RT Journal Article
SR Electronic
T1 Bangladesh Environmental Enteric Dysfunction (BEED) study: protocol for a community-based intervention study to validate non-invasive biomarkers of environmental enteric dysfunction
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e017768
DO 10.1136/bmjopen-2017-017768
VO 7
IS 8
A1 Mustafa Mahfuz
A1 Subhasish Das
A1 Ramendra Nath Mazumder
A1 M Masudur Rahman
A1 Rashidul Haque
A1 Md Muzibur Rahman Bhuiyan
A1 Hasina Akhter
A1 Md. Shafiqul Alam Sarker
A1 Dinesh Mondal
A1 Syed Shafi Ahmed Muaz
A1 A S M Bazlul Karim
A1 Stephen M Borowitz
A1 Christopher A Moskaluk
A1 Michael J Barratt
A1 William A Petri
A1 Jeffrey I Gordon
A1 Tahmeed Ahmed
YR 2017
UL http://bmjopen.bmj.com/content/7/8/e017768.abstract
AB Introduction Environmental enteric dysfunction (EED) is a subacute inflammatory condition of the small intestinal mucosa with unclear aetiology that may account for more than 40% of all cases of stunting. Currently, there are no universally accepted protocols for the diagnosis, treatment and ultimately prevention of EED. The Bangladesh Environmental Enteric Dysfunction (BEED) study is designed to validate non-invasive biomarkers of EED with small intestinal biopsy, better understand disease pathogenesis and identify potential therapeutic targets for interventions designed to control EED and stunting.Methods and analysis The BEED study is a community-based intervention where participants are recruited from three cohorts: stunted children aged 12–18 months (length for age Z-score (LAZ) <−2), at risk of stunting children aged 12–18 months (LAZ <−1 to −2) and malnourished adults aged 18–45 years (body mass index <18.5 kg/m2). After screening, participants eligible for study provide faecal, urine and plasma specimens to quantify the levels of candidate EED biomarkers before and after receiving a nutritional intervention. Participants who fail to respond to nutritional therapy are considered as the candidates for upper gastrointestinal endoscopy with biopsy. Histopathological scoring for EED will be performed on biopsies obtained from several locations within the proximal small intestine. Candidate EED biomarkers will be correlated with nutritional status, the results of histochemical and immunohistochemical analyses of epithelial and lamina propria cell populations, plus assessments of microbial community structure.Ethics and dissemination Ethics approval was obtained in all participating institutes. Results of this study will be submitted for publication in peer-reviewed journals.Trial registration number ClinicalTrials.gov ID: NCT02812615. Registered on 21 June 2016.