Elegido Ana, Graell Montserrat, Andrés Patricia, Gheorghe Alina, Marcos Ascensión, Nova Esther
Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN)-CSIC, C/José Antonio Novais 10, 28040, Madrid, Spain.
Eating Disorders Unit, Child and Adolescent Psychiatry and Psychology Department, Children University Hospital Niño Jesús, Av Menéndez Pelayo, 65, 28009 Madrid, Spain; CIBERSAM, Biomedical Research Networking Centre for Mental Health, Ministry of Health, Spain.
Nutr Res. 2017 Mar;39:43-50. doi: 10.1016/j.nutres.2017.02.006. Epub 2017 Feb 6.
Anorexia nervosa (AN) is an atypical form of malnutrition with peculiar changes in the immune system. We hypothesized that different lymphocyte subsets are differentially affected by malnutrition in AN, and thus, our aim was to investigate the influence of body mass loss on the variability of lymphocyte subsets in AN patients. A group of 66 adolescent female patients, aged 12-17 years, referred for their first episode of either AN or feeding or eating disorders not elsewhere classified were studied upon admission (46 AN-restricting subtype, 11 AN-binge/purging subtype, and 9 feeding or eating disorders not elsewhere classified). Ninety healthy adolescents served as controls. White blood cells and lymphocyte subsets were analyzed by flow cytometry. Relationships with the body mass index (BMI) z score were assessed in linear models adjusted by diagnostic subtype and age. Leukocyte numbers were lower in AN patients than in controls, and relative lymphocytosis was observed in AN-restricting subtype. Lower CD8, NK, and memory CD8 counts were found in eating disorder patients compared with controls. No differences were found for CD4 counts or naive and memory CD4 subsets between the groups. Negative associations between lymphocyte percentage and the BMI z score, as well as between the B cell counts, naive CD4 percentage and counts, and the BMI z score, were found. In conclusion, increased naive CD4 and B lymphocyte subsets associated with body mass loss drive the relative lymphocytosis observed in AN patients, which reflects an adaptive mechanism to preserve the adaptive immune response.
神经性厌食症（AN）是一种非典型的营养不良形式，免疫系统会发生特殊变化。我们假设，在神经性厌食症中，不同的淋巴细胞亚群受营养不良的影响存在差异，因此，我们的目的是研究体重减轻对神经性厌食症患者淋巴细胞亚群变异性的影响。对一组66名年龄在12至17岁之间的青春期女性患者进行了研究，她们因首次发作神经性厌食症、进食障碍或未在其他地方分类的进食障碍而入院（46例为限制型神经性厌食症亚型，11例为暴食/清除型神经性厌食症亚型，9例为未在其他地方分类的进食障碍）。90名健康青少年作为对照。通过流式细胞术分析白细胞和淋巴细胞亚群。在根据诊断亚型和年龄进行调整的线性模型中评估与体重指数（BMI）z评分的关系。神经性厌食症患者的白细胞数量低于对照组，在限制型神经性厌食症亚型中观察到相对淋巴细胞增多。与对照组相比，进食障碍患者的CD8、NK和记忆性CD8计数较低。两组之间的CD4计数或初始和记忆性CD4亚群没有差异。发现淋巴细胞百分比与BMI z评分之间以及B细胞计数、初始CD4百分比和计数与BMI z评分之间存在负相关。总之，与体重减轻相关的初始CD4和B淋巴细胞亚群增加导致了神经性厌食症患者中观察到的相对淋巴细胞增多，这反映了一种维持适应性免疫反应的适应性机制。
