Clinical Trial: Microbiome Shifts in Adolescent Anorexia Nervosa

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Observational

Official Title: Microbiome Shifts in Adolescent Anorexia Nervosa

Brief Summary: The aim of this study is to evaluate the effect of starvation and recovery in adolescent anorexia nervosa patients in regard to microbiome activity and composition and to elucidate potential connections between weight gain, depression and other comorbidities, further to capture hormone levels and inflammation parameters in a longitudinal design.

Detailed Summary: Anorexia Nervosa (AN) has the highest mortality of all psychiatric disorders. Large part of all patients the disorder becomes chronical. Until now, no (bio-) markers which allow a prognosis of outcome are known. Recently the function of the intestinal microbiome and its effects on food uptake, immunological processes and barrier malfunctions in the intestine is discussed. Especially the concept of the "leaky gut", an adsorption malfunction of the intestinal wall under starvation for antigens may help to explain the low inflammatory response which is commonly found in Anorexia Nervosa subjects and a connection to higher rate of autoimmune diseases by Anorexia Nervosa. Furthermore the presence and quantity of specific bacteria in the intestine seems to be dependent on patient's sex which would contribute to the gender gap of prevalence for Anorexia Nervosa. Stress induced changes of the HPA-axis which are well documented in Anorexia Nervosa patients and often persist even after weight rehabilitation, play an important part for intestinal wall permeability disorders. In the most often used animal model for AN, the Activity-Based Anorexia (ABA) model which combines nutrition restriction and weight loss with hyper activity, a malfunction in intestinal wall permeability was found. Malnutrition and long lasting dieting have a fast and reproducible impact on the intestinal microbiome. Especially animal derived food seems to support proliferation of pro-inflammatory bacteria. A substantial intestinal dysbiosis (reduced alpha-diversity) was found in AN patients which only partly recovered after weight rehabilitation. Reduction in diversity and composition of the microbiome was significantly associated with severity of depressive symptoms in patient, where severity is an indicator for higher level eating pathologies and poorer prognosis. Aim of this longitudinal study is therefore to investigate to interconnections between fecal microbiome and progression of AN, incl
Sponsor: RWTH Aachen University

Current Primary Outcome: Correlation BMI and Microbiome Variability [ Time Frame: 12 month ]

Correlation between Body Mass Index and Microbiome Variability.


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Bacteria [ Time Frame: 12 month ]
    Qualitative description of bacteria species
  • Bacteria activity [ Time Frame: 12 month ]
    Quantitative description of Bacterial activity
  • Inflammatory parameters [ Time Frame: 12 month ]
  • Depression [ Time Frame: 12 month ]
    Depression assessment Beck's Depression Inventory II


Original Secondary Outcome: Same as current

Information By: RWTH Aachen University

Dates:
Date Received: November 9, 2016
Date Started: September 2016
Date Completion: September 2019
Last Updated: November 11, 2016
Last Verified: November 2016