Gut Microbial Dysbiosis and Elevated Mucosal Inflammation in Severe Acute Malnutrition: A Case-Control Study from India

Severe Acute Malnutrition (SAM) in early days of life has been a concerning global health challenge, contributing to high child mortality and morbidity. The mechanistic role of the gut microbiota in its pathophysiology remains incompletely understood. In this case-control study we profiled gut-microbiota using 16S-rRNA sequencing for V3-V4 region for 115 SAM children (52 SAM and 63 Healthy) aged 6-59 months. Inflammatory markers along with fecal sIgA levels were analysed and correlated with clinical parameters, and dietary intake of these children. Alpha diversity has revealed a significant difference in ChaoI index indicating reduced richness in SAM group (p<0.001). Children with SAM have also shown reduced abundance of beneficial groups such as Blautia, Akkermansia, and Ruminococcus gnavus, with an expansion of opportunistic groups like Enterococcus, Staphylococcus, and Turicibacter. Inflammatory markers show elevated levels of inflammation in SAM children when compared to healthy controls. Reduced fecal sIgA levels in SAM group have been noted, suggesting an impaired immune response. Male children were at higher risk of inflammation and immune dysfunction. Our findings delineate gut-microbial disruption as a central feature of childhood SAM. Targeting these specific taxa and their associated metabolic pathways can help in tailoring future interventions.