RT Journal Article
SR Electronic
T1 Are Obesity-Related Insulin Resistance and Type 2 Diabetes Autoimmune Diseases?
JF Diabetes
JO Diabetes
FD American Diabetes Association
SP 1886
OP 1897
DO 10.2337/db14-1488
VO 64
IS 6
A1 Tsai, Sue
A1 Clemente-Casares, Xavier
A1 Revelo, Xavier S.
A1 Winer, Shawn
A1 Winer, Daniel A.
YR 2015
UL http://diabetes.diabetesjournals.org/content/64/6/1886.abstract
AB Obesity and associated insulin resistance predispose individuals to develop chronic metabolic diseases, such as type 2 diabetes and cardiovascular disease. Although these disorders affect a significant proportion of the global population, the underlying mechanisms of disease remain poorly understood. The discovery of elevated tumor necrosis factor-α in adipose tissue as an inducer of obesity-associated insulin resistance marked a new era of understanding that a subclinical inflammatory process underlies the insulin resistance and metabolic dysfunction that precedes type 2 diabetes. Advances in the field identified components of both the innate and adaptive immune response as key players in regulating such inflammatory processes. As antigen specificity is a hallmark of an adaptive immune response, its role in modulating the chronic inflammation that accompanies obesity and type 2 diabetes begs the question of whether insulin resistance and type 2 diabetes can have autoimmune components. In this Perspective, we summarize current data that pertain to the activation and perpetuation of adaptive immune responses during obesity and discuss key missing links and potential mechanisms for obesity-related insulin resistance and type 2 diabetes to be considered as potential autoimmune diseases.