MALE ANOREXIA AND BULIMIA NERVOSA: DISORDER SYMPTOMS AND IMPULSIVE BEHAVIOUR DURING HOSPITAL TREATMENT AND ONE YEAR FOLLOW-UP PERIOD

Background: The study aimed to evaluate treatment efficacy in male patients with anorexia (AN) and bulimia nervosa (BN) treated at the Eating Disorder Unit, University Psychiatric Clinic Ljubljana, Slovenia (EDU UPCL), using longitudinal assessments of eating disorder (ED) symptoms and selected impulsive behaviours highly correlated with these entities from hospital admission till twelve months after. Subjects and methods: 35 male AN and 35 male BN patients were included. Participants were aged 17 or more and somatically stable with the BMI>12 kg/m2. Patients with psychiatric comorbidity, mental disorder due to a general medical condition, or serious somatic or neurological disease were excluded. Intensity of ED symptoms and presence of selected impulsive behaviours were evaluated at hospital admission and discharge, and three, six and twelve months after, using an internal Eating Disorder Unit Questionnaire. For statistical analysis multivariate analysis of variance was used. Results: Throughout the research period the appropriate changes in BMI were observed in both patient groups. In both, AN and BN patient groups, the evaluation of longitudinal differences regarding the intensity of all ED symptoms and the presence of studied impulsive behaviours showed a significant decline at discharge and all subsequent assessments compared to the results obtained upon admission to the hospital. The re-hospitalization rates of patients with AN and BN in the first year after discharge from the hospital were 3.84% vs. 3.7% respectively. Conclusions: In male patients with AN and BN treated at the EDU UPCL, ED symptoms, BMI, and studied impulsive behaviours show a substantial improvement during hospital treatment. These changes seem to be long lasting, still being effective through oneyear post-hospitalization follow-up

AGGRESSION AND IMPULSIVITY WITH IMPULSIVE BEHAVIOURS IN PATIENTS WITH PURGATIVE ANOREXIA AND BULIMIA NERVOSA

Background: The study aimed to compare purgative anorexia and bulimia nervosa patients in regard of their level of aggression and impulsivity traits, as well as dynamics of selected impulsive behaviours over time-course of eating disorder treatment. Subjects and methods: 30 females with purgative anorexia nervosa, 33 females with purgative bulimia nervosa and 31 controls were included. Impulsive behaviours were assessed upon hospital admission, discharge, and three and six months after, using the internal ward questionnaire. Aggression and impulsivity traits were evaluated three months after discharge using Buss-Durkee Hostility Inventory and Barratt Impulsiveness Scale, 11th Revision. Results: In all patients, the expressed impulsive behaviours were most frequent upon admission, when bingeing, striking and quarrelling were more expressed in bulimic patients. Later, patient groups did not differ regarding any impulsive behaviour. These all substantially resolved till discharge, and showed further decline at later assessments. All patients had a higher level of aggression and impulsivity traits and lower overt and higher covert aggression than controls. Patient groups had similar within group distribution of aggression and impulsivity intensity levels. Regarding individual dimensions of these traits no difference was found between them, except for the higher level of suspiciousness in anorectic individuals. Conclusions: Purgative anorectic and bulimic patients show similar dynamics of impulsive behaviours which substantially decline over time-course of eating disorder treatment. They both present similarly heightened levels of aggression and impulsivity traits, with some minor differences regarding their individual dimensions, possibly reflecting higher overt aggression in bulimic and higher covert aggression in anorectic patients

Art v 1 IgE epitopes of patients and humanized mice are conformational

Background: Worldwide, pollen of the weed mugwort (Artemisia vulgaris) is a major cause of severe respiratory allergy, with its major allergen, Art v 1, being the key pathogenic molecule for millions of patients. Humanized mice transgenic for a human T-cell receptor specific for the major Art v 1 T-cell epitope and the corresponding HLA have been made. Objective: We sought to characterize IgE epitopes of Art v 1–sensitized patients and humanized mice for molecular immunotherapy of mugwort allergy. Methods: Four overlapping peptides incorporating surface-exposed amino acids representing the full-length Art v 1 sequence were synthesized and used to search for IgE reactivity to sequential epitopes. For indirect mapping, peptide-specific rabbit antibodies were raised to block IgE against surface-exposed epitopes on folded Art v 1. IgE reactivity and basophil activation studies were performed in clinically defined mugwort-allergic patients. Secondary structure of recombinant (r) Art v 1 and peptides was determined by circular dichroism spectroscopy. Results: Mugwort-allergic patients and humanized mice sensitized by allergen inhalation showed IgE reactivity and/or basophil activation mainly to folded, complete Art v 1 but not to unfolded, sequential peptide epitopes. Blocking of allergic patients’ IgE with peptide-specific rabbit antisera identified a hitherto unknown major conformational IgE binding site in the C-terminal Art v 1 domain. Conclusions: Identification of the new major conformational IgE binding site on Art v 1, which can be blocked with IgG raised against non-IgE reactive Art v 1 peptides, is an important basis for the development of a hypoallergenic peptide vaccine for mugwort allergy