Department of Biophysics, Physiology & Pathophysiology, Faculty of Health Sciences, Medical University of Warsaw, 02-004 Warsaw, Poland.
Int J Mol Sci. 2023 Jun 6;24(12):9818. doi: 10.3390/ijms24129818.
The comprehensive anabolic effects of insulin throughout the body, in addition to the control of glycemia, include ensuring lipid homeostasis and anti-inflammatory modulation, especially in adipose tissue (AT). The prevalence of obesity, defined as a body mass index (BMI) ≥ 30 kg/m, has been increasing worldwide on a pandemic scale with accompanying syndemic health problems, including glucose intolerance, insulin resistance (IR), and diabetes. Impaired tissue sensitivity to insulin or IR paradoxically leads to diseases with an inflammatory component despite hyperinsulinemia. Therefore, an excess of visceral AT in obesity initiates chronic low-grade inflammatory conditions that interfere with insulin signaling via insulin receptors (INSRs). Moreover, in response to IR, hyperglycemia itself stimulates a primarily defensive inflammatory response associated with the subsequent release of numerous inflammatory cytokines and a real threat of organ function deterioration. In this review, all components of this vicious cycle are characterized with particular emphasis on the interplay between insulin signaling and both the innate and adaptive immune responses related to obesity. Increased visceral AT accumulation in obesity should be considered the main environmental factor responsible for the disruption in the epigenetic regulatory mechanisms in the immune system, resulting in autoimmunity and inflammation.
胰岛素在全身的综合合成代谢作用,除了控制血糖外,还包括确保脂质代谢平衡和抗炎调节,特别是在脂肪组织(AT)中。肥胖的流行,定义为体重指数(BMI)≥30 kg/m,在全球范围内呈流行规模地增加,并伴有伴生的健康问题,包括葡萄糖耐量受损、胰岛素抵抗(IR)和糖尿病。组织对胰岛素的敏感性受损或 IR 会导致尽管存在高胰岛素血症,但仍具有炎症成分的疾病。因此,肥胖中内脏 AT 的过多会引发慢性低度炎症状态,通过胰岛素受体(INSR)干扰胰岛素信号。此外,为了应对 IR,高血糖本身会刺激与随后释放的大量炎症细胞因子相关的主要防御性炎症反应,并且真正存在器官功能恶化的威胁。在这篇综述中,我们对这个恶性循环的所有组成部分进行了描述,特别强调了胰岛素信号与与肥胖相关的固有和适应性免疫反应之间的相互作用。肥胖中内脏 AT 的积累增加应被视为破坏免疫系统中表观遗传调节机制的主要环境因素,导致自身免疫和炎症。