๐ก 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.
๐ Key Findings:
๐ 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.
๐ 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.
๐ 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.
๐ 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. ๐๐ถ๐ต๐ต๐ฆ๐ณ๐ฆ๐ญ๐ญ๐ข abundance associated with positive clinical outcomes, suggesting its potential as a probiotic target.
๐ 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.
๐ Taxonomic Changes and Clinical Implications: Various taxonomic changes observed, including alterations in ๐๐ฆ๐ด๐ถ๐ญ๐ง๐ฐ๐ท๐ช๐ฃ๐ณ๐ช๐ฐ๐ฏ๐ข๐ค๐ฆ๐ข๐ฆ, ๐๐ช๐ข๐ญ๐ช๐ด๐ต๐ฆ๐ณ, ๐๐ด๐ค๐ฉ๐ฆ๐ณ๐ช๐ค๐ฉ๐ช๐ข-๐๐ฉ๐ช๐จ๐ฆ๐ญ๐ญ๐ข, ๐๐ญ๐ช๐ด๐ต๐ช๐ฑ๐ฆ๐ด, ๐๐ถ๐ฎ๐ช๐ฏ๐ฐ๐ค๐ฐ๐ค๐ค๐ถ๐ด, ๐ข๐ฏ๐ฅ ๐๐ถ๐ต๐ต๐ฆ๐ณ๐ฆ๐ญ๐ญ๐ข. Dysbiosis renewed in low-weight patients at 1-year follow-up after repeated weight loss, emphasizing the importance of maintaining a healthy weight.
๐ Microbiome and Inflammatory Markers: ๐๐ข๐ค๐ฉ๐ฏ๐ฐ๐ด๐ฑ๐ช๐ณ๐ข๐ค๐ฆ๐ข๐ฆ, 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.
๐ 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
