Study of plasma neuropeptides and their respective immunoglobulins in 120 patients with eating disorders | Étude des neuropeptides plasmatiques et de leurs immunoglobulines respectives chez 120 patients atteints de troubles du comportement alimentaire

Introduction and purpose of the study: Eating behavior disorders (TCA) are common pathologies, the pathophysiology of which involves the microbiota-intestine-brain axis. Several neuropeptides and hormones are involved in the regulation of eating behavior and energy metabolism. Studies have shown that autoantibodies (AutoAc) against orexigenic and anorectic neuropeptides are present in APCs, with differences in profile (rate / affinity) that could contribute to neurobiological dysregulation of feeding behavior. To evaluate the main neuropeptides involved in the regulation of eating behavior and the corresponding antibodies during the different TCA: anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). Material and methods: Plasma analyzes were performed in 120 patients (34 NA, 12 BN and 74 BED) included before treatment in the EDILS ( Eating Disorder Inventory Longitudinal Study ) cohort . The levels of leptin, GLP-1, PYY and insulin, were analyzed by Milliplex and those of acyl ghrelin, des-acyl ghrelin and α-MSH by Elisa. The affinity of the IgGs recognizing these peptides was measured by surface plasmon resonance and the level of IgG analyzed by ELISA. The Kruskal-Wallis and Spearman test was used. Results and statistical analysis: Leptinemia was positively correlated with BMI and higher in the BED group (AN vs. BED and BN vs. BED: p < 0.001). Insulinemia was positively correlated with BMI and higher in BED vs AN patients ( p < 0.001). GLP-1 and PYY levels were increased in BED patients: AN vs BED (GLP-1, p = 0.004) and AN vs BED (PYY, p = 0.02). The rate of α-MSH was higher in AN vs BED patients ( p = 0.02). Total ghrelin was negatively correlated with BMI ( p < 0.001). This negative correlation was also observed with des-acyl ghrelin levels ( p < 0.001) and acyl ghrelin levels ( p < 0.001). The anti-GLP-1 IgG level was increased in AN vs BED patients ( p = 0.008), as well as the autoAc PYY level (AN vs BED: p = 0.03). Anti-insulin IgG levels were also higher in AN vs BN patients ( p = 0.02). Conclusion: Elevated leptin, PYY and GLP-1 levels during hyperphagia underline the resistance to anorexigenic signals during this TCA. Conversely, the level of α-MSH is higher during AN vs BED and is associated with an increase in total ghrelin, acyl ghrelin and des-acyl ghrelin, which seems to be involved in ghrelin resistance. during the year. These analyzes will be extended to a larger number of patients, to specify neuropeptidergic dysregulation profiles during TCA and to identify therapeutic targets.