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METABOLIC SYNDROME AND THE IMMUNE SYSTEM
Authors: Pardo-Morales RV1, Zúñiga-Torres MG2, Martínez-Carrillo BE2, Valdés-Ramos
R2 .
1
Hospital de Gynecology and Obstetrics. Instituto Materno Infantil del Estado de México.
Center for Research and Graduate Studies in Health Sciences, Faculty of Medicine,
Universidad Autónoma del Estado de México.
2
The metabolic syndrome and obesity are the major players in a global epidemic, its
increasing prevalence and morbidity associated affect health systems and quality of life of
the people who have it.
Its pathophysiology has not been fully explained because of complex biological processes
and complex cellular interactions. However, epidemiological and clinical evidence suggest
a multifactorial disorder resulting from the interaction between genetic, environmental,
hormonal and immunological; with obesity and the inflammatory response as key factors in
the occurrence of this syndrome. The adipocyte is an active cell whose physiological role is
linked to metabolic regulation, cell growth, immune response, thermogenesis and
cardiovascular functions. Alterations in the cell are the ones leading to the metabolic
imbalance that causes morbidity associated to the metabolic syndrome.
Multiple studies have shown that adipocytes produce a host of chemical messengers with
local and systemic actions called adipokines. The number of identified adipokines has
grown; their functions are to mediate immune and inflammatory reactions in the organism.
The better known adipokines are leptin, adiponectin, resistin and proinflammatory
cytokines such as TNF-α, IL-6 and IL-1. "New" adipokines, with an incomplete
characterization are visfatin, apelin, vaspin, omentin, quemerin, adrenomedullin and
adipsin, as well as proinflammatory cytokines IL-7, IL-8, IL-10, IL-15, IL-17, IL-18, IL-32,
IL-33.
Other factors involved in the metabolic syndrome are nitric oxide, L-arginine, free fatty
acids, NK cells, Toll-like receptors (TLR2, 4, 5, 9), intestinal microbiota interaction and
activation of macrophages and monocytes.
Adipokines have diverse effects on metabolic syndrome, and can be divided arbitrarily in
proinflammatory and anti-inflammatory effects, this classification is incorrect because
some adipokines have ambiguous effects or are not yet certain.
The anti-inflammatory adipokine release increases directly proportional to the release of
proinflammatory adipokines, but as the disease progresses, the first become unable to
counteract the inflammatory effects and homeostasis is broken, thus allowing the
appearance of cardiometabolic diseases.