A spatially resolved atlas of the human lung characterizes a gland-associated immune niche.

Single-cell transcriptomics has allowed unprecedented resolution of cell types/states in the human lung, but their spatial context is less well defined. To (re)define tissue architecture of lung and airways, we profiled five proximal-to-distal locations of healthy human lungs in depth using multi-omic single cell/nuclei and spatial transcriptomics (queryable at lungcellatlas.org ). Using computational data integration and analysis, we extend beyond the suspension cell paradigm and discover macro and micro-anatomical tissue compartments including previously unannotated cell types in the epithelial, vascular, stromal and nerve bundle micro-environments. We identify and implicate peribronchial fibroblasts in lung disease. Importantly, we discover and validate a survival niche for IgA plasma cells in the airway submucosal glands (SMG). We show that gland epithelial cells recruit B cells and IgA plasma cells, and promote longevity and antibody secretion locally through expression of CCL28, APRIL and IL-6. This new 'gland-associated immune niche' has implications for respiratory health.

Offspring of mothers with bipolar disorder: a systematic review considering personality features.

OBJECTIVE: To examine personality/temperament features and mental health vulnerability in offspring of mothers with bipolar disorders (BD), including dimensions which may impact psychological characteristics or therapeutic measures. METHODS: A systematic review, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, was conducted to search for original articles that investigated personality/temperament features of offspring of women with BD and emotional factors involved in the mother-child relationship. The electronic search was performed in the PubMed, Web of Science, and PsycINFO databases from February 2010 to February 2017. RESULTS: Ten quantitative studies were included in the analysis: seven from the United States, two from Brazil, and one from Canada. The narrative synthesis was categorized into three dimensions: 1) reliability of instruments for prediction of future psychopathology in offspring; 2) environmental risk factors for offspring; and 3) early interventions. The findings showed impairments in the offspring's lives, high rates of behavior and temperament problems, and psychiatric disorders. CONCLUSION: BD is a frequent psychiatric disorder, and the offspring of mothers with this condition are exposed to complex family relationships and psychosocial difficulties. If they are to ensure a good provision of mental health and psychosocial care to this unique population, early interventions must not neglect their contextual specificities. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD-42017039010.

Offspring of mothers with bipolar disorder: a systematic review considering personality features

Objective: To examine personality/temperament features and mental health vulnerability in offspring of mothers with bipolar disorders (BD), including dimensions which may impact psychological characteristics or therapeutic measures. Methods: A systematic review, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, was conducted to search for original articles that investigated personality/temperament features of offspring of women with BD and emotional factors involved in the mother-child relationship. The electronic search was performed in the PubMed, Web of Science, and PsycINFO databases from February 2010 to February 2017. Results: Ten quantitative studies were included in the analysis: seven from the United States, two from Brazil, and one from Canada. The narrative synthesis was categorized into three dimensions: 1) reliability of instruments for prediction of future psychopathology in offspring; 2) environmental risk factors for offspring; and 3) early interventions. The findings showed impairments in the offspring's lives, high rates of behavior and temperament problems, and psychiatric disorders. Conclusion: BD is a frequent psychiatric disorder, and the offspring of mothers with this condition are exposed to complex family relationships and psychosocial difficulties. If they are to ensure a good provision of mental health and psychosocial care to this unique population, early interventions must not neglect their contextual specificities. Systematic review registration: PROSPERO CRD-42017039010

Mapping the temporal and spatial dynamics of the human endometrium in vivo and in vitro.

The endometrium, the mucosal lining of the uterus, undergoes dynamic changes throughout the menstrual cycle in response to ovarian hormones. We have generated dense single-cell and spatial reference maps of the human uterus and three-dimensional endometrial organoid cultures. We dissect the signaling pathways that determine cell fate of the epithelial lineages in the lumenal and glandular microenvironments. Our benchmark of the endometrial organoids reveals the pathways and cell states regulating differentiation of the secretory and ciliated lineages both in vivo and in vitro. In vitro downregulation of WNT or NOTCH pathways increases the differentiation efficiency along the secretory and ciliated lineages, respectively. We utilize our cellular maps to deconvolute bulk data from endometrial cancers and endometriotic lesions, illuminating the cell types dominating in each of these disorders. These mechanistic insights provide a platform for future development of treatments for common conditions including endometriosis and endometrial carcinoma.

Mutational signatures in esophageal squamous cell carcinoma from eight countries with varying incidence.

Esophageal squamous cell carcinoma (ESCC) shows remarkable variation in incidence that is not fully explained by known lifestyle and environmental risk factors. It has been speculated that an unknown exogenous exposure(s) could be responsible. Here we combine the fields of mutational signature analysis with cancer epidemiology to study 552 ESCC genomes from eight countries with varying incidence rates. Mutational profiles were similar across all countries studied. Associations between specific mutational signatures and ESCC risk factors were identified for tobacco, alcohol, opium and germline variants, with modest impacts on mutation burden. We find no evidence of a mutational signature indicative of an exogenous exposure capable of explaining differences in ESCC incidence. Apolipoprotein B mRNA-editing enzyme, catalytic polypeptide-like (APOBEC)-associated mutational signatures single-base substitution (SBS)2 and SBS13 were present in 88% and 91% of cases, respectively, and accounted for 25% of the mutation burden on average, indicating that APOBEC activation is a crucial step in ESCC tumor development.

Cells of the human intestinal tract mapped across space and time.

The cellular landscape of the human intestinal tract is dynamic throughout life, developing in utero and changing in response to functional requirements and environmental exposures. Here, to comprehensively map cell lineages, we use single-cell RNA sequencing and antigen receptor analysis of almost half a million cells from up to 5 anatomical regions in the developing and up to 11 distinct anatomical regions in the healthy paediatric and adult human gut. This reveals the existence of transcriptionally distinct BEST4 epithelial cells throughout the human intestinal tract. Furthermore, we implicate IgG sensing as a function of intestinal tuft cells. We describe neural cell populations in the developing enteric nervous system, and predict cell-type-specific expression of genes associated with Hirschsprung's disease. Finally, using a systems approach, we identify key cell players that drive the formation of secondary lymphoid tissue in early human development. We show that these programs are adopted in inflammatory bowel disease to recruit and retain immune cells at the site of inflammation. This catalogue of intestinal cells will provide new insights into cellular programs in development, homeostasis and disease.

Tumors induce de novo steroid biosynthesis in T cells to evade immunity.

Tumors subvert immune cell function to evade immune responses, yet the complex mechanisms driving immune evasion remain poorly understood. Here we show that tumors induce de novo steroidogenesis in T lymphocytes to evade anti-tumor immunity. Using a transgenic steroidogenesis-reporter mouse line we identify and characterize de novo steroidogenic immune cells, defining the global gene expression identity of these steroid-producing immune cells and gene regulatory networks by using single-cell transcriptomics. Genetic ablation of T cell steroidogenesis restricts primary tumor growth and metastatic dissemination in mouse models. Steroidogenic T cells dysregulate anti-tumor immunity, and inhibition of the steroidogenesis pathway is sufficient to restore anti-tumor immunity. This study demonstrates T cell de novo steroidogenesis as a mechanism of anti-tumor immunosuppression and a potential druggable target.

Expanded potential stem cell media as a tool to study human developmental hematopoiesis in vitro.

Pluripotent stem cell (PSC) differentiation in vitro represents a powerful and tractable model to study mammalian development and an unlimited source of cells for regenerative medicine. Within hematology, in vitro PSC hematopoiesis affords novel insights into blood formation and represents an exciting potential approach to generate hematopoietic and immune cell types for transplantation and transfusion. Most studies to date have focused on in vitro hematopoiesis from mouse PSCs and human PSCs. However, differences in mouse and human PSC culture protocols have complicated the translation of discoveries between these systems. We recently developed a novel chemical media formulation, expanded potential stem cell medium (EPSCM), that maintains mouse PSCs in a unique cellular state and extraembryonic differentiation capacity. Herein, we describe how EPSCM can be directly used to stably maintain human PSCs. We further demonstrate that human PSCs maintained in EPSCM can spontaneously form embryoid bodies and undergo in vitro hematopoiesis using a simple differentiation protocol, similar to mouse PSC differentiation. EPSCM-maintained human PSCs generated at least two hematopoietic cell populations, which displayed distinct transcriptional profiles by RNA-sequencing (RNA-seq) analysis. EPSCM also supports gene targeting using homologous recombination, affording generation of an SPI1 (PU.1) reporter PSC line to study and track in vitro hematopoiesis. EPSCM therefore provides a useful tool not only to study pluripotency but also hematopoietic cell specification and developmental-lineage commitment.

Establishment of porcine and human expanded potential stem cells.

We recently derived mouse expanded potential stem cells (EPSCs) from individual blastomeres by inhibiting the critical molecular pathways that predispose their differentiation. EPSCs had enriched molecular signatures of blastomeres and possessed developmental potency for all embryonic and extra-embryonic cell lineages. Here, we report the derivation of porcine EPSCs, which express key pluripotency genes, are genetically stable, permit genome editing, differentiate to derivatives of the three germ layers in chimeras and produce primordial germ cell-like cells in vitro. Under similar conditions, human embryonic stem cells and induced pluripotent stem cells can be converted, or somatic cells directly reprogrammed, to EPSCs that display the molecular and functional attributes reminiscent of porcine EPSCs. Importantly, trophoblast stem-cell-like cells can be generated from both human and porcine EPSCs. Our pathway-inhibition paradigm thus opens an avenue for generating mammalian pluripotent stem cells, and EPSCs present a unique cellular platform for translational research in biotechnology and regenerative medicine.

BCL11A interacts with SOX2 to control the expression of epigenetic regulators in lung squamous carcinoma.

Patients diagnosed with lung squamous cell carcinoma (LUSC) have limited targeted therapies. We report here the identification and characterisation of BCL11A, as a LUSC oncogene. Analysis of cancer genomics datasets revealed BCL11A to be upregulated in LUSC but not in lung adenocarcinoma (LUAD). Experimentally we demonstrate that non-physiological levels of BCL11A in vitro and in vivo promote squamous-like phenotypes, while its knockdown abolishes xenograft tumour formation. At the molecular level we found that BCL11A is transcriptionally regulated by SOX2 and is required for its oncogenic functions. Furthermore, we show that BCL11A and SOX2 regulate the expression of several transcription factors, including SETD8. We demonstrate that shRNA-mediated or pharmacological inhibition of SETD8 selectively inhibits LUSC growth. Collectively, our study indicates that BCL11A is integral to LUSC pathology and highlights the disruption of the BCL11A-SOX2 transcriptional programme as a novel candidate for drug development.

O transtorno bipolar como experiência: a perspectiva dos filhos / Bipolar disorder as experience: the perspective of children

RESUMO Objetivo Compreender o transtorno afetivo bipolar (TAB) e suas implicações pela perspectiva dos filhos adultos de mães que receberam o diagnóstico quando eles eram crianças. Métodos Pesquisa qualitativa, por meio de entrevistas semiestruturadas de questões abertas em profundidade com 21 filhos de pacientes do Ambulatório de Psiquiatria Geral de Adultos do HC/Unicamp. A técnica de tratamento de dados foi feita por meio da análise de conteúdo das entrevistas transcritas na íntegra e categorização. Resultados Os significados psicológicos atribuídos pelos filhos à experiência de ter uma mãe com TAB possibilitaram a elaboração de um esquema da infância, adolescência à vida adulta. Os achados revelam que na infância a instabilidade da mãe, característica do TAB, gera sentimentos de culpa e desamparo nos filhos, pela percepção da introspecção materna nos períodos dos episódios em contraste com os momentos de remissão, nos quais percebem envolvimento emocional e disponibilidade para a maternidade. Na adolescência, os filhos contestam as demandas de suas mães. Demonstram identificação com os sintomas maternos. Na vida adulta, há percepção de melhora na relação mãe-filho diante da abdicação das escolhas pessoais para a dedicação aos cuidados à mãe. Os achados revelam que a compreensão do TAB feita por meio da experiência dos filhos com suas mães fica apenas na racionabilidade, pois eles não conseguem manejá-la de forma efetiva e sentem-se aprisionados. Conclusões A equipe de saúde pode auxiliar os filhos desde o manejo de questões cotidianas até o diagnóstico precoce de psicopatologias ao se dedicar ao acolhimento deles quando da vinda de suas mães ao tratamento.

ABSTRACT Objective To understand bipolar disorder (BD) from the perspective of the adult offspring of mothers who received the diagnosis when they were children and their implications. Methods Qualitative research conducted through in-depth semistructured interviews with 21 children of patients of the General Psychiatry Outpatient Clinic for Adults at HC/Unicamp. The technical data processing was done through qualitative content analysis of the transcribed interviews and categorization. Results The psychological meanings attributed by the offspring to the experience of having a mother with BD enabled the elaboration of a schematic from childhood, adolescence to adulthood. The findings reveal that in childhood the instability of the mother, characteristic of BD, generates feelings of guilt and helplessness in the children, by the perception of maternal introspection in the periods of the episodes in contrast to moments of remission in which they perceive emotional involvement and availability for motherhood. In adolescence, the children challenge the demands of their mothers. Demonstrate identification with maternal symptoms. In adulthood, there is perception of improvement in the mother-child relationship due to the abdication of personal choices for dedication to the mother's care. The findings reveal that the understanding of BD made through the experience of the offspring with their mothers is only in rationality, they can not handle it effectively and they feel trapped. Conclusions The health team involved can help these children from management of daily issues to the early diagnosis of psychopathologies by dedicating themselves to receiving these children when their mothers come to the treatment.

Establishment of mouse expanded potential stem cells.

Mouse embryonic stem cells derived from the epiblast contribute to the somatic lineages and the germline but are excluded from the extra-embryonic tissues that are derived from the trophectoderm and the primitive endoderm upon reintroduction to the blastocyst. Here we report that cultures of expanded potential stem cells can be established from individual eight-cell blastomeres, and by direct conversion of mouse embryonic stem cells and induced pluripotent stem cells. Remarkably, a single expanded potential stem cell can contribute both to the embryo proper and to the trophectoderm lineages in a chimaera assay. Bona fide trophoblast stem cell lines and extra-embryonic endoderm stem cells can be directly derived from expanded potential stem cells in vitro. Molecular analyses of the epigenome and single-cell transcriptome reveal enrichment for blastomere-specific signature and a dynamic DNA methylome in expanded potential stem cells. The generation of mouse expanded potential stem cells highlights the feasibility of establishing expanded potential stem cells for other mammalian species.

Single-cell RNA-seq identifies a PD-1hi ILC progenitor and defines its development pathway.

Innate lymphoid cells (ILCs) functionally resemble T lymphocytes in cytotoxicity and cytokine production but lack antigen-specific receptors, and they are important regulators of immune responses and tissue homeostasis. ILCs are generated from common lymphoid progenitors, which are subsequently committed to innate lymphoid lineages in the α-lymphoid progenitor, early innate lymphoid progenitor, common helper innate lymphoid progenitor and innate lymphoid cell progenitor compartments. ILCs consist of conventional natural killer cells and helper-like cells (ILC1, ILC2 and ILC3). Despite recent advances, the cellular heterogeneity, developmental trajectory and signalling dependence of ILC progenitors are not fully understood. Here, using single-cell RNA-sequencing (scRNA-seq) of mouse bone marrow progenitors, we reveal ILC precursor subsets, delineate distinct ILC development stages and pathways, and report that high expression of programmed death 1 (PD-1hi) marked a committed ILC progenitor that was essentially identical to an innate lymphoid cell progenitor. Our data defined PD-1hiIL-25Rhi as an early checkpoint in ILC2 development, which was abolished by deficiency in the zinc-finger protein Bcl11b but restored by IL-25R overexpression. Similar to T lymphocytes, PD-1 was upregulated on activated ILCs. Administration of a PD-1 antibody depleted PD-1hi ILCs and reduced cytokine levels in an influenza infection model in mice, and blocked papain-induced acute lung inflammation. These results provide a perspective for exploring PD-1 and its ligand (PD-L1) in immunotherapy, and allow effective manipulation of the immune system for disease prevention and therapy.

Signalling Through Retinoic Acid Receptors is Required for Reprogramming of Both Mouse Embryonic Fibroblast Cells and Epiblast Stem Cells to Induced Pluripotent Stem Cells.

We previously demonstrated that coexpressing retinoic acid (RA) receptor gamma and liver receptor homolog-1 (LRH1 or NR5A2) with OCT4, MYC, KLF4, and SOX2 (4F) rapidly reprograms mouse embryonic fibroblast cells (MEFs) into induced pluripotent stem cells (iPSCs). Here, we further explore the role of RA in reprogramming and report that the six factors (6F) efficiently and directly reprogram MEFs into integration-free iPSCs in defined medium (N2B27) in the absence of feeder cells. Through genetic and chemical approaches, we find that RA signalling is essential, in a highly dose-sensitive manner, for MEF reprogramming. The removal of exogenous RA from N2B27, the inhibition of endogenous RA synthesis or the expression of a dominant-negative form of RARA severely impedes reprogramming. By contrast, supplementing N2B27 with various retinoids substantially boosts reprogramming. In addition, when coexpressed with LRH1, RA receptors (RARs) can promote reprogramming in the absence of both exogenous and endogenously synthesized RA. Remarkably, the reprogramming of epiblast stem cells into embryonic stem cell-like cells also requires low levels of RA, which can modulate Wnt signalling through physical interactions of RARs with ß-catenin. These results highlight the important functions of RA signalling in reprogramming somatic cells and primed stem cells to naïve pluripotency. Stem Cells 2015;33:1390-1404.

Polygenic in vivo validation of cancer mutations using transposons.

The in vivo validation of cancer mutations and genes identified in cancer genomics is resource-intensive because of the low throughput of animal experiments. We describe a mouse model that allows multiple cancer mutations to be validated in each animal line. Animal lines are generated with multiple candidate cancer mutations using transposons. The candidate cancer genes are tagged and randomly expressed in somatic cells, allowing easy identification of the cancer genes involved in the generated tumours. This system presents a useful, generalised and efficient means for animal validation of cancer genes.

Significados dos episódios maníacos para pacientes com transtorno bipolar em remissão: um estudo qualitativo / Meanings of manic episodes in patients with bipolar disorder in remission: a qualitative study

Objetivo Discutir os significados da vivência de episódios maníacos para pacientes com transtorno bipolar (TAB). Métodos Trata-se de uma pesquisa qualitativa, feita por meio de entrevistas semidirigidas em profundidade, em uma amostra fechada pelo critério de saturação com oito pacientes com TAB em remissão. A técnica de tratamento de dados foi feita por meio da análise de conteúdo das entrevistas transcritas na íntegra e categorização. Os resultados foram submetidos à validação externa, no Laboratório de Pesquisa Clínico-Qualitativa do Departamento de Psicologia Médica e Psiquiatria da Unicamp, composto por 37 pesquisadores do método, entre eles mestrandos, doutorandos, pós-doutorados e pesquisadores seniores. Resultados Foram identificadas três categorias – Ambivalência e vergonha: pensar ou não pensar sobre os episódios maníacos; Organizando sentimentos pessoais: a remissão como um momento de autoconsciência; Episódios maníacos estruturando relações interpessoais versus projeções da angústia. Conclusão Os achados da presente pesquisa contribuem para a maior compreensão dos quadros maníacos no TAB, que podem auxiliar nas reflexões acerca da relação profissional-paciente, para elaborar estratégias para aderência e para as medidas terapêuticas e preventivas da recorrência dos episódios. Podem auxiliar a equipe de saúde envolvida no acompanhamento desses casos e também os pesquisadores na investigação da contribuição dos significados aqui discutidos nos fenômenos de aderência ao tratamento e de um melhor prognóstico. .

Objective To discuss the meanings of the experiences of manic episodes in patients with bipolar disorder (BD). Methods This is a qualitative research, done through semi-structured in-depth interviews in a sample closed by saturation criterion with eight patients with BD in remission. The technical data processing was done through qualitative content analysis of the transcribed interviews and categorization. The results were validated by peer-reviewers from the Laboratory of Clinical-Qualitative Research of the Department of Medical Psychology and Psychiatry, Unicamp consisting of 37 researchers of the method, including, masters, doctoral, postdoctoral and senior researchers. Results Three categories were identified – Ambivalence and shame: to think or not to think about the manic episodes; Organizing personal feelings: remission as a moment of self-consciousness; Maniac episodes: structuring interpersonal relationships versus projections of self-criticism. Conclusion The findings of this research contribute to a greater understanding of manic frames in BD that can assist in the reflections on the doctor-patient relationship, to develop strategies for adherence and the therapeutic and preventive measures of recurrent. Can assist the health team involved in monitoring these cases and also the researchers in investigation of the contribution of these meanings discussed here in the phenomena of adherence to treatment and a better prognosis. .

MiR-25 regulates Wwp2 and Fbxw7 and promotes reprogramming of mouse fibroblast cells to iPSCs.

BACKGROUND: miRNAs are a class of small non-coding RNAs that regulate gene expression and have critical functions in various biological processes. Hundreds of miRNAs have been identified in mammalian genomes but only a small number of them have been functionally characterized. Recent studies also demonstrate that some miRNAs have important roles in reprogramming somatic cells to induced pluripotent stem cells (iPSCs). METHODS: We screened 52 miRNAs cloned in a piggybac (PB) vector for their roles in reprogramming of mouse embryonic fibroblast cells to iPSCs. To identify targets of miRNAs, we made Dgcr8-deficient embryonic stem (ES) cells and introduced miRNA mimics to these cells, which lack miRNA biogenesis. The direct target genes of miRNA were identified through global gene expression analysis and target validation. RESULTS AND CONCLUSION: We found that over-expressing miR-25 or introducing miR-25 mimics enhanced production of iPSCs. We identified a number of miR-25 candidate gene targets. Of particular interest were two ubiquitin ligases, Wwp2 and Fbxw7, which have been proposed to regulate Oct4, c-Myc and Klf5, respectively. Our findings thus highlight the complex interplay between miRNAs and transcription factors involved in reprogramming, stem cell self-renewal and maintenance of pluripotency.

Psychological characteristics of mothers of patients with anorexia nervosa: implications for treatment and prognosis.

INTRODUCTION: The complexity of factors involved in anorexia nervosa (AN) and the recommendations of prominent health organizations underscore the importance of reflecting on therapeutic interventions aimed at patients' family members. OBJECTIVE: To expand knowledge about the mother-daughter relationship in AN, with a focus on developing a conceptual framework that is able to improve the treatment of the disorder, reduce factors that perpetuate it and improve prognosis. METHOD: A clinical method, anchored by psychodynamic references, was employed in a group of family members of patients with eating disorders. The group met weekly, and sessions were led by psychologists from the eating disorder outpatient clinic of a university hospital. RESULTS AND DISCUSSION: Common characteristics in the mother-daughter relationship in cases of AN were identified. The issue of mutual control, the dialectic between omnipotence and impotence, and the relationship of devotion, passion and annihilation between mothers and daughters are phenomena that form the basis of AN, with a direct influence on the severity of each case and on treatment success. CONCLUSION: Our findings allowed us to identify important aspects in the mother-daughter relationship in AN, which may improve the clinical interventions aimed at treating the disorder.

Características psicológicas de mães de pacientes com anorexia nervosa: implicações para o tratamento e prognóstico / Psychological characteristics of mothers of patients with anorexia nervosa: implications for treatment and prognosis

INTRODUCTION: The complexity of factors involved in anorexia nervosa (AN) and the recommendations of prominent health organizations underscore the importance of reflecting on therapeutic interventions aimed at patients' family members. OBJECTIVE: To expand knowledge about the mother-daughter relationship in AN, with a focus on developing a conceptual framework that is able to improve the treatment of the disorder, reduce factors that perpetuate it and improve prognosis. METHOD: A clinical method, anchored by psychodynamic references, was employed in a group of family members of patients with eating disorders. The group met weekly, and sessions were led by psychologists from the eating disorder outpatient clinic of a university hospital. RESULTS AND DISCUSSION: Common characteristics in the mother-daughter relationship in cases of AN were identified. The issue of mutual control, the dialectic between omnipotence and impotence, and the relationship of devotion, passion and annihilation between mothers and daughters are phenomena that form the basis of AN, with a direct influence on the severity of each case and on treatment success. CONCLUSION: Our findings allowed us to identify important aspects in the mother-daughter relationship in AN, which may improve the clinical interventions aimed at treating the disorder.

INTRODUÇÃO: A complexidade de fatores que compõem a anorexia nervosa (AN) e as recomendações de importantes organizações ligadas à saúde torna fundamental uma reflexão acerca de propostas de intervenções psicoterapêuticas direcionadas aos familiares desses pacientes. OBJETIVO: Expandir o conhecimento acerca da relação mãe-filha na AN, visando desenvolver uma estrutura conceitual que aperfeiçoe o tratamento do transtorno, reduza os fatores que o mantêm e melhore o prognóstico. MÉTODO: Utilizou-se um método clínico de observação fundamentado em referenciais psicodinâmicos de um grupo de familiares de pacientes com transtornos alimentares. O grupo aberto, semanal, era coordenado por psicólogas do ambulatório de transtornos alimentares de um hospital universitário. RESULTADOS E DISCUSSÃO: Foram identificadas características comuns da relação mãe-filha nos casos de AN. A questão do controle mútuo, a dialética entre onipotência e impotência e a relação de devoção, paixão e aniquilamento entre mães e filhas são fenômenos que estão na base da estrutura da AN, com influência direta sobre a gravidade de cada caso e sobre o sucesso das possibilidades terapêuticas. CONCLUSÃO: Os achados possibilitaram identificar importantes aspectos da relação mãe-filha na AN, que podem aprimorar as intervenções clínicas para seu tratamento.