T lymphocyte subpopulations in anorexia nervosa and refeeding.
ABSTRACT Several studies have addressed the question of the effects of starvation on immune function and changes in lymphocyte subsets. Patients with anorexia nervosa are severely malnourished, but there have been few studies of immune parameters in this group. For this reason, phenotypic markers of T cell function and activation were studied in 20 severely underweight patients with anorexia nervosa and again after a period of refeeding. The most significant finding was a reduction in the percentage and absolute number of CD8+ T cells in patients with anorexia, the result of a marked reduction in memory (CD45RO+RA-) CD8 cells. A tendency for recovery in numbers of this subset was seen after refeeding. A decreased memory:maive cell ratio was also seen among CD4 cells, but was less marked. Subtle abnormalities in activated CD4 and CD8 cells were also found in the patient group at the initial sampling, but did not follow any clear pattern. These findings indicate that starvation in anorexic patients is accompanied by a large change in memory CD8 T cells. It may be speculated that this relates to the perceived lack of symptomatic common viral infections in underweight anorexic patients and their return with the recovery of weight.
Journal of Clinical Endocrinology & Metabolism 04/1999; 84(4):1226-1228. DOI:10.1210/jc.84.4.1226 · 6.31 Impact Factor
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ABSTRACT: The purpose of this study was to assess anthropometry and immune responses in three groups of young females age 13–17 years: 24 anorexia nervosa patients (ANP), 10 elite gymnasts (GYM) who exercised for at least 48 hours per week, and 50 sedentary students who exercised for less than 12 hours per week and were assessed as controls (C). BMI, IBW, total leukocyte and lymphocyte counts, CD2, CD3, CD$ and CD8 subset counts were lower in GYM and ANP groups compared with controls. Leukocyte count was higher and lymphocyte count was lower in GYM than in ANP. CD56 counts were the lowest in ANP and were similar in GYM and C groups. The response to delayed hypersensitivity tests was lower in GYM compared to than in C group. None of the ANP subjects showed any response, thereby demonstrating complete anergy. It may be concluded that both anthropometry and immunological tests are consistent with the presence of subclinical malnutrition in GYM and ANP groups, particularly the latter. These findings should form the basis of strategies for prevention of overt malnutrition and its consequences in young elite sportswomen.Nutrition Research 02/1998; 18(2). DOI:10.1016/S0271-5317(98)00017-7 · 2.59 Impact Factor
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ABSTRACT: Tumor necrosis factor-a (TNF-a) is a cytokine with numerous im- munological and metabolic activities. To study the role of TNF-a on the pathophysiology of anorexia nervosa and its complications, plasma concentrations of TNF-a, 2 soluble TNF receptors (sTNF-RI and sTNF-RII), and leptin were measured in 20 female patients with anorexia nervosa (AN) and 20 age-matched normal women (N). Plasma TNF-a concentrations in AN were significantly higher than those in N (4.1 6 0.6 pg/mL vs. 1.6 6 0.1 pg/mL; P , 0.01). Although no significant difference was observed in plasma sTNF-RI concen- trations between the two groups, plasma sTNF-RII concentrations in AN were significantly higher than those in N (2094.0 6 138.5 pg/mL vs. 1569.5 6 84.0 pg/mL; P , 0.01). Plasma concentrations of TNF-a and sTNF-RII after treatment of 8 anorectic patients were not dif- ferent from those before treatment, although body fat mass and plasma leptin concentrations significantly increased after treatment. Plasma TNF-a concentrations were not related to body fat mass in anorectic patients. These results suggest that the adipose tissue may not be the immediate source of TNF-a in anorectic patients and that TNF-a may contribute to the pathophysiology of immunological and metabolic abnormalities in anorexia nervosa. (J Clin Endocrinol Metab 84: 1226 -1228, 1999).Clinical Endocrinology 09/2001; 53(3):383-388. DOI:10.1046/j.1365-2265.2000.01091.x · 3.35 Impact Factor