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Zimmermann-Rösner A, Prehn-Kristensen A. The Microbiome in Child and Adolescent Psychiatry. ZEITSCHRIFT FUR KINDER- UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2024; 52:213-226. [PMID: 38240707 DOI: 10.1024/1422-4917/a000965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/06/2024]
Abstract
Recent research has increasingly emphasized the function of the microbiome in human health. The gut microbiome is essential for digesting food and seems to play a vital role in mental health as well. This review briefly overviews the gut microbiome and its interplay with the central nervous system. We then summarize some of the latest findings on the possible role of the microbiome in psychiatric disorders in children and adolescents. In particular, we focus on autism spectrum disorder, attention-deficit/hyperactivity disorder, anorexia nervosa, bipolar disorder, and major depressive disorder. Although the role of microbiota in mental development and health still needs to be researched intensively, it has become increasingly apparent that the impact of microbiota must be considered to better understand psychiatric disorders.
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Affiliation(s)
| | - Alexander Prehn-Kristensen
- Institute for Child and Adolescent Psychiatry, Center of Integrative Psychiatry GmbH, Kiel, Germany
- Department of Psychology, Faculty of Human Sciences, MSH Medical School Hamburg - University of Applied Sciences and Medical University, Hamburg, Germany
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Van Hul M, Neyrinck AM, Everard A, Abot A, Bindels LB, Delzenne NM, Knauf C, Cani PD. Role of the intestinal microbiota in contributing to weight disorders and associated comorbidities. Clin Microbiol Rev 2024:e0004523. [PMID: 38940505 DOI: 10.1128/cmr.00045-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024] Open
Abstract
SUMMARYThe gut microbiota is a major factor contributing to the regulation of energy homeostasis and has been linked to both excessive body weight and accumulation of fat mass (i.e., overweight, obesity) or body weight loss, weakness, muscle atrophy, and fat depletion (i.e., cachexia). These syndromes are characterized by multiple metabolic dysfunctions including abnormal regulation of food reward and intake, energy storage, and low-grade inflammation. Given the increasing worldwide prevalence of obesity, cachexia, and associated metabolic disorders, novel therapeutic strategies are needed. Among the different mechanisms explaining how the gut microbiota is capable of influencing host metabolism and energy balance, numerous studies have investigated the complex interactions existing between nutrition, gut microbes, and their metabolites. In this review, we discuss how gut microbes and different microbiota-derived metabolites regulate host metabolism. We describe the role of the gut barrier function in the onset of inflammation in this context. We explore the importance of the gut-to-brain axis in the regulation of energy homeostasis and glucose metabolism but also the key role played by the liver. Finally, we present specific key examples of how using targeted approaches such as prebiotics and probiotics might affect specific metabolites, their signaling pathways, and their interactions with the host and reflect on the challenges to move from bench to bedside.
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Affiliation(s)
- Matthias Van Hul
- UCLouvain, Université catholique de Louvain, Louvain Drug Research Institute (LDRI), Metabolism and Nutrition Research Group (MNUT), Brussels, Belgium
- Walloon Excellence in Life Sciences and BIOtechnology (WELBIO), WELBIO department, WEL Research Institute, Wavre, Belgium
- NeuroMicrobiota, International Research Program (IRP) INSERM/UCLouvain, France/Belgium
| | - Audrey M Neyrinck
- UCLouvain, Université catholique de Louvain, Louvain Drug Research Institute (LDRI), Metabolism and Nutrition Research Group (MNUT), Brussels, Belgium
| | - Amandine Everard
- UCLouvain, Université catholique de Louvain, Louvain Drug Research Institute (LDRI), Metabolism and Nutrition Research Group (MNUT), Brussels, Belgium
- Walloon Excellence in Life Sciences and BIOtechnology (WELBIO), WELBIO department, WEL Research Institute, Wavre, Belgium
| | | | - Laure B Bindels
- UCLouvain, Université catholique de Louvain, Louvain Drug Research Institute (LDRI), Metabolism and Nutrition Research Group (MNUT), Brussels, Belgium
- Walloon Excellence in Life Sciences and BIOtechnology (WELBIO), WELBIO department, WEL Research Institute, Wavre, Belgium
| | - Nathalie M Delzenne
- UCLouvain, Université catholique de Louvain, Louvain Drug Research Institute (LDRI), Metabolism and Nutrition Research Group (MNUT), Brussels, Belgium
| | - Claude Knauf
- NeuroMicrobiota, International Research Program (IRP) INSERM/UCLouvain, France/Belgium
- INSERM U1220, Institut de Recherche en Santé Digestive (IRSD), Université Paul Sabatier, Toulouse III, CHU Purpan, Toulouse, France
| | - Patrice D Cani
- UCLouvain, Université catholique de Louvain, Louvain Drug Research Institute (LDRI), Metabolism and Nutrition Research Group (MNUT), Brussels, Belgium
- Walloon Excellence in Life Sciences and BIOtechnology (WELBIO), WELBIO department, WEL Research Institute, Wavre, Belgium
- NeuroMicrobiota, International Research Program (IRP) INSERM/UCLouvain, France/Belgium
- UCLouvain, Université catholique de Louvain, Institute of Experimental and Clinical Research (IREC), Brussels, Belgium
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Hu Y, Xiong Z, Huang P, He W, Zhong M, Zhang D, Tang G. Association of mental disorders with sepsis: a bidirectional Mendelian randomization study. Front Public Health 2024; 12:1327315. [PMID: 38827616 PMCID: PMC11140049 DOI: 10.3389/fpubh.2024.1327315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 05/08/2024] [Indexed: 06/04/2024] Open
Abstract
Background Substantial research evidence supports the correlation between mental disorders and sepsis. Nevertheless, the causal connection between a particular psychological disorder and sepsis remains unclear. Methods For investigating the causal relationships between mental disorders and sepsis, genetic variants correlated with mental disorders, including anorexia nervosa (AN), attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder (BD), major depressive disorder (MDD), obsessive-compulsive disorder (OCD), panic disorder (PD), posttraumatic stress disorder (PTSD), schizophrenia (SCZ), and tourette syndrome (TS), were all extracted from the Psychiatric Genomics Consortium (PGC). The causal estimates and direction between these mental disorders and sepsis were evaluated employing a two-sample bidirectional MR strategy. The inverse variance weighted (IVW) method was the primary approach utilized. Various sensitivity analyses were performed to confirm the validity of the causal effect. Meta-analysis, multivariable MR, and mediation MR were conducted to ensure the credibility and depth of this research. Results The presence of AN was in relation to a greater likelihood of sepsis (OR 1.08, 95% CI 1.02-1.14; p = 0.013). A meta-analysis including validation cohorts supported this observation (OR 1.06, 95% CI 1.02-1.09). None of the investigated mental disorders appeared to be impacted when sepsis was set as the exposure factor. Even after adjusting for confounding factors, AN remained statistically significant (OR 1.08, 95% CI 1.02-1.15; p = 0.013). Mediation analysis indicated N-formylmethionine levels (with a mediated proportion of 7.47%), cystatin D levels (2.97%), ketogluconate Metabolism (17.41%) and N10-formyl-tetrahydrofolate biosynthesis (20.06%) might serve as mediators in the pathogenesis of AN-sepsis. Conclusion At the gene prediction level, two-sample bidirectional MR analysis revealed that mental disorder AN had a causal association with an increased likelihood of sepsis. In addition, N-formylmethionine levels, cystatin D levels, ketogluconate metabolism and N10-formyl-tetrahydrofolate biosynthesis may function as potential mediators in the pathophysiology of AN-sepsis. Our research may contribute to the investigation of novel therapeutic strategies for mental illness and sepsis.
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Affiliation(s)
- Yuanzhi Hu
- Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zihui Xiong
- Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Pinge Huang
- Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wan He
- Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Minlin Zhong
- Emergency Department of Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Danqi Zhang
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Guanghua Tang
- Emergency Department of Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
- Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou, China
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McVey Neufeld SF, Ahn M, Kunze WA, McVey Neufeld KA. Adolescence, the Microbiota-Gut-Brain Axis, and the Emergence of Psychiatric Disorders. Biol Psychiatry 2024; 95:310-318. [PMID: 37839790 DOI: 10.1016/j.biopsych.2023.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 09/06/2023] [Accepted: 10/07/2023] [Indexed: 10/17/2023]
Abstract
Second only to early life, adolescence is a period of dramatic change and growth. For the developing young adult, this occurs against a backdrop of distinct environmental challenges and stressors. A significant body of work has identified an important role for the microbiota-gut-brain (MGB) axis in the development and function of the brain. Given that the MGB axis is both highly plastic during the teenage years and vulnerable to environmental stressors, more attention needs to be drawn to its potential role in the emergence of psychiatric illnesses, many of which first manifest during adolescence. Here, we review the current literature surrounding the developing microbiome, enteric nervous system, vagus nerve, and brain during the adolescent period. We also examine preclinical and clinical research involving the MGB axis during this dynamic developmental window and argue that more research is needed to further understand the role of the MGB in the pathogenesis of brain disorders. Greater understanding of the adolescent MGB axis will open up the exciting potential for new microbial-based therapeutics for the treatment of these often-refractory psychiatric illnesses.
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Affiliation(s)
| | - Matthew Ahn
- McMaster Brain-Body Institute at St Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada
| | - Wolfgang A Kunze
- McMaster Brain-Body Institute at St Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada
| | - Karen-Anne McVey Neufeld
- McMaster Brain-Body Institute at St Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada.
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Baenas I, Camacho-Barcia L, Miranda-Olivos R, Solé-Morata N, Misiolek A, Jiménez-Murcia S, Fernández-Aranda F. Probiotic and prebiotic interventions in eating disorders: A narrative review. EUROPEAN EATING DISORDERS REVIEW 2024. [PMID: 38297469 DOI: 10.1002/erv.3069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 11/17/2023] [Accepted: 12/29/2023] [Indexed: 02/02/2024]
Abstract
AIMS The review aimed to summarise and discuss findings focused on therapeutic probiotic and prebiotic interventions in eating disorders (ED). METHODS Using PubMed/MEDLINE, Cochrane Library, and Web of Science all published studies were retrieved until February 2023, following PRISMA guidelines. From the 111 initial studies, 5 met the inclusion criteria for this review. RESULTS All studies included in this narrative review were focused on anorexia nervosa (AN). Three longitudinal, randomised, controlled trials aimed to evaluate interventions with probiotics (Lactobacillus reuteri, yoghurt with Lactobacillus, and Streptococcus) in children and adolescents. These studies primarily emphasised medical outcomes and anthropometric measures following the administration of probiotics. However, the findings yielded mixed results in terms of short-term weight gain or alterations in specific immunological parameters. With a lower level of evidence, supplementation with synbiotics (probiotic + prebiotic) has been associated with improvements in microbiota diversity and attenuation of inflammatory responses. CONCLUSIONS Research on probiotics and prebiotics in ED is limited, primarily focussing on anorexia nervosa (AN). Their use in AN regarding medical and anthropometric outcomes needs further confirmation and future research should be warranted to assess their impact on psychological and ED symptomatology, where there is a notable gap in the existing literature.
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Affiliation(s)
- Isabel Baenas
- Department of Clinical Psychology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviours, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Doctoral Program in Medicine and Translational Research, University of Barcelona (UB), Barcelona, Spain
| | - Lucía Camacho-Barcia
- Department of Clinical Psychology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviours, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Romina Miranda-Olivos
- Department of Clinical Psychology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviours, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Doctoral Program in Medicine and Translational Research, University of Barcelona (UB), Barcelona, Spain
| | - Neus Solé-Morata
- Department of Clinical Psychology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Alejandra Misiolek
- Proyecto Autoestima Relaciones y Trastornos Alimenticios (ART), Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Clinical Psychology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviours, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona (UB), L'Hospitalet de Llobregat, Barcelona, Spain
- Psychology Services, University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Clinical Psychology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviours, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona (UB), L'Hospitalet de Llobregat, Barcelona, Spain
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Baenas I, Etxandi M, Fernández-Aranda F. [Medical complications in anorexia and bulimia nervosa]. Med Clin (Barc) 2024; 162:67-72. [PMID: 37598049 DOI: 10.1016/j.medcli.2023.07.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/21/2023]
Abstract
Anorexia nervosa and bulimia nervosa are eating disorders associated with life-threatening multisystemic medical complications. This narrative review aimed to present the medical complications most related to these disorders. In anorexia nervosa, many of them are linked to malnutrition and underweight, usually reversible with renutrition and weight restoration, although refeeding can also be linked to some medical complications. Purging behaviors observed in the anorexia nervosa binge-purging subtype and bulimia nervosa have been mainly related to hydrolectrolyte and acid-base disturbances, in addition to local complications. Thus, an early identification and therapeutic intervention of these disorders is considered crucial. Integral medical monitoring should be ensured to prevent potential serious complications from the early stages, with the involvement of physicians, psychologists, nutritionists, and other specialists in a multidisciplinary approach according to the patient's needs.
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Affiliation(s)
- Isabel Baenas
- Unidad de Psicología Clínica, Hospital Universitario de Bellvitge-Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, España; Grupo de Investigación de Psiconeurobiología de los Trastornos de la Conducta Alimentaria y Adicciones Comportamentales, Programa de Neurociencias, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, España; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, España; Programa de Doctorado en Medicina e Investigación Traslacional, Universidad de Barcelona (UB), Barcelona, España
| | - Mikel Etxandi
- Unidad de Psicología Clínica, Hospital Universitario de Bellvitge-Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, España; Programa de Doctorado en Medicina e Investigación Traslacional, Universidad de Barcelona (UB), Barcelona, España; Servicio de Psiquiatría, Hospital Universitario Germans Trias i Pujol, IGTP Campus Can Ruti, Badalona, España
| | - Fernando Fernández-Aranda
- Unidad de Psicología Clínica, Hospital Universitario de Bellvitge-Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, España; Grupo de Investigación de Psiconeurobiología de los Trastornos de la Conducta Alimentaria y Adicciones Comportamentales, Programa de Neurociencias, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, España; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, España; Departamento de Ciencias Clínicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, Barcelona, España.
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Wu Y, Feng X, Li M, Hu Z, Zheng Y, Chen S, Luo H. Gut microbiota associated with appetite suppression in high-temperature and high-humidity environments. EBioMedicine 2024; 99:104918. [PMID: 38103514 PMCID: PMC10765014 DOI: 10.1016/j.ebiom.2023.104918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/22/2023] [Accepted: 12/01/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Food is crucial for maintaining vital human and animal activities. Disorders in appetite control can lead to various metabolic disturbances. Alterations in the gut microbial composition can affect appetite and energy metabolism. While alterations in the gut microbiota have been observed in high-temperature and high-humidity (HTH) environments, the relationship between the gut microbiota during HTH and appetite remains unclear. METHODS We utilised an artificial climate box to mimic HTH environments, and established a faecal bacteria transplantation (FMT) mouse model. Mendelian randomisation (MR) analysis was used to further confirm the causal relationship between gut microbiota and appetite or appetite-related hormones. FINDINGS We found that, in the eighth week of exposure to HTH environments, mice showed a decrease in food intake and body weight, and there were significant changes in the intestinal microbiota compared to the control group. After FMT, we observed similar changes in food intake, body weight, and gut bacteria. Appetite-related hormones, including ghrelin, glucagon-like peptide-1, and insulin, were reduced in DH (mice exposed to HTH conditions) and DHF (FMT from mice exposed to HTH environments for 8 weeks), while the level of peptide YY initially increased and then decreased in DH and increased after FMT. Moreover, MR analysis further confirmed that these changes in the intestinal microbiota could affect appetite or appetite-related hormones. INTERPRETATION Together, our data suggest that the gut microbiota is closely associated with appetite suppression in HTH. These findings provide novel insights into the effects of HTH on appetite. FUNDING This work was supported by the National Natural Science Foundation of China and Guangzhou University of Chinese Medicine.
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Affiliation(s)
- Yalan Wu
- Research Centre of Basic Integrative Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangzhou, China
| | - Xiangrong Feng
- Research Centre of Basic Integrative Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangzhou, China
| | - Mengjun Li
- Research Centre of Basic Integrative Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangzhou, China
| | - Zongren Hu
- Department of Rehabilitation and Healthcare, Hunan University of Medicine, Hunan, China
| | - Yuhua Zheng
- Research Centre of Basic Integrative Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangzhou, China
| | - Song Chen
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Huanhuan Luo
- Research Centre of Basic Integrative Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangzhou, China; State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangzhou University of Chinese Medicine, Guangzhou, China.
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Andreani NA, Sharma A, Dahmen B, Specht HE, Mannig N, Ruan V, Keller L, Baines JF, Herpertz-Dahlmann B, Dempfle A, Seitz J. Longitudinal analysis of the gut microbiome in adolescent patients with anorexia nervosa: microbiome-related factors associated with clinical outcome. Gut Microbes 2024; 16:2304158. [PMID: 38294867 PMCID: PMC10832965 DOI: 10.1080/19490976.2024.2304158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 01/08/2024] [Indexed: 02/01/2024] Open
Abstract
There is mounting evidence regarding the role of gut microbiota in anorexia nervosa (AN). Previous studies have reported that patients with AN show dysbiosis compared to healthy controls (HCs); however, the underlying mechanisms are unclear, and data on influencing factors and longitudinal course of microbiome changes are scarce. Here, we present longitudinal data of 57 adolescent inpatients diagnosed with AN at up to nine time points (including a 1-year follow-up examination) and compare these to up to six time points in 34 HCs. 16S rRNA gene sequencing was used to investigate the microbiome composition of fecal samples, and data on food intake, weight change, hormonal recovery (leptin levels), and clinical outcomes were recorded. Differences in microbiome composition compared to HCs were greatest during acute starvation and in the low-weight group, while diminishing with weight gain and especially weight recovery at the 1-year follow-up. Illness duration and prior weight loss were strongly associated with microbiome composition at hospital admission, whereas microbial changes during treatment were associated with kilocalories consumed, weight gain, and hormonal recovery. The microbiome at admission was prognostic for hospital readmission, and a higher abundance of Sutterella was associated with a higher body weight at the 1-year follow-up. Identifying these clinically important factors further underlines the potential relevance of gut microbial changes and may help elucidate the underlying pathophysiology of gut-brain interactions in AN. The characterization of prognostically relevant taxa could be useful to stratify patients at admission and to potentially identify candidate taxa for future supplementation studies aimed at improving AN treatment.
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Affiliation(s)
- Nadia Andrea Andreani
- Section of Evolutionary Medicine, Max Planck Institute for Evolutionary Biology, Plön, Germany
- Section of Evolutionary Medicine, Institute for Experimental Medicine, Kiel University, Kiel, Germany
| | - Arunabh Sharma
- Institute of Medical Informatics and Statistics, Kiel University, Kiel, Germany
| | - Brigitte Dahmen
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen University, Aachen, Germany
| | - Hannah E. Specht
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen University, Aachen, Germany
| | - Nina Mannig
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen University, Aachen, Germany
| | - Vanessa Ruan
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen University, Aachen, Germany
| | - Lara Keller
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen University, Aachen, Germany
| | - John F. Baines
- Section of Evolutionary Medicine, Max Planck Institute for Evolutionary Biology, Plön, Germany
- Section of Evolutionary Medicine, Institute for Experimental Medicine, Kiel University, Kiel, Germany
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen University, Aachen, Germany
| | - Astrid Dempfle
- Institute of Medical Informatics and Statistics, Kiel University, Kiel, Germany
| | - Jochen Seitz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen University, Aachen, Germany
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Morisaki Y, Miyata N, Nakashima M, Hata T, Takakura S, Yoshihara K, Suematsu T, Nomoto K, Miyazaki K, Tsuji H, Sudo N. Persistence of gut dysbiosis in individuals with anorexia nervosa. PLoS One 2023; 18:e0296037. [PMID: 38117788 PMCID: PMC10732397 DOI: 10.1371/journal.pone.0296037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/03/2023] [Indexed: 12/22/2023] Open
Abstract
Recent evidence suggests a crucial role of the gut microbiota in the pathogenesis of anorexia nervosa (AN). In this study, we carried out a series of multiple analyses of the gut microbiota of hospitalized individuals with AN over three months using 16S or 23S rRNA-targeted reverse transcription-quantitative polymerase chain reaction (PCR) technology (YIF-SCAN®), which is highly sensitive and enables the precise quantification of viable microorganisms. Despite the weight gain and improvements in psychological features observed during treatment, individuals with AN exhibited persistent gut microbial dysbiosis over the three-month duration. Principal component analysis further underscored the distinct microbial profile of individuals with AN, compared with that of age-matched healthy women at all time points. Regarding the kinetics of bacterial detection, the detection rate of Lactiplantibacillus spp. significantly increased after inpatient treatment. Additionally, the elevation in the Bifidobacterium counts during inpatient treatment was significantly correlated with the subsequent body weight gain after one year. Collectively, these findings suggest that gut dysbiosis in individuals with AN may not be easily restored solely through weight gain, highlighting the potential of therapeutic interventions targeting microbiota via dietary modifications or live biotherapeutics.
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Affiliation(s)
- Yukiko Morisaki
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Noriyuki Miyata
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Megumi Nakashima
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomokazu Hata
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shu Takakura
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazufumi Yoshihara
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Health Sciences and Counseling, Kyushu University, Fukuoka, Japan
| | - Takafumi Suematsu
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Nomoto
- Faculty of Life Sciences, Department of Molecular Microbiology, Tokyo University of Agriculture, Setagaya City, Japan
| | | | | | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Anton-Păduraru DT, Trofin F, Nastase EV, Miftode RS, Miftode IL, Trandafirescu MF, Cojocaru E, Țarcă E, Mindru DE, Dorneanu OS. The Role of the Gut Microbiota in Anorexia Nervosa in Children and Adults-Systematic Review. Int J Mol Sci 2023; 25:41. [PMID: 38203211 PMCID: PMC10779038 DOI: 10.3390/ijms25010041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
Among the factors incriminated in the appearance of eating disorders, intestinal microbiota has recently been implicated. Now there is evidence that the composition of gut microbiota is different in anorexia nervosa. We gathered many surveys on the changes in the profile of gut microbiota in patients with anorexia nervosa. This review comprehensively examines the contemporary experimental evidence concerning the bidirectional communication between gut microbiota and the brain. Drawing from recent breakthroughs in this area of research, we propose that the gut microbiota significantly contributes to the intricate interplay between the body and the brain, thereby contributing to overall healthy homeostasis while concurrently impacting disease risk, including anxiety and mood disorders. Particular attention is devoted to elucidating the structure and functional relevance of the gut microbiota in the context of Anorexia Nervosa.
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Affiliation(s)
- Dana-Teodora Anton-Păduraru
- Department of Mother and Child Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.-T.A.-P.); (D.E.M.)
- “Sf. Maria” Children Emergency Hospital, 700309 Iasi, Romania; (E.C.); (E.Ț.)
| | - Felicia Trofin
- Department of Preventive Medicine and Interdisciplinarity—Microbiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Clinical Hospital of Infectious Diseases “Sf. Parascheva”, 700116 Iasi, Romania;
| | - Eduard Vasile Nastase
- Clinical Hospital of Infectious Diseases “Sf. Parascheva”, 700116 Iasi, Romania;
- Department of Internal Medicine II—Infectious Diseases, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Radu Stefan Miftode
- Department of Internal Medicine I—Cardiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- “Sf. Spiridon” Clinical Hospital, 700111 Iasi, Romania
| | - Ionela-Larisa Miftode
- Clinical Hospital of Infectious Diseases “Sf. Parascheva”, 700116 Iasi, Romania;
- Department of Internal Medicine II—Infectious Diseases, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mioara Florentina Trandafirescu
- Department of Morphofunctional Sciences I—Histology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Elena Cojocaru
- “Sf. Maria” Children Emergency Hospital, 700309 Iasi, Romania; (E.C.); (E.Ț.)
- Department of Morphofunctional Sciences I—Pathology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Elena Țarcă
- “Sf. Maria” Children Emergency Hospital, 700309 Iasi, Romania; (E.C.); (E.Ț.)
- Department of Surgery II—Pediatric Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Dana Elena Mindru
- Department of Mother and Child Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.-T.A.-P.); (D.E.M.)
- “Sf. Maria” Children Emergency Hospital, 700309 Iasi, Romania; (E.C.); (E.Ț.)
| | - Olivia Simona Dorneanu
- Department of Preventive Medicine and Interdisciplinarity—Microbiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Clinical Hospital of Infectious Diseases “Sf. Parascheva”, 700116 Iasi, Romania;
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11
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Hussain AA, Bilgin M, Carlsson J, Foged MM, Mortensen EL, Bulik CM, Støving RK, Sjögren JM. Elevated lipid class concentrations in females with anorexia nervosa before and after intensive weight restoration treatment-A lipidomics study. Int J Eat Disord 2023; 56:2260-2272. [PMID: 37715358 DOI: 10.1002/eat.24063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVE To study the plasma lipidome of patients with anorexia nervosa (AN) before and after weight restoration treatment and report associations with AN subtypes and oral contraceptive pill (OCP) usage. METHODS Quantitative shotgun lipidomics analysis was used to study plasma lipids of 50 female patients with AN before and after weight restoration treatment and 50 healthy female controls (HC). The AN group was assessed with blood samples and questionnaires before and after weight restoration. RESULTS In total we quantified 260 lipid species representing 26 lipid classes of which 13 lipid class concentrations were elevated in patients with AN at admission compared with HC. Lipid classes remained elevated after weight restoration treatment of 84 days (median; interquartile range 28), and only the concentration of the ceramide lipid class increased between pre- and post-treatment (p = .03), whereas lysophosphatidylcholine (LPC, p = .02), ether-linked Phosphatidylcholine (LPCO, p = .02), and lysophosphatidylethanolamine (LPE, p = .009) decreased. CONCLUSION In AN, 13 out of 26 lipid class concentrations were elevated at admission and remained elevated post-treatment. Ceramides increased further between pre- and post-weight restoration treatment, which could be related to the rapid weight gain during re-nutrition. Further research is needed to elucidate the effects of weight restoration treatment on short- and long-term lipid profiles in individuals with AN. PUBLIC SIGNIFICANCE STATEMENT Lipidomics research can increase the understanding of AN, a complex and potentially life-threatening eating disorder. By analyzing lipids, or fats, in the body, we can identify biological markers that may inform diagnosis and develop more effective treatments. This research can also shed light on the underlying mechanisms of the disorder, leading to a better understanding of the processes involved in eating behavior.
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Affiliation(s)
- Alia Arif Hussain
- Eating Disorder Research Unit, Mental Health Center, Ballerup, Copenhagen University Hospital-Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Mesut Bilgin
- Lipidomics Core Facility, Danish Cancer Institute, Copenhagen, Denmark
| | - Jessica Carlsson
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Mental Health Services of the Capital Region of Denmark, Copenhagen, Denmark
| | - Mads Møller Foged
- Lipidomics Core Facility, Danish Cancer Institute, Copenhagen, Denmark
| | - Erik Lykke Mortensen
- Unit of Medical Psychology, Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Cynthia M Bulik
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - René Klinkby Støving
- Center for Eating Disorders, Odense University Hospital, Odense, Denmark
- Research Unit for Medical Endocrinology, Odense University Hospital, Odense, Denmark
- Research Unit, Child and Adolescent Psychiatry, Mental Health Services in the Region of Southern Denmark, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jan Magnus Sjögren
- Eating Disorder Research Unit, Mental Health Center, Ballerup, Copenhagen University Hospital-Mental Health Services CPH, Copenhagen, Denmark
- Institute of Clinical Science, Department of Psychiatry, Umeå University, Umeå, Sweden
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12
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Landini L, Dadson P, Gallo F, Honka MJ, Cena H. Microbiota in anorexia nervosa: potential for treatment. Nutr Res Rev 2023; 36:372-391. [PMID: 35875979 DOI: 10.1017/s0954422422000130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Anorexia nervosa (AN) is characterised by the restriction of energy intake in relation to energy needs and a significantly lowered body weight than normally expected, coupled with an intense fear of gaining weight. Treatment of AN is currently based on psychological and refeeding approaches, but their efficacy remains limited since 40% of patients after 10 years of medical care still present symptoms of AN. The intestine hosts a large community of microorganisms, called the "microbiota", which live in symbiosis with the human host. The gut microbiota of a healthy human is dominated by bacteria from two phyla: Firmicutes and, majorly, Bacteroidetes. However, the proportion in their representation differs on an individual basis and depends on many external factors including medical treatment, geographical location and hereditary, immunological and lifestyle factors. Drastic changes in dietary intake may profoundly impact the composition of the gut microbiota, and the resulting dysbiosis may play a part in the onset and/or maintenance of comorbidities associated with AN, such as gastrointestinal disorders, anxiety and depression, as well as appetite dysregulation. Furthermore, studies have reported the presence of atypical intestinal microbial composition in patients with AN compared with healthy normal-weight controls. This review addresses the current knowledge about the role of the gut microbiota in the pathogenesis and treatment of AN. The review also focuses on the bidirectional interaction between the gastrointestinal tract and the central nervous system (microbiota-gut-brain axis), considering the potential use of the gut microbiota manipulation in the prevention and treatment of AN.
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Affiliation(s)
- Linda Landini
- S.S.D. Dietetics and Clinical Nutrition ASL 4 Chiavarese Liguria-Sestri Levante Hospital, Sestri Levante, Italy
| | - Prince Dadson
- Turku PET Centre, University of Turku, Turku, Finland
| | - Fabrizio Gallo
- S.S.D. Dietetics and Clinical Nutrition ASL 4 Chiavarese Liguria-Sestri Levante Hospital, Sestri Levante, Italy
| | | | - Hellas Cena
- Dietetics and Clinical Nutrition Laboratory, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, Pavia, Italy
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13
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Ye Q, Sun S, Deng J, Chen X, Zhang J, Lin S, Du H, Gao J, Zou X, Lin X, Cai Y, Lu Z. Using 16S rDNA and metagenomic sequencing technology to analyze the fecal microbiome of children with avoidant/restrictive food intake disorder. Sci Rep 2023; 13:20253. [PMID: 37985845 PMCID: PMC10661725 DOI: 10.1038/s41598-023-47760-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/17/2023] [Indexed: 11/22/2023] Open
Abstract
To investigate the gut microbiota distribution and its functions in children with avoidant/restrictive food intake disorder (ARFID). A total of 135 children were enrolled in the study, including 102 children with ARFID and 33 healthy children. Fecal samples were analyzed to explore differences in gut microbiota composition and diversity and functional differences between the ARFID and healthy control (HC) groups via 16S rDNA and metagenomic sequencing. The gut microbiota composition and diversity in children with ARFID were different from those in heathy children, but there is no difference in the composition and diversity of gut microbiota between children at the age of 3-6 and 7-12 with ARFID. At the phylum level, the most abundant microbes in the two groups identified by 16S rDNA and metagenomic sequencing were the same. At the genus level, the abundance of Bacteroides was higher in the ARFID group (P > 0.05); however, different from the result of 16SrDNA sequencing, metagenomic sequencing showed that the abundance of Bacteroides in the ARFID group was significantly higher than that in the HC group (P = 0.041). At the species level, Escherichia coli, Streptococcus thermophilus and Lachnospira eligens were the most abundant taxa in the ARFID group, and Prevotella copri, Bifidobacterium pseudocatenulatum, and Ruminococcus gnavus were the top three microbial taxa in the HC group; there were no statistically significant differences between the abundance of these microbial taxa in the two groups. LefSe analysis indicated a greater abundance of the order Enterobacterales and its corresponding family Enterobacteriaceae, the family Bacteroidaceae and corresponding genus Bacteroides, the species Bacteroides vulgatus in ARFID group, while the abundance of the phylum Actinobacteriota and its corresponding class Actinobacteria , the order Bifidobacteriales and corresponding family Bifidobacteriaceae, the genus Bifidobacterium were enriched in the HC group. There were no statistically significant differences in the Chao1, Shannon and Simpson indices between the Y1 and Y2 groups (P = 0.1, P = 0.06, P = 0.06). At the phylum level, Bacillota, Bacteroidota, Proteobacteria and Actinobacteriota were the most abundant taxa in both groups, but there were no statistically significant differences among the abundance of these bacteria (P = 0.958, P = 0.456, P = 0.473, P = 0.065). At the genus level, Faecalibacterium was more abundant in the Y2 group than in the Y1 group, and the difference was statistically significant (P = 0.037). The KEGG annotation results showed no significant difference in gut microbiota function between children with ARFID and healthy children; however, GT26 was significantly enriched in children with ARFID based on the CAZy database. The most abundant antibiotic resistance genes in the ARFID group were the vanT, tetQ, adeF, ermF genes, and the abundance of macrolide resistance genes in the ARFID group was significantly higher than that in the HC group (P = 0.041). Compared with healthy children, children with ARFID have a different distribution of the gut microbiota and functional genes. This indicates that the gut microbiome might play an important role in the pathogenesis of ARFID.Clinical trial registration: ChiCTR2300074759.
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Affiliation(s)
- Qina Ye
- Department of Traditional Chinese Medicine, Guangzhou Women and Children Medical Center, No. 9 Jinsui Road, Guangzhou, 510623, China
- Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Shaodan Sun
- Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Jian Deng
- Department of Traditional Chinese Medicine, Guangzhou Women and Children Medical Center, No. 9 Jinsui Road, Guangzhou, 510623, China
| | - Xiaogang Chen
- Department of Pediatrics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Jing Zhang
- Department of Traditional Chinese Medicine, Guangzhou Women and Children Medical Center, No. 9 Jinsui Road, Guangzhou, 510623, China
| | - Suihua Lin
- Department of Traditional Chinese Medicine, Guangzhou Women and Children Medical Center, No. 9 Jinsui Road, Guangzhou, 510623, China
| | - Hongxuan Du
- Department of Traditional Chinese Medicine, Guangzhou Women and Children Medical Center, No. 9 Jinsui Road, Guangzhou, 510623, China
| | - Jinxiong Gao
- Department of Traditional Chinese Medicine, Guangzhou Women and Children Medical Center, No. 9 Jinsui Road, Guangzhou, 510623, China
| | - Xiaoyin Zou
- Department of Traditional Chinese Medicine, Guangzhou Women and Children Medical Center, No. 9 Jinsui Road, Guangzhou, 510623, China
| | - Xiaoling Lin
- Department of Pediatrics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Yawen Cai
- Department of Pediatrics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Zhuoming Lu
- Department of Traditional Chinese Medicine, Guangzhou Women and Children Medical Center, No. 9 Jinsui Road, Guangzhou, 510623, China.
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14
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Fan S, Guo W, Xiao D, Guan M, Liao T, Peng S, Feng A, Wang Z, Yin H, Li M, Chen J, Xiong W. Microbiota-gut-brain axis drives overeating disorders. Cell Metab 2023; 35:2011-2027.e7. [PMID: 37794596 DOI: 10.1016/j.cmet.2023.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 08/10/2023] [Accepted: 09/11/2023] [Indexed: 10/06/2023]
Abstract
Overeating disorders (ODs), usually stemming from dieting history and stress, remain a pervasive issue in contemporary society, with the pathological mechanisms largely unresolved. Here, we show that alterations in intestinal microbiota are responsible for the excessive intake of palatable foods in OD mice and patients with bulimia nervosa (BN). Stress combined with a history of dieting causes significant changes in the microbiota and the intestinal metabolism, which disinhibit the vagus nerve terminals in the gut and thereby lead to a subsequent hyperactivation of the gut-brain axis passing through the vagus, the solitary tract nucleus, and the paraventricular nucleus of the thalamus. The transplantation of a probiotic Faecalibacterium prausnitzii or dietary supplement of key metabolites restores the activity of the gut-to-brain pathway and thereby alleviates the OD symptoms. Thus, our study delineates how the microbiota-gut-brain axis mediates energy balance, unveils the underlying pathogenesis of the OD, and provides potential therapeutic strategies.
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Affiliation(s)
- Sijia Fan
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230001, China
| | - Weiwei Guo
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230001, China
| | - Dan Xiao
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230001, China
| | - Mengyuan Guan
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230001, China
| | - Tiepeng Liao
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230001, China; Anhui Province Key Laboratory of Biomedical Imaging and Intelligent Processing, Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei 230088, China
| | - Sufang Peng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Airong Feng
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230001, China
| | - Ziyi Wang
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230001, China
| | - Hao Yin
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230001, China
| | - Min Li
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei 230026, China.
| | - Jue Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
| | - Wei Xiong
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230001, China; Anhui Province Key Laboratory of Biomedical Imaging and Intelligent Processing, Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei 230088, China; Anhui Province Key Laboratory of Biomedical Aging Research, Hefei 230026, China.
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15
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West ML, Hart S, Loughman A, Jacka FN, Staudacher HM, Abbaspour A, Phillipou A, Ruusunen A, Rocks T. Challenges and priorities for researching the gut microbiota in individuals living with anorexia nervosa. Int J Eat Disord 2023; 56:2001-2011. [PMID: 37548294 DOI: 10.1002/eat.24033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/10/2023] [Accepted: 07/19/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE The gut microbiota is implicated in several symptoms and biological pathways relevant to anorexia nervosa (AN). Investigations into the role of the gut microbiota in AN are growing, with a specific interest in the changes that occur in response to treatment. Findings suggest that microbial species may be associated with some of the symptoms common in AN, such as depression and gastrointestinal disturbances (GID). Therefore, researchers believe the gut microbiota may have therapeutic relevance. Whilst research in this field is rapidly expanding, the unique considerations relevant to conducting gut microbiota research in individuals with AN must be addressed. METHOD We provide an overview of the published literature investigating the relationship between the gut microbiota and symptoms and behaviors present in AN, discuss important challenges in gut microbiota research, and offer recommendations for addressing these. We conclude by summarizing research design priorities for the field to move forward. RESULTS Several ways exist to reduce participant burden and accommodate challenges when researching the gut microbiota in individuals with AN. DISCUSSION Recommendations from this article are foreseen to encourage scientific rigor and thoughtful protocol planning for microbiota research in AN, including ways to reduce participant burden. Employing such methods will contribute to a better understanding of the role of the gut microbiota in AN pathophysiology and treatment. PUBLIC SIGNIFICANCE The field of gut microbiota research is rapidly expanding, including the role of the gut microbiota in anorexia nervosa. Thoughtful planning of future research will ensure appropriate data collection for meaningful interpretation while providing a positive experience for the participant. We present current challenges, recommendations for research design and priorities to facilitate the advancement of research in this field.
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Affiliation(s)
- Madeline L West
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Susan Hart
- Eating and Nutrition Research Group, School of Medicine, Western Sydney University, Cambelltown, Australia
- Nutrition Services, St Vincent's Health Network, Darlinghurst, Australia
- Translational Health Research Institute, Eating Disorders and Body Image, School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
| | - Amy Loughman
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Felice N Jacka
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Black Dog Institute, Randwick, New South Wales, Australia
- James Cook University, Townsville, Queensland, Australia
| | - Heidi M Staudacher
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Afrouz Abbaspour
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Solna, Stockholm, Sweden
| | - Andrea Phillipou
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia
- Department of Mental Health, Austin Health, Melbourne, Victoria, Australia
| | - Anu Ruusunen
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Tetyana Rocks
- Deakin University, IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
- Translational Health Research Institute, Eating Disorders and Body Image, School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
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16
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Quagebeur R, Dalile B, Raes J, Van Oudenhove L, Verbeke K, Vrieze E. The role of short-chain fatty acids (SCFAs) in regulating stress responses, eating behavior, and nutritional state in anorexia nervosa: protocol for a randomized controlled trial. J Eat Disord 2023; 11:191. [PMID: 37884972 PMCID: PMC10605799 DOI: 10.1186/s40337-023-00917-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/19/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE This protocol proposes investigating the effects of short-chain fatty acids (SCFAs)-namely acetate, propionate, and butyrate-as mediators of microbiota-gut-brain interactions on the acute stress response, eating behavior, and nutritional state in malnourished patients with anorexia nervosa (AN). SCFAs are produced by bacterial fermentation of dietary fiber in the gut and have recently been proposed as crucial mediators of the gut microbiota's effects on the host. Emerging evidence suggests that SCFAs impact human psychobiology through endocrine, neural, and immune pathways and may regulate stress responses and eating behavior. METHOD We will conduct a randomized, triple-blind, placebo-controlled trial in 92 patients with AN. Patients will receive either a placebo or a mixture of SCFAs (acetate propionate, butyrate) using pH-dependent colon-delivery capsules for six weeks. This clinical trial is an add-on to the standard inpatient psychotherapeutic program focusing on nutritional rehabilitation. HYPOTHESES We hypothesize that colonic SCFAs delivery will modulate neuroendocrine, cardiovascular, and subjective responses to an acute laboratory psychosocial stress task. As secondary outcome measures, we will assess alterations in restrictive eating behavior and nutritional status, as reflected by changes in body mass index. Additionally, we will explore changes in microbiota composition, gastrointestinal symptoms, eating disorder psychopathology, and related comorbidities. DISCUSSION The findings of this study would enhance our understanding of how gut microbiota-affiliated metabolites, particularly SCFAs, impact the stress response and eating behavior of individuals with AN. It has the potential to provide essential insights into the complex interplay between the gut, stress system, and eating behavior and facilitate new therapeutic targets for stress-related psychiatric disorders. This protocol is prospectively registered with ClinicalTrials.gov, with trial registration number NCT06064201.
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Affiliation(s)
- Robin Quagebeur
- Mind-Body Research, Department of Neurosciences, KU Leuven, Leuven, Belgium.
- Leuven Brain Institute, KU Leuven, Leuven, Belgium.
| | - Boushra Dalile
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Jeroen Raes
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium
- Center for Microbiology, Vlaams Instituut Voor Biotechnologie (VIB), Leuven, Belgium
| | - Lukas Van Oudenhove
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
- Cognitive and Affective Neuroscience Lab (CANlab), Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA
| | - Kristin Verbeke
- Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Elske Vrieze
- Mind-Body Research, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
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Calder A, Mock S, Friedli N, Pasi P, Hasler G. Psychedelics in the treatment of eating disorders: Rationale and potential mechanisms. Eur Neuropsychopharmacol 2023; 75:1-14. [PMID: 37352816 DOI: 10.1016/j.euroneuro.2023.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/25/2023] [Accepted: 05/28/2023] [Indexed: 06/25/2023]
Abstract
Eating disorders are serious illnesses showing high rates of mortality and comorbidity with other mental health problems. Psychedelic-assisted therapy has recently shown potential in the treatment of several common comorbidities of eating disorders, including mood disorders, post-traumatic stress disorder, and substance use disorders. The theorized therapeutic mechanisms of psychedelic-assisted therapy suggest that it could be beneficial in the treatment of eating disorders as well. In this review, we summarize preliminary data on the efficacy of psychedelic-assisted therapy in people with anorexia nervosa, bulimia nervosa, and binge eating disorder, which include studies and case reports of psychedelic-assisted therapy with ketamine, MDMA, psilocybin, and ayahuasca. We then discuss the potential therapeutic mechanisms of psychedelic-assisted therapy in these three eating disorders, including both general therapeutic mechanisms and those which are relatively specific to eating disorders. We find preliminary evidence that psychedelic-assisted therapy may be effective in the treatment of anorexia nervosa and bulimia nervosa, with very little data available on binge eating disorder. Regarding mechanisms, psychedelic-assisted therapy may be able to improve beliefs about body image, normalize reward processing, promote cognitive flexibility, and facilitate trauma processing. Just as importantly, it appears to promote general therapeutic factors relevant to both eating disorders and many of their common comorbidities. Lastly, we discuss potential safety concerns which may be associated with these treatments and present recommendations for future research.
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Affiliation(s)
- Abigail Calder
- University Center for Psychiatric Research, University of Fribourg, Chemin du Cardinal-Journet 3, 1752 Villars-sur-Glâne, Switzerland
| | - Seline Mock
- University Center for Psychiatric Research, University of Fribourg, Chemin du Cardinal-Journet 3, 1752 Villars-sur-Glâne, Switzerland
| | - Nicole Friedli
- University Center for Psychiatric Research, University of Fribourg, Chemin du Cardinal-Journet 3, 1752 Villars-sur-Glâne, Switzerland
| | - Patrick Pasi
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Switzerland
| | - Gregor Hasler
- University Center for Psychiatric Research, University of Fribourg, Chemin du Cardinal-Journet 3, 1752 Villars-sur-Glâne, Switzerland.
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Igudesman D, Abbaspour A, Reed KK, Flatt RE, Becken B, Thornton LM, Bulik CM, Carroll IM. Laxative Abuse Is Associated With a Depleted Gut Microbial Community Structure Among Women and Men With Binge-Eating Disorder or Bulimia Nervosa: The Binge Eating Genetics Initiative. Psychosom Med 2023; 85:727-735. [PMID: 37363967 PMCID: PMC10543565 DOI: 10.1097/psy.0000000000001226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
OBJECTIVE This study assessed the associations of binge eating, compensatory behaviors, and dietary restraint with the composition and diversity of the intestinal microbiota among participants with binge-eating disorder or bulimia nervosa. METHODS We analyzed data from 265 participants aged 18 to 45 years with current binge-eating disorder or bulimia nervosa enrolled in the Binge Eating Genetics Initiative study. We evaluated the associations of binge-eating frequency; presence/absence and frequency of vomiting, laxative use, and compulsive exercise; and dietary restraint with abundances of gut microbial genera, species, and diversity (Shannon diversity, Faith phylogenetic diversity, and Peilou's evenness) from 16S rRNA gene sequencing. General linear regression models adjusted for potential confounders, including age and current body mass index, were used to test associations; p values were corrected for the false discovery rate. RESULTS The normalized abundance of four genus- and species-level gut microbes and three diversity indices were lower among Binge Eating Genetics Initiative participants who reported any laxative use compared with those who reported no laxative use. Vomiting frequency was positively associated with the normalized abundance of the genus Escherichia-Shigella , a potential pathobiont, although the association was attenuated to nonsignificance after adjustment for age, body mass index, and binge-eating episodes. CONCLUSIONS Laxative use was highly and uniformly predictive of a reduced gut microbial diversity including potential commensals and pathobionts, and should be assessed and accounted for in all future studies of eating disorders and the gut microbiota. Future studies should collect data on specific medications-particularly laxatives-and dietary intake to obtain unbiased estimates of the effect of eating disorders on the gut microbiota and identify potential downstream clinical implications.Trial Registration:ClinicalTrials.gov identifier: NCT04162574 .
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Affiliation(s)
- Daria Igudesman
- From the Department of Nutrition (Igudesman, Reed, Bulik, Carroll), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Medical Epidemiology and Biostatistics (Abbaspour, Bulik) Karolinska Institutet, Stockholm, Sweden; Department of Psychology and Neuroscience (Flatt), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Division of Pediatric Infectious Diseases (Becken), University of Nebraska Medical Center, Omaha, Nebraska; and Department of Psychiatry, University of North Carolina at Chapel Hill (Thornton, Bulik), Chapel Hill, North Carolina
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19
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Gancz NN, Levinson JA, Callaghan BL. Sex and gender as critical and distinct contributors to the human brain-gut-microbiome axis. Brain Res Bull 2023; 199:110665. [PMID: 37192716 PMCID: PMC11149430 DOI: 10.1016/j.brainresbull.2023.110665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/25/2023] [Accepted: 05/13/2023] [Indexed: 05/18/2023]
Abstract
The brain-gut-microbiome axis (BGMA) is a pivotal contributor to human health. A large body of research, especially from animal models, has revealed bidirectional, causal relationships between the BGMA and sex. In particular, sex steroids appear to be affected by the BGMA, to influence the BGMA, and to moderate environmental effects on the BGMA. However, animal research on the relationship between sex and the BGMA has not translated well to human models. We contend that this is due in part to an oversimplified approach to sex: although BGMA researchers have traditionally approached sex as a unidimensional, dichotomous variable, it is in fact multidimensional and is comprised of both multi-categorical and continuous dimensions. We also contend that research on the BGMA in humans should approach gender as a variable that is distinct from sex and that gender may influence the BGMA through pathways that are independent from the effects of sex alone. Research practices that consider the complexity and distinctiveness of sex and gender in relation to the human BGMA will not only yield improved understanding of this consequential system, but will also enhance the development of treatments for adverse health outcomes with BGMA-related etiologies. We conclude with recommendations for the implementation of such practices.
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Affiliation(s)
- N N Gancz
- University of California, Los Angeles, Department of Psychology, 502 Portola Plaza, Los Angeles, CA 90095, USA.
| | - J A Levinson
- University of California, Los Angeles, Department of Psychology, 502 Portola Plaza, Los Angeles, CA 90095, USA
| | - B L Callaghan
- University of California, Los Angeles, Department of Psychology, 502 Portola Plaza, Los Angeles, CA 90095, USA
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20
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Clemente-Suárez VJ, Ramírez-Goerke MI, Redondo-Flórez L, Beltrán-Velasco AI, Martín-Rodríguez A, Ramos-Campo DJ, Navarro-Jiménez E, Yáñez-Sepúlveda R, Tornero-Aguilera JF. The Impact of Anorexia Nervosa and the Basis for Non-Pharmacological Interventions. Nutrients 2023; 15:2594. [PMID: 37299557 PMCID: PMC10255390 DOI: 10.3390/nu15112594] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
Anorexia nervosa is a psychiatric disorder with an unknown etiology that is characterized by an individual's preoccupation with their weight and body structure while denying the severity of their low body weight. Due to the fact that anorexia nervosa is multifaceted and may indicate the coexistence of genetic, social, hormonal, and psychiatric disorders, a description of non-pharmacological interventions can be used to ameliorate or reduce the symptoms of this condition. Consequently, the purpose of the present narrative review is to describe the profile's context in the anorexic person as well as the support they would require from their family and environment. In addition, it is aimed at examining preventative and non-pharmacological interventions, such as nutritional interventions, physical activity interventions, psychological interventions, psychosocial interventions, and physical therapy interventions. To reach the narrative review aims, a critical review was conducted utilizing both primary sources, such as scientific publications, and secondary sources, such as bibliographic indexes, web pages, and databases. Nutritional interventions include nutritional education and an individualized treatment for each patient, physical activity interventions include allowing patients to perform controlled physical activity, psychological interventions include family therapy and evaluation of the existence of other psychological disorders, psychosocial interventions include management of the relationship between the patient and social media and physical therapy interventions include relaxation massages and exercises to relieve pain. All these non-pharmacological interventions need to be individualized based on each patient's needs.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (M.I.R.-G.); (J.F.T.-A.)
| | - Maria Isabel Ramírez-Goerke
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (M.I.R.-G.); (J.F.T.-A.)
| | - Laura Redondo-Flórez
- Department of Health Sciences, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, C/Tajo s/n, Villaviciosa de Odón, 28670 Madrid, Spain;
| | - Ana Isabel Beltrán-Velasco
- Psychology Department, Facultad de Ciencias de la Vida y la Naturaleza, Universidad Antonio de Nebrija, 28240 Madrid, Spain;
| | - Alexandra Martín-Rodríguez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (M.I.R.-G.); (J.F.T.-A.)
| | - Domingo Jesús Ramos-Campo
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | | | - Rodrigo Yáñez-Sepúlveda
- Faculty of Education and Social Sciences, Universidad Andres Bello, Viña del Mar 2520000, Chile;
| | - José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (M.I.R.-G.); (J.F.T.-A.)
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21
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Sun J, Fang D, Wang Z, Liu Y. Sleep Deprivation and Gut Microbiota Dysbiosis: Current Understandings and Implications. Int J Mol Sci 2023; 24:ijms24119603. [PMID: 37298553 DOI: 10.3390/ijms24119603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/25/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
Gut microbiota comprises the microbial communities inhabiting our gastrointestinal (GI) tracts. Accordingly, these complex communities play a fundamental role in many host processes and are closely implicated in human health and diseases. Sleep deprivation (SD) has become increasingly common in modern society, partly owing to the rising pressure of work and the diversification of entertainment. It is well documented that sleep loss is a significant cause of various adverse outcomes on human health including immune-related and metabolic diseases. Furthermore, accumulating evidence suggests that gut microbiota dysbiosis is associated with these SD-induced human diseases. In this review, we summarize the gut microbiota dysbiosis caused by SD and the succedent diseases ranging from the immune system and metabolic system to various organs and highlight the critical roles of gut microbiota in these diseases. The implications and possible strategies to alleviate SD-related human diseases are also provided.
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Affiliation(s)
- Jingyi Sun
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China
| | - Dan Fang
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China
| | - Zhiqiang Wang
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China
- Joint International Research Laboratory of Agriculture and Agri-Product Safety, The Ministry of Education of China, Yangzhou University, Yangzhou 225009, China
- Institute of Comparative Medicine, Yangzhou University, Yangzhou 225009, China
| | - Yuan Liu
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China
- Joint International Research Laboratory of Agriculture and Agri-Product Safety, The Ministry of Education of China, Yangzhou University, Yangzhou 225009, China
- Institute of Comparative Medicine, Yangzhou University, Yangzhou 225009, China
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22
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Trinh S, Kogel V, Kneisel L, Müller-Limberger E, Herpertz-Dahlmann B, Beyer C, Seitz J. Gut Microbiota and Brain Alterations after Refeeding in a Translational Anorexia Nervosa Rat Model. Int J Mol Sci 2023; 24:ijms24119496. [PMID: 37298445 DOI: 10.3390/ijms24119496] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 05/23/2023] [Accepted: 05/27/2023] [Indexed: 06/12/2023] Open
Abstract
The gut microbiota composition is causally involved in the regulation of body weight. Through the gut-brain axis, microbiota play a role in psychiatric disorders including anorexia nervosa (AN). Previously, we showed microbiome changes to be associated with brain volume and astrocyte reductions after chronic starvation in an AN animal model. Here, we analyzed whether these alterations are reversible after refeeding. The activity-based anorexia (ABA) model is a well-established animal model that mimics several symptoms of AN. Fecal samples and the brain were analyzed. Like previous results, significant alterations in the microbiome were observed after starvation. After refeeding, including the normalization of food intake and body weight, α- and β-diversity, as well as the relative abundance of specific genera, were largely normalized in starved rats. Brain parameters appeared to normalize alongside microbial restitution with some aberrations in the white matter. We confirmed our previous findings of microbial dysbiosis during starvation and showed a high degree of reversibility. Thus, microbiome alterations in the ABA model appear to be mostly starvation-related. These findings support the usefulness of the ABA model in investigating starvation-induced effects on the microbiota-gut-brain axis to help comprehend the pathomechanisms of AN and potentially develop microbiome-targeted treatments for patients.
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Affiliation(s)
- Stefanie Trinh
- Institute of Neuroanatomy, RWTH Aachen University, Wendlingweg 2, 52074 Aachen, Germany
| | - Vanessa Kogel
- Institute of Neuroanatomy, RWTH Aachen University, Wendlingweg 2, 52074 Aachen, Germany
| | - Lilly Kneisel
- Institute of Neuroanatomy, RWTH Aachen University, Wendlingweg 2, 52074 Aachen, Germany
| | | | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Neuenhofer Weg 21, 52074 Aachen, Germany
| | - Cordian Beyer
- Institute of Neuroanatomy, RWTH Aachen University, Wendlingweg 2, 52074 Aachen, Germany
| | - Jochen Seitz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Neuenhofer Weg 21, 52074 Aachen, Germany
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23
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Trinh S, Käver L, Schlösser A, Simon A, Kogel V, Voelz C, Beyer C, Seitz J. Gut-Associated Lymphatic Tissue in Food-Restricted Rats: Influence of Refeeding and Probiotic Supplementation. Microorganisms 2023; 11:1411. [PMID: 37374913 DOI: 10.3390/microorganisms11061411] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/11/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
Anorexia nervosa (AN) is a severe and often chronic eating disorder that leads to alterations in the gut microbiome, which is known to influence several processes, such as appetite and body weight regulation, metabolism, gut permeability, inflammation, and gut-brain interactions. Using a translational activity-based anorexia (ABA) rat model, this study examined the effect of chronic food starvation, as well as multistrain probiotic supplementation and refeeding, on the structure of the gut and gut-associated lymphatic tissue (GALT). Our results indicated that ABA had an atrophic influence on intestinal morphology and increased the formation of GALT in the small bowel and colon. Higher formation of GALT in ABA rats appeared to be reversible upon application of a multistrain probiotic mixture and refeeding of the starved animals. This is the first time that increased GALT was found following starvation in the ABA model. Our results underscore a potential role of gut inflammatory alterations in the underlying pathophysiology of AN. Increased GALT could be linked to the gut microbiome, as probiotics were able to reverse this finding. These results emphasize the role of the microbiome-gut-brain axis in the pathomechanisms of AN and point to probiotics as potentially beneficial addendum in the treatment of AN.
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Affiliation(s)
- Stefanie Trinh
- Institute of Neuroanatomy, RWTH Aachen University, Wendlingweg 2, 52074 Aachen, Germany
| | - Larissa Käver
- Institute of Neuroanatomy, RWTH Aachen University, Wendlingweg 2, 52074 Aachen, Germany
| | - Anna Schlösser
- Institute of Neuroanatomy, RWTH Aachen University, Wendlingweg 2, 52074 Aachen, Germany
| | - Anna Simon
- Institute of Neuroanatomy, RWTH Aachen University, Wendlingweg 2, 52074 Aachen, Germany
| | - Vanessa Kogel
- Institute of Neuroanatomy, RWTH Aachen University, Wendlingweg 2, 52074 Aachen, Germany
| | - Clara Voelz
- Institute of Neuroanatomy, RWTH Aachen University, Wendlingweg 2, 52074 Aachen, Germany
| | - Cordian Beyer
- Institute of Neuroanatomy, RWTH Aachen University, Wendlingweg 2, 52074 Aachen, Germany
| | - Jochen Seitz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Neuenhofer Weg 21, 52074 Aachen, Germany
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24
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Mir HD, Giorgini G, Di Marzo V. The emerging role of the endocannabinoidome-gut microbiome axis in eating disorders. Psychoneuroendocrinology 2023; 154:106295. [PMID: 37229916 DOI: 10.1016/j.psyneuen.2023.106295] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/13/2023] [Accepted: 05/16/2023] [Indexed: 05/27/2023]
Abstract
Among the sources of chemical signals regulating food intake, energy metabolism and body weight, few have attracted recently as much attention as the expanded endocannabinoid system, or endocannabinoidome (eCBome), and the gut microbiome, the two systems on which this review article is focussed. Therefore, it is legitimate to expect that these two systems also play a major role in the etiopathology of eating disorders (EDs), in particular of anorexia nervosa, bulimia nervosa and binge-eating disorder. The major mechanisms through which, also via interactions with other endogenous signaling systems, the eCBome, with its several lipid mediators and receptors, and the gut microbiome, via its variety of microbial kingdoms, phyla and species, and armamentarium of metabolites, intervene in these disorders, are described here, based on several published studies in either experimental models or patients. Additionally, in view of the emerging multi-faceted cross-talk mechanisms between these two complex systems, we discuss the possibility that the eCBome-gut microbiome axis is also involved in EDs.
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Affiliation(s)
- Hayatte-Dounia Mir
- Centre de Recherche de l'Institut Universitaire de Pneumologie et Cardiologie (CRIUCPQ), Université Laval, Québec, Canada; Department of Medicine, Faculty of Medicine (FMED), Université Laval, Québec, Canada; Canada Excellence Research Chair on the Microbiome-Endocannabinoidome Axis in Metabolic Health (CERC-MEND), Université Laval, Québec, Canada
| | - Giada Giorgini
- Centre de Recherche de l'Institut Universitaire de Pneumologie et Cardiologie (CRIUCPQ), Université Laval, Québec, Canada; Department of Medicine, Faculty of Medicine (FMED), Université Laval, Québec, Canada; Unité Mixte Internationale en Recherche Chimique et Biomoléculaire sur le Microbiome et son Impact sur la Santé Métabolique et la Nutrition (UMI-MicroMeNu) entre l'Université Laval, Québec, Canada, et le Consiglio Nazionale delle Ricerche, Institute of Biomolecular Chemistry (ICB-CNR), Pozzuoli, Italy; Canada Excellence Research Chair on the Microbiome-Endocannabinoidome Axis in Metabolic Health (CERC-MEND), Université Laval, Québec, Canada
| | - Vincenzo Di Marzo
- Centre de Recherche de l'Institut Universitaire de Pneumologie et Cardiologie (CRIUCPQ), Université Laval, Québec, Canada; Department of Medicine, Faculty of Medicine (FMED), Université Laval, Québec, Canada; Unité Mixte Internationale en Recherche Chimique et Biomoléculaire sur le Microbiome et son Impact sur la Santé Métabolique et la Nutrition (UMI-MicroMeNu) entre l'Université Laval, Québec, Canada, et le Consiglio Nazionale delle Ricerche, Institute of Biomolecular Chemistry (ICB-CNR), Pozzuoli, Italy; Centre Nutrition, Santé et Société (NUTRISS), Université Laval, Québec, Canada; Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada; École de nutrition, Faculté des Sciences de l'agriculture et de l'alimentation (FSAA), Université Laval, Québec, Canada; Canada Excellence Research Chair on the Microbiome-Endocannabinoidome Axis in Metabolic Health (CERC-MEND), Université Laval, Québec, Canada.
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25
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Amerio A, Escelsior A, Martino E, Strangio A, Giacomini C, Montagna E, Aguglia A, Bellomo M, Sukkar SG, Saverino D. Dysfunction of Inflammatory Pathways and Their Relationship with Anti-Hypothalamic Autoantibodies in Patients with Anorexia Nervosa. Nutrients 2023; 15:2199. [PMCID: PMC10180712 DOI: 10.3390/nu15092199] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/27/2023] [Accepted: 05/03/2023] [Indexed: 06/29/2023] Open
Abstract
Background: Despite several attempts, the etiopathogenesis of anorexia nervosa (AN) is still unknown. However, the activation of the immune response in neuropsychiatric diseases, including AN, is increasingly evident. We aimed to explore immune response parameters in patients with AN and identify the link between the presence of specific autoantibodies for hypothalamic antigens and the inflammatory response. The relationship between inflammatory markers and the duration of the disease has been also investigated. Methods: Twenty-two patients with AN were included, and none were under psychopharmacological treatment or suffering from autoimmune conditions. Serum concentrations of interleukin (IL)-6, IL-1β, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β, and IL-21 were determined by ELISA kits. In addition, autoantibodies against hypothalamic antigens are quantitatively evaluated. Results: IL-6, IL-1 β, TNF-α, and TGF-β are significantly increased in patients with AN. A positive correlation with body mass index and with the amount of autoantibody specific for hypothalamic antigens exists. Notably, a progressive reduction of cytokines correlates with the progression of AN. In addition, IL-21 is increased in the blood of patients with AN and negatively correlates with autoantibody concentrations. Conclusions: This study shows that the increased pro-inflammatory phenotype in patients affected by AN correlates with the concentration of autoantibody specific for hypothalamic antigens. Of interest, the pro-inflammatory state seems to be reduced with duration of AN. In addition, IL-21 could work as a stimulant of the immune response, thus possibly increasing the autoreactivity.
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Affiliation(s)
- Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16126 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Andrea Escelsior
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16126 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Eleonora Martino
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
- Dietetics and Clinical Nutrition Unit, Genoa University, 16132 Genoa, Italy
| | - Antonella Strangio
- Department of Experimental Medicine (DiMeS), Section of Human Anatomy, University of Genoa, 16126 Genoa, Italy
| | - Costanza Giacomini
- Department of Mental Health and Pathological Addictions, Genoa Local Health Authority ASL4, 16043 Chiavari, Italy
| | - Elisa Montagna
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16126 Genoa, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16126 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Marina Bellomo
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Samir Giuseppe Sukkar
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
- Dietetics and Clinical Nutrition Unit, Genoa University, 16132 Genoa, Italy
| | - Daniele Saverino
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
- Department of Experimental Medicine (DiMeS), Section of Human Anatomy, University of Genoa, 16126 Genoa, Italy
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Fan Y, Støving RK, Berreira Ibraim S, Hyötyläinen T, Thirion F, Arora T, Lyu L, Stankevic E, Hansen TH, Déchelotte P, Sinioja T, Ragnarsdottir O, Pons N, Galleron N, Quinquis B, Levenez F, Roume H, Falony G, Vieira-Silva S, Raes J, Clausen L, Telléus GK, Bäckhed F, Oresic M, Ehrlich SD, Pedersen O. The gut microbiota contributes to the pathogenesis of anorexia nervosa in humans and mice. Nat Microbiol 2023; 8:787-802. [PMID: 37069399 PMCID: PMC10159860 DOI: 10.1038/s41564-023-01355-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 03/03/2023] [Indexed: 04/19/2023]
Abstract
Anorexia nervosa (AN) is an eating disorder with a high mortality. About 95% of cases are women and it has a population prevalence of about 1%, but evidence-based treatment is lacking. The pathogenesis of AN probably involves genetics and various environmental factors, and an altered gut microbiota has been observed in individuals with AN using amplicon sequencing and relatively small cohorts. Here we investigated whether a disrupted gut microbiota contributes to AN pathogenesis. Shotgun metagenomics and metabolomics were performed on faecal and serum samples, respectively, from a cohort of 77 females with AN and 70 healthy females. Multiple bacterial taxa (for example, Clostridium species) were altered in AN and correlated with estimates of eating behaviour and mental health. The gut virome was also altered in AN including a reduction in viral-bacterial interactions. Bacterial functional modules associated with the degradation of neurotransmitters were enriched in AN and various structural variants in bacteria were linked to metabolic features of AN. Serum metabolomics revealed an increase in metabolites associated with reduced food intake (for example, indole-3-propionic acid). Causal inference analyses implied that serum bacterial metabolites are potentially mediating the impact of an altered gut microbiota on AN behaviour. Further, we performed faecal microbiota transplantation from AN cases to germ-free mice under energy-restricted feeding to mirror AN eating behaviour. We found that the reduced weight gain and induced hypothalamic and adipose tissue gene expression were related to aberrant energy metabolism and eating behaviour. Our 'omics' and mechanistic studies imply that a disruptive gut microbiome may contribute to AN pathogenesis.
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Affiliation(s)
- Yong Fan
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - René Klinkby Støving
- Center for Eating Disorders, Odense University Hospital, and Research Unit for Medical Endocrinology, Mental Health Services in the Region of Southern Denmark, Open Patient data Explorative Network (OPEN) and Clinical Institute, University of Southern Denmark, Odense, Denmark
| | | | | | | | - Tulika Arora
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Liwei Lyu
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
- Department of Medicine, University of Copenhagen and Herlev-Gentofte University Hospital, Copenhagen, Denmark
| | - Evelina Stankevic
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Tue Haldor Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Pierre Déchelotte
- INSERM U1073 Research Unit and TargEDys, Rouen University, Rouen, France
| | - Tim Sinioja
- School of Science and Technology, Örebro University, Örebro, Sweden
| | | | - Nicolas Pons
- Université Paris-Saclay, INRAE, MGP, Jouy-en-Josas, France
| | | | | | | | - Hugo Roume
- Université Paris-Saclay, INRAE, MGP, Jouy-en-Josas, France
| | - Gwen Falony
- Laboratory of Molecular bacteriology, Department of Microbiology and Immunology, Rega Institute Ku Leuven, Leuven, Belgium
- Center for Microbiology, VIB, Leuven, Belgium
- Institute of Medical Microbiology and Hygiene and Research Center for Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Institute of Molecular Biology (IMB), Mainz, Germany
| | - Sara Vieira-Silva
- Laboratory of Molecular bacteriology, Department of Microbiology and Immunology, Rega Institute Ku Leuven, Leuven, Belgium
- Center for Microbiology, VIB, Leuven, Belgium
- Institute of Medical Microbiology and Hygiene and Research Center for Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Institute of Molecular Biology (IMB), Mainz, Germany
| | - Jeroen Raes
- Laboratory of Molecular bacteriology, Department of Microbiology and Immunology, Rega Institute Ku Leuven, Leuven, Belgium
- Center for Microbiology, VIB, Leuven, Belgium
| | - Loa Clausen
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Gry Kjaersdam Telléus
- Unit for Psychiatric Research, Aalborg University Hospital, Aalborg, Denmark
- Department of Communication and Psychology, The Faculty of Social Sciences and Humanities, Aalborg University, Aalborg, Denmark
| | - Fredrik Bäckhed
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
- The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Physiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Matej Oresic
- School of Medical Sciences, Örebro University, Örebro, Sweden
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland
| | - S Dusko Ehrlich
- Université Paris-Saclay, INRAE, MGP, Jouy-en-Josas, France
- Department of Clinical and Movement Neurosciences, University College London, London, UK
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark.
- Department of Medicine, University of Copenhagen and Herlev-Gentofte University Hospital, Copenhagen, Denmark.
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Majumdar A, Siva Venkatesh IP, Basu A. Short-Chain Fatty Acids in the Microbiota-Gut-Brain Axis: Role in Neurodegenerative Disorders and Viral Infections. ACS Chem Neurosci 2023; 14:1045-1062. [PMID: 36868874 DOI: 10.1021/acschemneuro.2c00803] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Abstract
The gut-brain axis (GBA) is the umbrella term to include all bidirectional communication between the brain and gastrointestinal (GI) tract in the mammalian body. Evidence from over two centuries describes a significant role of GI microbiome in health and disease states of the host organism. Short-chain fatty acids (SCFAs), mainly acetate, butyrate, and propionate that are the physiological forms of acetic acid, butyric acid, and propionic acid respectively, are GI bacteria derived metabolites. SCFAs have been reported to influence cellular function in multiple neurodegenerative diseases (NDDs). In addition, the inflammation modulating properties of SCFAs make them suitable therapeutic candidates in neuroinflammatory conditions. This review provides a historical background of the GBA and current knowledge of the GI microbiome and role of individual SCFAs in central nervous system (CNS) disorders. Recently, a few reports have also identified the effects of GI metabolites in the case of viral infections. Among these viruses, the flaviviridae family is associated with neuroinflammation and deterioration of CNS functions. In this context, we additionally introduce SCFA based mechanisms in different viral pathogenesis to understand the former's potential as agents against flaviviral disease.
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Affiliation(s)
- Atreye Majumdar
- National Brain Research Centre, Manesar, Haryana 122052, India
| | | | - Anirban Basu
- National Brain Research Centre, Manesar, Haryana 122052, India
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Zhu R, Tian P, Zhang H, Wang G, Chen W. Gut microbiome-brain interactions in anorexia nervosa: Potential mechanisms and regulatory strategies. Neuropharmacology 2023; 224:109315. [PMID: 36356938 DOI: 10.1016/j.neuropharm.2022.109315] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 09/29/2022] [Accepted: 10/30/2022] [Indexed: 11/09/2022]
Abstract
Anorexia nervosa (AN) is a psychiatric disorder characterised by malnutrition, fear of weight gain, and body image disturbances. The aetiology of AN is complex, and may involve environmental factors, genetic factors, and biochemical factors, with the latter meaning that AN may be closely associated with neurons, neurotransmitters, and hormones related to appetite and emotional regulation. In addition, an increasing number of studies have shown there is a link between the intestinal microbiota and psychiatric disorders, such as depression. However, few studies and reviews have focused on AN and gut microbes. Accordingly, in this review, we examine the potential pathogenesis of AN in terms of changes in the gut microbiota and its metabolites, and their effects on AN. The neurobiological function of the nervous system in relation to AN are also been mentioned. Furthermore, we suggest future research directions for this field, and note that probiotics may be developed for use as dietary supplements to help alleviate AN in patients.
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Affiliation(s)
- Ran Zhu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, PR China; School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Peijun Tian
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, PR China; School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Hao Zhang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, PR China; School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, China; National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, Jiangsu, 214122, China; (Yangzhou) Institute of Food Biotechnology, Jiangnan University, Yangzhou, 225004, China; Wuxi Translational Medicine Research Center and Jiangsu Translational Medicine Research Institute Wuxi Branch, Wuxi, Jiangsu, 214122, China
| | - Gang Wang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, PR China; School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, China; National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, Jiangsu, 214122, China; (Yangzhou) Institute of Food Biotechnology, Jiangnan University, Yangzhou, 225004, China.
| | - Wei Chen
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, PR China; School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, China; Wuxi Translational Medicine Research Center and Jiangsu Translational Medicine Research Institute Wuxi Branch, Wuxi, Jiangsu, 214122, China
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Anorexia nervosa and microbiota: systematic review and critical appraisal. Eat Weight Disord 2023; 28:1. [PMID: 36752887 PMCID: PMC9908645 DOI: 10.1007/s40519-023-01529-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/04/2023] [Indexed: 02/09/2023] Open
Abstract
PURPOSE Recent studies have reported a gut microbiota imbalance or dysbiosis associated with anorexia nervosa (AN), which has prompted an appraisal of its aetiological role, and the reformulation of AN as a metabo-psychiatric disorder. Thus, the aim of this paper was to critically review the current scientific findings regarding the role of microbiota in anorexia nervosa. METHODS A systematic study of peer-reviewed literature published in four databases between 2009 and 2022 was conducted according to PRISMA guidelines. Both human and animal studies were included. RESULTS A total of 18 studies were included. In animal models, both the preclinical and clinical findings were inconsistent regarding microbiota composition, faecal metabolite concentrations, and the effects of human faecal microbiota transplants. CONCLUSION The methodological limitations, lack of standardisation, and conceptual ambiguity hinder the analysis of microbiota as a key explanatory factor for AN. LEVEL OF EVIDENCE Level I, systematic review.
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Igudesman D, Crandell J, Corbin KD, Zaharieva DP, Addala A, Thomas JM, Bulik CM, Pence BW, Pratley RE, Kosorok MR, Maahs DM, Carroll IM, Mayer-Davis EJ. Associations of disordered eating with the intestinal microbiota and short-chain fatty acids among young adults with type 1 diabetes. Nutr Metab Cardiovasc Dis 2023; 33:388-398. [PMID: 36586772 PMCID: PMC9925402 DOI: 10.1016/j.numecd.2022.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 11/05/2022] [Accepted: 11/10/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS Disordered eating (DE) in type 1 diabetes (T1D) includes insulin restriction for weight loss with serious complications. Gut microbiota-derived short chain fatty acids (SCFA) may benefit host metabolism but are reduced in T1D. We evaluated the hypothesis that DE and insulin restriction were associated with reduced SCFA-producing gut microbes, SCFA, and intestinal microbial diversity in adults with T1D. METHODS AND RESULTS We collected stool samples at four timepoints in a hypothesis-generating gut microbiome pilot study ancillary to a weight management pilot in young adults with T1D. 16S ribosomal RNA gene sequencing measured the normalized abundance of SCFA-producing intestinal microbes. Gas-chromatography mass-spectrometry measured SCFA (total, acetate, butyrate, and propionate). The Diabetes Eating Problem Survey-Revised (DEPS-R) assessed DE and insulin restriction. Covariate-adjusted and Bonferroni-corrected generalized estimating equations modeled the associations. COVID-19 interrupted data collection, so models were repeated restricted to pre-COVID-19 data. Data were available for 45 participants at 109 visits, which included 42 participants at 65 visits pre-COVID-19. Participants reported restricting insulin "At least sometimes" at 53.3% of visits. Pre-COVID-19, each 5-point DEPS-R increase was associated with a -0.34 (95% CI -0.56, -0.13, p = 0.07) lower normalized abundance of genus Anaerostipes; and the normalized abundance of Lachnospira genus was -0.94 (95% CI -1.5, -0.42), p = 0.02 lower when insulin restriction was reported "At least sometimes" compared to "Rarely or Never". CONCLUSION DE and insulin restriction were associated with a reduced abundance of SCFA-producing gut microbes pre-COVID-19. Additional studies are needed to confirm these associations to inform microbiota-based therapies in T1D.
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Affiliation(s)
- Daria Igudesman
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA; AdventHealth Translational Research Institute, Orlando, 32804, USA.
| | - Jamie Crandell
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
| | - Karen D Corbin
- AdventHealth Translational Research Institute, Orlando, 32804, USA
| | - Dessi P Zaharieva
- Department of Pediatrics, Division of Endocrinology, Stanford University, Stanford, 94304, USA
| | - Ananta Addala
- Department of Pediatrics, Division of Endocrinology, Stanford University, Stanford, 94304, USA
| | - Joan M Thomas
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
| | - Cynthia M Bulik
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Brian W Pence
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
| | | | - Michael R Kosorok
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
| | - David M Maahs
- Department of Pediatrics, Division of Endocrinology, Stanford University, Stanford, 94304, USA
| | - Ian M Carroll
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
| | - Elizabeth J Mayer-Davis
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
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31
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Yu Z, Muehleman V. Eating Disorders and Metabolic Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2446. [PMID: 36767812 PMCID: PMC9916228 DOI: 10.3390/ijerph20032446] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
Eating disorders are complex diseases with multifactorial causes. According to the Diagnostic and Statistical Manual of Mental Disorders text version (DSM-5-TR) and the WHO International Classification of Diseases and Related Health Problems (ICD-11), the major types of eating disorders include anorexia nervosa, bulimia nervosa, and binge eating disorder. The prevalence of eating disorders is alarmingly increasing globally. Moreover, the COVID-19 pandemic has led to more development and worsening of eating disorders. Patients with eating disorders exhibit high rates of psychiatric comorbidities and medical comorbidities such as obesity, diabetes, and metabolic syndrome. This paper aims to review and discuss the comorbidities of eating disorders with those metabolic diseases. Eating disorder treatment typically includes a combination of some or all approaches such as psychotherapy, nutrition education, and medications. Early detection and intervention are important for the treatment of eating disorders.
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Affiliation(s)
- Zhiping Yu
- Department of Nutrition and Dietetics, University of North Florida, 1 UNF Drive, Jacksonville, FL 32224, USA
| | - Valerie Muehleman
- Department of Nutrition and Dietetics, University of North Florida, 1 UNF Drive, Jacksonville, FL 32224, USA
- Beaufort Jasper Hampton Comprehensive Health Services, Inc., P.O. Box 357, Ridgeland, SC 29926, USA
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Dhopatkar N, Keeler JL, Mutwalli H, Whelan K, Treasure J, Himmerich H. Gastrointestinal symptoms, gut microbiome, probiotics and prebiotics in anorexia nervosa: A review of mechanistic rationale and clinical evidence. Psychoneuroendocrinology 2023; 147:105959. [PMID: 36327759 DOI: 10.1016/j.psyneuen.2022.105959] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/22/2022] [Accepted: 10/20/2022] [Indexed: 11/27/2022]
Abstract
Recent research has revealed the pivotal role that the gut microbiota might play in psychiatric disorders. In anorexia nervosa (AN), the gut microbiota may be involved in pathophysiology as well as in the gastrointestinal (GI) symptoms commonly experienced. This review collates evidence for the potential role of gut microbiota in AN, including modulation of the immune system, the gut-brain axis and GI function. We examined studies comparing gut microbiota in AN with healthy controls as well as those looking at modifications in gut microbiota with nutritional treatment. Changes in energy intake and nutritional composition influence gut microbiota and may play a role in the evolution of the gut microbial picture in AN. Additionally, some evidence indicates that pre-morbid gut microbiota may influence risk of developing AN. There appear to be similarities in gut microbial composition, mechanisms of interaction and GI symptoms experienced in AN and other GI disorders such as inflammatory bowel disease and functional GI disorders. Probiotics and prebiotics have been studied in these disorders showing therapeutic effects of probiotics in some cases. Additionally, some evidence exists for the therapeutic benefits of probiotics in depression and anxiety, commonly seen as co-morbidities in AN. Moreover, preliminary evidence for the use of probiotics in AN has shown positive effects on immune modulation. Based on these findings, we discuss the potential therapeutic role for probiotics in ameliorating symptoms in AN.
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Affiliation(s)
- Namrata Dhopatkar
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham BR3 3BX, UK.
| | - Johanna Louise Keeler
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.
| | - Hiba Mutwalli
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.
| | - Kevin Whelan
- Department of Nutritional Sciences, King's College London, London SE1 9NH, UK.
| | - Janet Treasure
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham BR3 3BX, UK; Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.
| | - Hubertus Himmerich
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham BR3 3BX, UK; Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.
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Garcia-Gil M, Ceccarini MR, Stoppini F, Cataldi S, Mazzeschi C, Delvecchio E, Albi E, Gizzi G. Brain and gut microbiota disorders in the psychopathology of anorexia nervosa. Transl Neurosci 2022; 13:516-526. [PMID: 36660007 PMCID: PMC9824428 DOI: 10.1515/tnsci-2022-0267] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/05/2022] [Accepted: 12/05/2022] [Indexed: 01/08/2023] Open
Abstract
Studies of pathophysiological mechanisms involved in eating disorders (EDs) have intensified over the past several years, revealing their unprecedented and unanticipated complexity. Results from many articles highlight critical aspects in each member of ED family. Notably, anorexia nervosa (AN) is a disorder due to undefined etiology, frequently associated with symptoms of depression, anxiety, obsessive-compulsiveness, accompanied by endocrine alterations, altered immune response, increased inflammation, and dysbiosis of the gut microbiota. Hence, an advanced knowledge of how and why a multisystem involvement exists is of paramount importance to understand the pathogenetic mechanisms of AN. In this review, we describe the change in the brain structure/function focusing on hypothalamic endocrine disorders and the disequilibrium of gut microbiota in AN that might be responsible for the psychopathological complication.
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Affiliation(s)
- Mercedes Garcia-Gil
- Department of Biology, University of Pisa, 56127, Pisa, Italy,Department of Biology, Interdepartmental Research Center Nutrafood “Nutraceuticals and Food for Health”, University of Pisa, 56127 Pisa, Italy,Department of Biology, CISUP, Center for Instrument Sharing of the University of Pisa, 56127 Pisa, Italy
| | | | - Fabrizio Stoppini
- Department of Pharmaceutical Science, University of Perugia, 06126 Perugia, Italy
| | - Samuela Cataldi
- Department of Pharmaceutical Science, University of Perugia, 06126 Perugia, Italy
| | - Claudia Mazzeschi
- Department of Philosophy, Social Sciences and Education, University of Perugia, 06126 Perugia, Italy
| | - Elisa Delvecchio
- Department of Philosophy, Social Sciences and Education, University of Perugia, 06126 Perugia, Italy
| | - Elisabetta Albi
- Department of Pharmaceutical Science, University of Perugia, 06126 Perugia, Italy
| | - Giulia Gizzi
- Department of Philosophy, Social Sciences and Education, University of Perugia, 06126 Perugia, Italy
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Asbjornsdottir B, Miranda-Ribera A, Fiorentino M, Konno T, Cetinbas M, Lan J, Sadreyev RI, Gudmundsson LS, Gottfredsson M, Lauth B, Birgisdottir BE, Fasano A. Prophylactic Effect of Bovine Colostrum on Intestinal Microbiota and Behavior in Wild-Type and Zonulin Transgenic Mice. Biomedicines 2022; 11:biomedicines11010091. [PMID: 36672598 PMCID: PMC9855927 DOI: 10.3390/biomedicines11010091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
The microbiota-gut-brain axis (MGBA) involves bidirectional communication between intestinal microbiota and the gastrointestinal (GI) tract, central nervous system (CNS), neuroendocrine/neuroimmune systems, hypothalamic-pituitary-adrenal (HPA) axis, and enteric nervous system (ENS). The intestinal microbiota can influence host physiology and pathology. Dysbiosis involves the loss of beneficial microbial input or signal, diversity, and expansion of pathobionts, which can lead to loss of barrier function and increased intestinal permeability (IP). Colostrum, the first milk from mammals after birth, is a natural source of nutrients and is rich in oligosaccharides, immunoglobulins, growth factors, and anti-microbial components. The aim of this study was to investigate if bovine colostrum (BC) administration might modulate intestinal microbiota and, in turn, behavior in two mouse models, wild-type (WT) and Zonulin transgenic (Ztm)-the latter of which is characterized by dysbiotic microbiota, increased intestinal permeability, and mild hyperactivity-and to compare with control mice. Bioinformatics analysis of the microbiome showed that consumption of BC was associated with increased taxonomy abundance (p = 0.001) and diversity (p = 0.004) of potentially beneficial species in WT mice and shifted dysbiotic microbial community towards eubiosis in Ztm mice (p = 0.001). BC induced an anxiolytic effect in WT female mice compared with WT female control mice (p = 0.0003), and it reduced anxiogenic behavior in Ztm female mice compared with WT female control mice (p = 0.001), as well as in Ztm male mice compared with WT BC male mice (p = 0.03). As evidenced in MGBA interactions, BC supplementation may well be applied for prophylactic approaches in the future. Further research is needed to explore human interdependencies between intestinal microbiota, including eubiosis and pathobionts, and neuroinflammation, and the potential value of BC for human use. The MGH Institutional Animal Care and Use Committee authorized the animal study (2013N000013).
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Affiliation(s)
- Birna Asbjornsdottir
- Department of Pediatric Gastroenterology and Nutrition, Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA 02152, USA
- School of Health Sciences, Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, 101 Reykjavik, Iceland
- Correspondence:
| | - Alba Miranda-Ribera
- Department of Pediatric Gastroenterology and Nutrition, Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA 02152, USA
| | - Maria Fiorentino
- Department of Pediatric Gastroenterology and Nutrition, Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA 02152, USA
| | - Takumi Konno
- Department of Pediatric Gastroenterology and Nutrition, Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA 02152, USA
| | - Murat Cetinbas
- Department of Molecular Biology and Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Jinggang Lan
- Department of Pediatric Gastroenterology and Nutrition, Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA 02152, USA
| | - Ruslan I. Sadreyev
- Department of Molecular Biology and Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Larus S. Gudmundsson
- School of Health Sciences, Faculty of Pharmaceutical Sciences, University of Iceland, 101 Reykjavik, Iceland
| | - Magnus Gottfredsson
- School of Health Sciences, Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland
- Department of Scientific Affairs, Landspitali University Hospital, 101 Reykjavik, Iceland
- Department of Infectious Diseases, Landspitali University Hospital, 101 Reykjavik, Iceland
| | - Bertrand Lauth
- School of Health Sciences, Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland
- Department of Child and Adolescent Psychiatry, Landspitali University Hospital, 105 Reykjavik, Iceland
| | - Bryndis Eva Birgisdottir
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, 101 Reykjavik, Iceland
| | - Alessio Fasano
- Department of Pediatric Gastroenterology and Nutrition, Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA 02152, USA
- Department of Pediatrics, Harvard Medical School, Harvard University, Boston, MA 02114, USA
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Liang S, Sin ZY, Yu J, Zhao S, Xi Z, Bruzzone R, Tun HM. Multi-cohort analysis of depression-associated gut bacteria sheds insight on bacterial biomarkers across populations. Cell Mol Life Sci 2022; 80:9. [PMID: 36495344 PMCID: PMC11072413 DOI: 10.1007/s00018-022-04650-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 11/15/2022] [Accepted: 11/24/2022] [Indexed: 12/13/2022]
Abstract
Gut microbes are associated with the development of depression based on extensive evidence. However, previous studies have led to conflicting reports on this association, posing challenges to the application of gut bacteria in the diagnostics and treatment of depression. To minimise heterogenicity in data analysis, the present meta-analysis adopted a standardised bioinformatics and statistical pipeline to analyse 16S rRNA sequences of 1827 samples from eight different cohorts. Although changes in the overall bacterial community were identified by our meta-analysis, depressive-correlated changes in alpha-diversity were absent. Enrichment of Bacteroidetes, Parabacteroides, Barnesiella, Bacteroides, and Bacteroides vulgatus, along with depletion in Firmicutes, Dialister, Oscillospiraceae UCG 003 and UCG 002, and Bacteroides plebeius, were observed in depressive-associated bacteria. By contrast, elevated L-glutamine degradation, and reduced L-glutamate and L-isoleucine biosynthesis were identified in depressive-associated microbiomes. After systemically reviewing the data of these collected cohorts, we have established a bacterial classifier to identify depressive symptoms with AUC 0.834 and 0.685 in the training and external validation dataset, respectively. Moreover, a low-risk bacterial cluster for depressive symptoms was identified, which was represented by a lower abundance of Escherichia-Shigella, and a higher abundance of Faecalibacterium, Oscillospiraceae UCG 002, Ruminococcus, and Christensenellaceae R.7 group.
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Affiliation(s)
- Suisha Liang
- HKU-Pasteur Research Pole, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Zhen Ye Sin
- HKU-Pasteur Research Pole, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Microbiota I-Center (MagIC), Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Juelei Yu
- Microbiota I-Center (MagIC), Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Shilin Zhao
- Microbiota I-Center (MagIC), Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zhang Xi
- HKU-Pasteur Research Pole, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Microbiota I-Center (MagIC), Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Roberto Bruzzone
- HKU-Pasteur Research Pole, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Hein M Tun
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Microbiota I-Center (MagIC), Hong Kong SAR, China.
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Plasma Concentrations of Short-Chain Fatty Acids in Active and Recovered Anorexia Nervosa. Nutrients 2022; 14:nu14245247. [PMID: 36558405 PMCID: PMC9781195 DOI: 10.3390/nu14245247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/01/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022] Open
Abstract
Anorexia nervosa (AN) is one of the most lethal psychiatric disorders. To date, we lack adequate knowledge about the (neuro)biological mechanisms of this disorder to inform evidence-based pharmacological treatment. Gut dysbiosis is a trending topic in mental health, including AN. Communication between the gut microbiota and the brain is partly mediated by metabolites produced by the gut microbiota such as short-chain fatty acids (SCFA). Previous research has suggested a role of SCFA in weight regulation (e.g., correlations between specific SCFA-producing bacteria and BMI have been demonstrated). Moreover, fecal SCFA concentrations are reported to be altered in active AN. However, data concerning SCFA concentrations in individuals who have recovered from AN are limited. In the present study, we analyzed and compared the plasma concentrations of seven SCFA (acetic-, butyric-, formic-, isobutyric-, isovaleric-, propionic-, and succinic acid) in females with active AN (n = 109), recovered from AN (AN-REC, n = 108), and healthy-weight age-matched controls (CTRL, n = 110), and explored correlations between SCFA concentrations and BMI. Significantly lower plasma concentrations of butyric, isobutyric-, and isovaleric acid were detected in AN as well as AN-REC compared with CTRL. We also show significant correlations between plasma concentrations of SCFA and BMI. These results encourage studies evaluating whether interventions directed toward altering gut microbiota and SCFA could support weight restoration in AN.
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Alloo J, Leleu I, Grangette C, Pied S. Parasite infections, neuroinflammation, and potential contributions of gut microbiota. Front Immunol 2022; 13:1024998. [PMID: 36569929 PMCID: PMC9772015 DOI: 10.3389/fimmu.2022.1024998] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
Many parasitic diseases (including cerebral malaria, human African trypanosomiasis, cerebral toxoplasmosis, neurocysticercosis and neuroschistosomiasis) feature acute or chronic brain inflammation processes, which are often associated with deregulation of glial cell activity and disruption of the brain blood barrier's intactness. The inflammatory responses of astrocytes and microglia during parasite infection are strongly influenced by a variety of environmental factors. Although it has recently been shown that the gut microbiota influences the physiology and immunomodulation of the central nervous system in neurodegenerative diseases like Alzheimer's disease and Parkinson's, the putative link in parasite-induced neuroinflammatory diseases has not been well characterized. Likewise, the central nervous system can influence the gut microbiota. In parasite infections, the gut microbiota is strongly perturbed and might influence the severity of the central nervous system inflammation response through changes in the production of bacterial metabolites. Here, we review the roles of astrocytes and microglial cells in the neuropathophysiological processes induced by parasite infections and their possible regulation by the gut microbiota.
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Terry SM, Barnett JA, Gibson DL. A critical analysis of eating disorders and the gut microbiome. J Eat Disord 2022; 10:154. [PMID: 36329546 PMCID: PMC9635068 DOI: 10.1186/s40337-022-00681-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022] Open
Abstract
The gut microbiota, also known as our "second brain" is an exciting frontier of research across a multitude of health domains. Gut microbes have been implicated in feeding behaviour and obesity, as well as mental health disorders including anxiety and depression, however their role in the development and maintenance of eating disorders (EDs) has only recently been considered. EDs are complex mental health conditions, shaped by a complicated interplay of factors. Perhaps due to an incomplete understanding of the etiology of EDs, treatment remains inadequate with affected individuals likely to face many relapses. The gut microbiota may be a missing piece in understanding the etiology of eating disorders, however more robust scientific inquiry is needed in the field before concrete conclusions can be made. In this spotlight paper, we critically evaluate what is known about the bi-directional relationship between gut microbes and biological processes that are implicated in the development and maintenance of EDs, including physiological functioning, hormones, neurotransmitters, the central nervous system, and the immune system. We outline limitations of current research, propose concrete steps to move the field forward and, hypothesize potential clinical implications of this research. Our gut is inhabited by millions of bacteria which have more recently been referred to as "our second brain". In fact, these microbes are thought to play a role in ED behaviour, associated anxiety and depression, and even affect our weight. Recent research has dove into this field with promising findings that have the potential to be applied clinically to improve ED recovery. The present paper discusses what is known about the gut microbiome in relation to EDs and the promising implications that leveraging this knowledge, through fecal microbiome transplants, probiotics, and microbiome-directed supplemental foods, could have on ED treatment.
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Affiliation(s)
- Sydney M Terry
- Department of Medicine, Faculty of Medicine, University of British Columbia, Okanagan Campus, Kelowna, BC, Canada
| | - Jacqueline A Barnett
- Department of Biology, I.K. Barber Faculty of Science, University of British Columbia, Okanagan Campus, Kelowna, BC, V1V 1V7, Canada
| | - Deanna L Gibson
- Department of Medicine, Faculty of Medicine, University of British Columbia, Okanagan Campus, Kelowna, BC, Canada. .,Department of Biology, I.K. Barber Faculty of Science, University of British Columbia, Okanagan Campus, Kelowna, BC, V1V 1V7, Canada.
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Ding W, Luo F, Lin P, Tang Y, Liu Y. Effect of Nursing Outcome-Oriented Intervention on Airway Management in Elderly Long-Term Bedridden Patients. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9557330. [PMID: 36267309 PMCID: PMC9578878 DOI: 10.1155/2022/9557330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/02/2022] [Accepted: 09/12/2022] [Indexed: 11/17/2022]
Abstract
Objective This study intended to explore the nursing outcome-oriented intervention's effect on airway management in elderly long-term bedridden patients. Methods A total of 120 cases of elderly long-term bedridden patients admitted to our hospital from May 2018 to June 2020 were enrolled and randomly divided into the observation group (n = 60) and control group (n = 60). The control group received the routine nursing intervention, while the observation group received the nursing outcome-oriented intervention. Forced expiratory volume (FEV1), forced vital capacity (FVC), and maximal voluntary ventilation (MVV) in the first second were compared between the two groups before and after the intervention. The pulmonary infection of the two groups was observed. Total protein, hemoglobin, albumin, and cholesterol levels were compared between the two groups. Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to evaluate the two groups' psychological status before and after the intervention. The Generic Quality of Life Inventory-74 (GQOLI-74) assessed the two groups' quality of life. Results After the intervention, the levels of FEV1, FVC, and MVV; total protein, hemoglobin, albumin, and cholesterol; and scores of physical function, psychological function, social function, and material life function in the observation group were higher than those in the control group. Pulmonary infection, secondary infection, the infection rate is more than 3%, HAMA, and HAMD scores, and the incidence of pressure ulcers, aspiration, constipation, and the falling bed was lower than those in the control group, with statistical significance (all P < 0.05). Conclusion Nursing outcome-oriented intervention can effectively improve lung function, pulmonary infection, nutritional status, negative mood, and quality of life of long-term bedridden elderly patients.
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Affiliation(s)
- Weiwei Ding
- Department of Neurosurgery, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Fei Luo
- Department of Gastrointestinal Surgery, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Pingping Lin
- Department of Obstetrics, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Yu Tang
- College of Basic Medicine, Binzhou Medical University, Yantai, Shandong 264000, China
| | - Ying Liu
- Department of Neurosurgery, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
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Eating disorders among middle school students in a Chinese population: Prevalence and associated clinical correlates. J Psychiatr Res 2022; 154:278-285. [PMID: 35964346 DOI: 10.1016/j.jpsychires.2022.07.062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 07/07/2022] [Accepted: 07/26/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Eating disorders are regarded to be associated with many psychological and behavioral problems. Moreover, adolescence has been reported to be the key period for developing eating habits, and eating disorders typically emerge in adolescence and early adulthood. This study aimed to investigate the prevalence of eating disorders and explore the associated factors among adolescents in Hunan province, China METHODS: A total of 1610 middle school students from Hunan province, China, were enrolled in this study. The participants were aged from 11 to 16 years old. The following data were collected: demographic variables, Body Mass Index (BMI), suicidal behaviors, non-suicidal self-injury, depression, anxiety, stress (depression - anxiety - stress scale, DASS-21), childhood trauma (Childhood Trauma Questionnaire, CTQ), symptoms of social anxiety (Social Anxiety Scale-Adolescents, SAS-A), and eating problems (Eating Attitudes Test, EAT-26). RESULTS The estimated prevalence of eating disorders was 8.9%. Compared with participants without eating disorders, participants with eating disorders were more likely to be at a younger age, obese and overweight, and have a history of non-suicidal self-injury, suicidal ideation, suicidal plans, suicide attempts, emotional abuse, physical abuse, emotional neglect, and physical neglect; more likely to experience stress, anxiety or depression as well as have high scores of social avoidance and distress related to general social contexts. Anxiety, emotional neglect, physical neglect, obesity, and overweight were still significant in the binary logistic regression model after controlling for confounding factors. Additionally, younger age, emotional abuse, physical abuse, stress, anxiety, depression, social avoidance, and distress related to general social contexts were significantly correlated with the EAT-26 scores in correlation analysis CONCLUSIONS: Eating disorders are quite common among middle school students. Moreover, eating disorders are associated with younger age, non-suicidal self-injury, suicidal ideation, suicide attempts, stress, anxiety, depression, emotional abuse, physical abuse, emotional neglect, physical neglect, social avoidance, and distress related to general social contents and BMI. This study provides a reference for school counselors and clinicians in the prevention and treatment of eating disorders.
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Aupetit A, Grigioni S, Roman H, Coëffier M, Bréant A, Hennetier C, Achamrah N. Association between Endometriosis, Irritable Bowel Syndrome and Eating Disorders: ENDONUT Pilot Study. J Clin Med 2022; 11:jcm11195773. [PMID: 36233641 PMCID: PMC9571159 DOI: 10.3390/jcm11195773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/20/2022] [Accepted: 09/23/2022] [Indexed: 11/23/2022] Open
Abstract
Background and aim: Irritable bowel syndrome (IBS), eating disorders (ED) and endometriosis share common pathophysiological mechanisms, involving alterations of the gut−brain axis. The aim of the ENDONUT pilot study was to investigate an association between these three diseases by screening for IBS and ED in patients with endometriosis. Method: We included patients from the CIRENDO cohort (Inter-Regional North-West Cohort of women with ENDOmetriosis) with a recent documented diagnosis of endometriosis of less than 4 years, regardless of age, date of onset of symptoms, type of endometriosis (digestive or not), with or without endometriosis-related digestive surgery. Validated questionnaires were used to screen for IBS (Rome IV, Francis score), ED (SCOFF-F, EAT-26), and anxiety/depression (HAD). Anthropometric data and lifestyle habits were also collected. The primary composite endpoint was SCOFF-F and ROME-IV scores. Results: Among 100 patients meeting inclusion criteria, 54 patients completed all the questionnaires. Of these, 19 had a positive SCOFF-F score (35.2%), 26 had a positive ROME-IV score (48.1%), and 14 patients (25.9%) had both a positive SCOFF-F score and a positive ROME-IV score (p = 0.006). Patients with positive SCOFF-F and ROME-IV scores had significantly higher HAD-anxiety and depression scores (p < 0.05). Conclusion: These results suggest a significant association between IBS, ED and endometriosis. The prevalence of IBS and ED in our population is higher than in the general population. Larger studies are needed to confirm these results, to better understand this triad, and to improve the diagnostic and multidisciplinary therapeutic management of these patients.
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Affiliation(s)
- Alexandra Aupetit
- Department of Gastroenterology, Rouen University Hospital, 37 Boulevard Gambetta, 76000 Rouen, France
- Correspondence: ; Tel.: +33-07-70-50-28-82
| | - Sébastien Grigioni
- Department of Nutrition, Rouen University Hospital, 37 Boulevard Gambetta, 76000 Rouen, France
- INSERM UMR 1073 «Nutrition, Inflammation and Gut–Brain Axis Dysfunction», Normandie University, 76000 Rouen, France
- Clinical Investigation Center CIC 1404, INSERM, Rouen University Hospital, 76000 Rouen, France
| | - Horace Roman
- Multidisciplinary Franco-European Institute of Endometriosis, Clinique Tivoli-Ducos, 91 Rue de Rivière, 33000 Bordeaux, France
| | - Moïse Coëffier
- Department of Nutrition, Rouen University Hospital, 37 Boulevard Gambetta, 76000 Rouen, France
- INSERM UMR 1073 «Nutrition, Inflammation and Gut–Brain Axis Dysfunction», Normandie University, 76000 Rouen, France
- Clinical Investigation Center CIC 1404, INSERM, Rouen University Hospital, 76000 Rouen, France
| | - Amélie Bréant
- Department of Gynecology, Rouen University Hospital, 37 Boulevard Gambetta, 76000 Rouen, France
| | - Clotilde Hennetier
- Department of Gynecology, Rouen University Hospital, 37 Boulevard Gambetta, 76000 Rouen, France
| | - Najate Achamrah
- Department of Nutrition, Rouen University Hospital, 37 Boulevard Gambetta, 76000 Rouen, France
- INSERM UMR 1073 «Nutrition, Inflammation and Gut–Brain Axis Dysfunction», Normandie University, 76000 Rouen, France
- Clinical Investigation Center CIC 1404, INSERM, Rouen University Hospital, 76000 Rouen, France
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Feeding Our Microbiota: Stimulation of the Immune/Semiochemical System and the Potential Amelioration of Non-Communicable Diseases. LIFE (BASEL, SWITZERLAND) 2022; 12:life12081197. [PMID: 36013376 PMCID: PMC9410320 DOI: 10.3390/life12081197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/30/2022] [Accepted: 08/03/2022] [Indexed: 12/12/2022]
Abstract
Non-communicable diseases are those conditions to which causative infectious agents cannot readily be assigned. It is increasingly likely that at least some of these conditions are due to the breakdown of the previously mutualistic intestinal microbiota under the influence of a polluted, biocide-rich, environment. Following the mid-20th century African studies of Denis Burkitt, the environmental cause of conditions such as obesity has been ascribed to the absence of sufficient fibre in the modern diet, however in itself that is insufficient to explain the parallel rise of problems with both the immune system and of mental health. Conversely, Burkitt himself noted that the Maasai, a cattle herding people, remained healthy even with their relatively low intake of dietary fibre. Interestingly, however, Burkitt also emphasised that levels of non-communicable disease within a population rose as faecal weight decreased significantly, to about one third of the levels found in healthy populations. Accordingly, a more cogent explanation for all the available facts is that the fully functioning, adequately diverse microbiome, communicating through what has been termed the microbiota–gut–brain axis, helps to control the passage of food through the digestive tract to provide itself with the nutrition it needs. The method of communication is via the production of semiochemicals, interkingdom signalling molecules, potentially including dopamine. In turn, the microbiome aids the immune system of both adult and, most importantly, the neonate. In this article we consider the role of probiotics and prebiotics, including fermented foods and dietary fibre, in the stimulation of the immune system and of semiochemical production in the gut lumen. Finally, we reprise our suggestion of an ingestible sensor, calibrated to the detection of such semiochemicals, to assess both the effectiveness of individual microbiomes and methods of amelioration of the associated non-communicable diseases.
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Lacaze L, Rochdi S, Couvert A, Touboulic S, Guérin S, Randuineau G, Martin D, Romé V, Malbert CH, Derbré F, Val-Laillet D, Thibault R. The Yucatan minipig model: A new preclinical model of malnutrition induced by a low-calorie/low-protein diet. Clin Nutr 2022; 41:2077-2086. [DOI: 10.1016/j.clnu.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/06/2022] [Accepted: 08/01/2022] [Indexed: 11/25/2022]
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Frostad S. Are the Effects of Malnutrition on the Gut Microbiota–Brain Axis the Core Pathologies of Anorexia Nervosa? Microorganisms 2022; 10:microorganisms10081486. [PMID: 35893544 PMCID: PMC9329996 DOI: 10.3390/microorganisms10081486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 11/29/2022] Open
Abstract
Anorexia nervosa (AN) is a disabling, costly, and potentially deadly illness. Treatment failure and relapse after treatment are common. Several studies have indicated the involvement of the gut microbiota–brain (GMB) axis. This narrative review hypothesizes that AN is driven by malnutrition-induced alterations in the GMB axis in susceptible individuals. According to this hypothesis, initial weight loss can voluntarily occur through dieting or be caused by somatic or psychiatric diseases. Malnutrition-induced alterations in gut microbiota may increase the sensitivity to anxiety-inducing gastrointestinal hormones released during meals, one of which is cholecystokinin (CCK). The experimental injection of a high dose of its CCK-4 fragment in healthy individuals induces panic attacks, probably via the stimulation of CCK receptors in the brain. Such meal-related anxiety attacks may take part in developing the clinical picture of AN. Malnutrition may also cause increased effects from appetite-reducing hormones that also seem to have roles in AN development and maintenance. The scientific background, including clinical, microbiological, and biochemical factors, of AN is discussed. A novel model for AN development and maintenance in accordance with this hypothesis is presented. Suggestions for future research are also provided.
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Affiliation(s)
- Stein Frostad
- Division of Psychiatry, Haukeland University Hospital, 5021 Bergen, Norway
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45
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Keller L, Dempfle A, Dahmen B, Schreiber S, Adan RAH, Andreani NA, Danner UN, Eisert A, Fetissov S, Fischmeister FPS, Karwautz A, Konrad K, Kooij KL, Trinh S, van der Vijgh B, van Elburg AA, Zeiler M, Baines J, Seitz J, Herpertz-Dahlmann B. The effects of polyunsaturated fatty acid (PUFA) administration on the microbiome-gut-brain axis in adolescents with anorexia nervosa (the MiGBAN study): study protocol for a longitudinal, double-blind, randomized, placebo-controlled trial. Trials 2022; 23:545. [PMID: 35790976 PMCID: PMC9254435 DOI: 10.1186/s13063-022-06413-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/20/2022] [Indexed: 12/03/2022] Open
Abstract
Background Anorexia nervosa (AN) is a severe psychiatric disease that often takes a chronic course due to insufficient treatment options. Emerging evidence on the gut-brain axis offers the opportunity to find innovative treatments for patients with psychiatric disorders. The gut microbiome of patients with AN shows profound alterations that do not completely disappear after weight rehabilitation. In previous studies, the administration of polyunsaturated fatty acids (PUFA) resulted in effects that might be beneficial in the treatment of AN, affecting the microbiome, body weight and executive functions. Therefore, the MiGBAN study aims to examine the effects of a nutritional supplementation with PUFA on the gut microbiome and body mass index (BMI) in patients with AN. Methods This is a longitudinal, double-blind, randomized, placebo-controlled trial. Within 2 years, 60 adolescent patients aged 12 to 19 years with AN will receive either PUFA or placebo for 6 months additional to treatment as usual. After 1 year, the long-term effect of PUFA on the gut microbiome and consecutively on BMI will be determined. Secondary outcomes include improvement of gastrointestinal symptoms, eating disorder psychopathology, and comorbidities. Additionally, the interaction of the gut microbiome with the brain (microbiome-gut-brain axis) will be studied by conducting MRI measurements to assess functional and morphological changes and neuropsychological assessments to describe cognitive functioning. Anti-inflammatory effects of PUFA in AN will be examined via serum inflammation and gut permeability markers. Our hypothesis is that PUFA administration will have positive effects on the gut microbiota and thus the treatment of AN by leading to a faster weight gain and a reduction of gastrointestinal problems and eating disorder psychopathology. Discussion Due to previously heterogeneous results, a systematic and longitudinal investigation of the microbiome-gut-brain axis in AN is essential. The current trial aims to further analyse this promising research field to identify new, effective therapeutic tools that could help improve the treatment and quality of life of patients. If this trial is successful and PUFA supplementation contributes to beneficial microbiome changes and a better treatment outcome, their administration would be a readily applicable additional component of multimodal AN treatment. Trial registration German Clinical Trials Register DRKS00017130. Registered on 12 November 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06413-7.
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Affiliation(s)
- Lara Keller
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany.
| | - Astrid Dempfle
- Institute of Medical Informatics and Statistics, Kiel University, Kiel, Germany
| | - Brigitte Dahmen
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
| | - Samira Schreiber
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
| | - Roger A H Adan
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Unna N Danner
- Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands.,Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands
| | - Albrecht Eisert
- Institute of Clinical Pharmacology, University Hospital RWTH Aachen, Aachen, Germany
| | | | - Florian Ph S Fischmeister
- Institute of Psychology, University of Graz, Graz, Austria.,BioTechMed, Graz, Austria.,Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Andreas Karwautz
- Eating Disorders Unit at the Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Kerstin Konrad
- Section for Neuropsychology, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
| | - Karlijn L Kooij
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Stefanie Trinh
- Institute of Neuroanatomy, University Hospital RWTH Aachen, Aachen, Germany
| | - Benny van der Vijgh
- Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands
| | - Annemarie A van Elburg
- Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands.,Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands
| | - Michael Zeiler
- Eating Disorders Unit at the Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - John Baines
- Max Planck Institute for Evolutionary Biology, Plön, Germany.,Institute for Experimental Medicine, Kiel University, Kiel, Germany
| | - Jochen Seitz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
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Rössler H, Flasbeck V, Gatermann S, Brüne M. Alterations of the gut microbiota in borderline personality disorder. J Psychosom Res 2022; 158:110942. [PMID: 35594813 DOI: 10.1016/j.jpsychores.2022.110942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/07/2022] [Accepted: 05/07/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE A growing body of research has shown that people with a wide range of psychiatric disorders, including depression, present with alterations of the gut microbiota, although it is unclear if differences may be caused by the action of psychotropic medication. No data exist for patients with borderline personality disorder (BPD), a psychiatric condition that is frequently comorbidly associated with depression. METHODS Twenty-four unmedicated patients and twenty-one age- and sex-matched healthy controls were recruited. Stool samples were frozen at -80 °C within ten minutes after defecation. The V4 region of bacterial 16S ribosomal RNA (rRNA) gene was sequenced on an Illumina platform. Operational taxonomic units (OTUs) were used for further analysis of community structure, alpha- and beta-diversity. RESULTS There was no significant difference in alpha- and beta-diversity between patients and controls. However, the Bacteroidetes/Firmicutes-ratio was higher in patients, approaching significance (p = 0.06, r = 0.23). Four species were significantly less abundant in BPD patients, namely Pseudoflavonifractor phocaensis (p = 0.003, r = 0.41), Eubacterium coprostanoligenes (p = 0.01, r = 0.34), Anaerotaenia torta (p = 0.01, r = 0.35), and (statistically somewhat weaker) Parabacteroides chongii (p = 0.046, r = 0.26), which correlated with various psychometric scores. CONCLUSION Differences in the taxonomic composition may indicate a potential dysbiosis among SCFA-producing bacteria in BPD. Future research is warranted to replicate these findings in independent and larger samples. If confirmed, the results suggest that microbiota-targeted therapies may be a useful adjunct strategy for BPD.
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Affiliation(s)
- Hannah Rössler
- LWL University Hospital, Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Social Neuropsychiatry and Evolutionary Medicine, Ruhr University Bochum, Germany; Department of Medical Microbiology; National Reference Centre for Multi-Resistant Gram-Negative Infectious Agents, Ruhr University Bochum, Germany
| | - Vera Flasbeck
- LWL University Hospital, Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Social Neuropsychiatry and Evolutionary Medicine, Ruhr University Bochum, Germany
| | - Sören Gatermann
- Department of Medical Microbiology; National Reference Centre for Multi-Resistant Gram-Negative Infectious Agents, Ruhr University Bochum, Germany
| | - Martin Brüne
- LWL University Hospital, Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Social Neuropsychiatry and Evolutionary Medicine, Ruhr University Bochum, Germany.
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Schneider S, Biggerstaff DL, Barber TM. Helpful or harmful? The impact of the ketogenic diet on eating disorder outcomes in type 1 diabetes mellitus. Expert Rev Endocrinol Metab 2022; 17:319-331. [PMID: 35748612 DOI: 10.1080/17446651.2022.2089112] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/09/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Eating disorders (EDs) are common complications in people with type 1 diabetes (PwT1D), given the rigid focus on food and insulin dose adjustment. Dietary recommendations for T1D match those for the general population, yet many fail to achieve target HbA1c. Evidence suggests that lower carbohydrate meals and thus reduced insulin requirements may decrease inconsistencies in insulin absorption, maintain euglycemia and weight. Dietary restriction is a recognized risk factor for ED development, and Ketogenic Diets (KD) involve restriction of common family-based foods, thus impacting social normality and microbiome diversity. We reviewed the current literature on PwT1D following a KD to understand effects on ED risks. AREAS COVERED Published data from MEDLINE, Embase, and PsycINFO were used. Search terms included: type 1 diabetes mellitus; or insulin dependent diabetes or T1D AND EDs or anorexia or bulimia or disordered eating AND low-carbohydrate diet or carbohydrate restricted diet or low carb diet or ketogenic diet. EXPERT OPINION Research into the effects of KDs on ED outcomes in PwT1D are limited, given the concerns over risks of diabetic ketoacidosis, hypoglycemia, and dyslipidemia. Longer term studies on the participants' experience and motivations of adhering or admonishing the diet are needed.
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Affiliation(s)
- Suzanne Schneider
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Deborah L Biggerstaff
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Thomas M Barber
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Coventry, UK
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Vera-Urbina F, Dos Santos-Torres MF, Godoy-Vitorino F, Torres-Hernández BA. The Gut Microbiome May Help Address Mental Health Disparities in Hispanics: A Narrative Review. Microorganisms 2022; 10:microorganisms10040763. [PMID: 35456813 PMCID: PMC9029366 DOI: 10.3390/microorganisms10040763] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/22/2022] [Accepted: 03/30/2022] [Indexed: 02/05/2023] Open
Abstract
The gut–brain axis is the biological connection between the enteric and the central nervous systems. Given the expansion of the microbial sciences with the new human microbiome field facilitated by the decrease in sequencing costs, we now know more about the role of gut microbiota in human health. In this short review, particular focus is given to the gut–brain axis and its role in psychiatric diseases such as anxiety and depression. Additionally, factors that contribute to changes in the gut–brain axis, including the gut microbiome, nutrition, the host’s genome, and ethnic difference, are highlighted. Emphasis is given to the lack of studies on Hispanic populations, despite the fact this ethnic group has a higher prevalence of anxiety and depression in the US.
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Affiliation(s)
- Fernando Vera-Urbina
- Faculty of Natural Sciences, University of Puerto Rico at Rio Piedras, San Juan 00925, Puerto Rico; (F.V.U.); (M.F.D.S.T.)
| | - María F. Dos Santos-Torres
- Faculty of Natural Sciences, University of Puerto Rico at Rio Piedras, San Juan 00925, Puerto Rico; (F.V.U.); (M.F.D.S.T.)
| | - Filipa Godoy-Vitorino
- Department of Microbiology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan 00925, Puerto Rico;
| | - Bianca A. Torres-Hernández
- Department of Pharmaceutical Sciences, School of Pharmacy, Medical Sciences Campus, University of Puerto Rico, P.O. Box 365067, San Juan 00936, Puerto Rico
- Correspondence: ; Tel.: +1-787-758-2525 (ext. 5437 or 5410)
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Shobeiri P, Kalantari A, Teixeira AL, Rezaei N. Shedding light on biological sex differences and microbiota-gut-brain axis: a comprehensive review of its roles in neuropsychiatric disorders. Biol Sex Differ 2022; 13:12. [PMID: 35337376 PMCID: PMC8949832 DOI: 10.1186/s13293-022-00422-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/14/2022] [Indexed: 12/15/2022] Open
Abstract
Women and men are suggested to have differences in vulnerability to neuropsychiatric disorders, including major depressive disorder (MDD), generalized anxiety disorder (GAD), schizophrenia, eating disorders, including anorexia nervosa, and bulimia nervosa, neurodevelopmental disorders, such as autism spectrum disorder (ASD), and neurodegenerative disorders including Alzheimer’s disease, Parkinson’s disease. Genetic factors and sex hormones are apparently the main mediators of these differences. Recent evidence uncovers that reciprocal interactions between sex-related features (e.g., sex hormones and sex differences in the brain) and gut microbiota could play a role in the development of neuropsychiatric disorders via influencing the gut–brain axis. It is increasingly evident that sex–microbiota–brain interactions take part in the occurrence of neurologic and psychiatric disorders. Accordingly, integrating the existing evidence might help to enlighten the fundamental roles of these interactions in the pathogenesis of neuropsychiatric disorders. In addition, an increased understanding of the biological sex differences on the microbiota–brain may lead to advances in the treatment of neuropsychiatric disorders and increase the potential for precision medicine. This review discusses the effects of sex differences on the brain and gut microbiota and the putative underlying mechanisms of action. Additionally, we discuss the consequences of interactions between sex differences and gut microbiota on the emergence of particular neuropsychiatric disorders. The human microbiome is a unique set of organisms affecting health via the gut–brain axis. Neuropsychiatric disorders, eating disorders, neurodevelopmental disorders, and neurodegenerative disorders are regulated by the microbiota–gut–brain axis in a sex-specific manner. Understanding the role of the microbiota–gut–brain axis and its sex differences in various diseases can lead to better therapeutic methods.
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Affiliation(s)
- Parnian Shobeiri
- School of Medicine, Tehran University of Medical Sciences (TUMS), Children's Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, 14194, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.,Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Dr. Gharib St, Keshavarz Blvd, Tehran, Iran
| | - Amirali Kalantari
- School of Medicine, Tehran University of Medical Sciences (TUMS), Children's Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, 14194, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Antônio L Teixeira
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Nima Rezaei
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran. .,Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Dr. Gharib St, Keshavarz Blvd, Tehran, Iran. .,Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Lengvenyte A, Strumila R, Maimoun L, Seneque M, Olié E, Lefebvre P, Renard E, Courtet P, Guillaume S. A specific association between laxative misuse and suicidal behaviours in patients with anorexia nervosa and bulimia nervosa. Eat Weight Disord 2022; 27:307-315. [PMID: 33797033 DOI: 10.1007/s40519-021-01180-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/22/2021] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE Eating disorders (ED) are associated with an in increased risk of suicidal behaviours. Laxative abuse might alter the gut-brain axis signaling, that might be implicated in the pathophysiology of suicide. This study aims to determine the association between laxative misuse and suicide attempt (SA) and suicidal ideation (SI) in patients with ED. METHODS 277 patients with ED were recruited from an Eating Disorder Unit of Lapeyronie Academic Hospital, Montpellier, France. Sociodemographic and clinical data were collected. Chi-square and t test were used, with Bonferroni corrections where required. Multiple regression models assessed the relationships between laxative misuse, SA, and SI. RESULTS 62 (22.4%) patients reported lifetime laxative misuse. They were more likely to have a history of SA than non-misusers [43.83 vs 19.9%, p < 0.001, odds ratio (OR) 3.68]. In the multivariate model, adjusted for other confounders, lifetime laxative misuse remained associated with SA (adjusted OR 3.79, p = 0.041). In past 28 days, patients with SA history reported misusing laxatives for more days than patients without SA history (6 vs 1.5 days, p = 0.01, adjusted for vomiting and ED severity). Laxative use days during past 28 days was associated with current SI, adjusted for vomiting in the same period (p = 0.017). CONCLUSIONS Current and lifetime laxative misuse were associated with SA history and current SI in patients with ED, at least in part independently of other suicide-related factors. LEVEL OF EVIDENCE Level III cohort, cross-sectional study.
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Affiliation(s)
- Aiste Lengvenyte
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
- Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania
| | - Robertas Strumila
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France.
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France.
- Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania.
| | - Laurent Maimoun
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
- Département de Médecine Nucléaire, Hôpital Lapeyronie, Centre Hospitalier Régional Universitaire (CHRU) Montpellier, 34295, Montpellier, France
| | - Maude Seneque
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
| | - Emilie Olié
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
| | - Patrick Lefebvre
- Department of Endocrinology, Diabetes, and Nutrition, CHRU Montpellier, Montpellier, France
| | - Eric Renard
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
- UMR CNRS 5203, INSERM U1191, Institute of Functional Genomics, University of Montpellier, Montpellier, France
| | - Philippe Courtet
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
| | - Sebastien Guillaume
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, 371 Av. du Doyen Gaston Giraud, 34090, Montpellier, France
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