INSERM CIC-1431, Centre d'Investigation Clinique Biothérapie, Pôle Recherche, CHU de Besançon, Besançon, France.
Fédération Hospitalo-Universitaire INCREASE, CHU de Besançon, Besançon, France.
Front Endocrinol (Lausanne). 2020 Dec 23;11:606560. doi: 10.3389/fendo.2020.606560. eCollection 2020.
Inflammatory rheumatic diseases (IRD) are complex disorders characterized by chronic inflammation of the joints and related skeletal structures. The most common forms of IRD are rheumatoid arthritis (RA) and spondyloarthritis (SpA), including axial SpA (axSpA) and psoriatic arthritis (PsA). Obesity is a frequent comorbidity in RA and PsA, and to a lesser extend in axial SpA. The association between obesity and IRD may be explained by the release from fat tissue of several bioactive proteins, namely adipokines. Adipokines are involved in the regulation of various processes such as lipid or glucose metabolism, but also inflammation. Adipokines are interrelated with the immune system, with both innate and adaptive immune cell connections. Several adipokines with pro-inflammatory effects have been identified such as leptin, visfatin or resistin. Conversely, adiponectin and more specifically its low molecular weight isoform, is considered to have antiinflammatory properties. In this review, we discuss the contribution of adipokines to the joint inflammation of IRD, the relation they have with immune pathways of these diseases, their links with the structural impact on peripheral joints and/or axial skeleton, and also the influence they may have on the cardiometabolic risk of IRD.
炎症性风湿病（IRD）是一种以关节和相关骨骼结构慢性炎症为特征的复杂疾病。最常见的 IRD 形式是类风湿关节炎（RA）和脊柱关节炎（SpA），包括中轴型 SpA（axSpA）和银屑病关节炎（PsA）。肥胖症是 RA 和 PsA 的常见合并症，在 axSpA 中则较为少见。肥胖症与 IRD 之间的关联可以用脂肪组织释放的几种生物活性蛋白（即脂肪因子）来解释。脂肪因子参与调节各种过程，如脂质或葡萄糖代谢，但也参与炎症。脂肪因子与免疫系统相互关联，与先天和适应性免疫细胞都有关联。已经确定了几种具有促炎作用的脂肪因子，如瘦素、内脂素或抵抗素。相反，脂联素，特别是其低分子量同工型，被认为具有抗炎特性。在这篇综述中，我们讨论了脂肪因子对 IRD 关节炎症的贡献，它们与这些疾病的免疫途径的关系，它们与外周关节和/或中轴骨骼的结构影响的联系，以及它们对 IRD 的心血管代谢风险可能产生的影响。
