Obesity, immunology and obesity surgery
The chronic low grade inflammation in the adipose tissue is called as “metabolic inflammation” and seems to play an important role in the pathogenesis of insulin resistance and T2DM
Abstract
Obesity is defined as energy surplus in the white adipose tissue (WAT). In the pathophysiology of the process, adipocyte hypertrophy and pro inflammatory activation of the immune cells that are dormant in the adipose tissue (especially lymphocytes and macrophages) play an important role. These cells cause an increase in pro-inflammatory cytokines in the circulation. The chronic low grade inflammation in the adipose tissue is called as “metabolic inflammation” and seems to play an important role in the pathogenesis of insulin resistance and T2DM. In the adipose tissue of the lean individual the pro-inflammatory cells are suppressed by the regulatory cells; furthermore, activation is through the Th2 lymphocytes and macrophages are of M2 phenotype and the adipocytes are of normal size. In the adipose tissue of obese individuals, immune suppression is not present, pro-inflammatory cells aggregate and there is boost of pro-inflammatory cytokine production. Macrophage phenotype shifts to M1 and adipocytes are hypertrophic [2,3].