OBJECTIVES:This World Federation of Societies of Biological Psychiatry (WFSBP) consensus paper aims to summarise and evaluate the published study results on objectively measurable biological markers associated with anorexia nervosa (AN). METHODS:The relevant literature was reviewed by the WFSBP Task Forces on Eating Disorders and on Biological Markers, and a consensus regarding the significance of the published evidence was reached. RESULTS:Candidate biological markers that have been associated with AN include clinical (e.g. body weight), molecular (e.g. genetic, epigenetic, hormonal, immunological, metabolomic), cellular (e.g. leukocytes), neuroimaging (e.g. structure, function, connectivity), digital, cardiac and neurophysiological parameters. Some clinical and laboratory parameters are risk markers in clinical practice. Biological markers have pathophysiological relevance in understanding the biological and metabolic pathophysiology of AN and its physical health consequences. Few studies have examined pharmacogenetics or therapeutic drug monitoring as tools to monitor and guide the treatment of AN. CONCLUSIONS:Biological markers will hopefully soon enable clinicians to intervene earlier in a more targeted manner to mitigate treatment resistance. However, the current scientific basis for most biological markers are group comparisons only. Studies on sensitivity, specificity and the prognostic value of these markers are lacking.
The mechanisms driving immune dysregulation in long COVID disease remain elusive. Here we integrated single-cell multiome data, immunological profiling and functional assays to investigate immune alterations across multiple cohorts. A transcriptional state in circulating monocytes (LC-Mo) was enriched in individuals with mild–moderate acute infection and accompanied by persistent elevations of plasma CCL2, CXCL11 and TNF. LC-Mo showed TGFβ and WNT–β-catenin signaling and correlated with fatigue severity. Protein markers of LC-Mo were increased in individuals with pronounced fatigue or dyspnea, and those with severe respiratory symptoms showed higher LC-Mo expression. Epigenetically, LC-Mo exhibited AP-1- and NF-κB1-driven profibrotic programs. LC-Mo-like macrophages in bronchoalveolar lavage samples from individuals with severe respiratory symptoms displayed a profibrotic profile, and individuals with a high LC-Mo transcriptional state showed impaired interferon responses after stimulation. Collectively, our findings define a pathogenic monocyte transcriptional state linking systemic immune dysfunction to persistent long COVID disease, providing mechanistic insights and potential therapeutic targets. Li and colleagues describe a monocyte-specific transcriptional state along with a persistent elevation of inflammatory markers specifically found in individuals with long COVID who had mild-to-moderate disease during acute SARS-CoV-2 infection.
BACKGROUND:The transition to adulthood poses particular challenges for healthcare systems. Eating disorders frequently occur during this developmental period and require continuity of care in order to achieve remission and to reduce the risk of relapses as well as long-term psychosocial and physical consequences. AIM OF THE STUDY:Presentation of the specific challenges of transition in cases of eating disorders and derivation of recommendations for improving transition management. MATERIAL AND METHODS:Narrative review of the current state of research and a description of selected models of transitional care. Based on this, practical recommendations for transition management and areas requiring further research are presented. RESULTS:Existing concepts emphasize the importance of structured transition management, including early planning, assessment of transition readiness, active involvement of patients and caregivers, close collaboration between child/adolescent and adult healthcare services, standardized handover procedures and continuity of specialized eating disorder-specific treatment. In addition, psychotherapeutic interventions should address development-related tasks of the transition, such as autonomy, self-management, identity development, and educational, vocational and socio-legal issues. Empirical evidence for the effectiveness of specific transition models remains limited. CONCLUSION:Structured transition management with clearly defined responsibilities appears essential to reduce treatment discontinuity, relapses, chronicity and the elevated risk of suicidality in this age group. There is a substantial need for further research on the effectiveness of transition concepts, including specialized transition programs or dedicated transition units.
