The role of short-chain fatty acids (SCFAs) in regulating stress responses, eating behavior, and nutritional state in anorexia nervosa: protocol for a randomized controlled trial

Journal of Eating Disorders

Study Protocol

Jeroen Raes¹  Boushra Dalile²  Lukas Van Oudenhove³  Elske Vrieze⁴  Robin Quagebeur⁴  Kristin Verbeke⁵ 

[1] Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium;Center for Microbiology, Vlaams Instituut Voor Biotechnologie (VIB), Leuven, Belgium;Leuven Brain Institute, KU Leuven, Leuven, Belgium;Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium;Leuven Brain Institute, KU Leuven, Leuven, Belgium;Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium;Cognitive and Affective Neuroscience Lab (CANlab), Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA;Mind-Body Research, Department of Neurosciences, KU Leuven, Leuven, Belgium;Leuven Brain Institute, KU Leuven, Leuven, Belgium;Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium;

关键词: Anorexia nervosa;    Short-chain fatty acids (SCFAs);    Gut-brain axis;    Gut microbiome;    Eating behavior;    Food choice;    Stress response;    Trier Social Stress Test (TSST);    Cortisol;    Randomized controlled trial;   

DOI  :  10.1186/s40337-023-00917-6

 received in 2023-08-04, accepted in 2023-10-19,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectiveThis protocol proposes investigating the effects of short-chain fatty acids (SCFAs)—namely acetate, propionate, and butyrate—as mediators of microbiota-gut-brain interactions on the acute stress response, eating behavior, and nutritional state in malnourished patients with anorexia nervosa (AN). SCFAs are produced by bacterial fermentation of dietary fiber in the gut and have recently been proposed as crucial mediators of the gut microbiota's effects on the host. Emerging evidence suggests that SCFAs impact human psychobiology through endocrine, neural, and immune pathways and may regulate stress responses and eating behavior.MethodWe will conduct a randomized, triple-blind, placebo-controlled trial in 92 patients with AN. Patients will receive either a placebo or a mixture of SCFAs (acetate propionate, butyrate) using pH-dependent colon-delivery capsules for six weeks. This clinical trial is an add-on to the standard inpatient psychotherapeutic program focusing on nutritional rehabilitation.HypothesesWe hypothesize that colonic SCFAs delivery will modulate neuroendocrine, cardiovascular, and subjective responses to an acute laboratory psychosocial stress task. As secondary outcome measures, we will assess alterations in restrictive eating behavior and nutritional status, as reflected by changes in body mass index. Additionally, we will explore changes in microbiota composition, gastrointestinal symptoms, eating disorder psychopathology, and related comorbidities.DiscussionThe findings of this study would enhance our understanding of how gut microbiota-affiliated metabolites, particularly SCFAs, impact the stress response and eating behavior of individuals with AN. It has the potential to provide essential insights into the complex interplay between the gut, stress system, and eating behavior and facilitate new therapeutic targets for stress-related psychiatric disorders.This protocol is prospectively registered with ClinicalTrials.gov, with trial registration number NCT06064201.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 1

Fig. 3

12864_2015_2198_Article_IEq1.gif