Novel Targetable BIOmarkers in ANorexia NervosA

University Hospital, Basel, Switzerland32 enrolled

Overview

The overall aim of this present study is to evaluate Growth Differentiation Factor-15 (GDF-15) and inflammatory cytokines as a possible novel and readily treatable target for the successful therapy of Anorexia Nervosa (AN). Therefore, GDF-15, neuronal and glial damage markers such as Neurofilament light chain (Nfl) and Glial fibrillary acidic protein (GFAP) and cytokines (such as Tumor necrosis factor alpha (TNF-α), Interleukin-6 (IL-6), and Interleukin 1β (IL-1β) levels will be assessed in the serum as well as in the cerebrospinal fluid of patients with diagnosed restrictive AN with and without exercising behavior compared to sex- and age-matched healthy controls to consolidate previous findings and to identify the main site of production of GDF-15 and cytokines in AN.

In addition, assessment of body composition via Dual Energy X-ray Absorptiometry (DEXA )scans and of energy expenditure via indirect calorimetry, respectively, will allow us to correlate GDF-15, Nfl and GFAP and cytokine levels with lean and fat mass measures as well as with energy expenditure, respectively, of AN patients and the matched controls. Overall, this will allow us to comprehensively evaluate GDF-15 and cytokines as possible novel targets for the treatment of AN and to set the basis for a follow up study using available neutralizing antibodies or inhibitors against GDF-15 and the respective cytokines for the treatment of patients with AN, respectively. This will also allow for a more tailored, individualized treatment approach of AN in the future. Our findings will hopefully challenge the viewpoint that AN is a condition which can be controlled by the individual but demonstrate that AN is a biological disease that should be treated by targeting the right biological players in addition to psychiatric treatment.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Anorexia Nervosa Anorexia Nervosa Restricting Type

Eligibility

Sex: ALLMin age: 18 YearsMax age: 60 YearsHealthy volunteers:

Medical Language ↔ Plain English

N=8 adult male and female patients with confirmed diagnosis of anorexia nervosa restrictive type, non-exercising subtype Inclusion criteria: * Age 18-60 years * Written informed consent * BMI 10-16 kg/m2 N=8 adult male and female patients with confirmed diagnosis of anorexia nervosa restrictive type, exercising subtype will be included in this study. Inclusion criteria: * Age 18-60 years * Written informed consent * BMI 10-16 kg/m2 N=16 control participants, sex- and age-matched to the individual anorexia nervosa patients. Inclusion criteria: * Age 18-60 years * Written informed consent * BMI 19-24.9 kg/m2 Exclusion Criteria: * Use of antibiotics within the last 31 days * Current illicit drug abuse including daily marijuana or CBD (cannabidiol) consumption (≤ 24 g of alcohol per day allowed) * Any kind of severe chronic disease other than AN (e.g. active cancer disease) * Severe renal impairment (e.g. estimated glomerular filtration rate \<30 ml/min/m2) if resulting from another disease than AN * Known liver cirrhosis or other severe liver impairment if resulting from another disease than AN * Acute upper respiratory tract infection within the last 31 days * Uncontrolled dysthyroidism * Uncontrolled hypertension * Current pregnancy/lactation or current treatment for in vitro fertilization * Inability to understand the study information, to sign the consent form and to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc.

Outcomes

Primary Outcomes

Growth Differentiation Factor-15 (GDF-15) (pg/ml) level in the plasma

Comparison of GDF-15 (pg/ml) level in the plasma of AN patients and normal-weight controls Blood in overnight-fasted study participants will be taken from a cubital vein and analyzed for GDF-15 (pg/ml)

Time frame: one time assessment 3 weeks after screening

Growth Differentiation Factor-15 (GDF-15) (pg/ml) level in the cerebrospinal fluids

Comparison of GDF-15 level in the cerebrospinal fluids of AN patients and normal-weight controls. CSF will be analysed only from patients who undergo a liquor puncture as part of their clinical assessment and consent to having taken an extra 5ml. Cerebrospinal fluid (CSF) will then be analysed for GDF-15 (pg/ml)