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Publications

Journal Article Epublish

PubMed: 42884588 DOI: 10.3390/nu18193136

Host-Microbiota Interactions in Adolescents with Severe Anorexia Nervosa: Linking Gut Dysbiosis, Intestinal Barrier Function and Microbial Metabolism.

Nutrients 18(19)

Authors: Livia Gargiullo, Federica Del Chierico, Maria Rosaria Marchili, Mariangela Irrera, Italo Pretelli, Matteo Scanu, Francesca Toto, Annalisa Grandin, Rosaria Marotta, Cristina Mascolo, Flavia Cirillo, Valentina Colistra, Ludovica Ricci, Valeria Zanna, Lorenza Putignani, Alberto Villani

Affiliations

  • General Pediatrics, Infectious Diseases and Level II Pediatric Emergency Department Unit, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.
  • Unit of Microbiome, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy.
  • Anorexia and Eating Disorders Unit, Child and Adolescent Psychiatry, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.
  • Pediatrics Residency Program, Department of Pediatrics, University of Rome Tor Vergata, 00133 Rome, Italy.
  • Department of Life Sciences, Health and Health Professions, Link Campus University, 00165 Rome, Italy.
  • Unit of Microbiomics and Unit of Microbiome, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy.
  • Systems Medicine Departments, University of Rome Tor Vergata, 00133 Rome, Italy.

Abstract

BACKGROUND

Anorexia nervosa (AN) is increasingly recognized as a multisystem disorder involving complex host-microbiota interactions, yet prospective pediatric studies with a comprehensive, longitudinal characterization of host-microbiota interactions remain scarce.

METHODS

In this prospective longitudinal study, 26 adolescents with severe AN were evaluated at hospital admission (T0), after one month (T1), and after three months of inpatient nutritional rehabilitation (T2). Gut microbiota composition was assessed by 16S rRNA sequencing and compared with healthy controls (HC) at the baseline; predicted functional profiling was performed using PICRUSt2. Serum and urinary biomarkers of intestinal barrier integrity and microbial metabolism, routine clinical and biochemical parameters, and psychometric scores (CDI-2, MASC-2) were evaluated longitudinally using linear mixed-effects models.

RESULTS

At the baseline, adolescents with AN showed reduced bacterial richness compared with healthy controls, with significantly lower Chao1 diversity (p = 0.00013), whereas the Shannon and Simpson indices did not differ significantly (p = 0.54 and p = 0.27, respectively). Microbial community composition differed significantly between groups based on Bray-Curtis (R 2 = 0.0724, FDR-adjusted p = 0.001) and unweighted UniFrac (R 2 = 0.0540, FDR-adjusted p = 0.001) distances. LEfSe identified 19 differentially abundant taxa; among the strongest discriminators, Blautia_A_141781, Romboutsia_B, and Clostridium_T were enriched in AN, whereas Akkermansia, Phocaeicola_A_858004, and Bacteroides_H were enriched in the healthy controls. Nutritional rehabilitation was associated with partial microbiota remodeling, alongside significant improvements in BMI and heart rate. Several host-derived biomarkers, including urinary indican, serotonin, nitric oxide, and serum occludin, changed significantly over time, whereas bile acids, short-chain fatty acids, IgA, lipopolysaccharide, and haptoglobin remained stable.

CONCLUSIONS

Gut microbiota and host-derived biomarkers evolve dynamically during nutritional rehabilitation in adolescents with severe AN, supporting their potential role as complementary tools for monitoring biological recovery.

MeSH

Dysbiosis, Anorexia, Rehabilitation, Biomarkers, Food, Adolescent, Host Microbial Interactions, Gastrointestinal Microbiome, Anorexia Nervosa, Microbiota