| 1. |
- Devarakonda, Sravani, et al.
(author)
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Low-grade intestinal inflammation two decades after pelvic radiotherapy.
- 2023
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In: EBioMedicine. - 2352-3964. ; 94
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Journal article (peer-reviewed)abstract
- Radiotherapy is effective in the treatment of cancer but also causes damage to non-cancerous tissue. Pelvic radiotherapy may produce chronic and debilitating bowel symptoms, yet the underlying pathophysiology is still undefined. Most notably, although pelvic radiotherapy causes an acute intestinal inflammation there is no consensus on whether the late-phase pathophysiology contains an inflammatory component or not. To address this knowledge gap, we examined the potential presence of a chronic inflammation in mucosal biopsies from irradiated pelvic cancer survivors.We biopsied 24 cancer survivors two to 20 years after pelvic radiotherapy, and four non-irradiated controls. Using tandem mass tag (TMT) mass spectrometry and mRNA sequencing (mRNA-seq), we charted proteomic and transcriptomic profiles of the mucosal tissue previously exposed to a high or a low/no dose of radiation. Changes in the immune cell populations were determined with flow cytometry. The integrity of the protective mucus layers were determined by permeability analysis and 16S rRNA bacterial detection.942 proteins were differentially expressed in mucosa previously exposed to a high radiation dose compared to a low radiation dose. The data suggested a chronic low-grade inflammation with neutrophil activity, which was confirmed by mRNA-seq and flow cytometry and further supported by findings of a weakened mucus barrier with bacterial infiltration.Our results challenge the idea that pelvic radiotherapy causes an acute intestinal inflammation that either heals or turns fibrotic without progression to chronic inflammation. This provides a rationale for exploring novel strategies to mitigate chronic bowel symptoms in pelvic cancer survivors.This study was supported by the King Gustav V Jubilee Clinic Cancer Foundation (CB), The Adlerbertska Research Foundation (CB), The Swedish Cancer Society (GS), The Swedish State under the ALF agreement (GS and CB), Mary von Sydow's foundation (MA and VP).
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| 2. |
- Gottfridsson, Hans Olof, 1962-, et al.
(author)
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Att gränspendla : samma fast olika
- 2012. - 1
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In: På gränsen. - Karlstad : Karlstad University Press. - 9789170634574 ; , s. 95-110
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Book chapter (other academic/artistic)
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| 3. |
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| 4. |
- Pettersson, Cecilia, 1962, et al.
(author)
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Dietary intake and nutritional status in adolescents and young adults with anorexia nervosa: A 3-year follow-up study
- 2021
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In: Clinical Nutrition. - : Elsevier BV. - 0261-5614. ; 40:10, s. 5391-5398
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Journal article (peer-reviewed)abstract
- Background & aims: Patients with anorexia nervosa (AN) restrict their dietary intake leading to malnutrition. Information is scarce on nutrition status during recovery. The aim of the study was to investigate dietary intake, body composition, biochemistry, and status in young women three years after hospital treatment due to severe restrictive AN. Methods: Dietary intake from four-day food records were compared to a reference group and the Nordic Nutrition Recommendations. Body composition was assessed by dual-energy X-ray absorptiometry (DXA). Serum levels of vitamin A, E, D, folate, and ferritin were assessed. Results: Three years after hospital treatment for AN, 12 subjects (60%) were recovered or in partial remission from AN. Subnormal values of body fat and skeletal muscle mass were present in 30% and 25%. Energy intake was 1730 kcal/day (min-max 705-2441) or 33 kcal/kg/day (16-54). Most (80%) had a total energy intake/day below the estimated needs and 6 (32%) had energy intakes below 1550 kcal/day. Micronutrient intakes from food were low; 16 (85%) had intakes below recommendations of iron, folate, and vitamin D. Serum levels of vitamins A, E, D, and folate were on average adequate; but a subnormal value (<50 nmol/L) of vitamin D was found in 20%. Ferritin levels were significantly lower at follow-up, and 25% had values below reference range. Return of menstruation was dependent of energy intake and body fat. Conclusions: A regular and careful assessment of nutritional status along with nutritional counseling during recovery is recommended to reduce malnutrition in patients with AN. (c) 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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| 5. |
- Pettersson, Cecilia, 1962
(author)
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Dietary intake, nutritional status and energy metabolism in individuals with anorexia nervosa - Effects of specialized eating disorder hospital treatment
- 2023
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Doctoral thesis (other academic/artistic)abstract
- Objective: Anorexia nervosa (AN) is a life-threatening condition affecting around 1% of the population. The aim of this thesis was to study nutritional aspects before and after specialized eating disorder hospital treatment of AN in adolescents and young adults. Methods: Data on 43 female patients was collected and used. Dietary intake was assessed by food records. Body composition was measured by dual energy X-ray absorptiometry (DXA) and resting energy expenditure by indirect calorimetry. Eating disorder symptoms were assessed by Eating Disorder Examination Questionnaire (EDE-Q) and Clinical Impairment Assessment (CIA). Gastrointestinal symptoms were assessed by Gastrointestinal Symptoms Rating Scale IBS (GSRS-IBS) and food related anxiety was measured using the Food Attitude Questionnaire. Results: Body weight increased by 22% and significant changes of improvement from admission to discharge were seen in body composition, energy expenditure, eating disorder symptoms, gastrointestinal symptoms and food related anxiety. At 3 year follow-up, 60% were recovered or in partial remission, 32% had very low energy intake, 85% had intakes below recommendations of iron, folate and vitamin D and subnormal values of body fat and skeletal muscle mass were present in 30% and 25%. Conclusions: Specialized eating disorder hospital treatment was successful regarding several nutritional aspects. Follow-up showed that 60% of young individuals with AN can reach full or partial symptom recovery, and that remission is possible also for patients with severe AN who need hospital treatment. Nutritional counseling is recommended during the whole treatment to reduce the risk of malnutrition in patients with anorexia nervosa.
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| 6. |
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| 7. |
- Svedlund, Anna, et al.
(author)
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Bone mass and biomarkers in young women with anorexia nervosa: a prospective 3-year follow-up study
- 2022
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In: Journal of Bone and Mineral Metabolism. - : Springer Science and Business Media LLC. - 0914-8779 .- 1435-5604. ; 40:6, s. 974-989
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Journal article (peer-reviewed)abstract
- Introduction Anorexia nervosa (AN) increases the risk of impaired bone health, low areal bone mineral density (aBMD), and subsequent fractures. This prospective study investigated the long-term effects of bone and mineral metabolism on bone and biomarkers in 22 women with AN. Materials and methods Body composition and aBMD were measured by dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography. Total and free 25-hydroxyvitamin D (25OHD), C-terminal collagen cross-links (CTX), osteocalcin, bone-specific alkaline phosphatase (BALP), leptin, sclerostin, and oxidized/non-oxidized parathyroid hormone (PTH) were analyzed before and after 12 weeks of intensive nutrition therapy and again 3 years later. An age-matched comparison group of 17 healthy women was recruited for the 3-year follow-up. Results Body mass index (BMI) and fat mass increased from baseline to 3 years in women with AN. Sclerostin decreased during nutrition therapy and further over 3 years, indicating reduced bone loss. CTX was elevated at baseline and after 12 weeks but decreased over 3 years. BALP increased during nutrition therapy and stabilized over 3 years. Free 25OHD was stable during treatment but decreased over 3 years. Non-oxidized PTH was stable during treatment but increased over 3 years. Trabecular volumetric BMD in AN patients decreased during the first 12 weeks and over 3 years despite stable BMI and bone biomarkers implying increased BMD. Conclusion Our findings highlight the importance of early detection and organized long-term follow-up of bone health in young women with a history of AN.
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| 8. |
- Svedlund, Anna, et al.
(author)
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Vitamin D status in young Swedish women with anorexia nervosa during intensive weight gain therapy
- 2017
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In: European Journal of Nutrition. - : SPRINGER HEIDELBERG. - 1436-6207 .- 1436-6215. ; 56:6, s. 2061-2067
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Journal article (peer-reviewed)abstract
- Purpose Anorexia nervosa (AN) is associated with reduced bone mass and an increased fracture risk. The aim was to evaluate the vitamin D status and the association with body mass index (BMI), fat mass and bone mineral density (BMD) in patients with severe AN during a prospective intervention study of intensive nutrition therapy. Methods This study comprised 25 Swedish female AN patients (20.1 +/- 2.3 years), who were treated as inpatients for 12 weeks with a high-energy diet. Serum 25-hydroxy-vitamin D (25(OH) D), calcium, phosphate and parathyroid hormone (PTH) were measured. BMD and body composition were assessed by dual-energy X-ray absorptiometry at study start and after 12 weeks. Results Twenty-two patients completed the study. The mean weight gain was 9.9 kg and BMI (mean +/- SD) increased from 15.5 +/- 0.9 to 19.0 +/- 0.9 kg/m(2), P amp;lt; 0.0001. Fat mass increased from median 12 to 27 %. The median serum 25(OH) D level was 84 nmol/L at baseline, which decreased to 76 nmol/L, P amp;lt; 0.05. PTH increased from median 21.9 to 30.0 ng/L, P amp;lt; 0.0001. BMC increased during the study period, P amp;lt; 0.001. Conclusions Serum 25(OH) D levels were adequate both at study start and completion, however, nominally decreased after the 12-week nutritional intervention. PTH increased subsequently, which coincide with the decreased 25(OH) D levels. The reduction in 25(OH) D could be due to an increased storage of vitamin D related to the increase in fat mass since vitamin D is sequestered in adipose tissue.
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| 9. |
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| 10. |
- Tubić, Bojan, 1984, et al.
(author)
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Increased Bone Mineral Content During Rapid Weight Gain Therapy in Anorexia Nervosa
- 2016
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In: Hormone and Metabolic Research. - : GEORG THIEME VERLAG KG. - 0018-5043 .- 1439-4286. ; 48:10, s. 664-672
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Journal article (peer-reviewed)abstract
- Patients with anorexia nervosa (AN) are at high risk of reduced bone mass. Osteocalcin (OC), a bone formation marker, has been proposed to act as a link between bone and energy metabolism. We investigated how the 3 forms of OC respond during a 12-week intensive nutrition therapy in AN patients, in whom large changes in energy metabolism are expected. Twenty-two female AN patients, mean 20.9 years of age, with a starting mean body mass index (BMI) 15.5kg/m(2) (minimum-maximum) (13.4-17.3kg/m(2)) completed the study. Biochemical markers, body composition, bone mass by DXA, and pQCT were assessed. Subjects gained in median 9.9kg (5.5-17.0kg), and BMI increased from median 15.4kg/m(2) (13.4-17.3kg/m(2)) to 19.0kg/m(2) (16.2-20.6kg/m(2)), pamp;lt;0.0001. Fat mass increased from median 11.4% (4.4-24.8%) to 26.7% (16.9-39.8%). Total OC, carboxylated OC (cOC), undercarboxylated OC (ucOC), and bone-specific alkaline phosphatase (BALP) increased during the study period. No change was observed for the resorption marker carboxy-terminal cross-linking telopeptide of type I collagen (CTX). Total body bone mineral content (BMC) increased, but no changes were found for whole body or lumbar spine bone mineral density. Tibial trabecular density measured by pQCT decreased. Total OC, cOC, and ucOC were not associated with BMI, insulin or body composition parameters. This prospective study demonstrates that all 3 forms of OC (total OC, cOC, ucOC) increase during rapid weight gain. BALP increased while the resorption marker CTX was unchanged, which corroborate with the increased total body BMC.
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