💡 This study presents a comprehensive longitudinal analysis of the gut microbiome in adolescent inpatients diagnosed with anorexia nervosa (AN) compared to age-matched healthy controls (HCs). Fecal samples from 57 AN patients at up to nine time points, including a 1-year follow-up, and 34 HCs were analyzed using 16S rRNA gene sequencing. The study aimed to elucidate the underlying mechanisms, influencing factors, and longitudinal course of microbiome changes in AN, correlating them with clinical outcomes, food intake, weight change, and hormonal recovery.
📍 Key Findings:
📌 Microbiome Dysbiosis in Acutely Ill Patients: Significant dysbiosis observed in acutely ill AN patients compared to HCs, diminishing with weight gain and especially at the 1-year follow-up. Greatest differences in microbiome composition during acute starvation and in the low-weight group.
📌 Association with Illness Duration and Prior Weight Loss: Illness duration and prior weight loss strongly associated with microbiome composition at hospital admission. Microbial changes during treatment associated with kilocalories consumed, weight gain, and hormonal recovery.
📌 Microbiome as Prognostic Indicator: Microbiome at admission prognostic for hospital readmission within the first year. Higher abundance of certain taxa associated with negative clinical outcomes, emphasizing their role as risk factors.
📌 Microbial Changes during Recovery: Alpha-diversity reduced at 1-year follow-up, with small but significant differences in microbiome composition in weight-recovered patients compared to HCs. 𝘚𝘶𝘵𝘵𝘦𝘳𝘦𝘭𝘭𝘢 abundance associated with positive clinical outcomes, suggesting its potential as a probiotic target.
📌 Clinical Factors Influencing Microbiome Changes: Kilocalories consumed, achieved weight gain, and hormonal recovery strongly related to changes in microbiome composition. Body weight recovery emerged as a crucial factor, indicating its link to metabolic normalization.
📌 Taxonomic Changes and Clinical Implications: Various taxonomic changes observed, including alterations in 𝘋𝘦𝘴𝘶𝘭𝘧𝘰𝘷𝘪𝘣𝘳𝘪𝘰𝘯𝘢𝘤𝘦𝘢𝘦, 𝘋𝘪𝘢𝘭𝘪𝘴𝘵𝘦𝘳, 𝘌𝘴𝘤𝘩𝘦𝘳𝘪𝘤𝘩𝘪𝘢-𝘚𝘩𝘪𝘨𝘦𝘭𝘭𝘢, 𝘈𝘭𝘪𝘴𝘵𝘪𝘱𝘦𝘴, 𝘙𝘶𝘮𝘪𝘯𝘰𝘤𝘰𝘤𝘤𝘶𝘴, 𝘢𝘯𝘥 𝘚𝘶𝘵𝘵𝘦𝘳𝘦𝘭𝘭𝘢. Dysbiosis renewed in low-weight patients at 1-year follow-up after repeated weight loss, emphasizing the importance of maintaining a healthy weight.
📌 Microbiome and Inflammatory Markers: 𝘓𝘢𝘤𝘩𝘯𝘰𝘴𝘱𝘪𝘳𝘢𝘤𝘦𝘢𝘦, known for anti-inflammatory effects, reduced in AN patients, suggesting implications for the chronic low-grade inflammation associated with AN. Immunomodulatory effects of specific taxa underscored their potential mechanistic role in AN outcomes.
📍 This longitudinal analysis provides valuable insights into the dynamic relationship between the gut microbiome and AN. Microbiome changes correlate with clinical parameters, prognosis, and recovery status, emphasizing the potential therapeutic relevance of microbiome modulation in AN treatment. Identification of taxa with prognostic value and association with clinical outcomes opens avenues for personalized interventions and highlights the microbiome’s intricate role in the pathophysiology of AN.
Link to the study : http://tinyurl.com/3kbvxbts
