Ten Pathways from Inflammation to Obesity 

Perhaps obesity is more an inflammatory disease than it is a lifestyle disease. Scientists are busy defining the pathways from inflammation to obesity. And it’s an impressive body of work. This month, in the Journal of Clinical Investigation, a new review series documents much of what we know about those pathways.

1. Obesity activates inflammation and skews the immune system into a permanently inflamed state. Alan Saltiel and Jerrold M. Olefsky provide an overview of the inflammatory mechanisms that have come to define this chronic disease.

2. Chronic inflammation in fat tissue plays a critical role in the onset of insulin resistance and type 2 diabetes. Tracey McLaughlin et al explain how this process gets started.

3. Islets become inflamed in the pancreas. The finding of islet inflammation in type 2 diabetes adds much to understanding of this inflammatory disease. Kosei Eguchi and Ryozo Nagai say it also opens up new targets for treatment.

4. Inflammation in the hypothalamus alters energy balance and also contributes to developing insulin resistance. Alexander Jais and Jens C. Brüning describe how these pathways work and help to activate the chronic disease of obesity.

5. Intestines are a site where inflammation arises and then alters both immune function and metabolism. Daniel A. Winer et al suggest that this site in the gut can be a springboard for immune system changes that bring metabolic changes to the entire body.

6. Activated immune cells invade muscles and then promote inflammation that leads to insulin resistance. Huaizhu Wu and Christie M. Ballantyne review the emerging science of this pathway.

7. Chronic liver inflammation and fibrosis results from obesity and has become the 12th leading cause of death in the U.S. Fatty liver disease can start inflammation that progresses to fibrosis and cirrhosis, as Yukinori Koyama and David A. Brenner describe.

8. Inflammation starts in childhood with obesity and sets up a lifelong problem. Kanakadurga Singer and Carey Lumeng frame the problem. They explain how it can start early in childhood, then become entrenched.

9. Inflammation, fibrosis, and blood vessels interact in a manner described by Clair Crewe et al. The result is dysfunctional fat tissue that promotes metabolic disease.

10. Targeting inflammation to treat metabolic diseases and obesity may be the payoff for this research. Allison Goldfine and Steven Shoelson explain how these insights are leading us toward new drug treatments for obesity and related metabolic diseases.

Do you get the impression that inflammation involves many, many parts of the body in obesity? If so, then you got the point.

Click here for the full series.

Cholesterol Crystals and Inflammation, photograph © NTNU medisin og helse / flickr

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January 8, 2017