Ghrelin and anorexia nervosa: A psychosomatic perspective

Ogiso, Kazuma; Asakawa, Akihiro; Amitani, Haruka; Inui, Akio

doi:10.1016/j.nut.2011.05.005

Cited by 32 publications

(24 citation statements)

References 56 publications

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“…Several studies found plasma ghrelin to be elevated in AN [40], consistent with the pattern found in another “wasting” clinical population, cancer patients with cachexia [41]. Of interest, post chemotherapy ghrelin level was found to increase significantly only in cancer patients with decreased food intake, but not in those without decreased food intake [41].…”

Section: Discussionsupporting

confidence: 68%

Personalized polyunsaturated fatty acids as a potential adjunctive treatment for anorexia nervosa

Shih

Morisseau

et al. 2017

Prostaglandins & Other Lipid Mediators

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Anorexia nervosa (AN) is a complex psychiatric disorder with high morbidity and mortality rates. While many individuals make full recoveries, up to a third of patients develop a chronic, treatment-resistant form of the illness that leads to a premature death in 15–20% of those affected. There have been few advances in treatment, both in terms of psychological or pharmacologic treatment over the last 30 years. Food aversion is commonly cited by patients with AN as a barrier to normalizing eating and weight. Our group has a keen interest in examining factors that might allow this to be addressed, thus improving treatment outcomes through personalized dietary plans or nutritional supplementation related to underlying genetic status. We demonstrated that polyunsaturated fatty acids (PUFAs)-derived bioactive lipids (eicosanoids) are implicated in not only the risk of AN, but also with its comorbid psychopathology. Of interest, the differential postprandial omega 6-derived eicosanoid shift observed in AN highlights the possibility that the metabolism of PUFAs is an important mechanism underlying the profound food version, contributing to pathological food restriction in AN. A concise knowledge of the relationships among PUFAs, eicosanoids, and AN clinical course and psychopathology could be the key to developing personalized nutritional rehabilitative treatments for those suffering from AN. This paper provides a comprehensive overview of the literature on PUFAs in AN. We also selectively reviewed the clinical benefits PUFA treatments exert in other psychiatric diseases, on weight and appetite regulation, and for resolution of inflammation, all of which are relevant in the disease course and outcome of AN. We propose that personalized PUFA formulation be developed and tested as a novel adjunctive treatment for patients with AN. We hypothesize that with personalized PUFA formulation, food aversion and anxiety about eating will decrease while mood, dietary behavior, and weight restoration will improve in AN, leading to improvements in the overall treatment outcome.

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Section: Discussionsupporting

confidence: 68%

Personalized polyunsaturated fatty acids as a potential adjunctive treatment for anorexia nervosa

Shih

Morisseau

et al. 2017

Prostaglandins & Other Lipid Mediators

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show abstract

“…Interestingly, fasting alters the secretion of ghrelin and des-acyl ghrelin, but des-acyl ghrelin appears to be a long-lasting signal associated with a negative energy balance. Indeed, when fasting is prolonged and implies a negative energy balance, such as in patients affected by anorexia or cachexia, des-acyl ghrelin is more stably elevated than ghrelin, and the des-acyl ghrelin/ghrelin ratio is also significantly increased (214). Prolonged fasting is mimicked by KD in patients affected by epilepsy.…”

Section: New Hypothesis: Peptide Hormones As Possible Mediators Of Kdmentioning

confidence: 99%

Neuroactive Peptides as Putative Mediators of Antiepileptic Ketogenic Diets

et al. 2014

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Various ketogenic diet (KD) therapies, including classic KD, medium chain triglyceride administration, low glycemic index treatment, and a modified Atkins diet, have been suggested as useful in patients affected by pharmacoresistant epilepsy. A common goal of these approaches is to achieve an adequate decrease in the plasma glucose level combined with ketogenesis, in order to mimic the metabolic state of fasting. Although several metabolic hypotheses have been advanced to explain the anticonvulsant effect of KDs, including changes in the plasma levels of ketone bodies, polyunsaturated fatty acids, and brain pH, direct modulation of neurotransmitter release, especially purinergic (i.e., adenosine) and γ-aminobutyric acidergic neurotransmission, was also postulated. Neuropeptides and peptide hormones are potent modulators of synaptic activity, and their levels are regulated by metabolic states. This is the case for neuroactive peptides such as neuropeptide Y, galanin, cholecystokinin, and peptide hormones such as leptin, adiponectin, and growth hormone-releasing peptides (GHRPs). In particular, the GHRP ghrelin and its related peptide des-acyl ghrelin are well-known controllers of energy homeostasis, food intake, and lipid metabolism. Notably, ghrelin has also been shown to regulate the neuronal excitability and epileptic activation of neuronal networks. Several lines of evidence suggest that GHRPs are upregulated in response to starvation and, particularly, in patients affected by anorexia and cachexia, all conditions in which also ketone bodies are upregulated. Moreover, starvation and anorexia nervosa are accompanied by changes in other peptide hormones such as adiponectin, which has received less attention. Adipocytokines such as adiponectin have also been involved in modulating epileptic activity. Thus, neuroactive peptides whose plasma levels and activity change in the presence of ketogenesis might be potential candidates for elucidating the neurohormonal mechanisms involved in the beneficial effects of KDs. In this review, we summarize the current evidence for altered regulation of the synthesis of neuropeptides and peripheral hormones in response to KDs, and we try to define a possible role for specific neuroactive peptides in mediating the antiepileptic properties of diet-induced ketogenesis.

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“…Грелин уже успешно применен у больного нервной анорексией. Очевидно, скоро грелин будет по-всеместно внедрен в клиническую практику не только для лече-ния психогенного истощения, но и при гипоталамо-гипофизар-ной недостаточности, раковой кахексии, стимуляции аппетита у онкологических больных [59].…”

Section: терапевтический архив 12 2014unclassified

The ghrelin-obestatin system in health and disease

Терещенко¹,

Kaiushev²

2014

Ter. arkh.

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Ghrelin and anorexia nervosa: A psychosomatic perspective

Cited by 32 publications

References 56 publications

Personalized polyunsaturated fatty acids as a potential adjunctive treatment for anorexia nervosa

Personalized polyunsaturated fatty acids as a potential adjunctive treatment for anorexia nervosa

Neuroactive Peptides as Putative Mediators of Antiepileptic Ketogenic Diets

The ghrelin-obestatin system in health and disease

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