Najate Achamrah, Pierre Déchelotte, Moïse Coëffier

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New therapeutic approaches to target gut-brain axis dysfunction during anorexia nervosa Najate Achamrah, Pierre Déchelotte, Moïse Coëffier Clinical Nutrition Experimental DOI: 10.1016/j.yclnex.2019.01.006 Copyright © 2019 Terms and Conditions

Fig. 1 Dysregulation of gut-brain axis in anorexia nervosa. Pathophysiology of anorexia nervosa involves central alterations of hypothalamic-pituitary-adrenal (HPA) axis, neurotransmission, food intake regulation, and peripheral alterations of gut barrier, gut microbiota and immune system. Many actors can modulate gut-brain axis including nervous (vagus, enteric nervous system), immune (cytokines), endocrine (cortisol), short-chain fatty acids (SCFAs), tryptophan-kynurenine metabolites (TRP-KYN). Clinical Nutrition Experimental DOI: (10.1016/j.yclnex.2019.01.006) Copyright © 2019 Terms and Conditions

Fig. 2 The role of stress in anorexia nervosa pathophysiology. Activation of HPA axis, increased plasmatic cortisol and inflammation are known to activate TRP-KYN metabolism, leading to little available TRP for serotonin synthesis, resulting in mood (anxiety, depression) and gastrointestinal disorders. HPA: hypothalamic-pituitary-adrenal, CRH: corticotrophin-releasing hormone, ACTH: adrenocorticotropin hormone, TRP: tryptophan, KYN: kynurenine, 5-HT: serotonin, KYNA: kynurenic acid, QA: quinolinic acid, TDO: tryptophane dioxygénase, IDO: indolamine-2,3-dioxygénase, KAT: kynurenine aminotransferase. Clinical Nutrition Experimental DOI: (10.1016/j.yclnex.2019.01.006) Copyright © 2019 Terms and Conditions