Goldfine Allison B, Shoelson Steven E
J Clin Invest. 2017 Jan 3;127(1):83-93. doi: 10.1172/JCI88884.
Obesity-related sub-acute chronic inflammation has been associated with incident type 2 diabetes and atherosclerotic cardiovascular disease. Inflammation is increasingly considered to be a pathologic mediator of these commonly co-occurring diseases. A growing number of preclinical and clinical studies support the inflammatory hypothesis, but clinical trials to confirm the therapeutic potential to target inflammation to treat or prevent cardiometabolic conditions are still ongoing. There are multiple inflammatory signaling pathways. Regulation is complex, with substantial crosstalk across these multiple pathways. The activity of select pathways may be differentially regulated in different tissues. Pharmacologic approaches to diabetes management may have direct or indirect antiinflammatory effects, the latter potentially attributable to an improved metabolic state. Conversely, some antiinflammatory approaches may affect glucose metabolism and cardiovascular health. To date, clinical trials suggest that targeting one portion of the inflammatory cascade may differentially affect dysglycemia and atherothrombosis. Understanding the underlying biological processes may contribute to the development of safe and effective therapies, although a single approach may not be sufficient for optimal management of both metabolic and athrothrombotic disease states.
肥胖相关的亚急性慢性炎症已与2型糖尿病和动脉粥样硬化性心血管疾病的发生相关。炎症越来越被认为是这些常见共病的病理介质。越来越多的临床前和临床研究支持炎症假说，但证实针对炎症进行治疗或预防心脏代谢疾病的治疗潜力的临床试验仍在进行中。存在多种炎症信号通路。调节很复杂，这些多种通路之间存在大量相互作用。特定通路的活性在不同组织中可能受到不同调节。糖尿病管理的药理学方法可能具有直接或间接的抗炎作用，后者可能归因于代谢状态的改善。相反，一些抗炎方法可能会影响葡萄糖代谢和心血管健康。迄今为止，临床试验表明，针对炎症级联反应的一部分可能会对血糖异常和动脉粥样血栓形成产生不同影响。了解潜在的生物学过程可能有助于开发安全有效的疗法，尽管单一方法可能不足以对代谢和动脉粥样血栓形成疾病状态进行最佳管理。
