Cytokines in de obsessief compulsieve stoornis en in anorexia nervosa: een overzicht

Summary The alterations in the inflammatory response system (IRS) appear to be quite different between OCD and anorexia nervosa and are also different from the changes observed in major depression. In anorexia nervosa, there is some evidence for increased production of monocytic cytokines, i.e. tumor necrosis factor-α (TNFα) and interleukin-6 (IL-6), and decreased production of Th-1 like cytokines, i.e. IL-2 and IFNγ. In the same patients there are also signs of immunosuppression, e.g. lowered numbers of CD4 and CD8 T cells and increased production of transforming growth factor-beta (TGFβ). The increased production of monocytic cytokines may be the consequence of the hyponutritional status of those patients. The diminished production of the Th-1 like cytokines may be the consequence of at least four different factors: 1) the deficiency in nutritional factors; 2) neuroendocrine disorders, such as increased Cortisol production; 3) the increased TGFβ production; and 4) lower serum dipeptidyl peptidase activity. In OCD no consistent or specific alterations in the IRS are observed. There is no evidence that IRS activation may play a role in the pathophysiology of OCD and anorexia nervosa.