Gut microbiota associations with chronic kidney disease: insights into nutritional and inflammatory parameters.

Introduction: The gut barrier, comprising gut microbiota, plays a pivotal role in chronic kidney disease (CKD) progression and nutritional status. This study aimed to explore gut barrier alterations in hemodialyzed (HD) patients, non-HD (NHD) CKD patients, and healthy volunteers. Methods: Our cross-sectional study enrolled 22 HD patients, 11 NHD patients, and 11 healthy volunteers. We evaluated fecal microbiota composition (assessed via bacterial 16S rRNA gene sequencing), fecal IgA levels, surrogate markers of gut permeability, serum cytokines, appetite mediators, nutritional status, physical activity, and quality of life. Results: HD patients exhibited significant alterations in fecal microbiota composition compared to healthy volunteers, with observed shifts in taxa known to be associated with dietary patterns or producing metabolites acting on human host. In comparison to healthy volunteers, individuals with HD patients exhibited elevated levels of inflammatory markers (CRP, IL-6 and TNF-α), glucagon-like peptide-2, and potential anorexigenic markers (including leptin and peptide YY). NHD patients had increased levels of CRP and peptide YY. Overall fecal microbiota composition was associated with height, soft lean mass, resting energy expenditure, handgrip strength, bone mineral content and plasma albumin and TNF-α. Discussion: Compared to healthy volunteers, HD patients have an altered fecal microbiota composition, a higher systemic inflammation, and a modification in plasma levels of appetite mediators. While some differences align with previous findings, heterogeneity exists likely due to various factors including lifestyle and comorbidities. Despite limitations such as sample size, our study underscores the multifaceted interplay between gut microbiota, physiological markers, and kidney function, warranting further investigation in larger cohorts.

Evolving immunometabolic response to the early Leishmania infantum infection in the spleen of BALB/c mice described by gene expression profiling.

Transcriptional analysis is a useful approximation towards the identification of global changes in host-pathogen interaction, in order to elucidate tissue-specific immune responses that drive the immunopathology of the disease. For this purpose, expression of 223 genes involved in innate and adaptive immune response, lipid metabolism, prostaglandin synthesis, C-type lectin receptors and MAPK signaling pathway, among other processes, were analyzed during the early infection in spleens of BALB/c mice infected by Leishmania infantum. Our results highlight the activation of immune responses in spleen tissue as early as 1 day p.i., but a mixed pro-inflammatory and regulatory response at day 10 p.i., failing to induce an effective response towards control of Leishmania infection in the spleen. This ineffective response is coupled to downregulation of metabolic markers relevant for pathways related to icosanoid biosynthesis, adipocytokine signaling or HIF-1 signaling, among others. Interestingly, the over-representation of processes related to immune response, revealed Il21 as a potential early biomarker of L. infantum infection in the spleen. These results provide insights into the relationships between immune and metabolic responses at transcriptional level during the first days of infection in the L. infantum-BALB/c experimental model, revealing the deregulation of many important pathways and processes crucial for parasitic control in infected tissues.

Early Transcriptional Liver Signatures in Experimental Visceral Leishmaniasis.

Transcriptional analysis of complex biological scenarios has been used extensively, even though sometimes the results of such analysis may prove imprecise or difficult to interpret due to an overwhelming amount of information. In this study, a large-scale real-time qPCR experiment was coupled to multivariate statistical analysis in order to describe the main immunological events underlying the early L. infantum infection in livers of BALB/c mice. High-throughput qPCR was used to evaluate the expression of 223 genes related to immunological response and metabolism 1, 3, 5, and 10 days post infection. This integrative analysis showed strikingly different gene signatures at 1 and 10 days post infection, revealing the progression of infection in the experimental model based on the upregulation of particular immunological response patterns and mediators. The gene signature 1 day post infection was not only characterized by the upregulation of mediators involved in interferon signaling and cell chemotaxis, but also the upregulation of some inhibitory markers. In contrast, at 10 days post infection, the upregulation of many inflammatory and Th1 markers characterized a more defined gene signature with the upregulation of mediators in the IL-12 signaling pathway. Our results reveal a significant connection between the expression of innate immune response and metabolic and inhibitory markers in early L. infantum infection of the liver.

Male eating disorders and therapy: a controlled pilot study with one year follow-up.

OBJECTIVES: To examine whether outpatient treatment for male patients with bulimic symptomatology is as effective as it is for females. METHOD: The outcome of 19 male patients was compared to that of 150 female eating disorder (ED) individuals after a group CBT treatment. RESULTS: A reduction in ED symptomatology was observed after treatment for both genders. Main effects for gender indicated that after collapsing across the mean pre/post values, lower mean scores were found for men in the EAT-40, in the EDI-total score and in the following EDI subscales: "drive for thinness", "body dissatisfaction" and "interoceptive awareness". CONCLUSIONS: A group CBT treatment appears to be effective for male and female ED patients.

Individual and family eating patterns during childhood and early adolescence: an analysis of associated eating disorder factors.

To examine whether there is an association between individual and family eating patterns during childhood and the likelihood of developing an eating disorder (ED) later in life. The sample comprised 261 eating disorder patients [33.5% [N=88] anorexia nervosa (AN), 47.2% [N=123] with bulimia nervosa (BN) and 19.3% [N=50] with Eating Disorders Not Otherwise Specified (EDNOS)] and 160 healthy controls from the Province of Catalonia, Spain, who were matched for age and education. All patients were consecutively admitted to our Psychiatry Department and were diagnosed according to DSM-IV criteria. Participants completed the Early Eating Environmental Subscale of the Cross-Cultural (Environmental) Questionnaire (CCQ), a retrospective measure of childhood eating attitudes and behaviours. In the control group, also the General Health Questionnaire-28 (GHQ-28) was used. During childhood and early adolescence, the following main factors were identified to be linked to eating disorders: eating excessive sweets and snacks and consuming food specially prepared for the respondent. Conversely, regular breakfast consumption was negatively associated with an eating disorder. Compared to healthy controls, eating disorder patients report unfavourable eating patterns early in life, which in conjunction with an excessive importance given to food by the individual and the family may increase the likelihood for developing a subsequent eating disorder.

Blood levels of brain-derived neurotrophic factor correlate with several psychopathological symptoms in anorexia nervosa patients.

BACKGROUND: Evidence of a role of brain-derived neurotrophic factor (BDNF) in the pathophysiology of eating disorders (ED) has been provided by association studies and by murine models. BDNF plasma levels have been found altered in ED and in psychiatric disorders that show comorbidity with ED. AIMS: Since the role of BDNF levels in ED-related psychopathological symptoms has not been tested, we investigated the correlation of BDNF plasma levels with the Symptom Checklist 90 Revised (SCL-90R) questionnaire in a total of 78 ED patients. METHODS: BDNF levels, measured by the enzyme-linked immunoassay system, and SCL-90R questionnaire, were assessed in a total of 78 ED patients. The relationship between BDNF levels and SCL-90R scales was calculated using a general linear model. RESULTS: BDNF plasma levels correlated with the Global Severity Index and the Positive Symptom Distress Index global scales and five of the nine subscales in the anorexia nervosa patients. BDNF plasma levels were able to explain, in the case of the Psychoticism subscale, up to 17% of the variability (p = 0.006). CONCLUSION: Our data suggest that BDNF levels could be involved in the severity of the disease through the modulation of psychopathological traits that are associated with the ED phenotype.

Ansiedad y fobia social en anorexia nerviosa: un estudio de casos y controles / Social anxiety and phobia in anorexia nervosa: a case-control study

Con frecuencia, se ha observado ansiedad social y aislamiento en los pacientes con anorexia nerviosa (AN); sin embargo, su relación con este trastorno ha sido raras veces investigada de forma específica. El objetivo del presente estudio es determinar la relevancia de la ansiedad y fobia social en pacientes con AN al ser comparados con un grupo de control. En este estudio participaron 40 pacientes con AN, diagnosticados según criterios DSM-IV, y 32 estudiantes control. Todos ellos fueron evaluados en ansiedad y fobia social (Social Avoidance and Distress Scale), depresión (Beck Depresión Inventory), y sintomatología alimentaria (Eating Attitudes Test; Eating Disorder Inventory). Los resultados indicaron que las pacientes con anorexia presentaban significativamente más ansiedad y fobia social que los sujetos del grupo de control (53 por ciento vs. 9 por ciento). Asimismo, se obtuvo que los pacientes que presentaban tal condición mostraban mayores valores en ineficacia personal (p< 0,001), desconfianza interpersonal (p< 0,001), conciencia interoceptiva (p< 0,001), impulso a la delgadez (p< 0,001) y mayor sintomatolgía depresiva (p< 0,001). Los niveles en ansiedad social y la presencia de sintomatología depresiva mostraron estar positivamente asociados (r= 0,62, p< 0,001). Estos resultados sugieren que los pacientes con anorexia nerviosa, y en especial el subgrupo de pacientes con altos niveles en ansiedad y fobia social, presentarían no sólo una mayor gravedad de su sintomatología alimentaria, sino también una más baja autoestima y mayor sintomatología depresiva (AU)

Marital status and eating disorders: an analysis of its relevance.

OBJECTIVES: This study attempts to understand the clinical impact of marital status on the psychopathology and symptomatology of anorexia (AN) and bulimia nervosa (BN) patients. METHOD: Eating disorder (ED) patients (n=332, 198 BN and 134 AN) consecutively admitted to our unit participated in the study. All subjects met DSM-IV criteria for those pathologies and were female. Our sample was divided retrospectively into three subgroups based on their marital status. For the assessment, commonly applied questionnaires in the field of ED were used [Eating Attitudes Test (EAT-40), Eating Disorder Inventory (EDI), Bulimic Investigatory Test Edinburgh (BITE), Body Shape Questionnaire (BSQ), Beck Depression Inventory (BDI) and Social Avoidance and Distress Scale (SAD)]. RESULTS: 2 x 3 (Diagnostic x Marital status) ANOVA and ANCOVA (with age as covariance) designs were applied in the current study. Our results suggested that ED patients who lived with a partner were significantly different with respect to the other ED patients in the following variables: higher age (P<.0001), higher motivation for change (P<.004), perfectionism (P<.03) and purging behavior (P<.04). DISCUSSION: The main finding in this study is that ED patients who live with a partner are those who presented greater eating symptomatology and psychopathology but even higher motivation for change. Interpersonal functionality has to be considered in the development and maintenance of ED.