Early-life malnutrition causes gastrointestinal dysmotility that is sexually dimorphic
Krishnakant G. Soni
Section of Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
Search for more papers by this authorPeace N. Dike
Section of Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
Search for more papers by this authorJi Ho Suh
Section of Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
Search for more papers by this authorTripti Halder
Section of Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
Search for more papers by this authorPrice T. Edwards
Section of Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
Search for more papers by this authorJaime P. P. Foong
Department of Physiology, The University of Melbourne, Parkville, Vic., Australia
Search for more papers by this authorMargaret E. Conner
Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
Search for more papers by this authorCorresponding Author
Geoffrey A. Preidis
Section of Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
Correspondence
Geoffrey A. Preidis, Pediatric Gastroenterology, Hepatology & Nutrition, Texas Children’s Hospital Feigin Tower, 1102 Bates Avenue, Suite 860, Houston, TX 77030, USA.
Email: [email protected]
Search for more papers by this authorKrishnakant G. Soni
Section of Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
Search for more papers by this authorPeace N. Dike
Section of Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
Search for more papers by this authorJi Ho Suh
Section of Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
Search for more papers by this authorTripti Halder
Section of Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
Search for more papers by this authorPrice T. Edwards
Section of Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
Search for more papers by this authorJaime P. P. Foong
Department of Physiology, The University of Melbourne, Parkville, Vic., Australia
Search for more papers by this authorMargaret E. Conner
Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
Search for more papers by this authorCorresponding Author
Geoffrey A. Preidis
Section of Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
Correspondence
Geoffrey A. Preidis, Pediatric Gastroenterology, Hepatology & Nutrition, Texas Children’s Hospital Feigin Tower, 1102 Bates Avenue, Suite 860, Houston, TX 77030, USA.
Email: [email protected]
Search for more papers by this authorAbstract
Background
Slow gastrointestinal (GI) transit occurs in moderate-to-severe malnutrition. Mechanisms underlying malnutrition-associated dysmotility remain unknown, partially due to lack of animal models. This study sought to characterize GI dysmotility in mouse models of malnutrition.
Methods
Neonatal mice were malnourished by timed maternal separation. Alternatively, low-protein, low-fat diet was administered to dams, with malnourished neonates tested at two weeks or weaned to the same chow and tested as young adults. We determined total GI transit time by carmine red gavage, colonic motility by rectal bead latency, and both gastric emptying and small bowel motility with fluorescein isothiocyanate-conjugated dextran. We assessed histology with light microscopy, ex vivo contractility and permeability with force-transduction and Ussing chamber studies, and gut microbiota composition by 16S rDNA sequencing.
Key Results
Both models of neonatal malnutrition and young adult malnourished males but not females exhibited moderate growth faltering, stunting, and grossly abnormal stomachs. Progression of fluorescent dye was impaired in both neonatal models of malnutrition, whereas gastric emptying was delayed only in maternally separated pups and malnourished young adult females. Malnourished young adult males but not females had atrophic GI mucosa, exaggerated intestinal contractile responses, and increased gut barrier permeability. These sex-specific abnormalities were associated with altered gut microbial communities.
Conclusions & Inferences
Multiple models of early-life malnutrition exhibit delayed upper GI transit. Malnutrition affects young adult males more profoundly than females. These models will facilitate future studies to identify mechanisms underlying malnutrition-induced pathophysiology and sex-specific regulatory effects.
CONFLICT OF INTEREST
No competing interests declared.
Supporting Information
Filename | Description |
---|---|
nmo13936-sup-0001-FigS1-S8.docxWord document, 5.6 MB | Fig S1-S8 |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
REFERENCES
- 1 Global Burden of Disease Risk Factor Collaborators, Forouzanfar MH, Alexander L,, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 386: 2287-2323.
- 2 United Nations Children's Fund (UNICEF), World Health Organization (WHO), The World Bank Group. Joint Child Malnutrition Estimates – Levels and Trends (2018 edition). Geneva: UNICEF-WHO-The World Bank Group; 2018.
- 3Guerrant RL, Oria RB, Moore SR, Oria MO, Lima AA. Malnutrition as an enteric infectious disease with long-term effects on child development. Nutr Rev. 2008; 66: 487-505.
- 4Velly H, Britton RA, Preidis GA. Mechanisms of cross-talk between the diet, the intestinal microbiome, and the undernourished host. Gut Microbes. 2017; 8: 98-112.
- 5Kowalski R. Roentgenologic studies of the alimentary tract in kwashiorkor. Am J Roentgenol Radium Ther Nucl Med. 1967; 100: 100-112.
- 6Redmond AO, Kaschula RO, Freeseman C, Hansen JD. The colon in kwashiorkor. Arch Dis Child. 1971; 46: 470-473.
- 7Viteri FE, Schneider RE. Gastrointestinal alterations in protein-calorie malnutrition. Med Clin North Am. 1974; 58: 1487-1505.
- 8Robel-Tillig E, Vogtmann C, Bennek J. Prenatal hemodynamic disturbances – pathophysiological background of intestinal motility disturbances in small for gestational age infants. Eur J Pediatr Surg. 2002; 12: 175-179.
- 9Robel-Tillig E, Knupfer M, Pulzer F, Vogtmann C. Blood flow parameters of the superior mesenteric artery as an early predictor of intestinal dysmotility in preterm infants. Pediatr Radiol. 2004; 34: 958-962.
- 10Dubois A, Gross HA, Ebert MH, Castell DO. Altered gastric emptying and secretion in primary anorexia nervosa. Gastroenterology. 1979; 77: 319-323.
- 11McCallum RW, Grill BB, Lange R, Planky M, Glass EE, Greenfeld DG. Definition of a gastric emptying abnormality in patients with anorexia nervosa. Dig Dis Sci. 1985; 30: 713-722.
- 12Stacher G, Kiss A, Wiesnagrotzki S, Bergmann H, Hobart J, Schneider C. Oesophageal and gastric motility disorders in patients categorised as having primary anorexia nervosa. Gut. 1986; 27: 1120-1126.
- 13Abell TL, Malagelada J-R, Lucas AR, et al. Gastric electromechanical and neurohormonal function in anorexia nervosa. Gastroenterology. 1987; 93: 958-965.
- 14Kamal N, Chami T, Andersen A, Rosell FA, Schuster MM, Whitehead WE. Delayed gastrointestinal transit times in anorexia nervosa and bulimia nervosa. Gastroenterology. 1991; 101: 1320-1324.
- 15Parkman HP, Yates KP, Hasler WL, et al. Dietary intake and nutritional deficiencies in patients with diabetic or idiopathic gastroparesis. Gastroenterology. 2011; 141(2): 486-498.
- 16Bharadwaj S, Meka K, Tandon P, et al. Management of gastroparesis-associated malnutrition. J Dig Dis. 2016; 17: 285-294.
- 17Byrne WJ, Cipel L, Euler AR, Halpin TC, Ament ME. Chronic idiopathic intestinal pseudo-obstruction syndrome in children–clinical characteristics and prognosis. J Pediatr. 1977; 90: 585-589.
- 18Goulet O, Talbotec C, Jan D, Ricour C. Nutritional management of pediatric patients with chronic intestinal pseudo-obstruction syndrome. J Pediatr Gastroenterol Nutr. 2001; 32(Suppl 1): S44-S47.
- 19Preidis GA, Keaton MA, Campeau PM, Bessard BC, Conner ME, Hotez PJ. The undernourished neonatal mouse metabolome reveals evidence of liver and biliary dysfunction, inflammation, and oxidative stress. J Nutr. 2014; 144: 273-281.
- 20Teodosio NR, Lago ES, Romani SA, Guedes RC. A regional basic diet from northeast Brazil as a dietary model of experimental malnutrition. Arch Latinoam Nutr. 1990; 40: 533-547.
- 21Maier EA, Weage KJ, Guedes MM, et al. Protein-energy malnutrition alters IgA responses to rotavirus vaccination and infection but does not impair vaccine efficacy in mice. Vaccine. 2013; 32: 48-53.
- 22Browning KN, Travagli RA. Central control of gastrointestinal motility. Curr Opin Endocrinol Diabetes Obes. 2019; 26: 11-16.
- 23Shin A, Preidis GA, Shulman R, Kashyap PC. The gut microbiome in adult and pediatric functional gastrointestinal disorders. Clin Gastroenterol Hepatol. 2019; 17: 256-274.
- 24Sanders KM, Koh SD, Ro S, Ward SM. Regulation of gastrointestinal motility–insights from smooth muscle biology. Nat Rev Gastroenterol Hepatol. 2012; 9: 633-645.
- 25Hoogerwerf WA. Role of clock genes in gastrointestinal motility. Am J Physiol Gastrointest Liver Physiol. 2010; 299: G549-G555.
- 26Preidis GA, Ajami NJ, Wong MC, Bessard BC, Conner ME, Petrosino JF. Composition and function of the undernourished neonatal mouse intestinal microbiome. J Nutr Biochem. 2015; 26: 1050-1057.
- 27Preidis GA, Ajami NJ, Wong MC, Bessard BC, Conner ME, Petrosino JF. Microbial-derived metabolites reflect an altered intestinal microbiota during catch-up growth in undernourished neonatal mice. J Nutr. 2016; 146: 940-948.
- 28Ueno PM, Oriá RB, Maier EA, et al. Alanyl-glutamine promotes intestinal epithelial cell homeostasis in vitro and in a murine model of weanling undernutrition. Am J Physiol Gastrointest Liver Physiol. 2011; 301: G612-G622.
- 29Soni KG, Halder T, Conner ME, Preidis GA. Sexual dimorphism in upper gastrointestinal motility is dependent on duration of fast, time of day, age, and strain of mice. Neurogastroenterol Motil. 2019; 31:e13654.
- 30Tasselli M, Chaumette T, Paillusson S, et al. Effects of oral administration of rotenone on gastrointestinal functions in mice. Neurogastroenterol Motil. 2013; 25: e183-e193.
- 31Gombash SE, Cowley CJ, Fitzgerald JA, et al. SMN deficiency disrupts gastrointestinal and enteric nervous system function in mice. Hum Mol Genet. 2015; 24: 3847-3860.
- 32Lichtenberger LM, Bhattarai D, Phan TM, Dial EJ, Uray K. Suppression of contractile activity in the small intestine by indomethacin and omeprazole. Am J Physiol Gastrointest Liver Physiol. 2015; 308: G785-G793.
- 33Chu J, Miller CT, Kislitsyna K, et al. Decreased myosin phosphatase target subunit 1(MYPT1) phosphorylation via attenuated rho kinase and zipper-interacting kinase activities in edematous intestinal smooth muscle. Neurogastroenterol Motil. 2012; 24(3): 257-266.
- 34Caporaso JG, Kuczynski J, Stombaugh J, et al. QIIME allows analysis of high-throughput community sequencing data. Nat Methods. 2010; 7: 335-336.
- 35Edgar RC. UPARSE: highly accurate OTU sequences from microbial amplicon reads. Nat Methods. 2013; 10: 996-998.
- 36Quast C, Pruesse E, Yilmaz P, et al. The SILVA ribosomal RNA gene database project: improved data processing and web-based tools. Nucleic Acids Res. 2013; 41: D590-D596.
- 37Genton L, Cani PD, Schrenzel J. Alterations of gut barrier and gut microbiota in food restriction, food deprivation and protein-energy wasting. Clin Nutr. 2015; 34: 341-349.
- 38Nicklas W, Bisgaard M, Aalbaek B, Kuhnert P, Christensen H. Reclassification of Actinobacillus muris as Muribacter muris gen. nov., comb. nov. Int J Syst Evol Microbiol. 2015; 65: 3344-3351.
- 39Little TJ, Horowitz M, Feinle-Bisset C. Modulation by high-fat diets of gastrointestinal function and hormones associated with the regulation of energy intake: implications for the pathophysiology of obesity. Am J Clin Nutr. 2007; 86: 531-541.
- 40Fu XY, Li Z, Zhang N, Yu HT, Wang SR, Liu JR. Effects of gastrointestinal motility on obesity. Nutr Metab (Lond). 2014; 11: 3.
- 41Baudry C, Reichardt F, Marchix J, et al. Diet-induced obesity has neuroprotective effects in murine gastric enteric nervous system: involvement of leptin and glial cell line-derived neurotrophic factor. J Physiol. 2012; 590: 533-544.
- 42Izzo AA, Piscitelli F, Capasso R, et al. Peripheral endocannabinoid dysregulation in obesity: relation to intestinal motility and energy processing induced by food deprivation and re-feeding. Br J Pharmacol. 2009; 158: 451-461.
- 43Tractenberg SG, Levandowski ML, de Azeredo LA, et al. An overview of maternal separation effects on behavioural outcomes in mice: Evidence from a four-stage methodological systematic review. Neurosci Biobehav Rev. 2016; 68: 489-503.
- 44Orso R, Wearick-Silva LE, Creutzberg KC, et al. Maternal behavior of the mouse dam toward pups: implications for maternal separation model of early life stress. Stress. 2018; 21: 19-27.
- 45Prusator DK, Greenwood-Van MB. Sex-related differences in pain behaviors following three early life stress paradigms. Biol Sex Differ. 2016; 7: 29.
- 46Chen TS, Doong ML, Chang FY, Lee SD, Wang PS. Effects of sex steroid hormones on gastric emptying and gastrointestinal transit in rats. Am J Physiol. 1995; 268: G171-G176.
- 47Shulman RJ, Jarrett ME, Cain KC, Broussard EK, Heitkemper MM. Associations among gut permeability, inflammatory markers, and symptoms in patients with irritable bowel syndrome. J Gastroenterol. 2014; 49: 1467-1476.
- 48Lang P, Hasselwander S, Li H, Xia N. Effects of different diets used in diet-induced obesity models on insulin resistance and vascular dysfunction in C57BL/6 mice. Sci Rep. 2019; 9: 19556.
- 49Boutari C, Pappas PD, Mintziori G, et al. The effect of underweight on female and male reproduction. Metabolism. 2020; 107: 154229.
- 50Chang L, Toner BB, Fukudo S, et al. Gender, age, society, culture, and the patient's perspective in the functional gastrointestinal disorders. Gastroenterology. 2006; 130: 1435-1446.
- 51Zia JK, Heitkemper MM. Upper gastrointestinal tract motility disorders in women, gastroparesis, and gastroesophageal reflux disease. Gastroenterol Clin North Am. 2016; 45: 239-251.
- 52France M, Skorich E, Kadrofske M, Swain GM, Galligan JJ. Sex-related differences in small intestinal transit and serotonin dynamics in high-fat-diet-induced obesity in mice. Exp Physiol. 2016; 101: 81-99.