Guzmán-Flores Juan Manuel, López-Briones Sergio
Departamento de Ciencias Médicas, Universidad de Guanajuato, México.
Gac Med Mex. 2012 Jul-Aug;148(4):381-9.
Both type 2 diabetes mellitus (T2DM) and obesity are a major public health problem in Mexico and around the world for increased incidence. In T2DM, insulin secretion, insulin action or both are altered. Also, in T2DM as well as in obesity a low grade chronic inflammation has been associated. In both conditions there is an important increase of visceral adipose tissue, which induces to an up-regulation of synthesis in proinflammatory molecules. This process involves different subsets of the immune system. The macrophages and monocytes are the best studied, but recently has been reported the involvement of other type of cells; such as neutrophils, mast cells, eosinophils, dendritic cells, NKs, NKT. Also, some T cells subsets, such as Th1, Th2, T regulatory, Th17 and B cells seems to be involved in the low grade chronic inflammation. This review focuses on recent evidences of the role of innate and adaptative immune system cells in the pathology of T2DM and obesity. We concluded with the general proposal of a theoretical model, how the immune cells may participate in inflammation of fat tissue, insulin resistance and T2DM.
2型糖尿病（T2DM）和肥胖症在墨西哥及全球范围内都是主要的公共卫生问题，其发病率呈上升趋势。在T2DM中，胰岛素分泌、胰岛素作用或两者均发生改变。此外，在T2DM以及肥胖症中，均存在低度慢性炎症。在这两种情况下，内脏脂肪组织均显著增加，这会导致促炎分子合成上调。这一过程涉及免疫系统的不同亚群。巨噬细胞和单核细胞是研究最多的，但最近有报道称其他类型的细胞也参与其中，如中性粒细胞、肥大细胞、嗜酸性粒细胞、树突状细胞、自然杀伤细胞（NK）、自然杀伤T细胞（NKT）。此外，一些T细胞亚群，如辅助性T细胞1型（Th1）、辅助性T细胞2型（Th2）、调节性T细胞、辅助性T细胞17型（Th17）和B细胞似乎也参与了低度慢性炎症。本综述重点关注先天性和适应性免疫系统细胞在T2DM和肥胖症病理过程中作用的最新证据。我们最后提出了一个理论模型的总体设想，即免疫细胞如何参与脂肪组织炎症、胰岛素抵抗和T2DM。
