Food Intake and IgA Microbiota in Anorexia Nervosa

Study Overview
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Brief Summary
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Anorexia nervosa is characterized by intestinal dysbiosis, related to the feeding behavior impairment presented by these patients. Pathophysiologic hypotheses are involving the trouble of the microbiota-gut-brain axis in the field of mental diseases.

Detailed Description
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Anorexia nervosa is characterized by intestinal dysbiosis, related to the feeding behavior impairment presented by these patients. Here we aim to characterize the IgA-coated fraction of bacteria from the intestinal microbiota, linked to the regulation of the mucosal immune system and the epithelium physiology. Abnormalities of this microbiota are reported in inflammatory bowel disease and are associated to immune trouble. As food intake plays a key role in shaping microbiota, we aim to correlate data from IgA microbiota to food intake specificity, and to anorexia nervosa phenotypes.

Official Title
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Food Intake and IgA Microbiota in Anorexia Nervosa

Conditions
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Anorexia Nervosa, Healthy Volunteer

Intervention / Treatment
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* Other: Stool sample
* Other: Food intake evaluation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: female subject, adult, affiliated to a social security system, under the care of the eating disorder department of university hospital of st Etienne presenting a diagnosis of pure restrictive anorexia nervosa. For acute subgroup : BMI between 11 and 17.5 kg/m2, patient with a first episode of restrictive anorexia nervosa or with hyperphagic episodes. For the chronic subgroup: BMI between 11 and 17.5 kg/m2, disease evolving for more than 5 years. For Healthy volunteer: BMI between 20 and 24 kg/m², stable weight for the last 3 months, no eating disorder or history of eating disorder Exclusion Criteria: patient does not understand French. laxative treatment in progress or stopped for less than 15 days, antibiotic treatment in the two months preceding inclusion, pre-pro or symbiotic treatment in progress or in the month preceding inclusion, patient with one of the following comorbid disorders: celiac disease, chronic inflammatory bowel disease, lactose intolerance, unstabilized hyperthyroidism, unstabilized diabetes, subject under legal protective measures.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Acute anorexia nervosa<br>patient diagnose for a first episode of pure restrictive anorexia nervosa will be included. They will have stool sample and Food intake evaluation. | Other: Stool sample<br>* Purification by affinity of the IgA coated bacteria from a fecal solution. Genomic analysis of the bacteria for diversity and richness<br>Other: Food intake evaluation<br>* Measure (by survey) of food group intake for : lipids /proteins / fibers / carbohydrates<br>|
| Experimental: Chronic anorexia nervosa<br>Patient diagnose for anorexia nervosa at least 5 years ago and still maintaining a significant thinness will be included. They will have stool sample and Food intake evaluation. | Other: Stool sample<br>* Purification by affinity of the IgA coated bacteria from a fecal solution. Genomic analysis of the bacteria for diversity and richness<br>Other: Food intake evaluation<br>* Measure (by survey) of food group intake for : lipids /proteins / fibers / carbohydrates<br>|
| Placebo Comparator: Healthy control<br>Healthy Patient will be included. They will have stool sample and Food intake evaluation. | Other: Stool sample<br>* Purification by affinity of the IgA coated bacteria from a fecal solution. Genomic analysis of the bacteria for diversity and richness<br>Other: Food intake evaluation<br>* Measure (by survey) of food group intake for : lipids /proteins / fibers / carbohydrates<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total microbiotic profile | abundance and diversity parameters of the IgA microbiota fraction of the intestinal microbiota obtained by 16s rDNA analysis of stool suspension samples from acute anorexia nervosa, chronic anorexia nervosa and control subjects. | 1 week after inclusion | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ELISA assay of fecal immunoglobulins | ELISA determination of immunoglobulin A and immunoglobulin M in the stool of acute anorexia nervosa, chronic anorexia nervosa and control subjects. | 1 week after inclusion | 
| Microbiotic profile of total intestinal microbiota | Total microbiotic profile (abundance and diversity) of the intestinal microbiota obtained by 16s rDNA analysis of stool suspension samples from acute anorexia nervosa, chronic anorexia nervosa and control subjects. | 1 week after inclusion | 
| Food intake characteristics | Qualitative and quantitative assessment of dietary intake by a dietary survey of acute anorexia nervosa, chronic anorexia nervosa and control subjects. | 1 week after inclusion | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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anorexia nervosa, microbiota, gut-brain-axis, immunology (IgA)