Anorexia Nervosa and the Immune System—A Narrative Review

Gibson, Dennis; Mehler, Philip S.

doi:10.3390/jcm8111915

Cited by 76 publications

(87 citation statements)

References 185 publications

(277 reference statements)

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“…Genetic and environmental factors have been shown to influence disease risk 6 – 8 . Accumulating evidence indicates that immune mechanisms are also involved in the pathogenesis of AN 9 . However, the underlying mechanisms are far from being understood.…”

Section: Introductionmentioning

confidence: 99%

Alterations in B cell subsets correlate with body composition parameters in female adolescents with anorexia nervosa

Freff

Schwarte

Bröker

et al. 2021

Sci Rep

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Anorexia nervosa (AN) is a severe eating disorder and often associated with altered humoral immune responses. However, distinct B cell maturation stages in peripheral blood in adolescents with AN have not been characterized. Treatment effects and the relationship between clinical and B cell parameters are also not fully understood. Here we investigated the phenotype of circulating B cell subsets and the relationship with body composition in adolescents with AN before (T0, n = 24) and after 6 weeks (T1, n = 20) of treatment. Using multi-parameter flow cytometry, we found increased percentages of antigen-experienced B cells and plasmablasts in patients with AN compared to healthy controls (n = 20). In contrast, percentages of CD1d+CD5+ B cells and transitional B cells with immunoregulatory roles were reduced at T0 and T1. These B cell frequencies correlated positively with fat mass, fat mass index (FMI), free fat mass index, and body mass index standard deviation score. In addition, scavenger-like receptor CD5 expression levels were downregulated on transitional B cells and correlated with fat mass and FMI in AN. Our findings that regulatory B cell subgroups were reduced in AN and their strong relationship with body composition parameters point toward an impact of immunoregulatory B cells in the pathogenesis of AN.

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Section: Introductionmentioning

confidence: 99%

Alterations in B cell subsets correlate with body composition parameters in female adolescents with anorexia nervosa

Freff

Schwarte

Bröker

et al. 2021

Sci Rep

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“…It has to be considered that a starvation-regulated induction of RNase 7 and psoriasin in human skin cells might not exist. Alternatively, undernutrition in patients with AN does not necessarily lead to protein deficiency 3,4,7 , so the observed results in starving Drosophila melanogaster might not be easily transferable to the nutritional status of patients with AN. Finally, the AMPs measured in our study might react differently compared to AMPs produced in airway epithelia, the gastrointestinal or urogenital tract.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial peptides in patients with anorexia nervosa: comparison with healthy controls and the impact of weight gain

Bendix

Stephan

Nöhre

et al. 2020

Sci Rep

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Clinical observations show that patients with anorexia nervosa (AN) are surprisingly free from infectious diseases. There is evidence from studies in Drosophila melanogaster that starvation leads to an increased expression of antimicrobial peptides (AMPs). AMPs are part of the innate immune system and protect human surfaces from colonization with pathogenic bacteria, viruses and fungi. We compared the expression of AMPs between patients with AN and healthy controls (HC) and investigated the influence of weight gain. Using a standardized skin rinsing method, quantitative determination of the AMPs psoriasin and RNase 7 was carried out by ELISA. Even though non-significant, effect sizes revealed slightly higher AMP concentrations in HC. After a mean weight gain of 2.0 body mass index points, the concentration of psoriasin on the forehead of patients with AN increased significantly. We could not confirm our hypotheses of higher AMP concentrations in patients with AN that decrease after weight gain. On the contrary, weight gain seems to be associated with increasing AMP concentrations.

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“…Symptoms may include fever, cough, rhinitis, dyspnea, general fatigue and a wide range of changes in pulmonary auscultation. Many studies and case reports point towards the conclusion that AN patients are more susceptible to infections due to a weakened immune system [ 4 , 12 ]. Furthermore, they are at a greater risk of rare complications, such as anatomical changes in the lungs [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Severe bronchiectasis and inflammatory lung disease in a patient with anorexia nervosa and severe and enduring malnutrition - a case report

et al. 2020

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Background Persistent structural changes of the lungs in anorexia nervosa (AN) patients are rarely described in contemporary medical literature. The objective of our paper is to report a rare case of severe bronchiectasis and inflammatory changes to the lungs resulting from chronic malnutrition in a AN patient. Case presentation We describe a patient with severe inflammatory lung disease caused by malnutrition, resulting in persistent bronchiectasis accompanying AN. We performed an analysis of the patient’s medical records including radiological findings and laboratory results. A review of available literature shows very little data available on this topic. Conclusion Bronchiectasis and other structural changes of the lungs are rare, but severe complications of severe, chronic malnutrition. As exemplified by our case report, they may require extensive differential diagnosis and pose a significant clinical challenge due to their non-reversible character. A successful treatment relies heavily on the patient’s compliance and may be hard to achieve. Clinicians managing patients with anorexia nervosa should be wary of early respiratory tract dysfunction-related symptoms and always consider malnutrition bronchiectasis as a differential diagnosis option.

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Anorexia Nervosa and the Immune System—A Narrative Review

Cited by 76 publications

References 185 publications

Alterations in B cell subsets correlate with body composition parameters in female adolescents with anorexia nervosa

Alterations in B cell subsets correlate with body composition parameters in female adolescents with anorexia nervosa

Antimicrobial peptides in patients with anorexia nervosa: comparison with healthy controls and the impact of weight gain

Severe bronchiectasis and inflammatory lung disease in a patient with anorexia nervosa and severe and enduring malnutrition - a case report

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