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Übersichtsarbeit

Das Darmmikrobiom und seine klinischen Implikationen im Kontext der Anorexia nervosa

Published Online:October 14, 2021https://doi.org/10.1024/1422-4917/a000830

Abstract

Zusammenfassung. Die vielseitigen Wechselwirkungen des Darmmikrobioms mit dem Stoffwechsel, dem Immunsystem und dem Gehirn des Wirtes werden zunehmend zu einem relevanten Forschungsschwerpunkt. Studien legen einen Zusammenhang zwischen einem veränderten Darmmikrobiom und sowohl somatischen Erkrankungen wie Colitis ulcerosa, Morbus Crohn und Diabetes als auch psychischen Erkrankungen wie Ängsten und Depression nahe. Auch Patient_innen mit Anorexia nervosa (AN) zeigen deutliche Veränderungen des Darmmikrobioms. Diese Veränderungen scheinen unter anderem mit einer abweichenden Energieaufnahme aus der Nahrung, immunologischen und entzündlichen Prozessen, genetischer Prädisposition, hormonellen Veränderungen und einer möglicherweise erhöhten Darmpermeabilität assoziiert zu sein. Transplantation von Stuhl von Patient_innen mit AN in Ratten führte zu einer Appetitminderung und Gewichtsreduktion sowie ängstlichem und zwanghaftem Verhalten. In dieser Übersichtsarbeit fassen wir mögliche Mechanismen der Interaktion zwischen dem Darmmikrobiom und dem Wirt zusammen und stellen erste Befunde zum Mikrobiom bei AN vor. Forschung zu Ernährungsinterventionen zum Beispiel mit Prä- und Probiotika oder Nahrungssupplementen wie Omega-3 Fettsäuren, die darauf abzielen, das Darmmikrobiom positiv zu beeinflussen, könnte zu zusätzlichen Behandlungsmöglichkeiten in der Therapie von Patient_innen mit AN führen.


The Gut Microbiome and Its Clinical Implications in Anorexia Nervosa

Abstract. The diverse interactions of the gut microbiome with the metabolism, the immune system, and the brain of the host are increasingly becoming to the forefront of relevant research. Studies suggest a connection between an altered intestinal microbiome and somatic diseases, such as colitis ulcerosa, Crohn’s disease, and diabetes, as well as mental illnesses such as anxiety and depression. Patients with anorexia nervosa (AN) also show significant changes in their gut microbiome which seem to be associated, among other things, with a different energy uptake from food, immunological and inflammatory processes, genetic predisposition, hormonal changes, and possibly increased intestinal permeability. In rats, stool transplantation from patients with AN resulted in decreased appetite and weight as well as anxious and compulsive behavior. In this review, we summarize the possible mechanisms of interaction between the microbiome and the host, and present initial findings on the microbiome in AN. Research on nutritional interventions, for example, with prebiotics and probiotics or nutritional supplements such as omega-3 fatty acids, which aim to positively influence the intestinal microbiome, could lead to additional treatment options in the therapy of patients with AN.

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