The impact of obesity on the immune response to infection
The impact of obesity on the immune response to infection
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DOI：
10.1017/s0029665112000158
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发表时间：
2012-05-01
影响因子：
7
通讯作者：
Beck, Melinda A.
中科院分区：
文献类型：
--
作者：
Milner, J. Justin;Beck, Melinda A.
有强有力的证据表明，过度肥胖会对肥胖个体的免疫功能和宿主防御产生负面影响。本文综述了有关肥胖对感染免疫反应影响的研究结果，包括对可能机制的讨论。肥胖的特点是低度慢性炎症状态，以及循环营养和代谢激素水平紊乱。这些代谢异常对肥胖相关合并症的影响在过去十年中受到了严格的审查。然而，对于免疫系统和宿主防御如何受到肥胖者的促炎和过剩能量环境的影响，人们知之甚少。流行病学数据表明，肥胖的人类受试者发生医院感染的风险更大，尤其是在手术后。此外，最近的研究报告强调了肥胖人类受试者免疫力改变的重要性，这些研究报告肥胖是感染 2009 年大流行甲型流感 (H1N1) 病毒后发病率和死亡率增加的独立危险因素。啮齿动物模型为了解与体重超重相关的代谢异常如何损害免疫力提供了重要的见解。然而，需要更多的研究来了解免疫力受损的具体方面以及哪些因素导致肥胖者免疫功能降低。此外，考虑到该人群可能对抗菌药物和疫苗接种没有最佳反应，因此需要特别考虑如何管理该高危人群的感染。肥胖影响着全球数百万人，更好地了解其相关的生理紊乱是一个关键的公共卫生问题。
There is strong evidence indicating that excess adiposity negatively impacts immune function and host defence in obese individuals. This is a review of research findings concerning the impact of obesity on the immune response to infection, including a discussion of possible mechanisms. Obesity is characterised by a state of low-grade, chronic inflammation in addition to disturbed levels of circulating nutrients and metabolic hormones. The impact of these metabolic abnormalities on obesity-related comorbidities has undergone intense scrutiny over the past decade. However, relatively little is known of how the immune system and host defence are influenced by the pro-inflammatory and excess energy milieu of the obese. Epidemiological data suggest obese human subjects are at greater risk for nosocomial infections, especially following surgery. Additionally, the significance of altered immunity in obese human subjects is emphasised by recent studies reporting obesity to be an independent risk factor for increased morbidity and mortality following infection with the 2009 pandemic influenza A (H1N1) virus. Rodent models offer important insight into how metabolic abnormalities associated with excess body weight can impair immunity. However, more research is necessary to understand the specific aspects of immunity that are impaired and what factors are contributing to reduced immunocompetence in the obese. Additionally, special consideration of how infection in this at-risk population is managed is required, given that this population may not respond optimally to antimicrobial drugs and vaccination. Obesity impacts millions globally, and greater understanding of its associated physiological disturbances is a key public health concern.