title: Increased naive CD4+and B lymphocyte subsets are associated with body mass loss and drive relative lymphocytosis in anorexia nervosa patients.
abstract: Anorexia nervosa (AN) is an atypical form of malnutrition with peculiar changes in the immune system. We hypothesized that different lymphocyte subsets are differentially affected by malnutrition in AN, and thus, our aim was to investigate the influence of body mass loss on the variability of lymphocyte subsets in AN patients. A group of 66 adolescent female patients, aged 12-17 years, referred for their first episode of either AN or feeding or eating disorders not elsewhere classified were studied upon admission (46 AN-restricting subtype, 11 AN-binge/purging subtype, and 9 feeding or eating disorders not elsewhere classified). Ninety healthy adolescents served as controls. White blood cells and lymphocyte subsets were analyzed by flow cytometry. Relationships with the body mass index (BMI) z score were assessed in linear models adjusted by diagnostic subtype and age. Leukocyte numbers were lower in AN patients than in controls, and relative lymphocytosis was observed in AN-restricting subtype. Lower CD8+, NK, and memory CD8+counts were found in eating disorder patients compared with controls. No differences were found for CD4+counts or naive and memory CD4+subsets between the groups. Negative associations between lymphocyte percentage and the BMI z score, as well as between the B cell counts, naive CD4+percentage and counts, and the BMI z score, were found. In conclusion, increased naive CD4+and B lymphocyte subsets associated with body mass loss drive the relative lymphocytosis observed in AN patients, which reflects an adaptive mechanism to preserve the adaptive immune response.
authors.affiliation: Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN)-CSIC, C/José Antonio Novais 10, 28040, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Elegido
authors.affiliation: Eating Disorders Unit, Child and Adolescent Psychiatry and Psychology Department, Children University Hospital Niño Jesús, Av Menéndez Pelayo, 65, 28009 Madrid, Spain; CIBERSAM, Biomedical Research Networking Centre for Mental Health, Ministry of Health, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Graell
authors.affiliation: Eating Disorders Unit, Child and Adolescent Psychiatry and Psychology Department, Children University Hospital Niño Jesús, Av Menéndez Pelayo, 65, 28009 Madrid, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Andrés
authors.affiliation: Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN)-CSIC, C/José Antonio Novais 10, 28040, Madrid, Spain.
authors.forename: Alina
authors.initials: A
authors.lastname: Gheorghe
authors.affiliation: Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN)-CSIC, C/José Antonio Novais 10, 28040, Madrid, Spain.
authors.forename: Ascensión
authors.initials: A
authors.lastname: Marcos
authors.affiliation: Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN)-CSIC, C/José Antonio Novais 10, 28040, Madrid, Spain. Electronic address: enova@ictan.csic.es.
authors.forename: Esther
authors.initials: E
authors.lastname: Nova
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000378:metabolism* / Q000473:pathology; D015703:Antigens, CD / Q000378:metabolism*; D016175:B-Lymphocyte Subsets / Q000378:metabolism*; D015992:Body Mass Index; D002032:Bulimia / Q000378:metabolism / Q000473:pathology; D015704:CD4 Antigens / Q000378:metabolism; D015496:CD4-Positive T-Lymphocytes / Q000378:metabolism*; D016827:CD8 Antigens / Q000378:metabolism; D018414:CD8-Positive T-Lymphocytes / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D001068:Feeding and Eating Disorders / Q000378:metabolism / Q000473:pathology; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007694:Killer Cells, Natural / Q000378:metabolism; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets / Q000378:metabolism; D008214:Lymphocytes / Q000378:metabolism; D008218:Lymphocytosis / Q000209:etiology* / Q000378:metabolism; D044342:Malnutrition / Q000378:metabolism / Q000473:pathology; D015431:Weight Loss / Q000502:physiology*
chemical_list: D015703:Antigens, CD; D015704:CD4 Antigens; D016827:CD8 Antigens
keywords: Anorexia nervosa; Body mass loss; Lymphocyte subsets; Relative lymphocytosis; White blood cells