title: The expression of cytokines and chemokines in the blood of patients with severe weight loss from anorexia nervosa: an exploratory study.
abstract: Anorexia nervosa (AN) is a serious, potentially life-threatening disorder characterized by severe weight loss, dysregulated eating, and often excessive exercise. While psychiatric illnesses such as depression are associated with increased levels of pro-inflammatory mediators, evidence for such disturbances in patients with AN has been less clear. In an exploratory study of possible disturbances in immune responses in AN, we assayed a panel of cytokines and chemokines in the blood of patients undergoing inpatient treatment, testing the hypothesis that metabolic disturbances in this disease would lead to a pattern of immune disturbances distinct from that of other psychiatric diseases. For this purpose, we evaluated patients by the Beck Depression Inventory-II (BDI-II) and the Eating Disorders Examination-Questionnaire and assessed cytokines and chemokines by enzyme-linked immunosorbent assays. Patients reported a moderate level of depression (mean BDI-II = 22.6) but exhibited few immunologic abnormalities of the kind associated with major depressive disorder [e.g., increased interleukin (IL)-6]; RANTES showed the most frequent elevations and was increased in 4 of the patients studied. Together, these findings suggest that features of AN such as loss of adipose tissue and excessive exercise may attenuate cytokine production and thus modulate the experience of illness that impacts on core features of disease.
authors.affiliation: Department of Medicine, Durham Veterans Affairs Medical Center, Medical Research Service and Duke University Medical Center, 151G, 508 Fulton Street, Durham, NC 27705, USA. Electronic address: dpiset@acpub.duke.edu.
authors.forename: D S
authors.initials: DS
authors.lastname: Pisetsky
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill, CB #7160, Chapel Hill, NC 27599, USA. Electronic address: strace@med.unc.edu.
authors.forename: S E
authors.initials: SE
authors.lastname: Trace
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill, CB #7175, Chapel Hill, NC 27599, USA. Electronic address: kim_brownley@med.unc.edu.
authors.forename: K A
authors.initials: KA
authors.lastname: Brownley
authors.affiliation: UNC Department of Psychiatry and UNC Department of Biostatistics, Neurosciences Hospital, 101 Manning Drive, Chapel Hill, NC 27514, USA. Electronic address: hamer@unc.edu.
authors.forename: R M
authors.initials: RM
authors.lastname: Hamer
authors.affiliation: Duke University Medical Center, Psychiatry, Box 3842 Med. Ctr., Durham, NC 27710, USA. Electronic address: nancy.zucker@dm.duke.edu.
authors.forename: N L
authors.initials: NL
authors.lastname: Zucker
authors.affiliation: Immunology and Allergy Laboratory, University Hospital of Geneva, Geneva, Switzerland. Electronic address: pascale.roux-lombard@hcuge.ch.
authors.forename: P
authors.initials: P
authors.lastname: Roux-Lombard
authors.affiliation: Faculty of Medicine, Centre Medical Universitaire, Geneva, Switzerland. Electronic address: jean-michel.dayer@unige.ch.
authors.forename: J-M
authors.initials: JM
authors.lastname: Dayer
authors.affiliation: Departments of Psychiatry and Nutrition, University of North Carolina at Chapel Hill, CB #7160, Chapel Hill, NC 27599, USA. Electronic address: cbulik@med.unc.edu.
authors.forename: C M
authors.initials: CM
authors.lastname: Bulik
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000097:blood*; D001823:Body Composition; D018946:Chemokine CCL5 / Q000096:biosynthesis / Q000097:blood*; D003863:Depression / Q000150:complications*; D004797:Enzyme-Linked Immunosorbent Assay; D015444:Exercise; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008875:Middle Aged; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D015431:Weight Loss; D055815:Young Adult
chemical_list: D018946:Chemokine CCL5; C508600:IL6 protein, human; D015850:Interleukin-6
keywords: Anorexia nervosa; Chemokines; Cytokines; Depression; Eating disorder