Peripheral Vascular Abnormalities in Anorexia Nervosa: A Psycho-Neuro-Immune-Metabolic Connection

Int J Mol Sci. 2021 May 10;22(9):5043. doi: 10.3390/ijms22095043.

Abstract

Immune, neuroendocrine, and autonomic nervous system dysregulation in anorexia nervosa lead to cardiovascular complications that can potentially result in increased morbidity and mortality. It is suggested that a complex non-invasive assessment of cardiovascular autonomic regulation-cardiac vagal control, sympathetic vascular activity, and cardiovascular reflex control-could represent a promising tool for early diagnosis, personalized therapy, and monitoring of therapeutic interventions in anorexia nervosa particularly at a vulnerable adolescent age. In this view, we recommend to consider in the diagnostic route, at least in the subset of patients with peripheral microvascular symptoms, a nailfold video-capillaroscopy as an easy not invasive tool for the early assessing of possible cardiovascular involvement.

Keywords: anorexia nervosa; autoimmunity; capillaroscopy; cardiovascular diseases; cytokines; eating disorders; microcirculation; microvascular damage; nailfoldcapillaroscopy; neuroendocrine dysregulation.

Publication types

  • Review

MeSH terms

  • Anorexia Nervosa / complications
  • Anorexia Nervosa / immunology
  • Anorexia Nervosa / metabolism
  • Anorexia Nervosa / pathology*
  • Cardiovascular Abnormalities / complications
  • Cardiovascular Abnormalities / immunology
  • Cardiovascular Abnormalities / metabolism
  • Cardiovascular Abnormalities / pathology*
  • Heart Rate / physiology
  • Humans
  • Immune System / pathology
  • Neurosecretory Systems / metabolism
  • Neurosecretory Systems / pathology
  • Peripheral Vascular Diseases / complications
  • Peripheral Vascular Diseases / immunology
  • Peripheral Vascular Diseases / metabolism
  • Peripheral Vascular Diseases / pathology*
  • Vagus Nerve / metabolism
  • Vagus Nerve / pathology