Abstract
Multiple studies on the dynamics of inflammatory cytokines in patients with anorexia nervosa (AN) have been published, although results are not consistent among reports. Thus the pathophysiologic roles of these cytokines are not clear. We performed an exploratory analysis that included (1) comparisons of plasma interleukin-18 (IL-18) concentrations between patients with AN (n = 21) and healthy controls (n = 39), and (2) correlations between body mass index (BMI) and IL-18 concentrations in both groups, exploring the relationship between malnourishment and IL-18. Plasma IL-18 levels were significantly decreased in patients with AN compared with controls. Plasma IL-18 levels correlated to BMI in controls, but not in patients with AN. These results suggest that a decline in plasma IL-18 levels in patients with AN is not only due to malnourishment, but other pathophysiologic changes as well. IL-18 has a role in the brain’s reaction to sadness and chronic stress. Therefore, decreased levels of IL-18 may commonly occur in patients with chronic AN.
Highlights
Anorexia nervosa (AN) is sometimes fatal due to severe malnutrition
body mass index (BMI) in the control group ranged from 17.12 kg/m2 to 33.23 kg/m2
Increased levels of IL-18 in plasma have been observed in patients with schizophrenia and moderate to severe depression [14], so a psychiatric comorbidity may have confounded plasma IL-18 levels in patients with anorexia nervosa (AN)
Summary
Anorexia nervosa (AN) is sometimes fatal due to severe malnutrition. Leukocytopenia frequently accompanies AN [1], the reason for this is unknown. Patients with AN appear to maintain standard immunity and do not show an increased risk for systemic infections [2,3]. Both in vitro and in vivo studies have explored the role of inflammatory cytokines, such as tumor necrosis factor-α (TNF-α), associated with immunity in patients with AN, but findings are inconsistent [2,4,5,6,7,8]. The latest meta-analysis suggests that plasma levels of certain types of inflammatory cytokines (e.g., TNF-α and interleukin-6 (IL-6)), are elevated in a malnourished state of AN and may partially account for the decreased appetite of anorexic patients [9]. Given its low power and Nutrients 2019, 11, 540; doi:10.3390/nu11030540 www.mdpi.com/journal/nutrients
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