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Plasma Concentrations of Tumor Necrosis Factor- (TNF-) and Soluble TNF Receptors in Patients with Anorexia Nervosa¹

College of Medical Technology (Y.N.) and Department of Psychiatry (S.H.) Kyoto University, Kyoto 606-8507; Takagi Psychiatric Clinic (R.T.), Kyoto 606-8507; Kansai-Denryoku-Hospital (A.T.), Osaka 553-0003; and Mitsubishi Kagaku Bio-Clinical Laboratory Inc. (F.K.), Tokyo 174-0056, Japan

Address all correspondence and requests for reprints to: Yoshikatsu Nakai, M.D., College of Medical Technology, Kyoto University, 53 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan. E-mail: YN{at}itan.kyoto-u.ac.jp

Tumor necrosis factor- (TNF-) is a cytokine with numerous immunological and metabolic activities. To study the role of TNF- on the pathophysiology of anorexia nervosa and its complications, plasma concentrations of TNF-, 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- concentrations in AN were significantly higher than those in N (4.1 ± 0.6 pg/mL vs. 1.6 ± 0.1 pg/mL; P < 0.01). Although no significant difference was observed in plasma sTNF-RI concentrations between the two groups, plasma sTNF-RII concentrations in AN were significantly higher than those in N (2094.0 ± 138.5 pg/mL vs. 1569.5 ± 84.0 pg/mL; P < 0.01). Plasma concentrations of TNF- and sTNF-RII after treatment of 8 anorectic patients were not different from those before treatment, although body fat mass and plasma leptin concentrations significantly increased after treatment. Plasma TNF- 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- in anorectic patients and that TNF- may contribute to the pathophysiology of immunological and metabolic abnormalities in anorexia nervosa. .

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