Low-grade systemic inflammation and the development of metabolic diseases: from the molecular evidence to the clinical practice

作者：Israel Leon Pedroza Jose; Alonso Gonzalez Tapia Luis; del Olmo Gil Esteban; Castellanos Rodriguez Diana; Escobedo Galileo; Gonzalez Chavez Antonio^*

来源：Cirugia y Cirujanos, 2015, 83(6): 543-551.

DOI：10.1016/j.circir.2015.05.041

• Low-grade systemic inflammation
• Adipose tissue
• Metabolic diseases
• Insulin resistance
• Type 2 diabetes
• Arteriosclerosis
• Macrophages

Background: Systemic inflammation is characterised by high circulating levels of inflammatory cytokines and increased macrophage infiltration in peripheral tissues. Most importantly, this inflammatory state does not involve damage or toss of function of the infiltrated tissue, which is a distinctive feature of the tow-grade systemic inflammation. The term "meta-inflammation" has also been used to refer to the tow-grade systemic inflammation due to its strong relationship with the development of cardio-metabolic diseases in obesity.
Objective: A review is presented on the recent clinical and experimental evidence concerning the role of adipose tissue inflammation as a key mediator of low-grade systemic inflammation. Furthermore, the main molecular mechanisms involved in the inflammatory polarization of macrophages with the ability to infiltrate both the adipose tissue and the vascular endothelium via activation of toll-like receptors by metabolic damage-associated molecular patterns, such as advanced glycation-end products and oxidized lipoproteins, is discussed. Finally, a review is made of the pathogenic mechanisms through which the low-grade systemic inflammation contributes to develop insulin resistance, dyslipidaemia, atherogenesis, type 2 diabetes, and hypertension in obese individuals.
Conclusions: A better understanding of the molecular mechanisms of tow-grade systemic inflammation in promoting cardio-metabolic diseases is necessary, in order to further design novel anti-inflammatory therapies that take into consideration clinical data, as well as the circulating levels of cytokines, immune cells, and metabolic damage-associated molecular patterns in each patient.

• 出版日期2015-12