Purpose of review: Anorexia nervosa remains a disease of unknown etiology. This situation explains the failure to develop effective therapy and emphasizes the fact that the neurobiological mechanisms of appetite and emotion are still incompletely understood. The present review is the first summary of recent research assigning to the immune system a new role in energy and emotional regulation by the production of autoantibodies directed against neuropeptides. The results of this research are promising to shed light on the etiology of eating disorders and open new fields for biological diagnosis and follow-up as well as designing new therapeutic strategies.
Recent findings: Following the initial identification of autoantibodies against alpha-melanocyte-stimulating hormone, a key neuropeptide involved in the regulation of satiety and mood, in the plasma of patients with anorexia and bulimia nervosa, it has been further found that the serum levels of these autoantibodies correlated with psychopathological traits in individuals with eating disorders. Furthermore, recent findings show that autoantibodies against alpha-melanocyte-stimulating hormone and against some other appetite-regulating peptide hormones are normally present in the blood of humans and rats and their production may be influenced by stress and the gut microflora.
Summary: Novel data provide evidence that autoantibodies against neuropeptides can be involved in the regulation of appetite and emotion and that alteration in autoantibody-mediated signaling pathways may be responsible for the development of eating disorders.