Altered host-gut microbes symbiosis in severely malnourished anorexia nervosa (AN) patients undergoing enteral nutrition: An explicative factor of functional intestinal disorders?
2019
Hanachi, Mouna | Manichanh, Chaysavanh | Schoenenberger, Andreu | Pascal, Victoria | Levenez, Florence | Cournède, Nicole | Dore, Joel | Melchior, Jean-Claude | Clinical Nutrition Unit ; University Hospital Raymond Poincaré | Université de Versailles Saint-Quentin-en-Yvelines (UVSQ) | Unité de recherche d'Écologie et Physiologie du Système Digestif (UEPSD) ; Institut National de la Recherche Agronomique (INRA) | Department of Gastroenterology ; Vall d’Hebron Research Institute (VHIR) | MetaGenoPolis ; Institut National de la Recherche Agronomique (INRA) | MICrobiologie de l'ALImentation au Service de la Santé (MICALIS) ; Institut National de la Recherche Agronomique (INRA)-AgroParisTech | Institute de Salud Carlos III/FEDER PI17/00614
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. (C) 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.
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