Paszynska Elzbieta, Hernik Amadeusz, Slopien Agnieszka, Boucher Yves, Tyszkiewicz-Nwafor Marta, Roszak Magdalena, Bilska Karolina, Dmitrzak-Weglarz Monika
Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), Bukowska St. 70, 60-812, Poznan, Poland.
Department of Child and Adolescent Psychiatry, PUMS, Poznan, Poland.
J Eat Disord. 2022 Aug 11;10(1):118. doi: 10.1186/s40337-022-00637-3.
Patients who suffer from anorexia nervosa (AN) are characterized by exceedingly lower body weight, micro- and macro-nutrient deficiencies, and hyposalivation as compared to healthy subjects. In addition, AN may predispose to difficulties in oral health maintenance. However, little is known about the relationship between stress-dependent salivary neuro/immunopeptidergic biomarkers such as opiorphin and immunoglobulins (Ig) and AN.The aim of this case-control study was to evaluate salivary opiorphin and immunoglobulins in female children and adolescents diagnosed with AN compared to healthy controls.
Adolescent patients with clinically-confirmed severe restrictive subtype AN (Body Mass Index BMI < 15 kg/m, mean age 15.0 ± 1.8, n = 83) were examined in the first week of hospital admission and compared to healthy matched controls (n = 79). Measurements of salivary opiorphin, IgA, IgG, IgM (ELISA technique), and oral hygiene levels (Plaque Control Record index-PCR) were performed.
In the AN group, a significantly higher concentration of opiorphin was evidenced (3.1 ± 4.1 ng/ml) compared to the control group (1.1 ± 1.2 ng/ml), (p < 0.001), contrary to IgM, which was significantly lower (311.0 ± 185.3 ng/ml) than in the control group (421.2 ± 168.1 ng/ml), (p < 0.001). There were no significant differences in the levels of IgA and IgG, despite a higher concentration of IgA in the AN group vs. controls (p = 0.14). Spearman analysis revealed a correlation between opiorphin and age (p < 0.05), but also with all immunoglobulins IgA, IgG, IgM (p = 0.006, p < 0.001, p < 0.001). Similarly a correlation was found between PCR index and immunoglobulins IgG, IgM (respectively p = 0.028, p < 0.001), and between body mass, BMI, IBW% and IgA, IgM (all p < 0.05).
In the acute phase of AN, salivary changes in opiorphin and immunoglobulins related to dental plaque suggest an essential role in oral health balance. Changes related to AN may affect the anti-inflammatory and analgesic components of saliva and suggest their use as neurobiological markers in severe malnutrition.
与健康受试者相比，神经性厌食症（AN）患者的特征是体重极低、微量和宏量营养素缺乏以及唾液分泌减少。此外，AN可能会导致口腔健康维护困难。然而，关于应激依赖性唾液神经/免疫肽生物标志物（如阿片素）和免疫球蛋白（Ig）与AN之间的关系知之甚少。本病例对照研究的目的是评估与健康对照相比，被诊断为AN的女童和青少年的唾液阿片素和免疫球蛋白。
对临床确诊为严重限制型亚型AN（体重指数BMI＜15kg/m²，平均年龄15.0±1.8岁，n = 83）的青少年患者在入院第一周进行检查，并与健康匹配对照（n = 79）进行比较。进行唾液阿片素、IgA、IgG、IgM的测量（ELISA技术）以及口腔卫生水平（菌斑控制记录指数-PCR）的测量。
与对照组（1.1±1.2ng/ml）相比，AN组阿片素浓度显著更高（3.1±4.1ng/ml），（p＜0.001），与IgM相反，IgM显著低于对照组（421.2±168.1ng/ml），（p＜0.001）。尽管AN组IgA浓度高于对照组（p = 0.14），但IgA和IgG水平无显著差异。Spearman分析显示阿片素与年龄之间存在相关性（p＜0.05），但也与所有免疫球蛋白IgA、IgG、IgM存在相关性（p = 0.006、p＜0.001、p＜0.001）。同样，PCR指数与免疫球蛋白IgG、IgM之间存在相关性（分别为p = 0.028、p＜0.001），体重、BMI、IBW%与IgA、IgM之间也存在相关性（均p＜0.05）。
在AN的急性期，与牙菌斑相关的唾液阿片素和免疫球蛋白变化表明其在口腔健康平衡中起重要作用。与AN相关的变化可能会影响唾液的抗炎和镇痛成分，并表明它们可作为严重营养不良的神经生物学标志物。
