Host-Microbiota Interactions in Adolescents with Severe Anorexia Nervosa: Linking Gut Dysbiosis, Intestinal Barrier Function and Microbial Metabolism.
7 affiliations
- 1General Pediatrics, Infectious Diseases and Level II Pediatric Emergency Department Unit, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.
- 2Unit of Microbiome, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy.
- 3Anorexia and Eating Disorders Unit, Child and Adolescent Psychiatry, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.
- 4Pediatrics Residency Program, Department of Pediatrics, University of Rome Tor Vergata, 00133 Rome, Italy.
- 5Department of Life Sciences, Health and Health Professions, Link Campus University, 00165 Rome, Italy.
- 6Unit of Microbiomics and Unit of Microbiome, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy.
- 7Systems Medicine Departments, University of Rome Tor Vergata, 00133 Rome, Italy.
Abstract
Background
Anorexia nervosa (AN) is increasingly recognized as a multisystem disorder involving complex host-microbiota interactions, yet prospective pediatric studies with a comprehensive, longitudinal characterization of host-microbiota interactions remain scarce.Methods
In this prospective longitudinal study, 26 adolescents with severe AN were evaluated at hospital admission (T0), after one month (T1), and after three months of inpatient nutritional rehabilitation (T2). Gut microbiota composition was assessed by 16S rRNA sequencing and compared with healthy controls (HC) at the baseline; predicted functional profiling was performed using PICRUSt2. Serum and urinary biomarkers of intestinal barrier integrity and microbial metabolism, routine clinical and biochemical parameters, and psychometric scores (CDI-2, MASC-2) were evaluated longitudinally using linear mixed-effects models.Results
At the baseline, adolescents with AN showed reduced bacterial richness compared with healthy controls, with significantly lower Chao1 diversity (p = 0.00013), whereas the Shannon and Simpson indices did not differ significantly (p = 0.54 and p = 0.27, respectively). Microbial community composition differed significantly between groups based on Bray-Curtis (R² = 0.0724, FDR-adjusted p = 0.001) and unweighted UniFrac (R² = 0.0540, FDR-adjusted p = 0.001) distances. LEfSe identified 19 differentially abundant taxa; among the strongest discriminators, Blautia_A_141781, Romboutsia_B, and Clostridium_T were enriched in AN, whereas Akkermansia, Phocaeicola_A_858004, and Bacteroides_H were enriched in the healthy controls. Nutritional rehabilitation was associated with partial microbiota remodeling, alongside significant improvements in BMI and heart rate. Several host-derived biomarkers, including urinary indican, serotonin, nitric oxide, and serum occludin, changed significantly over time, whereas bile acids, short-chain fatty acids, IgA, lipopolysaccharide, and haptoglobin remained stable.Conclusions
Gut microbiota and host-derived biomarkers evolve dynamically during nutritional rehabilitation in adolescents with severe AN, supporting their potential role as complementary tools for monitoring biological recovery.
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BibTeX
@article{gargiullo2026hostmicrobiota,
title = {{Host-Microbiota Interactions in Adolescents with Severe Anorexia Nervosa: Linking Gut Dysbiosis, Intestinal Barrier Function and Microbial Metabolism.}},
author = {Livia Gargiullo and Federica Del Chierico and Maria Rosaria Marchili and Mariangela Irrera and Italo Pretelli and Matteo Scanu and Francesca Toto and Annalisa Grandin and Rosaria Marotta and Cristina Mascolo and Flavia Cirillo and Valentina Colistra and Ludovica Ricci and Valeria Zanna and Lorenza Putignani and Alberto Villani},
journal = {Nutrients},
year = {2026},
month = sep,
doi = {10.3390/nu18193136},
url = {https://europepmc.org/article/MED/42884588},
note = {CC BY},
}
RIS
TY - JOUR
TI - Host-Microbiota Interactions in Adolescents with Severe Anorexia Nervosa: Linking Gut Dysbiosis, Intestinal Barrier Function and Microbial Metabolism.
AU - Livia Gargiullo
AU - Federica Del Chierico
AU - Maria Rosaria Marchili
AU - Mariangela Irrera
AU - Italo Pretelli
AU - Matteo Scanu
AU - Francesca Toto
AU - Annalisa Grandin
AU - Rosaria Marotta
AU - Cristina Mascolo
AU - Flavia Cirillo
AU - Valentina Colistra
AU - Ludovica Ricci
AU - Valeria Zanna
AU - Lorenza Putignani
AU - Alberto Villani
PY - 2026
DA - 2026/09/23
JO - Nutrients
DO - 10.3390/nu18193136
UR - https://europepmc.org/article/MED/42884588
AB - Background Anorexia nervosa (AN) is increasingly recognized as a multisystem disorder involving complex host-microbiota interactions, yet prospective pediatric studies with a comprehensive, longitudinal characterization of host-microbiota interactions remain scarce.Methods In this prospective longitudinal study, 26 adolescents with severe AN were evaluated at hospital admission (T0), after one month (T1), and after three months of inpatient nutritional rehabilitation (T2). Gut microbiota composition was assessed by 16S rRNA sequencing and compared with healthy controls (HC) at the baseline; predicted functional profiling was performed using PICRUSt2. Serum and urinary biomarkers of intestinal barrier integrity and microbial metabolism, routine clinical and biochemical parameters, and psychometric scores (CDI-2, MASC-2) were evaluated longitudinally using linear mixed-effects models.Results At the baseline, adolescents with AN showed reduced bacterial richness compared with healthy controls, with significantly lower Chao1 diversity (p = 0.00013), whereas the Shannon and Simpson indices did not differ significantly (p = 0.54 and p = 0.27, respectively). Microbial community composition differed significantly between groups based on Bray-Curtis (R² = 0.0724, FDR-adjusted p = 0.001) and unweighted UniFrac (R² = 0.0540, FDR-adjusted p = 0.001) distances. LEfSe identified 19 differentially abundant taxa; among the strongest discriminators, Blautia_A_141781, Romboutsia_B, and Clostridium_T were enriched in AN, whereas Akkermansia, Phocaeicola_A_858004, and Bacteroides_H were enriched in the healthy controls. Nutritional rehabilitation was associated with partial microbiota remodeling, alongside significant improvements in BMI and heart rate. Several host-derived biomarkers, including urinary indican, serotonin, nitric oxide, and serum occludin, changed significantly over time, whereas bile acids, short-chain fatty acids, IgA, lipopolysaccharide, and haptoglobin remained stable.Conclusions Gut microbiota and host-derived biomarkers evolve dynamically during nutritional rehabilitation in adolescents with severe AN, supporting their potential role as complementary tools for monitoring biological recovery.
SN - 2072-6643
ER -