Altered host-gut microbes symbiosis in severely malnourished anorexia nervosa (AN) patients undergoing enteral nutrition: An explicative factor of functional intestinal disorders?. Issue 5 (October 2019)

• Record Type: Journal Article
• Authors: Hanachi, Mouna; Manichanh, Chaysavanh; Schoenenberger, Andreu; Pascal, Victoria; Levenez, Florence; Cournède, Nicole; Doré, Joël; Melchior, Jean-Claude
• Is Part Of: Clinical nutrition. Volume 38:Issue 5(2019)
• Page Start: 2304
• Page End: 2310
• Publication Date: 2019-10
• Subjects: Undernutrition -- Gut dysbiosis -- Anorexia nervosa -- Functional intestinal disorders; AN anorexia nervosa -- FID Functional intestinal disorders -- BMI body mass index -- IBS Irritable Bowel Syndrome -- 16S rRNA 16S ribosomal RNA -- OTU operational taxonomic unit -- FDR false discovery rate; Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2018.10.004
• Languages: English
• ISSNs: 0261-5614

Abstract

Summary: Background: Functional intestinal disorders (FIDs) are frequently observed in patients with anorexia nervosa (AN). Relationship between FIDs and a potential gut microbiota dysbiosis has been poorly explored. Objective: We aimed to determine an association between FIDs severity and dysbiosis of the intestinal microbiota in a severely malnourished patient population with AN undergoing enteral nutrition. Design: Faecal microbiota of AN (DSM IVr criteria) female inpatients were collected and compared to healthy controls based on 16S rRNA profiling. The severity of FIDs was evaluated in patients and healthy controls using Francis Score. Results: Thirty-three patients (BMI: 11, 7 ± 1, 5; Age: 32 ± 12) and 22 healthy controls (BMI: 21 ± 2; age: 36 ± 12) were included. A marked dysbiosis was identified in AN patients compared to healthy controls ( p = 0.03). Some potentially pathogenic bacterial genera ( Klebsiella, Salmonella ) were more abundant in AN patients whereas, other bacterial symbionts ( Eubacterium and Roseburia ) involved in immune balance were significantly less abundant in patients than controls. Severity of FIDs was strongly correlated with several microbial genera (r = −0.581 for an unknown genus belonging to Peptostreptococcaceae family; r = 0.392 for Dialister, r = 0.444 for Robinsoniella and r = 0.488 for Enterococcus ). Other associations between dysbiosis, clinical and biological characteristics were identified including severity of undernutrition (BMI). Conclusion: Observed gut microbiota dysbiosis in malnourished patients with anorexia nervosa is correlated with the severity of FIDs and other metabolic disturbances, which strongly suggests an altered host-microbe symbiosis.