Abstract
Anorexia nervosa (AN) is a severe psychiatric disorder with high mortality and relapse rates. Even though changes in inflammatory markers and cytokines are known to accompany cachexia associated with somatic disorders such as cancer and chronic kidney disorder, studies on inflammatory markers in AN are rare and typically include few individuals. Here, we utilize an Olink Proteomics inflammatory panel to explore the concentrations of 92 preselected inflammation-related proteins in plasma samples from women with active AN (N = 113), recovered from AN (AN-REC, N = 113), and normal weight healthy controls (N = 114). After correction for multiple testing, twenty-five proteins differed significantly between the AN group and controls (lower levels: ADA, CCL19, CD40, CD5, CD8A, CSF1, CXCL1, CXCL5, HGF, IL10RB, IL12B, 1L18R1, LAP TGFß1, MCP3, OSM, TGFα, TNFRSF9, TNFS14 and TRANCE; higher levels: CCL11, CCL25, CST5, DNER, LIFR and OPG). Although more than half of these differences (N = 15) were present in the comparison between AN and AN-REC, no significant differences were seen between AN-REC and controls. Furthermore, twenty-five proteins correlated positively with BMI (ADA, AXIN1, CASP8, CD5, CD40, CSF1, CXCL1, CXCL5, EN-RAGE, HGF, IL6, IL10RB, IL12B, IL18, IL18R1, LAP TGFß1, OSM, SIRT2, STAMBP, TGFα, TNFRSF9, TNFS14, TRANCE, TRAIL and VEGFA) and four proteins correlated negatively with BMI (CCL11, CCL25, CCL28 and DNER).These results suggest that a dysregulated inflammatory status is associated with AN, but, importantly, seem to be confined to the acute illness state.
Highlights
Anorexia nervosa (AN) is a severe psychiatric disorder with high mortality and relapse rates (Berends et al, 2018)
Twin studies have identified a strong genetic contribution: 58–70% of variance in liability is due to additive genetic factors (Bulik, 2006), and the latest genome-wide association study (GWAS) has identified eight loci associated with AN (Watson, 2019)
We analysed the hitherto largest battery of inflammatory markers in plasma from women with active AN (N = 113), women who had recovered from AN (AN-REC, N = 113), and healthy female normalweight controls (N = 114)
Summary
Anorexia nervosa (AN) is a severe psychiatric disorder with high mortality and relapse rates (Berends et al, 2018). AN is characterized by persistent restriction of energy intake leading to severe underweight, combined with body image disturbances, and intense fear of gaining weight. The disorder is often accompanied by behaviours that interfere with weight gain, e.g., purging or extreme physical activity (Association, 2013; Schaumberg, 2017). In addition to genetic factors, environmental and neurobiological factors are known to contribute to the etiology of AN (Schaumberg, 2017). The pathophysiology underlying AN is still poorly understood, which makes the development of treatments challenging. No medications exist that effectively target the core biology of the disorder and evidence based treatments are psychotherapeutic in nature
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