Conversely, in chronic inflammatory or autoimmune diseases such as IBD and arthritis, where there is a tendency towards a negative energy balance, APN may contribute a paradoxical pro-inflammatory effect through the induction of pro-inflammatory cytokine and chemokine production such as IL-6, IL-1β, TNF-α, IL-8, granulocyte-macrophage colony stimulating factor, and monocyte chemotactic protein-1[6-8]. The gene discussed is IL6; the disease is inflammatory bowel disease.