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Malnutrition affects many millions of people in the developing world and remains a problem in wealthy nations, especially for disadvantaged groups. In many cases, it is the associated diarrhoea and intestinal inflammation that cause morbidity and death. A study published in this issue presents a molecular explanation for the increased susceptibility to intestinal inflammation in malnutrition. Angiotensin converting enzyme 2, which has a central role in blood-pressure regulation and has been implicated in diabetes, heart failure and viral infection, is shown to influence dietary amino-acid homeostasis, innate immunity, gut microbial ecology and susceptibility to colitis. Mice deficient in this enzyme show impaired tryptophan metabolism and develop colitis, which is alleviated by dietary tryptophan and its metabolite, nicotinamide. This surprising result explains nutritional effects that have been known for centuries and provides a molecular link between malnutrition and the intestinal microbiome. Cover: 22 March 1993, a victim of famine in Ayod, South Sudan (Jon Jones/Sygma/Corbis).
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