Multi-omics data integration in anorexia nervosa patients before and after weight regain: A microbiome-metabolomics investigation

Monteleone, Alessio Maria; Troisi, Jacopo; Fasano, Alessio; Grave, Riccardo Dalle; Marciello, Francesca; Serena, Gloria; Calugi, Simona; Scala, Giovanni; Corrivetti, Giulio; Cascino, Giammarco; Monteleone, Palmiero; Maj, Mario

doi:10.1016/j.clnu.2020.07.021

Cited by 39 publications

(56 citation statements)

References 30 publications

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“…Although most of the studies used the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV [14,25,26,29,37] and DSM-5 [32,34,35,40]) or the International Classification of Diseases (ICD-10) [33,38], some studies did not specify according to which criteria the diagnosis was made [27,28,30,31,36,39]. We included seven observational studies [14,25,26,30,33,34,37], three longitudinal studies [29,31,40], four case reports [27,28,36,39], one case series of three cases that was also longitudinal in its design [32], and two pilot studies [35,38]. The samples included mostly patients with a diagnosis of AN.…”

Section: Resultsmentioning

confidence: 99%

“…Only one study evaluated BN and BED patients [30]. All studies included a control group matched for age and gender [14,31,33,34,40], with the exception of case studies [27,28,32] and studies on FMT cases [36,39]. A group of overweight and/or obese participants were collected in three studies [25,26,33].…”

Section: Resultsmentioning

confidence: 99%

“…In AN, significant changes in the quality, quantity, and composition of gut microbiota were found during weight modification. Alpha diversity was lower during the phase of weight loss [29,33,[37][38][39][40], resulting in a reduction of Firmicutes [14] and SCFAs [14,34,35] and the increase of Bacteroides, Actinobacteria, Enterobacteriaceae, and Methanobrevibacter smithii. A re-established Firmicutes/Bacteroides (F/B) ratio and an increase of SCFAs levels were reported during renourishment and weight gain [29,31,32].…”

Section: Resultsmentioning

confidence: 99%

“…Weight regain with unbalanced diet, as high-lipid nutrition, in AN patients showed a reduction in Firmicutes and an elevation of Bacteroides and Ruminococci [25,35] an increase of mucin-degrading bacteria and a reduction of butyrate-producing bacteria [72]. Interestingly, the microbiota changed qualitatively and quantitatively, and microbial richness increased after weight regain in patients with AN [25,30,35], but in some patients the trend of changes in alpha diversity was lower compared to healthy controls [32] and gastrointestinal symptoms did not recover at the end of three months treatment [35]. This may be due to a diet rich in fibers and suggests that energy derived from macronutrients is crucial for modest alpha diversity.…”

Section: Microbial Diversity During Diet Restriction Renourishment Amentioning

confidence: 98%

“…The gut microbiota was examined from stool samples in all included studies. Other assessments comprised short-chain fatty acids (SCFAs) [29,31], faecal pH [14,35], culture growth and mass spectrometry [37], anthropometric measures, ultrasound measurement of subcutaneous adipose tissue thickness [25,33], caseinolytic peptidase B (ClpB) protein concentrations [36] or faecal metabolomics [32] [25,29,32,33,36,39].…”

Section: Although Most Of the Studies Used The Diagnostic And Statistmentioning

confidence: 99%

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A systematic review on the role of microbiota in the pathogenesis and treatment of eating disorders

et al. 2020

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Background There is growing interest in new factors contributing to the genesis of eating disorders (EDs). Research recently focused on the study of microbiota. Dysbiosis, associated with a specific genetic susceptibility, may contribute to the development of anorexia nervosa (AN), bulimia nervosa, or binge eating disorder, and several putative mechanisms have already been identified. Diet seems to have an impact not only on modification of the gut microbiota, facilitating dysbiosis, but also on its recovery in patients with EDs. Methods This systematic review based on the PICO strategy searching into PubMed, EMBASE, PsychINFO, and Cochrane Library examined the literature on the role of altered microbiota in the pathogenesis and treatment of EDs. Results Sixteen studies were included, mostly regarding AN. Alpha diversity and short-chain fatty acid (SCFA) levels were lower in patients with AN, and affective symptoms and ED psychopathology seem related to changes in gut microbiota. Microbiota-derived proteins stimulated the autoimmune system, altering neuroendocrine control of mood and satiety in EDs. Microbial richness increased in AN after weight regain on fecal microbiota transplantation. Conclusions Microbiota homeostasis seems essential for a healthy communication network between gut and brain. Dysbiosis may promote intestinal inflammation, alter gut permeability, and trigger immune reactions in the hunger/satiety regulation center contributing to the pathophysiological development of EDs. A restored microbial balance may be a possible treatment target for EDs. A better and more in-depth characterization of gut microbiota and gut–brain crosstalk is required. Future studies may deepen the therapeutic and preventive role of microbiota in EDs.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Microbial Diversity During Diet Restriction Renourishment Amentioning

confidence: 98%

Section: Although Most Of the Studies Used The Diagnostic And Statistmentioning

confidence: 99%

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A systematic review on the role of microbiota in the pathogenesis and treatment of eating disorders

et al. 2020

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Perturbations in Gut Microbiota Composition in Psychiatric Disorders

et al. 2021

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Challenges and priorities for researching the gut microbiota in individuals living with anorexia nervosa

West,

Hart,

Loughman

et al. 2023

Intl J Eating Disorders

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ObjectiveThe 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.MethodWe 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.ResultsSeveral ways exist to reduce participant burden and accommodate challenges when researching the gut microbiota in individuals with AN.DiscussionRecommendations 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 SignificanceThe 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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Multi-omics data integration in anorexia nervosa patients before and after weight regain: A microbiome-metabolomics investigation

Cited by 39 publications

References 30 publications

A systematic review on the role of microbiota in the pathogenesis and treatment of eating disorders

A systematic review on the role of microbiota in the pathogenesis and treatment of eating disorders

Perturbations in Gut Microbiota Composition in Psychiatric Disorders

Challenges and priorities for researching the gut microbiota in individuals living with anorexia nervosa

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