Adult attachment style and salivary alpha-amylase and emotional responses to a psychosocial stressor in women with eating disorders.

BACKGROUND: The fine-tuning of the endogenous stress response system, which includes the hypothalamus-pituitary-adrenal axis and the sympathetic nervous system (SNS), is influenced by early attachment relationships. A higher prevalence of insecure attachment has been detected in people with eating disorders (EDs). Thus, we investigated the emotional and the SNS reactivity to the Trier Social Stress Test (TSST) in women with EDs in relation to their attachment profiles. METHODS: Fifty women with EDs and 20 healthy women participated into an experimental study. Attachment was evaluated by Experience in Close Relationship questionnaire. Salivary α-amylase (sAA) levels were measured to assess the SNS reactivity to TSST while the emotional response was measured by the STAI state scale. RESULTS: Compared to women with EDs and low attachment anxiety and healthy controls, women with EDs and high attachment anxiety showed lower TSST-induced sAA production without difference in anxiety scores. Women with EDs and high attachment avoidance showed similar sAA response to TSST but higher levels of anxiety scores compared to those with low attachment avoidance and healthy controls. CONCLUSIONS: Our findings corroborate the idea that adult attachment may be associated with variability in emotional and biological responses to a psychosocial stressor in women with EDs.

Multiple levels assessment of the RDoC "system for social process" in Eating Disorders: Biological, emotional and cognitive responses to the Trier Social Stress Test.

BACKGROUND: Social dysfunction is a putative risk and maintaining factor for Eating Disorders (EDs). We assessed biological, emotional, and cognitive responses to a psychosocial stressor, in order to provide a multilevel investigation of the RDoC social process system in EDs. METHODS: Patients were recruited among those seeking treatment for an ED. Cortisol response to Trier Social Stress Test (TSST) was measured in 105 subjects: 35 women with anorexia nervosa (AN), 32 with bulimia nervosa (BN) and 38 healthy women. Anxiety, hunger, and desire to eat throughout TSST were rated in a subgroup of them (23 AN, 21 BN, and 25 control women). Two-way ANOVAs with repeated measures were run to assess differences among groups. RESULTS: The TSST-induced cortisol secretion of AN women was significantly higher than in BN and healthy women; this significance disappeared after controlling for body mass index. Compared to healthy women, both AN and BN women showed reduced cortisol reactivity that disappeared after controlling for trait anxiety and ineffectiveness. Both ED groups displayed increased anxiety response to TSST, while only AN group reported greater decreases in hunger and desire to eat. No significant correlations were found between cortisol and anxiety, hunger, or desire to eat in response to TSST. CONCLUSIONS: People with EDs are characterized by blunted cortisol reactivity and greater anxiety, hunger, and desire to eat responses to a psychosocial stressor without any significant association between these measures. This study provides the first empirical and multilevel support to a deranged functioning of the RDoC "system for social process" in EDs.

Early traumatic experiences impair the functioning of both components of the endogenous stress response system in adult people with eating disorders.

Childhood trauma is a non-specific risk factor for eating disorders (EDs). It has been suggested that this risk is exerted through trauma-induced long-lasting changes in the body stress response system. Therefore, we explored the activity of the hypothalamus-pituitary-adrenal axis and of the sympathetic nervous system in adult ED patients with or without a history of childhood trauma exposure. Salivary cortisol and alpha-amylase, a marker of the sympathetic nervous system activity, were measured at awakening and after 15, 30 and 60 min in 35 women with EDs. The Childhood Trauma Questionnaire (CTQ) was employed to assess exposure to childhood trauma and, according to the CTQ cut-off scores, 21 ED women were classified as maltreated (Mal) participants and 14 women as no-maltreated (noMal) ED participants. Compared to noMal ED women, Mal ED participants showed significantly decreased cortisol awakening response (between group difference: p = 0.0003) and morning salivary alpha-amylase secretion (between group difference: p = 0.02). Present results confirm that the cortisol awakening response of adult ED patients with childhood trauma exposure is lower than that of adult ED patients without childhood trauma experiences and show for the first time that also the morning secretion of salivary alpha-amylase is decreased in adult ED patients who have been exposed to early traumatic experiences. These results point for the first time to a dampening in the basal activity of both components of the endogenous stress response system in childhood maltreated adult ED women.

A Peptide from Kiwifruit Exerts Anti-Inflammatory Effects in Celiac Disease Mucosa.

Objective: Celiac disease is an immune-mediated disease of the intestine triggered by gluten. Gluten elicits, in genetically susceptible individuals, cytokine responses that are then transmitted to the immunocompetent cells. Vegetables and fruit have anti-inflammatory and antioxidant properties with a protective effect on intestinal epithelium. Kiwifruit is known to have beneficial effects on the intestinal tissues, and it is the only plant food containing the peptide kissper, with anti-inflammatory properties. The aim of this study was the evaluation of the kissper effect on the gluten-induced inflammation in celiac disease. Methods: We used an in vitro model of intestinal culture explant from celiac disease patients and non-celiac disease patients, cultured for 24 hours with the toxic gliadin peptide P31-43 and kissper preincubation. Results: Our data showed HLA-DR and TG2 reduction in the celiac disease mucosa pretreated with kissper, as well as a reduction of COX-2 in two patients. No differences we observed for the TGF-b1 and IL-15 levels in supernatants upon kissper pretreatment. Conclusions: The preliminary results suggest that kissper has a potential anti-inflammatory role in celiac disease.

The vulnerability to interpersonal stress in eating disorders: The role of insecure attachment in the emotional and cortisol responses to the trier social stress test.

BACKGROUND: Vulnerability to interpersonal stress is an important risk factor for Eating Disorders (EDs). Adult insecure attachment involves different emotional, biological and behavioural strategies to cope with social stressors. However, although attachment has proved to play a pivotal role in EDs, no study has yet explored the effects of attachment on the emotional and hypothalamic-pituitary-adrenal (HPA) axis responses to a psychosocial stressor in EDs. METHODS: Fifty-two ED women (29 with anorexia nervosa, 23 with bulimia nervosa) underwent the Trier Social Stress Test (TSST). Their emotional response was measured by means of the State-Trait Anxiety Inventory state scale while saliva samples were collected to measure cortisol secretion. RESULTS: According to the Experience in Close Relationship questionnaire scores, 21 ED patients had high attachment anxiety and 31 low attachment anxiety, whilst 34 had high attachment avoidance and 18 low attachment avoidance. Patients with high attachment anxiety or avoidance displayed heightened TSST-induced cortisol secretion and anxiety feelings, in comparison to those with low insecure attachment scores. Anxiety perception was associated with cortisol recovery after the test exposure but not with the HPA axis reactivity in insecure attached patients. CONCLUSIONS: The present findings corroborate the hypothesis that attachment modulates the biological and emotional reactivities to an acute social threat in ED patients. The role of these attachment-mediated changes in vulnerability to interpersonal stress in EDs needs to be clarified in future studies.

The culture of gut explants: A model to study the mucosal response.

Various experimental model designs have been used to analyze the inflammatory pathways in human gastrointestinal illnesses. Traditionally, analytical techniques and animal models are popular experimental tools to study the inflammation process of intestinal diseases. However, the comparison of results between animal and human models is difficult for the inconsistency of outcomes. Although there are different animal models for studying the intestinal diseases, none of them fully represents the physiological and environmental conditions typical of the human species. Also, there is currently a concerted effort to decrease the experimental use of animals. On the converse, experimental protocols using the culture of gut mucosa had become popular with the advent of endoscopy which allows explanting multiple fragments from the intestine. The peculiar characteristic of this model is the ability to preserve in vitro the features that we found in vivo, thus also the response to various stimuli that differs from person to person. The aim of the present paper is to provide a review of some of the possible uses of the organ intestinal mucosa culture.