Obesity, inflammation and the immune system
Obesity, inflammation and the immune system
复制标题
DOI：
10.1017/s0029665112000092
复制
发表时间：
2012-05-01
影响因子：
7
通讯作者：
Marcos, Ascension
中科院分区：
文献类型：
--
作者：
Perez de Heredia, Fatima;Gomez-Martinez, Sonia;Marcos, Ascension
肥胖与大多数慢性疾病一样，都存在炎症成分，这是代谢性疾病和其他相关健康变化的起因。这种炎症状态反映在促炎蛋白循环水平的增加上，它不仅发生在成人身上，也发生在青少年和儿童身上。慢性炎症反应起源于脂肪组织和免疫系统之间存在的联系。众所周知，肥胖和其他营养不良状态一样，会损害免疫功能，改变白细胞计数和细胞介导的免疫反应。此外，有证据表明，免疫功能的改变有助于肥胖的发病机制。这篇综述试图简要地评论对这一现象提出的各种似是而非的解释：(1)肥胖相关的瘦素（促炎）的产生增加和脂联素（抗炎）的减少似乎影响免疫细胞的激活；(2) NEFA可通过多种机制（如调节脂肪因子的产生或激活toll样受体）诱导炎症；(3)营养过剩和脂肪细胞扩张触发内质网应激；(4)肥胖脂肪组织缺氧刺激炎症基因表达，激活免疫细胞。有趣的是，数据显示内脏脂肪组织和中心性肥胖对炎症过程的影响更大，而不是全身脂肪。综上所述，脂肪组织局部炎症与肥胖患者免疫反应改变之间存在正反馈循环，两者都有助于相关代谢并发症的发生。
Obesity shares with most chronic diseases the presence of an inflammatory component, which accounts for the development of metabolic disease and other associated health alterations. This inflammatory state is reflected in increased circulating levels of pro-inflammatory proteins, and it occurs not only in adults but also in adolescents and children. The chronic inflammatory response has its origin in the links existing between the adipose tissue and the immune system. Obesity, like other states of malnutrition, is known to impair the immune function, altering leucocyte counts as well as cell-mediated immune responses. In addition, evidence has arisen that an altered immune function contributes to the pathogenesis of obesity. This review attempts to briefly comment on the various plausible explanations that have been proposed for the phenomenon: (1) the obesity-associated increase in the production of leptin (pro-inflammatory) and the reduction in adiponectin (anti-inflammatory) seem to affect the activation of immune cells; (2) NEFA can induce inflammation through various mechanisms (such as modulation of adipokine production or activation of Toll-like receptors); (3) nutrient excess and adipocyte expansion trigger endoplasmic reticulum stress; and (4) hypoxia occurring in hypertrophied adipose tissue stimulates the expression of inflammatory genes and activates immune cells. Interestingly, data suggest a greater impact of visceral adipose tissue and central obesity, rather than total body fat, on the inflammatory process. In summary, there is a positive feedback loop between local inflammation in adipose tissue and altered immune response in obesity, both contributing to the development of related metabolic complications.