Immunologic impact of the intestine in metabolic disease

• Published in: The Journal of clinical investigation Vol. 127; no. 1; pp. 33 - 42
• Main Authors: Winer, Daniel A, Winer, Shawn, Dranse, Helen J, Lam, Tony K T
• Format: Journal Article
• Language: English
• Published: United States American Society for Clinical Investigation 03.01.2017
• Subjects: Adaptive Immunity; Analysis; Animals; Biomedical research; Diabetes Mellitus - immunology; Diabetes Mellitus - pathology; Glucose - immunology; Humans; Immunity, Innate; Inflammation; Inflammation - immunology; Inflammation - pathology; Insulin resistance; Insulin Resistance - immunology; Intestines - immunology; Intestines - pathology; Nerve Net - immunology; Nerve Net - pathology; Obesity; Obesity - immunology; Obesity - pathology; Review Series; Risk factors; Small intestine; Studies; Type 2 diabetes
• ISSN: 0021-9738; 1558-8238
• DOI: 10.1172/jci88879

Obesity and diabetes are associated with increased chronic low-grade inflammation and elevated plasma glucose levels. Although inflammation in the fat and liver are established features of obesity-associated insulin resistance, the intestine is emerging as a new site for immunologic changes that affect whole-body metabolism. Specifically, microbial and dietary factors incurred by diet-induced obesity influence underlying innate and adaptive responses of the intestinal immune system. These responses affect the maintenance of the intestinal barrier, systemic inflammation, and glucose metabolism. In this Review we propose that an understanding of the changes to the intestinal immune system, and how these changes influence systemic immunity and glucose metabolism in a whole-body integrative and a neuronal-dependent network, will unveil novel intestinal pathologic and therapeutic targets for diabetes and obesity.