The Interconnection Between Immuno-Metabolism, Diabetes, and CKD
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Purpose of Review
Metabolic reprogramming is increasingly recognized as an essential trait of functional activation of immune cells. Here, we describe the link between immuno-metabolism, diabetes, and diabetic nephropathy.
Crosstalk between cellular metabolic functions and immune activation occurs when plasma levels of glucose, triglycerides, and free fatty acids increase, thus promoting systemic low-grade inflammation that further boosts the development of metabolic complications. In the long run, this settles an “apparent paradox,” where, despite excessive inflammation, the immune system is suppressed, further promoting progression to end-stage renal disease (ESRD) and predisposing to premature deaths from infections and cardiovascular diseases. Reviewing the effects of diabetes treatments on immuno-inflammatory responses suggests that the benefit of these drugs might extend beyond the simple control of glucose homeostasis.
Hyperglycemia and dyslipidemia correlate with enhancement of the immuno-inflammatory response that can promote and worsen metabolic diseases and support the progression toward ESRD. The identification of cellular checkpoints that modulate the immuno-metabolic machinery of immune cells opens new venues for metabolic drugs.
KeywordsImmune response Metabolism Diabetes Kidney disease
Compliance with Ethical Standards
Conflict of Interest
Fabrizia Bonacina and Andrea Baragetti declare that they have no conflict of interest.
Alberico Luigi Catapano reports grants from Sanofi, Amgen. He reports speaker fees from AstraZeneca, Genzyme, Bayer, SigmaTau, Menarini, Kowa, Eli Lilly, Recordati, Pfizer, Sanofi, Mediolanum, Pfizer, Merck, Sanofi, Aegerion, and Amgen.
Giuseppe Danilo Norata reports grants from Pfizer and Amgen, and speaker fees from Sanofi, Aegerion, Amgen, Alnylam, and Novartis.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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