{"id":23749,"date":"2025-07-11T11:53:03","date_gmt":"2025-07-11T09:53:03","guid":{"rendered":"https:\/\/www.biolife-publisher.it\/iji\/?p=23749"},"modified":"2025-07-11T11:53:03","modified_gmt":"2025-07-11T09:53:03","slug":"obesity-inflammation-and-infection","status":"publish","type":"post","link":"https:\/\/www.biolife-publisher.it\/iji\/obesity-inflammation-and-infection\/","title":{"rendered":"OBESITY, INFLAMMATION, AND INFECTION"},"content":{"rendered":"<p>Pellegrino R. Obesity, inflammation, and infection. <em>International Journal of Infection<\/em>. 2022;6(3):88-89<\/p>\n<hr \/>\n<p>R. Pellegrino<sup>*<\/sup><\/p>\n<p>Physiatry and Pain Therapy, Lecce-Castromediano\/Cavallino, Lecce, Italy.<\/p>\n<p><em>*Correspondence to:<\/em><br \/>\nDr. Raffaello Pellegrino,<br \/>\nPhysiatrist and Pain Therapist,<br \/>\nLecce-Castromediano\/Cavallino,<br \/>\nVia S. Pelico 34,<br \/>\n73100 Lecce, Italy.<br \/>\ne-mail: <a href=\"mailto:drpellegrino@yahoo.it\">drpellegrino@yahoo.it<\/a><\/p>\n<table style=\"width: 97.3735%;\">\n<tbody>\n<tr>\n<td style=\"width: 49.3958%; text-align: left;\" width=\"321\">Received: 09 October, 2022<br \/>\nAccepted: 03 November, 2022<\/p>\n<p><a href=\"https:\/\/www.biolife-publisher.it\/iji\/wp-content\/uploads\/2025\/07\/IJI-2022-63-Pellegrino_88-89.pdf\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-21604 size-full\" src=\"https:\/\/www.biolife-publisher.it\/ejnd\/wp-content\/uploads\/2024\/04\/adobe-pdf-download-icon-e1713175734457.jpg\" alt=\"adobe-pdf-download-icon\" width=\"100\" height=\"103\" \/><\/a><\/td>\n<td style=\"width: 151.057%; text-align: right;\" width=\"321\">ISSN 1972-6945 [online]<br \/>\nCopyright 2022 \u00a9 by Biolife-publisher<br \/>\nThis publication and\/or article is for individual use only and may not be further reproduced without written permission from the copyright holder. Unauthorized reproduction may result in financial and other penalties. Disclosure: all authors report no conflicts of interest relevant to this article.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>KEYWORDS:<\/strong><em> Obesity, inflammation, infection, immunity, inflammatory mediator<\/em><\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>INTRODUCTION<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p>Obesity is a disease characterized by a high volume of body fat in which there is chronic low-grade inflammation. Inflammation is mediated by elevated levels of cytokines such as interleukin (IL)-1, IL-6, tumor necrosis factor (TNF), and C-reactive protein (CRP). Fat accumulation occurs especially in some specific regions, including the abdomen and visceral regions, where it creates hypoxia and death of adipocytes. Both innate and adaptive immunity are involved in obesity, which induces the activation of anti-inflammatory M1 macrophages that are transformed into inflammatory M2 types. Microbial infections are a risk factor where the inflammatory environment induced by obesity can weaken the body&#8217;s immune response, with serious consequences for human health. Chronic inflammation not only predisposes individuals to infections but also contributes to the development of metabolic disorders and cardiovascular disease.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>DISCUSSION<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p>Statin therapy lowers cholesterol\u00a0and reduces the incidence of death from\u00a0cardiovascular disease and atherosclerosis, although some people treated with these drugs still suffer\u00a0from cardiovascular diseases (1).\u00a0 People affected by obesity and infection present a stronger degree of inflammation, compared to the low degree inflammatory state that is present in obesity alone.\u00a0Elevated lipid levels, mostly in the form of cholesterol and cholesteryl ester, are associated with obesity, atherosclerosis, and cardiovascular diseases. Obesity causes narrowing of the artery, predisposition to thrombosis, calcification, weakening of the muscles, and aneurysm dilatation.<\/p>\n<p>In obesity, there is a low grade of inflammation, and in the case of infection, the production of cytokines can influence the inflammatory state induced by obesity (2).\u00a0 However, lipids can be lowered by diet and\/or medication in most patients.<\/p>\n<p>Monocytes and macrophages are innate immune inflammatory cells that respond to the excessive uptake of lipoproteins in obese patients by generating chemokines and cytokines. The adaptive immune response involves antigen-specific T cells, as well as the activation of B cells, which all produce inflammatory cytokines and chemokines. In this case, IL-12 serves as an important bridge between innate and adaptive immunity (3).<\/p>\n<p>When the endothelium becomes inflamed, it expresses adhesion molecules that bind cognate ligands on leukocytes. Selectins, integrins, and chemokines mediate and\u00a0favor the action\u00a0of white inflammatory blood cells\u00a0such as\u00a0adherent leukocytes, diapedesis, migration and chemotactic stimulus. The Th1 cytokines involved in the effector T-cell response aggravate inflammation, whereas Th2 cytokines, such as IL-10 and IL-4, are anti-inflammatory\u00a0and\u00a0relieve inflammation.\u00a0\u00a0Leukocytes, as well as endothelial cells, secrete cytokines and\u00a0growth factors that promote the migration and proliferation of smooth muscle cells (4).<\/p>\n<p>Cytokines of the IL-1 family, such as IL-18, have an important function in host defense, immune regulation, and inflammation. IL-18 is an immunoregulatory cytokine which requires cleavage with caspase-1 to become active, and it was originally discovered as a factor that enhances IFN-gamma production from Th1 cells in the presence of anti-CD3 or anti-TcR Ab (5). IL-18 is essential to host defenses against severe infections and is a potent pro-inflammatory cytokine able to induce IFN-gamma, GM-CSF, TNF, and IL-1 in immunocompetent cells, and to activate killing by lymphocytes.\u00a0\u00a0Human pre-adipocytes of all differentiation stages spontaneously secrete IL-18, supporting\u00a0the concept that adipocytes participate in innate\u00a0immunity and that IL-18 mediates a fraction of the\u00a0complications of obesity such as cardiovascular\u00a0disease. It is known that IL-18\u00a0release from adipocytes of patients with obesity exceeds\u00a0approximately 3-fold that from adipocytes of non-obese subjects (6). An augmentation of IL-18 is correlated with a significantly increased risk of developing cardiovascular diseases and type 2 diabetes. These concepts suggest that IL-18 measurement may add prognostic information to lipid and inflammatory markers in patients with or without\u00a0obesity.<\/p>\n<p>Inflammation is the defense response against infectious microorganisms and the low degree of inflammation that is already present in obesity can be exacerbated by infectious organisms. These reactions aggravate the pathological state that has been established in obesity.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>CONCLUSIONS<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p>Obesity is characterized by chronic, low-grade inflammation.\u00a0 The adipose tissue, in particular the visceral fat, secretes various pro-inflammatory cytokines such as TNF, IL-6, and CRP that promote systemic inflammation. Adipocytes and immune cells in the adipose tissue, such as macrophages, perform crucial roles in maintaining this inflammatory state. Chronic inflammation in obesity contributes to insulin resistance and cytokines interfere with insulin signaling pathways, exacerbating metabolic syndrome and type 2 diabetes.<\/p>\n<p>Understanding the mechanisms that regulate inflammation in infected subjects with obesity can certainly help improve health strategies. Reducing obesity and treating the infectious state improves the inflammatory state, leading to improvements in health.<\/p>\n<p>&nbsp;<\/p>\n<p><em>Conflict of interest <\/em><\/p>\n<p>The author declares that they have no conflict of interest.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>REFERENCES<\/strong><\/p>\n<ol>\n<li>Sabatine MS, Giugliano RP, Keech AC, et al. Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease. <em>New England Journal of Medicine<\/em>. 2017;376(18):1713-1722. doi:https:\/\/doi.org\/10.1056\/nejmoa1615664<\/li>\n<li>Khanna D, Khanna S, Khanna P, Kahar P, Patel BM. Obesity: A Chronic Low-Grade Inflammation and Its Markers. <em>Cureus<\/em>. 2022;14(2). doi:https:\/\/doi.org\/10.7759\/cureus.22711<\/li>\n<li>Brombacher F, Dorfm\u00fcller A, Magram J, et al. IL-12 is dispensable for innate and adaptive immunity against low doses of Listeria monocytogenes. <em>International Immunology<\/em>. 1999;11(3):325-332. doi:https:\/\/doi.org\/10.1093\/intimm\/11.3.325<\/li>\n<li>Chrysanthopoulou A, Mitroulis I, Apostolidou E, et al. Neutrophil extracellular traps promote differentiation and function of fibroblasts. <em>The Journal of Pathology<\/em>. 2014;233(3):294-307. doi:https:\/\/doi.org\/10.1002\/path.4359<\/li>\n<li>Nakanishi K. Unique Action of Interleukin-18 on T Cells and Other Immune Cells. <em>Frontiers in Immunology<\/em>. 2018;9. doi:https:\/\/doi.org\/10.3389\/fimmu.2018.00763<\/li>\n<li>Fain JN, Tichansky DS, Madan AK. Most of the interleukin 1 receptor antagonist, cathepsin S, macrophage migration inhibitory factor, nerve growth factor, and interleukin 18 release by explants of human adipose tissue is by the non\u2013fat cells, not by the adipocytes. <em>Metabolism<\/em>. 2006;55(8):1113-1121. doi:https:\/\/doi.org\/10.1016\/j.metabol.2006.04.008<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Pellegrino R. Obesity, inflammation, and infection. International Journal of Infection.&#46;&#46;&#46;<\/p>\n","protected":false},"author":1035,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":"","_members_access_role":[],"_members_access_error":""},"categories":[3004,27],"tags":[802,1177,154,3201,231],"class_list":["post-23749","post","type-post","status-publish","format-standard","hentry","category-iji-2022-vol-6-issue-n-3","category-iji-2024","tag-immunity","tag-infection","tag-inflammation","tag-inflammatory-mediator","tag-obesity"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>OBESITY, INFLAMMATION, AND INFECTION - International Journal of Infection<\/title>\n<meta name=\"description\" content=\"Founded in 1987, BIOLIFE is an independent, academic publisher of innovative, high-quality content. 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