Study of Intestinal Permeability in Patients With Anorexia Nervosa
Condition: Anorexia Nervosa
MeSH terms: Anorexia; Anorexia Nervosa
Study type: Interventional

Summary: 
      In healthy humans, the intestinal mucosa acts as an absorption organ and a defensive barrier
      preventing the passage of toxic substances from the intestinal lumen to the blood stream.
      Malnutrition and absence of exogenous luminal nutrients in the gastrointestinal tract
      profoundly affect small bowel morphology and physiology. Many reports have described
      alterations of ion and nutrient transport, mucosal atrophy and modifications in the
      intestinal permeability to macromolecules in cases of prolonged intestinal rest, as in severe
      starvation. These changes may dampen both the absorptive and the barrier functions of
      intestinal mucosa.

      The assessment of intestinal permeability, by measuring the urinary excretion of substances
      that are not metabolised by human tissues and passively cross the intestinal epithelium, is a
      reliable and non invasive method to investigate the anatomo-functional integrity of the
      intestinal mucosa. Previous studies have shown an increase of permeability in malnourished
      humans . The increase of may also increase the risk for inappropriate passage of food
      antigens and other noxious substances across the mucosal barrier. To this regard, the
      enhanced susceptibility of malnourished subjects to systemic infections and postoperative
      sepsis has long been recognised.

      Anorexia nervosa is a psychiatric disorder characterised by abnormal eating behaviours aiming
      to decrease body weight. Typically, women with anorexia nervosa restrict food ingestion up to
      severe starvation. These behaviours usually lead to malnutrition and a more or less prolonged
      absence of luminal nutrients in the gastrointestinal tract. Therefore, alterations in the
      integrity and functioning of intestinal mucosa are likely to occur in this condition. There
      is no information on intestinal permeability in patients with eating disorders. We
      hypothesised that, as it occurs in simple starvation and malnutrition, intestinal
      permeability should be increased in fasted undernourished people with anorexia nervosa and
      decrease after re feeding. Therefore, in the present study, we explored intestinal
      permeability of 23 subjects with anorexia nervosa by means of the lactulose-mannitol test and
      urinary sucralose excretion and compare them to 46 controls.

      Moreover, auto-antibodies (α-MSH ) have been found in patients with anorexia nervosa. The
      origin of these auto-antibodies is still unknown , but some studies suggested a digestive
      origin. Moreover, modifications of intestinal flora have been described in patients with
      anorexia nervosa. Actually, a study of the intestinal barrier of patients with anorexia
      nervosa is necessary. In this study, a comparaison of intestinal permeability and
      autoantibodies (α-MSH) rate is proposed before and after re-feeding in patients with anorexia
      nervosa.
    


Intervention name(s): assessment of the intestinal permeability
Intervention type(s): Other
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: Intestinal permeability - Anorexia nervosa- Re feeding - auto-antibodies α-MSH