The double role of epicardial adipose tissue as pro- and anti-inflammatory organ
The double role of epicardial adipose tissue as pro- and anti-inflammatory organ
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DOI：
10.1055/s-2008-1062724
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发表时间：
2008-07-01
影响因子：
2.2
通讯作者：
Barbaro, G.
中科院分区：
文献类型：
--
作者：
Lacobellis, G.;Barbaro, G.
肥胖与低度炎症有关。这是否仅仅是对过度肥胖的适应性反应，以维持正常的氧气供应，还是先天性免疫系统的慢性激活，目前尚不清楚。最近的研究集中在肥胖症中炎性标志物的来源以及脂肪组织对其直接影响的程度。内脏脂肪组织产生的脂肪因子尤其令人感兴趣，因为内脏脂肪库的局部分泌可能在肥胖和相关的血管并发症之间提供了一种新的机制联系。越来越多的证据表明，心外膜脂肪组织，即位于心脏周围的内脏脂肪储存库，可能与心肌和冠状动脉局部相互作用。心外膜脂肪是脂联素和肾上腺髓质素、具有抗炎特性的脂肪因子、几种促炎细胞因子以及肿瘤坏死因子-α(TNF-α)、白介素1(IL-1)、白介素1(IL-1)、白介素16(IL-16)、单核细胞化学吸引蛋白-1(MCP-1)、神经生长因子(NGF)、抵抗素、纤溶酶原激活物抑制物-1(PAI-1)和游离脂肪酸的来源。心外膜脂肪组织可以通过旁分泌促炎和抗炎细胞因子来局部调节心脏和血管系统，从而在肥胖相关炎症和动脉粥样硬化中发挥可能的作用。另一方面，心外膜脂肪可通过分泌脂联素和肾上腺髓质素对局部或全身代谢或机械性损伤起到保护作用。未来的研究将继续为心外膜脂肪组织在心血管病理发展和/或保护心脏和动脉方面的双重作用提供新的和令人着迷的见解。
Obesity is associated with low grade inflammation. Whether this is just an adaptive response to excess adiposity to maintain a normal oxygen supply or a chronic activation of the innate immune system is still unknown. Recent research has focused on the origin of the inflammatory markers in obesity and the extent to which adipose tissue has a direct effect. The production of adipokines by visceral adipose tissue is of particular interest since their local secretion by visceral fat depots may provide a novel mechanistic link between obesity and the associated vascular complications. Growing evidences suggest that the epicardial adipose tissue, the visceral fat depot located around the heart, may locally interact with myocardium and coronary arteries. Epicardial fat is a source of adiponectin and adrenomedullin, adipokines with anti-inflammatory properties, and several proinflammatory cytokines as well as Tumor Necrosis Factor-alpha (TNF-alpha), Interleukin 1 (IL1), IL-1 h, Interleukin (16), Monocyte Chemoattractive Protein-1 (MCP-1), Nerve Growth Factor (NGF), resistin, Plasminogen Activator Inhibitor-1 (PAI-1), and free fatty acids. Epicardial adipose tissue could locally modulate the heart and vasculature, through paracrine secretion of pro- and anti-inflammatory cytokines, thereby playing a possible role in the adiposity-related inflammation and atherosclerosis. On the other hand, epicardial fat could exert a protective effect through adiponectin and adrenomedullin secretion as response to local or systemic metabolic or mechanical insults. Future studies will continue to provide new and fascinating insights into the double role of epicardial adipose tissue in the development of cardiovascular pathology and/or in protecting the heart and arteries.