Abstract
Immune, neuroendocrine, and autonomic nervous system dysregulation in anorexia nervosa lead to cardiovascular complications that can potentially result in increased morbidity and mortality. It is suggested that a complex non-invasive assessment of cardiovascular autonomic regulation—cardiac vagal control, sympathetic vascular activity, and cardiovascular reflex control—could represent a promising tool for early diagnosis, personalized therapy, and monitoring of therapeutic interventions in anorexia nervosa particularly at a vulnerable adolescent age. In this view, we recommend to consider in the diagnostic route, at least in the subset of patients with peripheral microvascular symptoms, a nailfold video-capillaroscopy as an easy not invasive tool for the early assessing of possible cardiovascular involvement.
Highlights
Anorexia nervosa (AN) is a severe psychiatric disorder, which mainly affects females, associated with frequent medical complications and characterized by malnutrition and starvation [1]
Mitochondrial dysfunction and oxidative stress in peripheral blood leukocytes at the level of the mitochondrial complex I are observed in anorexia nervosa due to reactive oxygen species (ROS) and proinflammatory cytokines released by immune cells
Elevated levels of proinflammatory cytokines such as IL-6 and TNF-α are reported in anorexia nervosa, and a peripheral proinflammatory state may result in chronic neuroinflammation
Summary
Anorexia nervosa (AN) is a severe psychiatric disorder, which mainly affects females, associated with frequent medical complications and characterized by malnutrition and starvation [1]. To elucidate the role of disease-associated epigenetic dysregulation in specific genetic and environmental contexts, integrated analyses are emerging that incorporate detailed environmental data with genotypic, epigenetic, and transcriptomic data [3,4,5]. Conditions attributable to purging, malnutrition, and weight loss are the frequent causes of medical complications. Almost all organs and systems are affected in the course of the disease, and sometimes some abnormalities that it causes persist even when it recovers. The occurrence of cardiovascular complications characterize anorexia nervosa. Dysregulation between peripheral vasoconstriction and vasodilatation, clinically appearing with Raynaud’s phenomenon (RP), is reported in AN [7]
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