurodevelopment and immune responses. Furthermore, stunting and its long-
term sequelae persist across generations, contributing to an intergenerational cycle of undernutrition. Existing
nutritional interventions fail to substantially improve stunting, highlighting the need to (i) better understand other
factors contributing to stunting and (ii) focus clinical efforts towards treating maternal undernutrition in order to
break the cycle of intergenerational undernutrition. In recent years, a subclinical disorder called environmental
enteric dysfunction (EED) has been suggested to contribute to 45% of childhood stunting globally. EED is an
inflammatory enteropathy localized to the small intestine; it is characterized histologically by loss of villi and
absorptive surface area, epithelial barrier dysfunction, and an immunoinflammatory infiltrate in the lamina
propria. While the pathogenesis of EED is poorly understood, researchers have postulated a role for enteric
microorganisms. However, the small intestinal microbiota remains largely understudied, in part due to challenges
in gaining access to samples. Moreover, few experimental models of EED exist, none of which account for the
intergenerational nature of undernutrition.
I hypothesize that perturbations in the small intestinal microbiota play a causal role in the pathogenesis
of EED and consequently undernutrition that persists across generations. To test this hypothesis, the first
aim of this proposal will use gnotobiotic mice to characterize the transmissibility of enteropathy and growth
faltering by the small intestinal microbiota of Bangladeshi children and women with evidence of EED based on
histopathology of their duodenal biopsies. Collections of sequenced bacterial strains, cultured from duodenal
aspirates obtained from these stunted children and malnourished women (BMI<18.5 kg/m2) will be introduced
into young germ-free mice. I will characterize host pathology by performing immune cell profiling, protein
immunoassays, and transcriptional profiling (whole tissue and single cell). Microbial community structure will be
quantified by shotgun sequencing of community DNA, and expressed community functions by microbial RNA-
Seq. In parallel, I will establish a novel model of intergenerational undernutrition by introducing these microbia l
communities into germ-free dams and assessing the pathology in dams and their pups. The second aim will test
prevention and/or treatment of enteropathy in the gnotobiotic mouse models through introduction of duodenal
bacterial communities derived from healthy Bangladeshi women (with normal BMI). Prevention or amelioration
of enteropathy by duodenal bacterial communities from healthy women will allow f...

## Key facts

- **NIH application ID:** 10463019
- **Project number:** 1F30DK132805-01
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Clara Kao
- **Activity code:** F30 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $32,686
- **Award type:** 1
- **Project period:** 2022-02-01 → 2025-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10463019

## Citation

> US National Institutes of Health, RePORTER application 10463019, CHARACTERIZATION OF THE ROLE OF THE SMALL INTESTINAL MICROBIOTA IN THE PATHOGENESIS OF ENVIRONMENTAL ENTERIC DYSFUNCTION IN UNDERNOURISHED CHILDREN AND MOTHERS (1F30DK132805-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10463019. Licensed CC0.

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