Inflammatory mediators and their clinical repercussions on anorexia nervosa
DOI:
https://doi.org/10.33448/rsd-v10i1.11474Keywords:
Anorexia Nervosa; Eat Disorders; Inflammation; Neuroimmunomodulation.Abstract
Anorexia Nervosa (AN) is an eating disorder that affects adults, young people and children, has a multifactorial etiology, characterized by a distortion of body image associated with fear of gaining weight, leading the individual to commit severe food restriction, causing extreme weight loss and malnutrition. This, clinical and metabolic manifestations associated with inflammatory biomarkers are triggered, based on evidence on the dysregulation of the immune system and an inflammatory immunomodudulation during AN. The present study aims to present evidence that demonstrates how inflammatory mediators are systematically related to the most common clinical manifestations more in AN. This is an integrative review, based on consultation of the databases: MEDLINE and LILACS. Sixteen studies were selected from 2014 to 2020 with 56, 25% NE3, followed by 31, 25% NE 5 and 12, 5% NE 2. Studies have shown that inflammatory biomarkers such as interleukins, and chemokines, leptin, ghrelin, omentine-1, adinonectin, BDNF, VEGF, VCAM, PCR, OC, CTX, OPG, RANK, RANKL, IFN -γ, NO, IGF and some classes of TNF are related to clinical manifestations in AN contributing to prolonged and difficult to reverse symptoms, such as depression, sleep disorders, memory and learning, altered behavior , tissue damage, decreased appetite, risk for cardiovascular disease, changes in the intestinal microbiome, osteoporosis, amenorrhea, inflammation of the hypothalamus, impaired energy metabolism and unregulated inflammatory state. However, further clarification is needed on this topic, as there are still few studies in this line of research.
References
Belmonte, L., Achamrah, N., Nobis, S., Guérin, C., Riou, G., Bôle-Feysot, C., Boyer, O., Richard, V., Rego, J. C., Déchelotte, P., Goichon, A., & Coëffier, M. (2016). A role for intestinal TLR4-driven inflammatory response during activity-based anorexia. Scientific reports, 6, 35813. https://doi.org/10.1038/srep35813.
Bordignon, J. A., Coutinho, V. F., & Fernandes, A. C. (2014). Anorexia: Aspectos clínicos e nutricionais. Inova Saúde, 3(1). http://periodicos.unesc.net/Inovasaude/article/view/1312/
Carmo, C., Pereira, P., Cândido, A.P. (2014). Transtornos alimentares: uma revisão dos aspectos etiológicos e das principais complicações clínicas. HU ver., 173-181. https://docs.bvsalud.org/biblioref/2016/09/1845/2439-13557-1-pb.pdf.
Caroleo, M., Carbone, E. A., Greco, M., Corigliano, D. M., Arcidiacono, B., Fazia, G., Rania, M., Aloi, M., Gallelli, L., Segura-Garcia, C., Foti, D. P., & Brunetti, A. (2019). Brain-Behavior-Immune Interaction: Serum Cytokines and Growth Factors in Patients with Eating Disorders at Extremes of the Body Mass Index (BMI) Spectrum. Nutrients, 11(9), 1995. https://doi.org/10.3390/nu11091.
Caso, J. R., Graell, M., Navalón, A., MacDowell, K. S., Gutiérrez, S., Soto, M., Leza, J. C., Carrasco, J. L., & Marsá, M. D. (2020). Dysfunction of inflammatory pathways in adolescent female patients with anorexia nervosa. Progress in neuro-psychopharmacology & biological psychiatry, 96, 109727. https://doi.org/10.1016/j.pnpbp.2019.109727
Dalton, B., Campbell, I. C., Chung, R., Breen, G., Schmidt, U., & Himmerich, H. (2018a). Inflammatory Markers in Anorexia Nervosa: An Exploratory Study. Nutrients, 10(11), 1573. https://doi.org/10.3390/nu10111573.
Dalton, B., Bartholdy, S., Robinson, L., Solmi, M., Ibrahim, M., Breen, G., Schmidt, U., & Himmerich, H. (2018b). A meta-analysis of cytokine concentrations in eating disorders. Journal of psychiatric research, 103, 252–264. https://doi.org/10.1016/j.jpsychires.2018.06.002.
Dwarkasing, JT, Witkamp, RF, Boekschoten, MV, Ter Laak, MC, Heins, MS e van Norren, K. (2016). Aumento do turnover da serotonina hipotalâmica na anorexia induzida por inflamação. BMC neurocience , 17 (1), 1-13.
Ercole, F. F., Melo, L. S. D., & Alcoforado, C. L. G. C. (2014). Revisão integrativa versus revisão sistemática. Revista Mineira de Enfermagem, 18(1), 9-12.
Foo, J. P., Hamnvik, O. P., & Mantzoros, C. S. (2012). Optimizing bone health in anorexia nervosa and hypothalamic amenorrhea: new trials and tribulations. Metabolism: clinical and experimental, 61(7), 899–905. https://doi.org/10.1016/j.metabol.2012.01.003.
Gibson, D., & Mehler, P. S. (2019). Anorexia Nervosa and the Immune System-A Narrative Review. Journal of clinical medicine, 8(11), 1915. https://doi.org/10.3390/jcm8111915.
Gołąbek, K., Ostrowska, Z., Ziora, K., Oświęcimska, J., Świętochowska, E., Marek, B., Kajdaniuk, D., Strzelczyk, J., & Kos-Kudła, B. (2015). Association between omentin-1, bone metabolism markers, and cytokines of the RANKL/RANK/OPG system in girls with anorexia nervosa. Endokrynologia Polska, 66(6), 514–520. https://doi.org/10.5603/EP.2015.0063.
Grzelak, T., Dutkiewicz, A., Paszynska, E., Dmitrzak-Weglarz, M., Slopien, A., & Tyszkiewicz-Nwafor, M. (2017). Neurobiochemical and psychological factors influencing the eating behaviors and attitudes in anorexia nervosa. Journal of physiology and biochemistry, 73(2), 297–305. https://doi.org/10.1007/s13105-016-0540-2.
Miłkowska, P., Popko, K., Demkow, U., & Wolańczyk, T. (2017). Pro-Inflammatory Cytokines in Psychiatric Disorders in Children and Adolescents: A Review. Advances in experimental medicine and biology. Advance online publication. https://doi.org/10.1007/5584_2017_24.
Mörkl, S., Lackner, S., Meinitzer, A., Gorkiewicz, G., Kashofer, K., Painold, A., Holl, A., & Holasek, S. (2019). Pilot studie: Mikrobiom und Darmbarriere bei Anorexia nervosa [Pilot study: Gut microbiome and intestinal barrier in anorexia nervosa]. Fortschritte der Neurologie-Psychiatrie, 87(1), 39–45. https://doi.org/10.1055/s-0043-123826.
Nilsson, I. A. (2019). The anx/anx mouse–a valuable resource in anorexia nervosa research. Frontiers in neuroscience, 13, 59.
Nilsson, I., Millischer, V., Göteson, A., Hübel, C., Thornton, L. M., Bulik, C. M., Schalling, M., & Landén, M. (2020). Aberrant inflammatory profile in acute but not recovered anorexia nervosa. Brain, behavior, and immunity, 88, 718–724. https://doi.org/10.1016/j.bbi.2020.
024.
Nocturne, G., Boudaoud, S., Ly, B., Pascaud, J., Paoletti, A., & Mariette, X. (2017). Impact of anti-TNF therapy on NK cells function and on immunosurveillance against B-cell lymphomas. Journal of autoimmunity, 80, 56–64. https://doi.org/10.1016/j.jaut.2017.02.001
Oliveira, C. M. B., Sakata, Ri., K., Issy, A., M., Gerola, L., R., & Salomão, R. (2011). Citocinas e dor. Revista Brasileira de Anestesiologia, 61(2), 260-265. https://doi.org/10.1590/S0034-70942011000200014.
Olivo, G., Gaudio, S., & Schiöth, H. B. (2019). Brain and Cognitive Development in Adolescents with Anorexia Nervosa: A Systematic Review of fMRI Studies. Nutrients, 11(8), 1907. https://doi.org/10.3390/nu11081907.
Omodei, D., Pucino, V., Labruna, G., Procaccini, C., Galgani, M., Perna, F., Pirozzi, D., De Caprio, C., Marone, G., Fontana, L., Contaldo, F., Pasanisi, F., Matarese, G., & Sacchetti, L. (2015). Immune-metabolic profiling of anorexic patients reveals an anti-oxidant and anti-inflammatory phenotype. Metabolism: clinical and experimental, 64(3), 396–405. https://doi.org/10.1016/j.metabol.2014.10.025.
Ostrowska, Z., Ziora, K., Oświęcimska, J., Marek, B., Świętochowska, E., Kajdaniuk, D., Strzelczyk, J., Cieślicka, A., Wołkowska-Pokrywa, K., & Kos-Kudła, B. (2015). Selected pro-inflammatory cytokines, bone metabolism, osteoprotegerin, and receptor activator of nuclear factor-kB ligand in girls with anorexia nervosa. Endokrynologia Polska, 66(4), 313–321.
https://doi.org/10.5603/EP.2015.0040.
Oświęcimska, J., Ziora, K., Ziora, D., Machura, E., Smerdziński, S., Pyś-Spychała, M., Kasperski, J., Zamłyński, J., & Kasperska-Zajac, A. (2014). Elevated levels of exhaled nitric oxide in patients with anorexia nervosa. European child & adolescent psychiatry, 23(9), 845–850. https://doi.org/10.1007/s00787-013-0467-x.
Patsalos, O., Dalton, B., Leppanen, J., Ibrahim, M., & Himmerich, H. (2020). Impact of TNF-α Inhibitors on Body Weight and BMI: A Systematic Review and Meta-Analysis. Frontiers in pharmacology, 11, 481. https://doi.org/10.3389/fphar.2020.00481.
Palomino, D. C. T. & Marti, L. C. (2015). Quimiocinas e imunidade. einstein (São Paulo), 13 (3), 469-473. https://doi.org/10.1590/S1679-45082015RB3438.
Peterson K, Fuller R. Anorexia nervosa in adolescents: An overview. Nursing. 2019 Oct;49(10):24-30. doi: 10.1097/01.NURSE.0000580640.43071.15. PMID: 31568077.
Peluso, I., & Palmery, M. (2016). The relationship between body weight and inflammation: Lesson from anti-TNF-α antibody therapy. Human immunology, 77(1), 47–53. https://doi.org/10.1016/j.humimm.2015.10.008.
Phillipou, A., Rossell, S. L., & Castle, D. J. (2018). Anorexia nervosa or starvation?. The European journal of neuroscience, 48(11), 3317–3318. https://doi.org/10.1111/ejn.14158.
Pinheiro, M. A. R., Costa, I. K. F., da Cruz Matos, J., Júnior, B. S. S., de Albuquerque, A. M., da Silva, R. A. R., ... & de Mendonça, A. E. O. (2020). Instrumentos de avaliação da cicatrização de lesões por pressão: revisão integrativa. Research, Society and Development, 9(11), e65991110292-e65991110292.
Santos, M. A. R. C., & Galvão, M. G. A. (2014). A elaboração da pergunta adequada de pesquisa. Introdução à Metodologia Científica, 4(2), 53-56.
Savitz, J., & Harrison, N. A. (2018). Interoception and Inflammation in Psychiatric
Disorders. Biological psychiatry. Cognitive neuroscience and neuroimaging, 3(6), 514–524. https://doi.org/10.1016/j.bpsc.2017.12.011.
Schorr, M., & Miller, K. K. (2017). The endocrine manifestations of anorexia nervosa: mechanisms and management. Nature reviews. Endocrinology, 13(3), 174–186. https://doi.org/10.1038/nrendo.2016.175.
Słotwińska, S. M., & Słotwiński, R. (2017). Immune disorders in anorexia. Central-European journal of immunology, 42(3), 294–300. https://doi.org/10.5114/ceji.2017.70973.
Solmi, M., Veronese, N., Favaro, A., Santonastaso, P., Manzato, E., Sergi, G., & Correll, C. U. (2015). Inflammatory cytokines and anorexia nervosa: A meta-analysis of cross-sectional and longitudinal studies. Psychoneuroendocrinology, 51, 237–252. https://doi.org/10.1016/j.psyneuen.2014.09.031.
Tanaka, S., Oya-Ito, T., Murakami, Y., Saito, K., Furuta, S., Yu, Y., Imaeda, M., Kunimoto, S., & Ozaki, N. (2019). Decline of Plasma Concentrations of Interleukin-18 in Severely Malnourished Patients with Anorexia Nervosa: Exploratory Analysis. Nutrients, 11(3), 540.
https://doi.org/10.3390/nu11030540.
Vale, B., Brito, S., Paulos, L., & Moleiro, P. (2014). Menstruation disorders in adolescents with eating disorders-target body mass index percentiles for their resolution. Einstein (São Paulo, Brazil), 12(2), 175–180. https://doi.org/10.1590/s1679-45082014ao2942.
Víctor, V. M., Rovira-Llopis, S., Saiz-Alarcón, V., Sangüesa, M. C., Rojo-Bofill, L., Bañuls, C., de Pablo, C., Álvarez, Á., Rojo, L., Rocha, M., & Hernández-Mijares, A. (2015). Involvement of leucocyte/endothelial cell interactions in anorexia nervosa. European journal of clinical investigation, 45(7), 670–678. https://doi.org/10.1111/eci.12454.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Anny Priscylla Silva de Carvalho; Larissa Silva de Assis; Dayane Lorraine Vale Simões; Wollner Materko; Maysa de Vasconcelos Brito
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
