title: Weight gain in anorexia nervosa does not ameliorate the faecal microbiota, branched chain fatty acid profiles, and gastrointestinal complaints.
abstract: The gut microbiota not only influences host metabolism but can also affect brain function and behaviour through the microbiota-gut-brain axis. To explore the potential role of the intestinal microbiota in anorexia nervosa (AN), we comprehensively investigated the faecal microbiota and short-chain fatty acids in these patients before (n = 55) and after weight gain (n = 44) in comparison to normal-weight participants (NW, n = 55) along with dietary intake and gastrointestinal complaints. We show profound microbial perturbations in AN patients as compared to NW participants, with higher levels of mucin-degraders and members of Clostridium clusters I, XI and XVIII and reduced levels of the butyrate-producing Roseburia spp. Branched-chain fatty acid concentrations, being markers for protein fermentation, were elevated. Distinct perturbations in microbial community compositions were observed for individual restrictive and binge/purging AN-subtypes. Upon weight gain, microbial richness increased, however perturbations in intestinal microbiota and short chain fatty acid profiles in addition to several gastrointestinal symptoms did not recover. These insights provide new leads to modulate the intestinal microbiota in order to improve the outcomes of the standard therapy.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Mack
authors.affiliation: Klinik Roseneck, Center for Behavioral Medicine, Prien, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Cuntz
authors.affiliation: Klinik Roseneck, Center for Behavioral Medicine, Prien, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Grämer
authors.affiliation: Klinik Roseneck, Center for Behavioral Medicine, Prien, Germany.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Niedermaier
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Pohl
authors.affiliation: Institute of Microecology, Herborn, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schwiertz
authors.affiliation: SymbioPharm GmbH, Herborn, Germany.
authors.forename: Kurt
authors.initials: K
authors.lastname: Zimmermann
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Zipfel
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany.
authors.forename: Paul
authors.initials: P
authors.lastname: Enck
authors.affiliation: Maastricht University Medical Center, NUTRIM School for Nutrition and Translational Research in Metabolism, Department of Medical Microbiology, Maastricht, The Netherlands.
authors.forename: John
authors.initials: J
authors.lastname: Penders
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications / Q000378:metabolism* / Q000382:microbiology*; D004032:Diet; D004435:Eating; D005232:Fatty Acids, Volatile / Q000378:metabolism*; D005243:Feces / Q000382:microbiology*; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications*; D000069196:Gastrointestinal Microbiome; D006801:Humans; D015430:Weight Gain; D055815:Young Adult
chemical_list: D005232:Fatty Acids, Volatile