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Inflammation des Fettgewebes

Adipose tissue inflammation

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Zusammenfassung

Adipositas erhöht das Risiko für Stoffwechsel- (z. B. Typ-2-Diabetes, Fettlebererkrankung), kardiovaskuläre (z. B. arterielle Hypertonie, Myokardinfarkt, Schlaganfall), muskuloskelettale (z. B. Osteoarthrosen) und neurodegenerative Erkrankungen, Depression sowie einige Krebserkrankungen signifikant. Zudem geht sie bei den Betroffenen häufig mit einer Verminderung der Lebensqualität, sozialer Benachteiligung und einer deutlichen Verkürzung der Lebenserwartung einher. Die Zunahme des Fettgewebes bei Adipositas kann über Insulinresistenz und die Aktivierung proinflammatorischer Stoffwechselwege zu obigen Erkrankungen beitragen, obwohl die genauen Mechanismen dafür nicht vollständig verstanden sind. Fettleibigkeit führt häufig zur vermehrten Infiltration des Fettgewebes mit Immunzellen sowie zu dessen Inflammation, die eine systemische, häufig subklinische und chronische Entzündung aufrechterhalten kann. Die Inflammation des Fettgewebes scheint jedoch auch bei dessen physiologischer Expansion und dessen Anpassung an eine positive Energiebilanz eine wichtige Rolle zu spielen. Insgesamt kann ein besseres Verständnis der molekularen Mechanismen, über die Adipositas und Inflammation des Fettgewebes zu Insulinresistenz und chronischer Entzündung führen, zur Entwicklung antientzündlicher Therapiestrategien beitragen, die die zukünftige Behandlung von Folgeerkrankungen der Adipositas verbessern könnten. Im Rahmen dieses kurzen Übersichtsbeitrages sollen aktuelle Erkenntnisse, wie eine Inflammation des Fettgewebes entsteht und zu Endorganschäden bei Adipositas beitragen könnte, diskutiert werden.

Abstract

Obesity significantly increases the risk for metabolic (e. g. type 2 diabetes, fatty liver disease), cardiovascular (e. g. hypertension, myocardial infarction, stroke), and musculoskeletal (e. g. osteoarthritis) diseases, as well as Alzheimer’s disease, depression and some types of cancer. In addition, obesity is also associated with reduced quality of life, social disadvantages and reduced life expectancy. Insulin resistance and the activation of proinflammatory pathways may link accumulation of adipose tissue in obesity to these diseases, although the underlying mechanisms are not completely understood. Obesity is frequently associated with increasing immune cell infiltration into adipose tissue, which may contribute to a state of systemic subclinical chronic inflammation. In addition, adipose tissue inflammation has been shown to be essential for healthy adipose tissue expansion and remodelling. A better understanding of the molecular pathways linking obesity to chronic inflammation and insulin resistance may provide the basis for the future development of anti-inflammatory treatment strategies to improve a wide range of obesity related diseases. This short overview discusses the mechanisms underlying the development of adipose tissue inflammation and their contribution to end-organ damage in obesity.

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Literatur

  1. Apovian CM (2016) Obesity: definition, comorbidities, causes, and burden. Am J Manag Care 22:176–185

    Google Scholar 

  2. Blüher M (2016) Adipose tissue inflammation: a cause or consequence of obesity-related insulin resistance? Clin Sci (lond) 130:1603–1614

    Article  Google Scholar 

  3. Cancello R, Henegar C, Viguerie N, Taleb S, Poitou C, Rouault C, Coupaye M, Pelloux V, Hugol D, Bouillot JL, Bouloumié A, Barbatelli G, Cinti S, Svensson PA, Barsh GS, Zucker JD, Basdevant A, Langin D, Clément K (2005) Reduction of macrophage infiltration and chemoattractant gene expression changes in white adipose tissue of morbidly obese subjects after surgery-induced weight loss. Diabetes 54:2277–2286

    Article  CAS  Google Scholar 

  4. Cinti S (2012) The adipose organ at a glance. Dis Model Mech 5:588–594

    Article  CAS  Google Scholar 

  5. Cinti S, Mitchell G, Barbatelli G, Murano I, Ceresi E, Faloia E, Wang S, Fortier M, Greenberg AS, Obin MS (2005) Adipocyte death defines macrophage localization and function in adipose tissue of obese mice and humans. J Lipid Res 46:2347–2355

    Article  CAS  Google Scholar 

  6. Divoux A, Moutel S, Poitou C, Lacasa D, Veyrie N, Aissat A, Arock M, Guerre-Millo M, Clément K (2012) Mast cells in human adipose tissue: link with morbid obesity, inflammatory status, and diabetes. J Clin Endocrinol Metab 97:E1677–85

    Article  CAS  Google Scholar 

  7. Fasshauer M, Blüher M (2015) Adipokines in health and disease. Trends Pharmacol Sci 36:461–470

    Article  CAS  Google Scholar 

  8. Feuerer M, Herrero L, Cipolletta D, Naaz A, Wong J, Nayer A, Lee J, Goldfine AB, Benoist C, Shoelson S et al (2009) Lean, but not obese, fat is enriched for a unique population of regulatory T cells that affect metabolic parameters. Nat Med 15:930–939

    Article  CAS  Google Scholar 

  9. Fink MP (1990) Leaky gut hypothesis: a historical perspective. Crit Care Med 18:579–580

    Article  CAS  Google Scholar 

  10. Haase J, Weyer U, Immig K, Klöting N, Blüher M, Eilers J, Bechmann I, Gericke M (2014) Local proliferation of macrophages in adipose tissue during obesity-induced inflammation. Diabetologia 57:562–571

    Article  CAS  Google Scholar 

  11. Harman-Boehm I, Blüher M, Redel H, Sion-Vardy N, Ovadia S, Avinoach E, Shai I, Klöting N, Stumvoll M, Bashan N, Rudich A (2007) Macrophage infiltration into omental versus subcutaneous fat across different populations: effect of regional adiposity and the comorbidities of obesity. J Clin Endocrinol Metab 92:2240–2247

    Article  CAS  Google Scholar 

  12. Hotamisligil GS (2006) Inflammation and metabolic disorders. Nature 444:860–867

    Article  CAS  Google Scholar 

  13. Kintscher U, Hartge M, Hess K, Foryst-Ludwig A, Clemenz M, Wabitsch M, Fischer-Posovszky P, Barth TF, Dragun D, Skurk T, Hauner H, Blüher M, Unger T, Wolf AM, Knippschild U, Hombach V, Marx N (2008) T‑lymphocyte infiltration in visceral adipose tissue: a primary event in adipose tissue inflammation and the development of obesity-mediated insulin resistance. Arter Thromb Vasc Biol 28:1304–1310

    Article  CAS  Google Scholar 

  14. Klöting N, Fasshauer M, Dietrich A, Kovacs P, Schön MR, Kern M, Stumvoll M, Blüher M (2010) Insulin-sensitive obesity. Am J Physiol Endocrinol Metab 299:E506–E515

    Article  Google Scholar 

  15. Kurth BM (2012) Erste Ergebnisse aus der „Studie zur Gesundheit Erwachsener in. Gesundheitsschutz, Bd. 55. “ (DEGS). Bundesgesundheitsblatt Gesundheitsforschung, Deutschland, S 980–990

    Google Scholar 

  16. Landgraf K, Rockstroh D, Wagner IV, Weise S, Tauscher R, Schwartze JT, Löffler D, Bühligen U, Wojan M, Till H, Kratzsch J, Kiess W, Blüher M, Körner A (2015) Evidence of early alterations in adipose tissue biology and function and its association with obesity-related inflammation and insulin resistance in children. Diabetes 64:1249–1261

    Article  CAS  Google Scholar 

  17. Macdougall CE, Wood EG, Loschko J, Scagliotti V, Cassidy FC, Robinson ME, Feldhahn N, Castellano L, Voisin MB, Marelli-Berg F, Gaston-Massuet C, Charalambous M, Longhi MP (2018) Visceral Adipose Tissue Immune Homeostasis Is Regulated by the Crosstalk between Adipocytes and Dendritic Cell Subsets. Cell Metab 27:588–601

    Article  CAS  Google Scholar 

  18. Ozcan U, Cao Q, Yilmaz E, Lee AH, Iwakoshi NN, Ozdelen E, Tuncman G, Görgün C, Glimcher LH, Hotamisligil GS (2004) Endoplasmic reticulum stress links obesity, insulin action, and type 2 diabetes. Science 306:457–461

    Article  Google Scholar 

  19. Reilly SM, Saltiel AR (2017) Adapting to obesity with adipose tissue inflammation. Nat Rev Endocrinol 13:633–643

    Article  CAS  Google Scholar 

  20. Schmitz J, Evers N, Awazawa M, Nicholls HT, Brönneke HS, Dietrich A, Mauer J, Blüher M, Brüning JC (2016) Obesogenic memory can confer long-term increases in adipose tissue but not liver inflammation and insulin resistance after weight loss. Mol Metab 5:328–339

    Article  CAS  Google Scholar 

  21. Shoelson SE, Lee J, Goldfine AB (2006) Inflammation and insulin resistance. J Clin Invest 116:1793–1801

    Article  CAS  Google Scholar 

  22. Skurk T, Alberti-Huber C, Herder C, Hauner H (2007) Relationship between adipocyte size and adipokine expression and secretion. J Clin Endocrinol Metab 92:1023–1033

    Article  CAS  Google Scholar 

  23. Spalding KL, Arner E, Westermark PO, Bernard S, Buchholz BA, Bergmann O, Blomqvist L, Hoffstedt J, Näslund E, Britton T, Concha H, Hassan M, Rydén M, Frisén J, Arner P (2008) Dynamics of fat cell turnover in humans. Nature 453:783–787

    Article  CAS  Google Scholar 

  24. Weisberg SP, McCann D, Desai M, Rosenbaum M, Leibel RL, Ferrante AW Jr (2003) Obesity is associated with macrophage accumulation in adipose tissue. J Clin Invest 112:1796–1808

    Article  CAS  Google Scholar 

  25. Wernstedt Asterholm I, Tao C, Morley TS, Wang QA, Delgado-Lopez F, Wang ZV, Scherer PE (2014) Adipocyte inflammation is essential for healthy adipose tissue expansion and remodeling. Cell Metab 20:103–118

    Article  CAS  Google Scholar 

  26. World Health Organization (WHO) (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organization Technical Report Series 894:1–253

  27. Xu H, Barnes GT, Yang Q, Tan G, Yang D, Chou CJ, Sole J, Nichols A, Ross JS, Tartaglia LA, Chen H (2003) Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. J Clin Invest 112:1821–1830

    Article  CAS  Google Scholar 

  28. Zhang Y, Proenca R, Maffei M et al (1994) Positional cloning of the mouse obese gene and its human homologue. Nature 372:425–432

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Klinik und Poliklinik für Endokrinologie und Nephrologie, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig, AöR, Liebigstr. 20, 04103, Leipzig, Deutschland

    Matthias Blüher

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Correspondence to Matthias Blüher.

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Interessenkonflikt

M. Blüher gibt an, Honorare für Vortrags- oder Beratertätigkeit von AstraZeneca, Boehringer-Ingelheim, Lilly, Novartis, Novo Nordisk und Sanofi erhalten zu haben.

Dieser Beitrag beinhaltet keine vom Autor durchgeführten Studien an Menschen oder Tieren.

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Blüher, M. Inflammation des Fettgewebes. Diabetologe 15, 296–304 (2019). https://doi.org/10.1007/s11428-019-0450-3

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