Dynamic Interplay Between Metabolic Syndrome and Immunity

  • György Paragh
  • Ildikó Seres
  • Mariann Harangi
  • Péter Fülöp
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 824)


Obesity and its co-morbidities as metabolic syndrome, type 2 diabetes mellitus and cardiovascular diseases are major health problems worldwide. Several reports indicated that nutrient excess and metabolic syndrome are linked with altered immune response. Indeed, metabolic syndrome is characterized by insulin resistance and chronic low-grade inflammation, which conditions are the consequences of the complex interaction between adipocytes and immune cells. Enlarged white adipose tissue is infiltrated by immune cells and secretes various bioactive substances, like adipokines, cytokines and other inflammatory mediators. Due to its special architecture in which metabolic and immune cells are in intimate proximity, metabolic and immunologic pathways are closely integrated in adipose tissue. With the contribution of altered gut microbiota, adipokines and cytokines modulate insulin signaling and immune response leading to adipose tissue inflammation and systemic insulin resistance. In this chapter, we focus on the cellular and molecular mechanisms that lead to impaired insulin sensitivity and chronic low-grade inflammation in obesity. We also detail the potential role of adipokines and immune cells in this deleterious process, and the concerns of vaccination in metabolic syndrome. Finally, we address the links between obesity and gut microbiota as an emerging new field of interest, and scratch the surface of potential therapeutic opportunities.


Adipokines Gut microbiota Immunity Metabolic syndrome Obesity Obesity therapy Vaccination 



This work was supported by the TÁMOP-4.2.2.A-11/1/KONV-2012-0031 project. The TÁMOP project is co-financed by the European Union and the European Social Fund.


  1. 1.
    Mozumdar A, Liguori G. Persistent increase of prevalence of metabolic syndrome among U.S. adults: NHANES III to NHANES 1999–2006. Diabetes Care. 2011;34:216–9.PubMedCentralPubMedGoogle Scholar
  2. 2.
    Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988;37:1595–607.PubMedGoogle Scholar
  3. 3.
    Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120:1640–5.PubMedGoogle Scholar
  4. 4.
    Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA. 2012;307:491–7.PubMedGoogle Scholar
  5. 5.
    Hak AE, Stehouwer CD, Bots ML, Polderman KH, Schalkwijk CG, Westendorp IC, et al. Associations of C-reactive protein with measures of obesity, insulin resistance, and subclinical atherosclerosis in healthy, middle-aged women. Arterioscler Thromb Vasc Biol. 1999;19:1986–91.PubMedGoogle Scholar
  6. 6.
    Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB. Elevated C-reactive protein levels in overweight and obese adults. JAMA. 1999;282:2131–5.PubMedGoogle Scholar
  7. 7.
    Hotamisligil GS. Inflammation and metabolic disorders. Nature. 2006;444:860–7.PubMedGoogle Scholar
  8. 8.
    Ebstein W. Zur therapie des Diabetes mellitus, insbesondere über die Anwendung des salicylsauren Natron bei demselben. Berliner Klinische Wochenschrift. 1876;13:337–40.Google Scholar
  9. 9.
    Reid J, Macdougall AI, Andrews MM. On the efficacy of salicylate in treating diabetes mellitus. Br Med J. 1957;2:1071–4.PubMedCentralPubMedGoogle Scholar
  10. 10.
    Spranger J, Kroke A, Möhlig M, Hoffmann K, Bergmann MM, Ristow M, et al. Inflammatory cytokines and the risk to develop type 2 diabetes: results of the prospective population-based European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study. Diabetes. 2003;52:812–7.PubMedGoogle Scholar
  11. 11.
    Freeman DJ, Norrie J, Caslake MJ, Gaw A, Ford I, Lowe GD, et al. C-reactive protein is an independent predictor of risk for the development of diabetes in the West of Scotland Coronary Prevention Study. Diabetes. 2002;51:1596–600.PubMedGoogle Scholar
  12. 12.
    Wilson PW. Evidence of systemic inflammation and estimation of coronary artery disease risk: a population perspective. Am J Med. 2008;121 Suppl 10:S15–20.PubMedGoogle Scholar
  13. 13.
    Haffner S, Temprosa M, Crandall J, Fowler S, Goldberg R, Horton E, et al. Intensive lifestyle intervention or metformin on inflammation and coagulation in participants with impaired glucose tolerance. Diabetes. 2005;54:1566–72.PubMedGoogle Scholar
  14. 14.
    Hajer GR, van Haeften TW, Visseren FL. Adipose tissue dysfunction in obesity, diabetes, and vascular diseases. Eur Heart J. 2008;29:2959–71.PubMedGoogle Scholar
  15. 15.
    Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet. 2005;365:1415–28.PubMedGoogle Scholar
  16. 16.
    Blüher M. Clinical relevance of adipokines. Diabetes Metab J. 2012;36:317–27.PubMedCentralPubMedGoogle Scholar
  17. 17.
    Lőrincz H, Katkó M, Harangi M, Somodi S, Gaál K, Fülöp P, et al. Strong correlations between circulating chemerin levels and lipoprotein subfractions in nondiabetic obese and nonobese subjects. Clin Endocrinol (Oxf). 2013. doi: 10.1111/cen.12363.Google Scholar
  18. 18.
    Tönjes A, Fasshauer M, Kratzsch J, Stumvoll M, Blüher M. Adipokine pattern in subjects with impaired fasting glucose and impaired glucose tolerance in comparison to normal glucose tolerance and diabetes. PLoS One. 2010. doi: 10.1371/journal.pone.0013911.PubMedCentralPubMedGoogle Scholar
  19. 19.
    Sun XJ, Rothenberg P, Kahn CR, Backer JM, Araki E, Wilden PA, et al. Structure of the insulin receptor substrate IRS-1 defines a unique signal transduction protein. Nature. 1991;352:73–7.PubMedGoogle Scholar
  20. 20.
    Taniguchi CM, Emanuelli B, Kahn CR. Critical nodes in signalling pathways: insights into insulin action. Nat Rev Mol Cell Biol. 2006;7:85–96.PubMedGoogle Scholar
  21. 21.
    Cross DA, Alessi DR, Cohen P, Andjelkovich M, Hemmings BA. Inhibition of glycogen synthase kinase-3 by insulin mediated by protein kinase B. Nature. 1995;378:785–9.PubMedGoogle Scholar
  22. 22.
    Nakae J, Kitamura T, Silver DL, Accili D. The forkhead transcription factor Foxo1 (Fkhr) confers insulin sensitivity onto glucose-6-phosphatase expression. J Clin Invest. 2001;108:1359–67.PubMedCentralPubMedGoogle Scholar
  23. 23.
    Harrington LS, Findlay GM, Gray A, Tolkacheva T, Wigfield S, Rebholz H, et al. The TSC1-2 tumor suppressor controls insulin-PI3K signaling via regulation of IRS proteins. J Cell Biol. 2004;166:213–23.PubMedCentralPubMedGoogle Scholar
  24. 24.
    Boura-Halfon S, Zick Y. Phosphorylation of IRS proteins, insulin action, and insulin resistance. Am J Physiol Endocrinol Metab. 2009;296:E581–91.PubMedGoogle Scholar
  25. 25.
    Gual P, Le Marchand-Brustel Y, Tanti JF. Positive and negative regulation of insulin signaling through IRS-1 phosphorylation. Biochimie. 2005;87:99–109.PubMedGoogle Scholar
  26. 26.
    Hotamisligil GS, Shargill NS, Spiegelman BM. Adipose expression of tumor necrosis factor-alpha: direct role in obesity-linked insulin resistance. Science. 1993;259:87–91.PubMedGoogle Scholar
  27. 27.
    Schenk S, Saberi M, Olefsky JM. Insulin sensitivity: modulation by nutrients and inflammation. J Clin Invest. 2008;118:2992–3002. doi: 10.1172/JCI34260.PubMedCentralPubMedGoogle Scholar
  28. 28.
    Kwon H, Pessin JE. Adipokines mediate inflammation and insulin resistance. Front Endocrinol (Lausanne). 2013;4:71. doi: 10.3389/fendo.2013.00071.Google Scholar
  29. 29.
    Shoelson SE, Lee J, Goldfine AB. Inflammation and insulin resistance. J Clin Invest. 2006;116:1793–801.PubMedCentralPubMedGoogle Scholar
  30. 30.
    Samuel VT, Shulman GI. Mechanisms for insulin resistance: common threads and missing links. Cell. 2012;148:852–71.PubMedCentralPubMedGoogle Scholar
  31. 31.
    Arkan MC, Hevener AL, Greten FR, Maeda S, Li ZW, Long JM, et al. IKK-beta links inflammation to obesity-induced insulin resistance. Nat Med. 2005;11:191–8.PubMedGoogle Scholar
  32. 32.
    Solinas G, Vilcu C, Neels JG, Bandyopadhyay GK, Luo JL, Naugler W, et al. JNK1 in hematopoietically derived cells contributes to diet-induced inflammation and insulin resistance without affecting obesity. Cell Metab. 2007;6:386–97.PubMedGoogle Scholar
  33. 33.
    Akira S, Uematsu S, Takeuchi O. Pathogen recognition and innate immunity. Cell. 2006;124:783–801.PubMedGoogle Scholar
  34. 34.
    Adams DH, Shaw S. Leucocyte-endothelial interactions and regulation of leucocyte migration. Lancet. 1994;343:831–6.PubMedGoogle Scholar
  35. 35.
    Seino Y, Ikeda U, Ikeda M, Yamamoto K, Misawa Y, Hasegawa T, et al. Interleukin 6 gene transcripts are expressed in human atherosclerotic lesions. Cytokine. 1994;6:87–91.PubMedGoogle Scholar
  36. 36.
    Schönbeck U, Libby P. CD40 signaling and plaque instability. Circ Res. 2001;89:1092–103.PubMedGoogle Scholar
  37. 37.
    Emanuelli B, Peraldi P, Filloux C, Chavey C, Freidinger K, Hilton DJ, et al. SOCS-3 inhibits insulin signaling and is up-regulated in response to tumor necrosis factor-alpha in the adipose tissue of obese mice. J Biol Chem. 2001;276:47944–9.PubMedGoogle Scholar
  38. 38.
    Rui L, Yuan M, Frantz D, Shoelson S, White MF. SOCS-1 and SOCS-3 block insulin signaling by ubiquitin-mediated degradation of IRS1 and IRS2. J Biol Chem. 2002;277:42394–8.PubMedGoogle Scholar
  39. 39.
    Ueki K, Kondo T, Tseng YH, Kahn CR. Central role of suppressors of cytokine signaling proteins in hepatic steatosis, insulin resistance, and the metabolic syndrome in the mouse. Proc Natl Acad Sci U S A. 2004;101:10422–7.PubMedCentralPubMedGoogle Scholar
  40. 40.
    Sell H, Habich C, Eckel J. Adaptive immunity in obesity and insulin resistance. Nat Rev Endocrinol. 2012;8:709–16. doi: 10.1038/nrendo.2012.114.PubMedGoogle Scholar
  41. 41.
    Cousin B, Munoz O, Andre M, Fontanilles AM, Dani C, Cousin JL, et al. A role for preadipocytes as macrophage-like cells. FASEB J. 1999;13:305–12.PubMedGoogle Scholar
  42. 42.
    Zhang Y, Proenca R, Maffei M, Barone M, Leopold L, Friedman JM. Positional cloning of the mouse obese gene and its human homologue. Nature. 1994;372:425–32.PubMedGoogle Scholar
  43. 43.
    Friedman JM, Halaas JL. Leptin and the regulation of body weight in mammals. Nature. 1998;395:763–70.PubMedGoogle Scholar
  44. 44.
    Considine RV, Sinha MK, Heiman ML, Kriauciunas A, Stephens TW, Nyce MR, et al. Serum immunoreactive-leptin concentrations in normal-weight and obese humans. N Engl J Med. 1996;334:292–5.PubMedGoogle Scholar
  45. 45.
    Grunfeld C, Zhao C, Fuller J, Pollack A, Moser A, Friedman J, Feingold KR. Endotoxin and cytokines induce expression of leptin, the ob gene product, in hamsters. J Clin Invest. 1996;97:2152–7.PubMedCentralPubMedGoogle Scholar
  46. 46.
    Farooqi IS, Jebb SA, Langmack G, Lawrence E, Cheetham CH, Prentice AM, et al. Effects of recombinant leptin therapy in a child with congenital leptin deficiency. N Engl J Med. 1999;341:879–84.PubMedGoogle Scholar
  47. 47.
    Halaas JL, Gajiwala KS, Maffei M, Cohen SL, Chait BT, Rabinowitz D, et al. Weight-reducing effects of the plasma protein encoded by the obese gene. Science. 1995;269:543–6.PubMedGoogle Scholar
  48. 48.
    Bjørbaek C, El-Haschimi K, Frantz JD, Flier JS. The role of SOCS-3 in leptin signaling and leptin resistance. J Biol Chem. 1999;274:30059–65.PubMedGoogle Scholar
  49. 49.
    Ozcan L, Ergin AS, Lu A, Chung J, Sarkar S, Nie D, et al. Endoplasmic reticulum stress plays a central role in development of leptin resistance. Cell Metab. 2009;9:35–51.PubMedGoogle Scholar
  50. 50.
    Procaccini C, De Rosa V, Galgani M, Carbone F, La Rocca C, Formisano L, Matarese G. Role of adipokines signaling in the modulation of T cells function. Front Immunol. 2013;4:332. doi: 10.3389/fimmu.2013.00332.PubMedCentralPubMedGoogle Scholar
  51. 51.
    Kloek C, Haq AK, Dunn SL, Lavery HJ, Banks AS, Myers Jr MG. Regulation of Jak kinases by intracellular leptin receptor sequences. J Biol Chem. 2002;277:41547–55.PubMedGoogle Scholar
  52. 52.
    Sweeney G. Leptin signalling. Cell Signal. 2002;14:655–63.PubMedGoogle Scholar
  53. 53.
    Gainsford T, Willson TA, Metcalf D, Handman E, McFarlane C, Ng A, et al. Leptin can induce proliferation, differentiation, and functional activation of hemopoietic cells. Proc Natl Acad Sci U S A. 1996;93:14564–8.PubMedCentralPubMedGoogle Scholar
  54. 54.
    Aleffi S, Petrai I, Bertolani C, Parola M, Colombatto S, Novo E, et al. Upregulation of proinflammatory and proangiogenic cytokines by leptin in human hepatic stellate cells. Hepatology. 2005;42:1339–48.PubMedGoogle Scholar
  55. 55.
    Lord GM, Matarese G, Howard JK, Baker RJ, Bloom SR, Lechler RI. Leptin modulates the T-cell immune response and reverses starvation-induced immunosuppression. Nature. 1998;394:897–901.PubMedGoogle Scholar
  56. 56.
    Procaccini C, De Rosa V, Galgani M, Abanni L, Calì G, Porcellini A, et al. An oscillatory switch in mTOR kinase activity sets regulatory T cell responsiveness. Immunity. 2010;33:929–41. doi: 10.1016/j.immuni.2010.11.024.PubMedCentralPubMedGoogle Scholar
  57. 57.
    Hu E, Liang P, Spiegelman BM. AdipoQ is a novel adipose-specific gene dysregulated in obesity. J Biol Chem. 1996;271:10697–703.PubMedGoogle Scholar
  58. 58.
    Hotta K, Funahashi T, Arita Y, Takahashi M, Matsuda M, Okamoto Y, et al. Plasma concentrations of a novel, adipose-specific protein, adiponectin, in type 2 diabetic patients. Arterioscler Thromb Vasc Biol. 2000;20:1595–9.PubMedGoogle Scholar
  59. 59.
    Pischon T, Girman CJ, Hotamisligil GS, Rifai N, Hu FB, Rimm EB. Plasma adiponectin levels and risk of myocardial infarction in men. JAMA. 2004;291:1730–7.PubMedGoogle Scholar
  60. 60.
    Bajnok L, Csongradi E, Seres I, Varga Z, Jeges S, Peti A, et al. Relationship of adiponectin to serum paraoxonase 1. Atherosclerosis. 2008;197:363–7.PubMedGoogle Scholar
  61. 61.
    Díez JJ, Iglesias P. The role of the novel adipocyte-derived hormone adiponectin in human disease. Eur J Endocrinol. 2003;48:293–300.Google Scholar
  62. 62.
    Yokota T, Oritani K, Takahashi I, Ishikawa J, Matsuyama A, Ouchi N, et al. Adiponectin, a new member of the family of soluble defense collagens, negatively regulates the growth of myelomonocytic progenitors and the functions of macrophages. Blood. 2000;96:1723–32.PubMedGoogle Scholar
  63. 63.
    Maeda N, Shimomura I, Kishida K, Nishizawa H, Matsuda M, Nagaretani H, et al. Diet-induced insulin resistance in mice lacking adiponectin/ACRP30. Nat Med. 2002;8:731–7.PubMedGoogle Scholar
  64. 64.
    Bruun JM, Lihn AS, Verdich C, Pedersen SB, Toubro S, Astrup A, Richelsen B. Regulation of adiponectin by adipose tissue-derived cytokines: in vivo and in vitro investigations in humans. Am J Physiol Endocrinol Metab. 2003;285:E527–33.PubMedGoogle Scholar
  65. 65.
    Wolf AM, Wolf D, Rumpold H, Enrich B, Tilg H. Adiponectin induces the anti-inflammatory cytokines IL-10 and IL-1RA in human leukocytes. Biochem Biophys Res Commun. 2004;323:630–5.PubMedGoogle Scholar
  66. 66.
    Takemura Y, Ouchi N, Shibata R, Aprahamian T, Kirber MT, Summer RS, et al. Adiponectin modulates inflammatory reactions via calreticulin receptor-dependent clearance of early apoptotic bodies. J Clin Invest. 2007;117:375–86.PubMedCentralPubMedGoogle Scholar
  67. 67.
    Kim KY, Kim JK, Han SH, Lim JS, Kim KI, Cho DH, et al. Adiponectin is a negative regulator of NK cell cytotoxicity. J Immunol. 2006;176:5958–64.PubMedGoogle Scholar
  68. 68.
    Motoshima H, Wu X, Mahadev K, Goldstein BJ. Adiponectin suppresses proliferation and superoxide generation and enhances eNOS activity in endothelial cells treated with oxidized LDL. Biochem Biophys Res Commun. 2004;315:264–71.PubMedGoogle Scholar
  69. 69.
    Otero M, Lago R, Gomez R, Lago F, Dieguez C, Gómez-Reino JJ, Gualillo O. Changes in plasma levels of fat-derived hormones adiponectin, leptin, resistin and visfatin in patients with rheumatoid arthritis. Ann Rheum Dis. 2006;65:1198–201.PubMedCentralPubMedGoogle Scholar
  70. 70.
    Shoji T, Shinohara K, Hatsuda S, Kimoto E, Fukumoto S, Emoto M, et al. Altered relationship between body fat and plasma adiponectin in end-stage renal disease. Metabolism. 2005;54:330–4.PubMedGoogle Scholar
  71. 71.
    Sztanek F, Seres I, Harangi M, Lőcsey L, Koncsos P, Paragh G. Effect of nutritional status on human paraoxonase-1 activity in patients with chronic kidney disease. Kidney Blood Press Res. 2012;36:310–9.PubMedGoogle Scholar
  72. 72.
    Hattori Y, Hattori S, Kasai K. Globular adiponectin activates nuclear factor-kappaB in vascular endothelial cells, which in turn induces expression of proinflammatory and adhesion molecule genes. Diabetes Care. 2006;29:139–41.PubMedGoogle Scholar
  73. 73.
    Horn F, Henze C, Heidrich K. Interleukin-6 signal transduction and lymphocyte function. Immunobiology. 2000;202:151–67.PubMedGoogle Scholar
  74. 74.
    Weisberg SP, McCann D, Desai M, Rosenbaum M, Leibel RL, Ferrante Jr AW. Obesity is associated with macrophage accumulation in adipose tissue. J Clin Invest. 2003;112:1796–808.PubMedCentralPubMedGoogle Scholar
  75. 75.
    Mohamed-Ali V, Goodrick S, Rawesh A, Katz DR, Miles JM, Yudkin JS, et al. Subcutaneous adipose tissue releases interleukin-6, but not tumor necrosis factor-alpha, in vivo. J Clin Endocrinol Metab. 1997;82:4196–200.PubMedGoogle Scholar
  76. 76.
    Bastard JP, Jardel C, Bruckert E, Blondy P, Capeau J, Laville M, et al. Elevated levels of interleukin 6 are reduced in serum and subcutaneous adipose tissue of obese women after weight loss. J Clin Endocrinol Metab. 2000;85:3338–42.PubMedGoogle Scholar
  77. 77.
    Senn JJ, Klover PJ, Nowak IA, Zimmers TA, Koniaris LG, Furlanetto RW, Mooney RA. Suppressor of cytokine signaling-3 (SOCS-3), a potential mediator of interleukin-6-dependent insulin resistance in hepatocytes. J Biol Chem. 2003;278:13740–6.PubMedGoogle Scholar
  78. 78.
    Wallenius V, Wallenius K, Ahrén B, Rudling M, Carlsten H, Dickson SL, et al. Interleukin-6-deficient mice develop mature-onset obesity. Nat Med. 2002;8:75–9.PubMedGoogle Scholar
  79. 79.
    Matthews VB, Allen TL, Risis S, Chan MH, Henstridge DC, Watson N, et al. Interleukin-6-deficient mice develop hepatic inflammation and systemic insulin resistance. Diabetologia. 2010;53:2431–41.PubMedGoogle Scholar
  80. 80.
    Tsigos C, Kyrou I, Chala E, Tsapogas P, Stavridis JC, Raptis SA, Katsilambros N. Circulating tumor necrosis factor alpha concentrations are higher in abdominal versus peripheral obesity. Metabolism. 1999;48:1332–5.PubMedGoogle Scholar
  81. 81.
    Fülöp P, Derdák Z, Sheets A, Sabo E, Berthiaume EP, Resnick MB, et al. Lack of UCP2 reduces Fas-mediated liver injury in ob/ob mice and reveals importance of cell-specific UCP2 expression. Hepatology. 2006;44:592–601.PubMedGoogle Scholar
  82. 82.
    Bugianesi E, Moscatiello S, Ciaravella MF, Marchesini G. Insulin resistance in nonalcoholic fatty liver disease. Curr Pharm Des. 2010;16:1941–51.PubMedGoogle Scholar
  83. 83.
    Feldstein AE, Werneburg NW, Canbay A, Guicciardi ME, Bronk SF, Rydzewski R, et al. Free fatty acids promote hepatic lipotoxicity by stimulating TNF-alpha expression via a lysosomal pathway. Hepatology. 2004;40:185–94.PubMedGoogle Scholar
  84. 84.
    Grunfeld C, Feingold KR. The metabolic effects of tumor necrosis factor and other cytokines. Biotherapy. 1991;3:143–58.PubMedGoogle Scholar
  85. 85.
    Kern PA, Di Gregorio GB, Lu T, Rassouli N, Ranganathan G. Adiponectin expression from human adipose tissue: relation to obesity, insulin resistance, and tumor necrosis factor-alpha expression. Diabetes. 2003;52:1779–85.PubMedGoogle Scholar
  86. 86.
    Hotamisligil GS, Peraldi P, Budavari A, Ellis R, White MF, Spiegelman BM. IRS-1-mediated inhibition of insulin receptor tyrosine kinase activity in TNF-alpha- and obesity-induced insulin resistance. Science. 1996;271:665–8.PubMedGoogle Scholar
  87. 87.
    Wellen KE, Hotamisligil GS. Inflammation, stress, and diabetes. J Clin Invest. 2005;115:1111–9.PubMedCentralPubMedGoogle Scholar
  88. 88.
    Ofei F, Hurel S, Newkirk J, Sopwith M, Taylor R. Effects of an engineered human anti-TNF-alpha antibody (CDP571) on insulin sensitivity and glycemic control in patients with NIDDM. Diabetes. 1996;45:881–5.PubMedGoogle Scholar
  89. 89.
    Patel SD, Rajala MW, Rossetti L, Scherer PE, Shapiro L. Disulfide-dependent multimeric assembly of resistin family hormones. Science. 2004;304:1154–8.PubMedGoogle Scholar
  90. 90.
    Patel L, Buckels AC, Kinghorn IJ, Murdock PR, Holbrook JD, Plumpton C, et al. Resistin is expressed in human macrophages and directly regulated by PPAR gamma activators. Biochem Biophys Res Commun. 2003;300:472–6.PubMedGoogle Scholar
  91. 91.
    Steppan CM, Bailey ST, Bhat S, Brown EJ, Banerjee RR, Wright CM, et al. The hormone resistin links obesity to diabetes. Nature. 2001;409:307–12.PubMedGoogle Scholar
  92. 92.
    Choi SH, Hong ES, Lim S. Clinical implications of adipocytokines and newly emerging metabolic factors with relation to insulin resistance and cardiovascular health. Front Endocrinol (Lausanne). 2013;4:97. doi: 10.3389/fendo.2013.00097.Google Scholar
  93. 93.
    Kaser S, Kaser A, Sandhofer A, Ebenbichler CF, Tilg H, Patsch JR. Resistin messenger-RNA expression is increased by proinflammatory cytokines in vitro. Biochem Biophys Res Commun. 2003;309:286–90.PubMedGoogle Scholar
  94. 94.
    Bokarewa M, Nagaev I, Dahlberg L, Smith U, Tarkowski A. Resistin, an adipokine with potent proinflammatory properties. J Immunol. 2005;174:5789–95.PubMedGoogle Scholar
  95. 95.
    Benomar Y, Gertler A, De Lacy P, Crépin D, Ould Hamouda H, Riffault L, Taouis M. Central resistin overexposure induces insulin resistance through Toll-like receptor 4. Diabetes. 2013;62:102–14.PubMedCentralPubMedGoogle Scholar
  96. 96.
    Yang Q, Graham TE, Mody N, Preitner F, Peroni OD, Zabolotny JM, et al. Serum retinol binding protein 4 contributes to insulin resistance in obesity and type 2 diabetes. Nature. 2005;436:356–62.PubMedGoogle Scholar
  97. 97.
    Ost A, Danielsson A, Lidén M, Eriksson U, Nystrom FH, Strålfors P. Retinol-binding protein-4 attenuates insulin-induced phosphorylation of IRS1 and ERK1/2 in primary human adipocytes. FASEB J. 2007;21:3696–704.PubMedGoogle Scholar
  98. 98.
    Graham TE, Yang Q, Blüher M, Hammarstedt A, Ciaraldi TP, Henry RR, et al. Retinol-binding protein 4 and insulin resistance in lean, obese, and diabetic subjects. N Engl J Med. 2006;354:2552–63.PubMedGoogle Scholar
  99. 99.
    Promintzer M, Krebs M, Todoric J, Luger A, Bischof MG, Nowotny P, et al. Insulin resistance is unrelated to circulating retinol binding protein and protein C inhibitor. J Clin Endocrinol Metab. 2007;92:4306–12.PubMedGoogle Scholar
  100. 100.
    Chen MP, Chung FM, Chang DM, Tsai JC, Huang HF, Shin SJ, Lee YJ. Elevated plasma level of visfatin/pre-B cell colony-enhancing factor in patients with type 2 diabetes mellitus. J Clin Endocrinol Metab. 2006;91:295–9.PubMedGoogle Scholar
  101. 101.
    Sommer G, Kralisch S, Kloting N, Kamprad M, Schrock K, Kratzsch J, et al. Visfatin is a positive regulator of MCP-1 in human adipocytes in vitro and in mice in vivo. Obesity (Silver Spring). 2010;18:1486–92. doi: 10.1038/oby.2009.462.Google Scholar
  102. 102.
    Moschen AR, Kaser A, Enrich B, Mosheimer B, Theurl M, Niederegger H, Tilg H. Visfatin, an adipocytokine with proinflammatory and immunomodulating properties. J Immunol. 2007;178:1748–58.PubMedGoogle Scholar
  103. 103.
    da Kim S, Kang S, Moon NR, Park S. Central visfatin potentiates glucose-stimulated insulin secretion and β-cell mass without increasing serum visfatin levels in diabetic rats. Cytokine. 2014;65:159–66. doi: 10.1016/j.cyto.2013.11.008.Google Scholar
  104. 104.
    Bozaoglu K, Bolton K, McMillan J, Zimmet P, Jowett J, Collier G, et al. Chemerin is a novel adipokine associated with obesity and metabolic syndrome. Endocrinology. 2007;148:4687–94.PubMedGoogle Scholar
  105. 105.
    Sell H, Laurencikiene J, Taube A, Eckardt K, Cramer A, Horrighs A, et al. Chemerin is a novel adipocyte-derived factor inducing insulin resistance in primary human skeletal muscle cells. Diabetes. 2009;58:2731–40.PubMedCentralPubMedGoogle Scholar
  106. 106.
    Roman AA, Parlee SD, Sinal CJ. Chemerin: a potential endocrine link between obesity and type 2 diabetes. Endocrine. 2012;42:243–51.PubMedGoogle Scholar
  107. 107.
    Lehrke M, Becker A, Greif M, Stark R, Laubender RP, von Ziegler F, et al. Chemerin is associated with markers of inflammation and components of the metabolic syndrome but does not predict coronary atherosclerosis. Eur J Endocrinol. 2009;161:339–44. doi: 10.1530/EJE-09-0380.PubMedGoogle Scholar
  108. 108.
    Wittamer V, Franssen JD, Vulcano M, Mirjolet JF, Le Poul E, Migeotte I, et al. Specific recruitment of antigen-presenting cells by chemerin, a novel processed ligand from human inflammatory fluids. J Exp Med. 2003;198:977–85.PubMedCentralPubMedGoogle Scholar
  109. 109.
    Goralski KB, McCarthy TC, Hanniman EA, Zabel BA, Butcher EC, Parlee SD, et al. Chemerin, a novel adipokine that regulates adipogenesis and adipocyte metabolism. J Biol Chem. 2007;282:28175–88.PubMedGoogle Scholar
  110. 110.
    Cash JL, Hart R, Russ A, Dixon JP, Colledge WH, Doran J, et al. Synthetic chemerin-derived peptides suppress inflammation through ChemR23. J Exp Med. 2008;205:767–75.PubMedCentralPubMedGoogle Scholar
  111. 111.
    Luangsay S, Wittamer V, Bondue B, De Henau O, Rouger L, Brait M, et al. Mouse ChemR23 is expressed in dendritic cell subsets and macrophages, and mediates an anti-inflammatory activity of chemerin in a lung disease model. J Immunol. 2009;183:6489–99.PubMedGoogle Scholar
  112. 112.
    White RT, Damm D, Hancock N, Rosen BS, Lowell BB, Usher P, et al. Human adipsin is identical to complement factor D and is expressed at high levels in adipose tissue. J Biol Chem. 1992;267:9210–3.PubMedGoogle Scholar
  113. 113.
    Ronti T, Lupattelli G, Mannarino E. The endocrine function of adipose tissue: an update. Clin Endocrinol (Oxf). 2006;64:355–65.Google Scholar
  114. 114.
    Cianflone K, Xia Z, Chen LY. Critical review of acylation-stimulating protein physiology in humans and rodents. Biochim Biophys Acta. 2003;1609:127–43.PubMedGoogle Scholar
  115. 115.
    de Souza Batista CM, Yang RZ, Lee MJ, Glynn NM, Yu DZ, Pray J, et al. Omentin plasma levels and gene expression are decreased in obesity. Diabetes. 2007;56:1655–61.PubMedGoogle Scholar
  116. 116.
    Shang FJ, Wang JP, Liu XT, Zheng QS, Xue YS, Wang B, Zhao LY. Serum omentin-1 levels are inversely associated with the presence and severity of coronary artery disease in patients with metabolic syndrome. Biomarkers. 2011;16:657–62.PubMedGoogle Scholar
  117. 117.
    Yang RZ, Lee MJ, Hu H, Pray J, Wu HB, Hansen BC, et al. Identification of omentin as a novel depot-specific adipokine in human adipose tissue: possible role in modulating insulin action. Am J Physiol Endocrinol Metab. 2006;290:E1253–61.PubMedGoogle Scholar
  118. 118.
    Tan BK, Adya R, Farhatullah S, Chen J, Lehnert H, Randeva HS. Metformin treatment may increase omentin-1 levels in women with polycystic ovary syndrome. Diabetes. 2010;59:3023–31. doi: 10.2337/db10-0124.PubMedCentralPubMedGoogle Scholar
  119. 119.
    Xu H, Barnes GT, Yang Q, Tan G, Yang D, Chou CJ, et al. Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. J Clin Invest. 2003;112:1821–30.PubMedCentralPubMedGoogle Scholar
  120. 120.
    Cancello R, Henegar C, Viguerie N, Taleb S, Poitou C, Rouault C, et al. Reduction of macrophage infiltration and chemoattractant gene expression changes in white adipose tissue of morbidly obese subjects after surgery-induced weight loss. Diabetes. 2005;54:2277–86.PubMedGoogle Scholar
  121. 121.
    Mantovani A, Sica A, Sozzani S, Allavena P, Vecchi A, Locati M. The chemokine system in diverse forms of macrophage activation and polarization. Trends Immunol. 2004;25:677–86.PubMedGoogle Scholar
  122. 122.
    Hevener AL, Olefsky JM, Reichart D, Nguyen MT, Bandyopadyhay G, Leung HY, et al. Macrophage PPAR gamma is required for normal skeletal muscle and hepatic insulin sensitivity and full antidiabetic effects of thiazolidinediones. J Clin Invest. 2007;117:1658–69.PubMedCentralPubMedGoogle Scholar
  123. 123.
    Lumeng CN, Bodzin JL, Saltiel AR. Obesity induces a phenotypic switch in adipose tissue macrophage polarization. J Clin Invest. 2007;117:175–84.PubMedCentralPubMedGoogle Scholar
  124. 124.
    Trayhurn P, Wood IS. Adipokines: inflammation and the pleiotropic role of white adipose tissue. Br J Nutr. 2004;92:347–55.PubMedGoogle Scholar
  125. 125.
    Cinti S, Mitchell G, Barbatelli G, Murano I, Ceresi E, Faloia E, et al. Adipocyte death defines macrophage localization and function in adipose tissue of obese mice and humans. J Lipid Res. 2005;46:2347–55.PubMedGoogle Scholar
  126. 126.
    Talukdar S, da Oh Y, Bandyopadhyay G, Li D, Xu J, McNelis J, et al. Neutrophils mediate insulin resistance in mice fed a high-fat diet through secreted elastase. Nat Med. 2012;18:1407–12.PubMedCentralPubMedGoogle Scholar
  127. 127.
    Divoux A, Moutel S, Poitou C, Lacasa D, Veyrie N, Aissat A, et al. Mast cells in human adipose tissue: link with morbid obesity, inflammatory status, and diabetes. J Clin Endocrinol Metab. 2012;97:E1677–85. doi: 10.1210/jc.2012-1532.PubMedGoogle Scholar
  128. 128.
    Wu D, Molofsky AB, Liang HE, Ricardo-Gonzalez RR, Jouihan HA, Bando JK, et al. Eosinophils sustain adipose alternatively activated macrophages associated with glucose homeostasis. Science. 2011;332:243–7.PubMedCentralPubMedGoogle Scholar
  129. 129.
    Lynch L, Nowak M, Varghese B, Clark J, Hogan AE, Toxavidis V, et al. Adipose tissue invariant NKT cells protect against diet-induced obesity and metabolic disorder through regulatory cytokine production. Immunity. 2012;37:574–87. doi: 10.1016/j.immuni.2012.06.016.PubMedGoogle Scholar
  130. 130.
    Nishimura S, Manabe I, Nagasaki M, Eto K, Yamashita H, Ohsugi M, et al. CD8+ effector T cells contribute to macrophage recruitment and adipose tissue inflammation in obesity. Nat Med. 2009;15:914–20.PubMedGoogle Scholar
  131. 131.
    Meijer K, de Vries M, Al-Lahham S, Bruinenberg M, Weening D, Dijkstra M, et al. Human primary adipocytes exhibit immune cell function: adipocytes prime inflammation independent of macrophages. PLoS One. 2011. doi: 10.1371/journal.pone.0017154.Google Scholar
  132. 132.
    Feuerer M, Herrero L, Cipolletta D, Naaz A, Wong J, Nayer A, et al. Lean, but not obese, fat is enriched for a unique population of regulatory T cells that affect metabolic parameters. Nat Med. 2009;15:930–9.PubMedCentralPubMedGoogle Scholar
  133. 133.
    Winer S, Chan Y, Paltser G, Truong D, Tsui H, Bahrami J, et al. Normalization of obesity-associated insulin resistance through immunotherapy. Nat Med. 2009;15:921–9.PubMedCentralPubMedGoogle Scholar
  134. 134.
    Sell H, Eckel J. Adipose tissue inflammation: novel insight into the role of macrophages and lymphocytes. Curr Opin Clin Nutr Metab Care. 2010;13:366–70.PubMedGoogle Scholar
  135. 135.
    De Rosa V, Procaccini C, Calì G, Pirozzi G, Fontana S, Zappacosta S, et al. A key role of leptin in the control of regulatory T cell proliferation. Immunity. 2007;26:241–55.PubMedGoogle Scholar
  136. 136.
    Duffaut C, Galitzky J, Lafontan M, Bouloumié A. Unexpected trafficking of immune cells within the adipose tissue during the onset of obesity. Biochem Biophys Res Commun. 2009;384:482–5. doi: 10.1016/j.bbrc.2009.05.002.PubMedGoogle Scholar
  137. 137.
    Winer DA, Winer S, Shen L, Wadia PP, Yantha J, Paltser G, et al. B cells promote insulin resistance through modulation of T cells and production of pathogenic IgG antibodies. Nat Med. 2011;17:610–7.PubMedCentralPubMedGoogle Scholar
  138. 138.
    Jagannathan M, McDonnell M, Liang Y, Hasturk H, Hetzel J, Rubin D, et al. Toll-like receptors regulate B cell cytokine production in patients with diabetes. Diabetologia. 2010;53:1461–71.PubMedCentralPubMedGoogle Scholar
  139. 139.
    Rowe J, Yerkovich ST, Richmond P, Suriyaarachchi D, Fisher E, Feddema L, et al. Th2-associated local reactions to the acellular diphtheria-tetanus-pertussis vaccine in 4- to 6-year-old children. Infect Immun. 2005;73:8130–5.PubMedCentralPubMedGoogle Scholar
  140. 140.
    Classen JB. Review of evidence that epidemics of type 1 diabetes and type 2 diabetes/metabolic syndrome are polar opposite responses to iatrogenic inflammation. Curr Diabetes Rev. 2012;8:413–8.PubMedGoogle Scholar
  141. 141.
    Posthouwer D, Voorbij HA, Grobbee DE, Numans ME, van der Bom JG. Influenza and pneumococcal vaccination as a model to assess C-reactive protein response to mild inflammation. Vaccine. 2004;23:362–5.PubMedGoogle Scholar
  142. 142.
    El Yousfi M, Mercier S, Breuillé D, Denis P, Papet I, Mirand PP, Obled C. The inflammatory response to vaccination is altered in the elderly. Mech Ageing Dev. 2005;126:874–81.PubMedGoogle Scholar
  143. 143.
    Bernstein ED, Gardner EM, Abrutyn E, Gross P, Murasko DM. Cytokine production after influenza vaccination in a healthy elderly population. Vaccine. 1998;16:1722–31.PubMedGoogle Scholar
  144. 144.
    Phillips DI, Barker DJ, Fall CH, Seckl JR, Whorwood CB, Wood PJ, Walker BR. Elevated plasma cortisol concentrations: a link between low birth weight and the insulin resistance syndrome? J Clin Endocrinol Metab. 1998;83:757–60.PubMedGoogle Scholar
  145. 145.
    Duncan GE, Li SM, Zhou XH. Prevalence and trends of a metabolic syndrome phenotype among U.S. adolescents, 1999–2000. Diabetes Care. 2004;27:2438–43.PubMedGoogle Scholar
  146. 146.
    Hooper LV, Gordon JI. Commensal host-bacterial relationships in the gut. Science. 2001;292:1115–8.PubMedGoogle Scholar
  147. 147.
    Tilg H, Kaser A. Gut microbiome, obesity, and metabolic dysfunction. J Clin Invest. 2011;121:2126–32.PubMedCentralPubMedGoogle Scholar
  148. 148.
    Ley RE, Bäckhed F, Turnbaugh P, Lozupone CA, Knight RD, Gordon JI. Obesity alters gut microbial ecology. Proc Natl Acad Sci U S A. 2005;102:11070–5.PubMedCentralPubMedGoogle Scholar
  149. 149.
    Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial ecology: human gut microbes associated with obesity. Nature. 2006;444:1022–3.PubMedGoogle Scholar
  150. 150.
    Schwiertz A, Taras D, Schäfer K, Beijer S, Bos NA, Donus C, Hardt PD. Microbiota and SCFA in lean and overweight healthy subjects. Obesity (Silver Spring). 2010;18:190–5.Google Scholar
  151. 151.
    Bäckhed F, Ding H, Wang T, Hooper LV, Koh GY, Nagy A, et al. The gut microbiota as an environmental factor that regulates fat storage. Proc Natl Acad Sci U S A. 2004;101:15718–23.PubMedCentralPubMedGoogle Scholar
  152. 152.
    Turnbaugh PJ, Ley RE, Mahowald MA, Magrini V, Mardis ER, Gordon JI. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature. 2006;444:1027–31.PubMedGoogle Scholar
  153. 153.
    Zhou YJ, Zhou H, Li Y, Song YL. NOD1 activation induces innate immune responses and insulin resistance in human adipocytes. Diabetes Metab. 2012;38:538–43.PubMedGoogle Scholar
  154. 154.
    Purohit J, Hu P, Burke SJ, Collier JJ, Chen J, Zhao L. The effects of NOD activation on adipocyte differentiation. Obesity (Silver Spring). 2013;21:737–47.Google Scholar
  155. 155.
    Vijay-Kumar M, Aitken JD, Carvalho FA, Cullender TC, Mwangi S, Srinivasan S, et al. Metabolic syndrome and altered gut microbiota in mice lacking Toll-like receptor 5. Science. 2010;328:228–31.PubMedGoogle Scholar
  156. 156.
    Cani PD, Bibiloni R, Knauf C, Waget A, Neyrinck AM, Delzenne NM, Burcelin R. Changes in gut microbiota control metabolic endotoxemia-induced inflammation in high-fat diet-induced obesity and diabetes in mice. Diabetes. 2008;57:1470–81.PubMedGoogle Scholar
  157. 157.
    Frazier TH, DiBaise JK, McClain CJ. Gut microbiota, intestinal permeability, obesity-induced inflammation, and liver injury. JPEN J Parenter Enteral Nutr. 2011;35 Suppl 5:14S–20.PubMedGoogle Scholar
  158. 158.
    Blaser MJ, Falkow S. What are the consequences of the disappearing human microbiota? Nat Rev Microbiol. 2009;7:887–94.PubMedGoogle Scholar
  159. 159.
    Kopp E, Ghosh S. Inhibition of NF-kappa B by sodium salicylate and aspirin. Science. 1994;265:956–9.PubMedGoogle Scholar
  160. 160.
    Yuan M, Konstantopoulos N, Lee J, Hansen L, Li ZW, Karin M, Shoelson SE. Reversal of obesity- and diet-induced insulin resistance with salicylates or targeted disruption of Ikkbeta. Science. 2001;293:1673–7.PubMedGoogle Scholar
  161. 161.
    Hundal RS, Petersen KF, Mayerson AB, Randhawa PS, Inzucchi S, Shoelson SE, Shulman GI. Mechanism by which high-dose aspirin improves glucose metabolism in type 2 diabetes. J Clin Invest. 2002;109:1321–6.PubMedCentralPubMedGoogle Scholar
  162. 162.
    Dominguez H, Storgaard H, Rask-Madsen C, Steffen Hermann T, Ihlemann N, Baunbjerg Nielsen D, et al. Metabolic and vascular effects of tumor necrosis factor-alpha blockade with etanercept in obese patients with type 2 diabetes. J Vasc Res. 2005;42:517–25.PubMedGoogle Scholar
  163. 163.
    Nissen SE, Wolski K. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. N Engl J Med. 2007;356:2457–71.PubMedGoogle Scholar
  164. 164.
    Yki-Järvinen H. Thiazolidinediones. N Engl J Med. 2004;351:1106–18.PubMedGoogle Scholar
  165. 165.
    Stienstra R, Duval C, Keshtkar S, van der Laak J, Kersten S, Müller M. Peroxisome proliferator-activated receptor gamma activation promotes infiltration of alternatively activated macrophages into adipose tissue. J Biol Chem. 2008;283:22620–7.PubMedGoogle Scholar
  166. 166.
    Pascual G, Fong AL, Ogawa S, Gamliel A, Li AC, Perissi V, et al. A SUMOylation-dependent pathway mediates transrepression of inflammatory response genes by PPAR-gamma. Nature. 2005;437:759–63.PubMedCentralPubMedGoogle Scholar
  167. 167.
    Ialenti A, Grassia G, Di Meglio P, Maffia P, Di Rosa M, Ianaro A. Mechanism of the anti-inflammatory effect of thiazolidinediones: relationship with the glucocorticoid pathway. Mol Pharmacol. 2005;67:1620–8.PubMedGoogle Scholar
  168. 168.
    Castrillo A, Tontonoz P. Nuclear receptors in macrophage biology: at the crossroads of lipid metabolism and inflammation. Annu Rev Cell Dev Biol. 2004;20:455–80.PubMedGoogle Scholar
  169. 169.
    Wang KL, Liu CJ, Chao TF, Chen SJ, Wu CH, Huang CM, Chang CC, Wang KF, Chen TJ, Lin SJ, Chiang CE. Risk of new-onset diabetes mellitus versus reduction in cardiovascular events with statin therapy. Am J Cardiol. 2013. doi: 10.1016/j.amjcard.2013.10.043.Google Scholar
  170. 170.
    Goldfine AB, Buck JS, Desouza C, Fonseca V, Chen YD, Shoelson SE, et al. Targeting inflammation using salsalate in patients with type 2 diabetes: effects on flow-mediated dilation (TINSAL-FMD). Diabetes Care. 2013;36:4132–9. doi: 10.2337/dc13-0859.PubMedGoogle Scholar
  171. 171.
    Bruun JM, Helge JW, Richelsen B, Stallknecht B. Diet and exercise reduce low-grade inflammation and macrophage infiltration in adipose tissue but not in skeletal muscle in severely obese subjects. Am J Physiol Endocrinol Metab. 2006;290:E961–7.PubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • György Paragh
    • 1
  • Ildikó Seres
    • 1
  • Mariann Harangi
    • 1
  • Péter Fülöp
    • 1
  1. 1.Division of Metabolism, Department of Internal Medicine, Faculty of MedicineUniversity of DebrecenDebrecenHungary

Personalised recommendations