Trial reportThe American journal of clinical nutrition2019
Tryptophan, glutamine, leucine, and micronutrient supplementation improves environmental enteropathy in Zambian adults: a randomized controlled trial.
Trial report in The American journal of clinical nutrition, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06676215 (Efficacy of Amino Acid Supplementation on Gut Function and Nutritional Status in FIlipino Children Below Three Years Old), which is not on this map. Cited by 21 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Efficacy of Amino Acid Supplementation on Gut Function and Nutritional Status in FIlipino Children Below Three Years Old
Who cites it
21 citing papers in PubMed, 32 citations in OpenAlex.
- Daily Complementary Feeding With Eggs Improves Fibroblast Growth Factor 21 in Infants.Maternal & child nutrition · 2025Trial
- Impact of Different Strategies for Delivering Supplemental Zinc on Selected Fecal Markers of Environmental Enteric Dysfunction among Young Laotian Children: A Randomized Controlled Trial.The American journal of tropical medicine and hygiene · 2020Trial
- Intervention and Mechanisms of Alanyl-glutamine for Inflammation, Nutrition, and Enteropathy: A Randomized Controlled Trial.Journal of pediatric gastroenterology and nutrition · 2020Trial
- Article
- An ecological study of the association between childhood stunting, water, sanitation, and protein access, 2000-20.BMC public health · 2026Article
- Systems biology insights into the molecular drivers of childhood stunting and implications for intervention.Frontiers in nutrition · 2026Review
- Article
- Characterization of the intestinal microorganism in patients with congenital intestinal atresia: the preliminary exploration for establishment and influence of initial intestinal flora in newborns.BMC microbiology · 2025Article
- Intestinal microbiome changes in response to amino acid and micronutrient supplementation: secondary analysis of the AMAZE trial.Gut microbiome (Cambridge, England) · 2025Article
- Dietary and metabolic effects on intestinal stem cells in health and disease.Nature reviews. Gastroenterology & hepatology · 2025Review
- NADScience translational medicine · 2024Article
- Nutritional deficiency in an intestine-on-a-chip recapitulates injury hallmarks associated with environmental enteric dysfunction.Nature biomedical engineering · 2022Article
- Single-cell profiling of environmental enteropathy reveals signatures of epithelial remodeling and immune activation.Science translational medicine · 2022Article
- Immunomodulatory Role of BLG-Derived Peptides Based on Simulated Gastrointestinal Digestion and DC-T Cell from Mice Allergic to Cow's Milk.Foods (Basel, Switzerland) · 2022Article
- Article
- Intestinal Biopsies for the Evaluation of Environmental Enteropathy and Environmental Enteric Dysfunction.The Journal of infectious diseases · 2021Review
- Diurnal changes in the murine small intestine are disrupted by obesogenic Western Diet feeding and microbial dysbiosis.Scientific reports · 2021Article
- Adaptation of the small intestine to microbial enteropathogens in Zambian children with stunting.Nature microbiology · 2021Article
- Nutritional Support in Malnourished Children With Compromised Gastrointestinal Function: Utility of Peptide-Based Enteral Therapy.Frontiers in pediatrics · 2021Review
- Plasma Kynurenine to Tryptophan Ratio Is Negatively Associated with Linear Growth of Children Living in a Slum of Bangladesh: Results from a Community-Based Intervention Study.The American journal of tropical medicine and hygiene · 2020Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEnvironmental enteropathy (EE) refers to villus blunting, reduced absorption, and microbial translocation in children and adults in tropical or deprived residential areas. In previous work we observed an effect of micronutrients on villus height (VH).
objectiveWe aimed to determine, in a randomized controlled trial, if amino acid (AA) or multiple micronutrient (MM) supplementation can improve intestinal structure or barrier dysfunction in Zambian adults with EE.
methodsAA (tryptophan, leucine, and glutamine) and/or MM supplements were given for 16 wk in a 2 × 2 factorial comparison against placebo. Primary outcomes were changes in VH, in vivo small intestinal barrier dysfunction assessed by confocal laser endomicroscopy (CLE), and mechanistic (or mammalian) target of rapamycin complex 1 (MTORC1) nutrient responsiveness in lamina propria CD4+ lymphocytes.
resultsOver 16 wk AA, but not MM, supplementation increased VH by 16% (34.5 μm) compared with placebo (P = 0.04). Fluorescein leak, measured by CLE, improved only in those allocated to both AA and MM supplementation. No effect was seen on MTORC1 activation, but posttreatment MTORC1 and VH were correlated (ρ = 0.51; P = 0.001), and change in MTORC1 was correlated with change in VH in the placebo group (ρ = 0.63; P = 0.03). In secondary analyses no effect was observed on biomarkers of microbial translocation. Metabolomic analyses suggest alterations in a number of microbial- and host-derived metabolites including the leucine metabolite β-hydroxy-β-methylbutyrate, which was increased by AA supplementation and correlated with VH.
conclusionsIn this phase 2 trial, AA supplementation protected against a decline in VH over the supplementation period, and improved barrier function when combined with micronutrients. Leucine and MTORC1 metabolism may be involved in the mechanism of effect. This trial was registered at www.pactr.org as PACTR201505001104412.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.