Adipopharmacology of inflammation and insulin resistance

Resumo

Among the rapidly expanding list of factors synthesized and released by white adipose tissue, the range of cytokines, chemokines and other signaling proteins, collectively termed adipokines, are of particular interest to better understand the pathogenesis of low-grade systemic inflammationassociatedwithobesity.Anoverwhelmingbodyofevidencefurtherlinkshighcirculatingconcentrations of inflammatorybiomarkerswiththedevelopmentofinsulinresistanceandtheprogressiontotype2diabetesmellitus.The secretory pattern of adipose tissue characteristic of obesity comprises an increase in pro-inflammatoryadipokinestogetherwith a decrease in adipokines with anti-inflammatory, cardioprotective and insulin sensitizing actions. These molecules exerts local autocrine and paracrine effects on white adipose tissue physiology at the same time as having systemic effects on other organs. A number of factors derived not only from adipocytes but also from infiltratedmacrophagesand mast cells, which have been shown to accompany morbid adiposity, further contribute to inflammationandinsulinresistance.The evolving notion of adipose tissue as an immuno-modulatory organ together with the improving knowledge of how inflammation exertsa(counter)regulatoryaction on glucose and lipid metabolism are opening up new therapeutic opportunities for applying anti-inflammatorystrategiesto counterbalance the detrimental consequences of excess adiposity and its comorbidities.