S.S.D. Dietetics and Clinical Nutrition ASL 4 Chiavarese Liguria-Sestri Levante Hospital, Sestri Levante, Italy.
Turku PET Centre, University of Turku, Turku, Finland.
Nutr Res Rev. 2023 Dec;36(2):372-391. doi: 10.1017/S0954422422000130. Epub 2022 Jul 25.
Anorexia nervosa (AN) is characterised by the restriction of energy intake in relation to energy needs and a significantly lowered body weight than normally expected, coupled with an intense fear of gaining weight. Treatment of AN is currently based on psychological and refeeding approaches, but their efficacy remains limited since 40% of patients after 10 years of medical care still present symptoms of AN. The intestine hosts a large community of microorganisms, called the "microbiota", which live in symbiosis with the human host. The gut microbiota of a healthy human is dominated by bacteria from two phyla: and, majorly, . However, the proportion in their representation differs on an individual basis and depends on many external factors including medical treatment, geographical location and hereditary, immunological and lifestyle factors. Drastic changes in dietary intake may profoundly impact the composition of the gut microbiota, and the resulting dysbiosis may play a part in the onset and/or maintenance of comorbidities associated with AN, such as gastrointestinal disorders, anxiety and depression, as well as appetite dysregulation. Furthermore, studies have reported the presence of atypical intestinal microbial composition in patients with AN compared with healthy normal-weight controls. This review addresses the current knowledge about the role of the gut microbiota in the pathogenesis and treatment of AN. The review also focuses on the bidirectional interaction between the gastrointestinal tract and the central nervous system (microbiota-gut-brain axis), considering the potential use of the gut microbiota manipulation in the prevention and treatment of AN.
神经性厌食症（AN）的特征是与能量需求相比，能量摄入受到限制，体重明显低于正常水平，同时伴有强烈的害怕体重增加的心理。AN 的治疗目前基于心理和重新喂养的方法，但它们的疗效仍然有限，因为在接受 10 年医疗护理后，仍有 40%的患者存在 AN 症状。肠道中存在大量微生物群落，称为“微生物群”，它们与人类宿主共生。健康人的肠道微生物群主要由两个门的细菌组成：和，主要是。然而，它们的代表性比例在个体基础上有所不同，取决于许多外部因素，包括医疗、地理位置和遗传、免疫和生活方式因素。饮食摄入的急剧变化可能会深刻影响肠道微生物群的组成，由此产生的微生态失调可能在与 AN 相关的共病（如胃肠道疾病、焦虑和抑郁以及食欲失调）的发生和/或维持中发挥作用。此外，研究报告称，与健康体重对照组相比，AN 患者存在非典型的肠道微生物组成。本综述探讨了肠道微生物群在 AN 的发病机制和治疗中的作用的现有知识。该综述还重点关注了胃肠道和中枢神经系统（微生物群-肠道-大脑轴）之间的双向相互作用，考虑了在预防和治疗 AN 中利用肠道微生物群操纵的潜在用途。
