Sabrina Paterniti

Involvement of cytokines in eating disorders: a critical review of the human literature

A number of findings from clinical and animal studies indicate that pro-inflammatory cytokines may play roles in eating disorders. The measurement of pro-inflammatory cytokines (IL-1, IL-6, TNFalpha), which are known to decrease food intake, provides highly variable data from which firm conclusions cannot be drawn. In most of the longitudinal studies where pro-inflammatory cytokines have been shown to be impaired in anorexia or bulimia nervosa, a return to normal values was observed after renutrition. However these findings do not exclude the possibility that pro-inflammatory cytokines might be overproduced in specific brain areas and act locally without concomitantly increased serum or immune production. It was also pointed out that the production of the major type-1 cytokines (especially IL-2) was depressed in anorexia nervosa. It remains unclear whether this is due to undernutrition or to a specific underlying cause common to eating disorders. The impaired cytokine profile observed in eating disorders could be related to several factors including impaired nutrition, psychopathological and neuroendocrine factors. More particular attention should be devoted to the deregulation of the anti/pro-inflammatory balance. Deregulation of the cytokine network may be responsible for medical complications in eating disorder patients who are afflicted with chronic underweight.

Correlation between serum levels of interleukin-4 and alexithymia scores in healthy female subjects: preliminary findings

Some studies suggest that inaccuracy in recognizing and describing emotional states, combined with a highly descriptive mode of expression, as in alexithymia, may influence the immune response. We therefore investigated in healthy women the relationship between alexithymia and circulating levels of IL-1, IL-2 and IL-4. Seventeen mentally and physically healthy women aged between 20 and 25 years completed psychological questionnaires to assess alexithymia (Toronto Alexithymia Scale: TAS) and depressed mood (Hospital Anxiety and Depression Scale: HAD). Serum concentrations of IL-1, IL-2 and IL-4 were measured by ELISA. We found a significant positive correlation between serum levels of IL-4 and TAS score (r=0.55; p=0.021) and between factor 1 of the TAS (difficulty in identifying feelings) and IL-4 (r=0.57; p=0.017) while serum IL-1 and IL-2 were not detected in ten and six patients, respectively. Although there was a significant correlation between age and IL-4 levels, a linear regression with BMI, age, depressed mood and TAS as independent variables showed that only alexithymia could predict significantly increased levels of IL-4. Alexithymia and difficulty in identifying feelings could be associated with increased levels of IL-4 which may result in chronic impairment of pro/anti-inflammatory cytokine balance with psychological and somatic consequences. Nevertheless, these intriguing findings would deserve replication and extension in a larger sample of subjects.

Cytokines and Anorexia Nervosa

Objective Recent studies have indicated that the inflammatory cytokines could be implicated in anorexia nervosa and in its complications. To determinate the potential role of interleukins (IL-1, IL-2, IL-4, IL-6, IL-10), interferon (IFN &ggr;), tumor necrosis factor (TNF-&agr;), and transforming growth factor (TGF-&bgr;2) in anorexia nervosa, serum concentrations of these cytokines were measured in patients suffering from anorexia nervosa in comparison to healthy subjects. Method Twenty-nine anorexic women according to DSM-IV criteria participated in the study. The control group consisted of 20 healthy women without eating disorders, mood disorders, and immunological disorders. Results We find that serum IL-2 and TGF-&bgr;2 concentrations were both significantly decreased in anorexic patients, although the other cytokines did not differ significantly between the two groups. Conclusion Our results show that in patients with anorexia nervosa, there are lower levels of specific cytokines (especially IL-2 and TGF-&bgr;2). These levels may reflect the combination of impaired nutrition and weight loss, therefore, the dysregulation of these cytokines may contribute in anorexia’s complications. Follow-up studies should examine the effects of parameters such as starvation, psychopathologic factors, and psychoneuroendocrinological perturbation which could affect interplay between cytokines, neuropeptides, and neurotransmitters.

L'intensité de la détresse péritraumatique prédit la survenue des symptômes post-traumatiques parmi des victimes d'agressions

Resume La detresse emotionnelle peritraumatique est une dimension recente dont nous avons cherche a verifier a quel point elle pouvait predire l’evolution des symptomes post-traumatiques. Les victimes ont ete recrutees consecutivement dans 5 centres de consultations specialisees en region parisienne aupres de victimes d’agressions individuelles et de hold-up. Parmi les 100 sujets inclus initialement, 63 ont ete suivis par deux evaluations a 6 mois d’intervalle, la premiere par un clinicien avec une hetero-evaluation associee a des questionnaires et la deuxieme uniquement par des questionnaires: le Peritraumatic Distress Inventory (PDI) pour la mesure de la detresse emotionnelle peritraumatique ; le Peritraumatic Dissociative Experience Questionnaire a ete utilise pour mesurer l’intensite de la dissociation ; l’Impact of Event Scale-Revised (IES-R) pour mesurer l’intensite des symptomes de l’etat de stress post-traumatique (ESPT) ; le Mini International Neuropsychiatric Interview (MINI) pour le diagnostic de depression et d’etat de stress post-traumatique (ESPT) pose par un evaluateur. Les scores de dissociation peritraumatique evalues a la premiere etape etaient correles aux scores d’IES-R initiaux et a 6 mois avec respectivement des coefficients de correlation de 0,50 et 0,63 entre les scores de PDEQ et PDI initial et le score d’IES-R a 6 mois. Alors que les analyses statistiques descriptives indiquent des «tendances» de lien, c’est par une regression lineaire multiple hierarchique en tenant compte du type d’evenement qu’il apparait que le score de detresse peritraumatique ameliore la variance de 14 % pour predire le score d’IES-R a 6 mois compare a la prediction du score d’IES-R initial. Cette etude est la premiere qui montre sur une enquete prospective la puissance du score de detresse emotionnelle peritraumatique pour predire l’evolution d’un trouble post-traumatique. Nos resultats confirment que le type de traumatisme predit fortement le pronostic a 6 mois dans cette population.