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KVINNEHELSE-Kvinners helse og kjønnsperspektiver

Gut microbiota alterations in anorexia nervosa - paving the way for personalized prebiotic treatment strategies

Alternative title: Endringer i tarmmikrobiota ved anorexia nervosa - muliggjøring for persontilpassede behandlingsstrategier med prebiotika

Awarded: NOK 16.0 mill.

Anorexia (anorexia nervosa) is a serious mental disorder that affects young women in particular. The disorder has major consequences for those affected, with huge impact on quality of life, participation in working life and fertility. All these consequences contribute to great personal, family, and societal costs. Treatment of anorexia usually involves a combination of nutritional treatment and various types of psychotherapeutic approaches. The treatment is complicated however and only 50 percent of patients get satisfactory outcomes. In addition, medical complications are common, and the mortality rate is high. Therefore, there is a great need for new strategies for anorexia treatment. Several studies indicate an association between the gut flora and mental disorders. Studies have also shown that anorexia associated symptoms can be transferred from patients to mice by transferring gut flora. Thus, there is a potential to treat anorexia patients by influencing the gut flora. In a large interdisciplinary collaborative project lead by the University of life sciences (NMBU) and Oslo University Hospital, a new clinical study will be conducted to gain more knowledge about the interaction between diet and the gut flora in patients with anorexia. Also, the project will investigate how the gut flora affects symptoms such as low appetite, bowel problems and other anorexia-associated problems. Laboratory tests will also be carried out to identify new types of prebiotics (carbohydrate types) that can potentially be used to normalize the intestinal flora in the patients. The effect of the prebiotic will then be tested on mice that has been transplanted with gut flora from anorexia patients. Hopefully, the project will form the basis for creating a prebiotic supplement that can aid in the current treatment to help anorexia patients on their way to achieving good health, normal life expectancy and a good quality of life.

Anorexia nervosa (AN) is a serious mental disorder occurring mainly in women. AN is characterized by severely restricted food-intake and subsequent low weight. The disease burden for the individual is high with medical complications and psychiatric comorbidities. Despite decades of research, there are large gaps in our understanding of the biological aspects of AN and lack of effective interventions. Current clinical treatment is associated with gastrointestinal problems, high rates of relapse and poor outcome causing long-term sickness absence and disability. During the COVID19 pandemic the prevalence and severity of AN has spiked. Therefore, we are in great need of novel strategies for AN treatment, that can be easily implemented in the clinic without adding complexity to the standard care of treatment. During the resent years it has been proposed that mental disorders might be treated via manipulating the composition and function of the microbes that live in our gut (the microbiota) by adding or restricting fermentable nutrients (prebiotics) in the diet. However, in order to use prebiotics to treat the microbiota in AN patients, we need more knowledge on how the AN microbiota is affected by the current standard care treatment. We also need to identify possible prebiotics that can be useful for normalizing AN microbiota. The overall aim of the “Norwegian Microbiota Anorexia Nervosa” (NorMA) study is to join forces of researchers, clinical health care services and voluntary sector in a transdiciplinary approach to improve our understanding of the role of the gut microbiota in AN patients. We will conduct a clinical trial in AN patients and also establish experimental procedures to screen novel prebiotics for their ability to modify and normalize AN derived microbiota. The long-term goal of the project is to pave the way for a targeted and clinically feasible individualized treatment for better tolerable weight-restoration and improved health in AN patients.

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KVINNEHELSE-Kvinners helse og kjønnsperspektiver

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