Altered Serum Immunological and Biochemical Parameters and Microbiota Composition in Patients With AN During Realimentation

Abstract

Anorexia nervosa (AN) is a life-threatening psychiatric disorder with not well-described pathogenesis. Besides the genetic and sociological factors, autoimmunity is also considered to take part in AN pathogenesis. We evaluated general serological factors showing the physiological state of 59 patients with AN at hospital admission and their discharge. We detected the altered levels of some general biochemical and immunological parameters. We also detected decreased levels of appetite-regulating alpha-melanocyte stimulating hormone (α-MSH) in patients at hospital admission. Moreover, elevated anti-α-MSH IgM levels and decreased anti-α-MSH IgA levels were observed in patients with AN. Therefore, we analyzed the gut microbiota composition with special focus on α-MSH antigen-mimetic containing microbes from the Enterobacteriaceae family. We correlated gut bacterial composition with anti-α-MSH Ig levels and detected decreasing IgG levels with increasing alpha diversity. The upregulation of pro-inflammatory cytokines IL-6, IL-17, and TNF-α were detected in patients with AN both prior and after hospitalization. We also evaluated the treatment outcome and improvement was observed in the majority of patients with AN. We provide new data about various serum biochemical parameters and their changes during the patients' hospitalization, with emphasis on the immune system, and its possible participation in AN pathogenesis.

NMR- and MS-Based Untargeted Metabolomic Study of Stool and Serum Samples from Patients with Anorexia Nervosa

“…Our study observed decreased TSH and fT4 levels in patients with AN (but still in the normal range defined for normal BMI subjects) that did not increase even after treatment (Table ). Our results are in accordance with previous studies that have described altered thyroid function in AN patients. , Endocrine dysregulation is considered to be an adaptation to long-term starvation followed by the slowdown of energy metabolism . As expected, these extensive hormonal changes were also projected in metabolism.…”

“…19,20 Endocrine dysregulation is considered to be an adaptation to long-term starvation followed by the slowdown of energy metabolism. 21 As expected, these extensive hormonal changes were also projected in metabolism.…”

Lower serum levels of IL-1β and IL-6 cytokines in adolescents with anorexia nervosa and their association with gut microbiota in a longitudinal study

“…Contrary to TNF-α and most previous adult studies, we found the cytokines IL-6 and IL-1β to be significantly reduced in our sample of adolescents with AN in comparison with HC and even remained so after short-term weight recovery. IL-1β and IL-6 were significantly increased in previous metanalyses (9, 10) and some recent publications (19, 47, 55); however, several current studies could not reproduce these findings or only reproduced them partially (10,25,47,56). Again, findings in adolescents were mixed (20,36,37).…”

“…Our results confirmed most previous research in terms of elevated proinflammatory TNF-α in adults with AN also in adolescents. This effect had been found in two large metanalyses (9,10) and several studies since (19,20,23,47). However, there is also a very well-controlled recent report challenging this finding (27), and adolescent findings are mixed (20,36,37).…”

Proteomics of appetite-regulating system influenced by menstrual cycle and intensive exercise in female athletes: a pilot study

“…Following the identification of IgM autoantibodies against alpha-melanocyte-stimulating hormone (α-MSH) in patients with anorexia nervosa by Fetissov et al 32 , several studies have been conducted to investigate the involvement of IgM autoantibodies in anorexia nervosa. Roubalova et al 47 found decreased levels of α-MSH and elevated levels of anti-α-MSH IgM in patients with anorexia nervosa, suggesting that the interaction between the immune system and gut bacterial diversity plays a role in the pathogenesis of anorexia nervosa. Although we did not analyze α-MSH in this study, the possibility that IgM acts as an autoantibody against α-MSH remains plausible.…”