Tumour necrosis factor production and cell-mediated immunityin anorexia nervosa

Abstract

SUMMARYFourteen patients with anorexia nervosa (AN) were studied for the production of tumour necrosis factor (TNF), the activation ofthe interferon (IFN) system and cell-mediated cytotoxicity (CMC) and the results were compared with 16 age-matched healthy women. AN patients had significantly increased spontaneous TNF production by peripheral blood mononuclear cells (PBMC) in vitro (16 + 5 tJ/ml uc' /.vw.v 4 + 3 U/ml in the control group; P<005), although no TNF was detectable in the plasma from cither group, TNF production in vilro, following stimulation of PBMC by phytohaemagglutinin (PHA) or tumour cells, was similar in AN patients and controls; however, lipopolysaeeharide (LPS) indueed TNF produetion was found to be lower in AN (f <OI), CMC was significantly lower in AN patients (4 + 2 versus 10 + 3 in controls, expressed as lytie units/10' eells; P<005), but no difference could be found between AN and controls in IFN activity as reflected by the level of the IFN-induced enzyme 2'-5' oligoadenylate synthetase (2-5A) in PBMC. Betaendorphins in the plasma were higher in the AN group {P<005) but these levels could not be correlated to those of IFN, CMC orTNF. Defective CMC and increased TNF production by PBMC in patients with anorexia nervosa may possibly result from the nutritional deficiencies and neuroendocrine abnormalities associated with the disease, and may contribute to the pathophysiology of AN.Keywords anorexia nervosa tumour necrosis factor interferon /i-endorphins natural killer

Involvement of leucocyte/endothelial cell interactions in anorexia nervosa

“…As TNF‐α is a proinflammatory cytokine, these findings are further proof of the role of inflammation in anorexia. Our data are supported by other studies that have demonstrated an increase of TNF‐α in patients with anorexia . TNF‐α is mainly produced by stimulated leucocytes in response to inflammatory stimuli .…”

Increased use of antimicrobial medication in bulimia nervosa and binge‐eating disorder prior to the eating disorder treatment

“…23 In addition, elevated proinflammatory cytokines, such as tumor necrosis factor (TNF)-a, have been hypothesized to contribute to the development of AN. 41,42 In our study, low use of antimicrobial medication in females with AN before the treatment suggests that the infection-triggered inflammation does probably not play a major role in the development of AN in a larger female patient population. However, our results suggest that males with AN may differ from females in this respect.…”

“…On the other hand, it has been shown that streptococcal infections may play a role in the development of a subtype of AN (PANDAS‐AN) . In addition, elevated proinflammatory cytokines, such as tumor necrosis factor (TNF)‐α, have been hypothesized to contribute to the development of AN . In our study, low use of antimicrobial medication in females with AN before the treatment suggests that the infection‐triggered inflammation does probably not play a major role in the development of AN in a larger female patient population.…”

The hematology of anorexia nervosa

“…32 Several studies, investigating the cytokine production of patients with AN were performed, but the results are controversial. 33 A number of studies investigated serum levels of IL-1, IL-4, IL-6, IL-10, TNF-a, or interferon (IFN)-c but could not observe a significant difference in patients with AN compared with a matched control group. In some studies, AN-patients had significant lower levels of IL-2 and TGF-b2, whereas in another study, AN-patients had normal levels of IL-2 but a significant lower capacity to synthesize IL-2 in comparison to the control group.…”