Gut Microbiomes of Malawian Twin Pairs Discordant for Kwashiorkor
Open accessAbstract
Not Just Wasting: Malnutrition is well known in Malawi, including a severe form—kwashiorkor—in which children do not simply waste away, they also suffer edema, liver damage, skin ulceration, and anorexia. Smith et al. (p. 548 ; see the Perspective by Relman ) investigated the microbiota of pairs of twins in Malawian villages and found notable differences in the composition of the gut microbiota in children with kwashiorkor. In these children, a bacterial species related to Desulfovibrio , which has been associated with bowel disease and inflammation, was noticeable. When the fecal flora from either the healthy or the sick twin was transplanted into groups of germ-free mice, the mice that received the kwashiorkor sample started to lose weight, like their human counterpart.
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Giving these mice a peanut-based ready-to-use therapeutic food led to a brief rise in weight and a return of their microbiota toward normal.
“when the mice are fed a peanut-based, ‘ready-to-use’ therapeutic food, their weight transiently increases and their microbiota normalize115.”
From Diet–microbiota interactions as moderators of human metabolism (2016) · cites this paper as [115]
When germ-free mice carrying a kwashiorkor-associated microbiota ate a standard Malawian diet of tomatoes and corn, they lost weight.
“germ-free mice that have been colonized with a ‘kwashiorkor’ microbiota experience weight loss when they are fed a typical Malawian diet, which is based on tomatoes and corn.”
From Diet–microbiota interactions as moderators of human metabolism (2016) · cites this paper as [115]
The gut microbiotas of twin pairs differing in kwashiorkor status are different.
“Twins that are discordant for kwashiorkor have distinct microbiotas”
From Diet–microbiota interactions as moderators of human metabolism (2016) · cites this paper as [115]
Several diet-induced host phenotypes are sufficiently mediated by changes in the gut microbiota.
“For example, several diet-induced host phenotypes are sufficiently mediated by changes in the gut microbiota (85–88).”
From Emerging Roles for the Gut Microbiome in Autism Spectrum Disorder (2017) · cites this paper as [86]
The gut microbiota and microbiome help extract and metabolize dietary ingredients.
“The microbiota/microbiome in turn plays an important role in extracting and metabolizing dietary ingredients9-14.”
From Persistent gut microbiota immaturity in malnourished Bangladeshi children (2014) · cites this paper as [12]
Food is a major determinant of the proportional representation of organisms in the gut microbiota and of its gene content.
“Food is a major factor that shapes the proportional representation of organisms present in the gut microbial community (microbiota), and its gene content (microbiome).”
From Persistent gut microbiota immaturity in malnourished Bangladeshi children (2014) · cites this paper as [12]
Studies using germ-free mice confirmed the role of the gut microbiome in obesity, Kwashiorkor, and autism-spectrum disorder by inducing disease features in recipient animals following transfer of a patient-associated microbiome.
“Seminal studies using germ‐free mice confirmed the role of the gut microbiome in a number of diseases, including obesity,47 Kwashiorkor,48 and autism‐spectrum disorder,49 by inducing disease features in recipient animals following transfer of a patient‐associated microbiome.”
From The oral microbiome: Role of key organisms and complex networks in oral health and disease (2021) · cites this paper as [48]
Animal data suggest that the "fasting" microbiome contributes to malnourishment in the host, as a microbial transplant from individuals with Kwashiorkor induced weight loss and altered protein and carbohydrate metabolism in recipient mice.
“Importantly, animal data further suggest that this “fasting” microbiome also contributes to malnourishment in the host, as a microbial transplant from individuals with Kwashiorkor (a form of severe protein-energy malnutrition) induced weight loss and altered protein and carbohydrate metabolism in the recipient mice [77].”
Transfer of fecal samples from undernourished children to germ-free mice elicited metabolic and immune dysregulations in the mouse model similar to those observed in the human host, suggesting that manifestations of malnutrition could in part be attributed to the absence of certain beneficial microbes.
“Transfer of fecal samples from undernourished children to GF mice elicited metabolic and immune dysregulations in the mouse model similar to those observed in the human host, suggesting that the manifestations of malnutrition could in part be attributed to the absence of certain beneficial microbes (280).”
From Diet and the Microbiota–Gut–Brain Axis: Sowing the Seeds of Good Mental Health (2021) · cites this paper as [280]
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- Authors
- Smith, M. I., Yatsunenko, T., Manary, M. J., Trehan, I., Mkakosya, R., Cheng, J., Kau, A. L., Rich, S. S., Concannon, P., Mychaleckyj, J. C., Liu, J., Houpt, E., Li, J. V., Holmes, E., Nicholson, J., Knights, D., Ursell, L. K., Knight, R., & Gordon, J. I.
- Affiliations
- Washington University in St. Louis (US)
- University of Malawi (MW)
- University of Virginia (US)
- Imperial College London (GB)
- University of Colorado Boulder (US)
- Howard Hughes Medical Institute (US)
- Corresponding author
- Smith, Michelle I.
- Yatsunenko, Tanya
- Gordon, Jeffrey I.
- ORCID
- Venue
- Science
- Published
- 2013-02
- Volume
- 339
- Issue
- 6119
- Pages
- 548-554
- ISSN
- 0036-8075 (ISSN-L)
- 1095-9203
- PMC
- PMC3667500
- OpenAlex
- W2097478615
- Cited by
- 1,173
- References
- 48
- Citations by year
- 2026: 40 · 2025: 49 · 2024: 67 · 2023: 73 · 2022: 66 · 2021: 71 · 2020: 101 · 2019: 82 · 2018: 101 · 2017: 92 · 2016: 126 · 2015: 105 · 2014: 119 · 2013: 77 · 2012: 2
- FWCI
- 63.95
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Science (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Spiral (Imperial College London) (submittedVersion)
- Funders
- National Institute of General Medical Sciences (T32GM008759, T32GM142607)
- National Institute of Diabetes and Digestive and Kidney Diseases (R37DK030292, DK-30292, DK078669, P01DK078669, T35DK074375, R01DK030292)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (T32HD049338)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
- Keywords
- kwashiorkor, gut microbiota, acute malnutrition, discordant twins, ready-to-use therapeutic food, microbial transplantation, gnotobiotic mice, infant nutrition, Malawi, microbial metabolic functions, weight loss
- MeSH terms
- Amino Acids, Animals, Child, Preschool, Diseases in Twins, Feces, Female, Germ-Free Life, Humans, Infant, Kwashiorkor, Longitudinal Studies, Malawi, Male, Mice, Inbred C57BL, Arachis, Gastrointestinal Tract, Carbohydrate Metabolism, Mice, Metagenome
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