Understanding the role of the gut in undernutrition: what can technology tell us?

Thompson, A. J., Bourke, C. D., Robertson, R. C., Shivakumar, N., Edwards, C. , Preston, T. , Holmes, E., Kelly, P., Frost, G. and Morrison, D. J. (2021) Understanding the role of the gut in undernutrition: what can technology tell us? Gut, 70, pp. 1580-1594. (doi: 10.1136/gutjnl-2020-323609) (PMID:34103403)

Abstract

Gut function remains largely under-investigated in undernutrition, despite its critical role in essential nutrient digestion, absorption and assimilation. In areas of high enteropathogen burden, alterations in gut barrier function and subsequent inflammatory effects are observable but remain poorly characterised. Environmental enteropathy (EE) – a condition that affects both gut morphology and function and is characterised by blunted villi, inflammation and increased permeability – is thought to play a role in impaired linear growth (stunting) and severe acute malnutrition. However, the lack of tools to quantitatively characterise gut functional capacity has hampered both our understanding of gut pathogenesis in undernutrition and evaluation of gut-targeted therapies to accelerate nutritional recovery. Here we survey the technology landscape for potential solutions to improve assessment of gut function, focussing on devices that could be deployed at point-of-care in low and middle income countries (LMICs). We assess the potential for technological innovation to assess gut morphology, function, barrier integrity and immune response in undernutrition and highlight the approaches that are currently most suitable for deployment and development. This article focuses on EE and undernutrition in LMICs, but many of these technologies may also become useful in monitoring of other gut pathologies.

• Item Type: Articles
• Additional Information: This work was undertaken as part of the HUNGer project (https://www.imperial.ac.uk/hunger-project/), which is funded by the UK’s Medical Research Council (MRC; award number MR/R019258/1). A.J.T. and G.F. were supported by the National Institute for Health Research (NIHR) Imperial Biomedical Research Centre (BRC; NIHR award number 1215-20013).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Preston, Professor Tom and Edwards, Professor Christine and Morrison, Dr Douglas
• Authors: Thompson, A. J., Bourke, C. D., Robertson, R. C., Shivakumar, N., Edwards, C., Preston, T., Holmes, E., Kelly, P., Frost, G., and Morrison, D. J.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing; College of Science and Engineering > Scottish Universities Environmental Research Centre
• Journal Name: Gut
• Publisher: BMJ Publishing Group
• ISSN: 0017-5749
• ISSN (Online): 1468-3288
• Published Online: 08 June 2021
• Copyright Holders: Copyright © Author(s) (or their employer(s)) 2021
• First Published: First published in Gut 70: 1580-1594
• Publisher Policy: Reproduced in accordance with the publisher copyright policy