Coordinated epigenetic dysregulation of CNR1 and FAAH genes drives endocannabinoid system dysfunction in anorexia nervosa

Abstract Background: Anorexia nervosa (AN) is a severe psychiatric disorder with limited biomarkers for diagnosis and treatment monitoring. We investigated endocannabinoid system (ECS) dysregulation in AN through integrated epigenetic and genetic analysis of saliva. Methods: We analyzed DNA methylation patterns of cannabinoid receptor 1 (CNR1) and fatty acid amide hydrolase (FAAH) genes, characterized genetic polymorphisms, and quantified expression of exosomal microRNAs targeting these genes in AN patients versus healthy controls. Results: We discovered a novel bidirectional epigenetic dysregulation of the