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2016 ; 94
(3
): 267-75
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Emerging evidence for beneficial macrophage functions in atherosclerosis and
obesity-induced insulin resistance
#MMPMID26847458
Fitzgibbons TP
; Czech MP
J Mol Med (Berl)
2016[Mar]; 94
(3
): 267-75
PMID26847458
show ga
The discovery that obesity promotes macrophage accumulation in visceral fat led
to the emergence of a new field of inquiry termed "immunometabolism". This broad
field of study was founded on the premise that inflammation and the corresponding
increase in macrophage number and activity was a pathologic feature of metabolic
diseases. There is abundant data in both animal and human studies that supports
this assertation. Established adverse effects of inflammation in visceral fat
include decreased glucose and fatty acid uptake, inhibition of insulin signaling,
and ectopic triglyceride accumulation. Likewise, in the atherosclerotic plaque,
macrophage accumulation and activation results in plaque expansion and
destabilization. Despite these facts, there is an accumulating body of evidence
that macrophages also have beneficial functions in both atherosclerosis and
visceral obesity. Potentially beneficial functions that are common to these
different contexts include the regulation of efferocytosis, lipid buffering, and
anti-inflammatory effects. Autophagy, the process by which cytoplasmic contents
are delivered to the lysosome for degradation, is integral to many of these
protective biologic functions. The macrophage utilizes autophagy as a molecular
tool to maintain tissue integrity and homeostasis at baseline (e.g., bone growth)
and in the face of ongoing metabolic insults (e.g., fasting,
hypercholesterolemia, obesity). Herein, we highlight recent evidence
demonstrating that abrogation of certain macrophage functions, in particular
autophagy, exacerbates both atherosclerosis and obesity-induced insulin
resistance. Insulin signaling through mammalian target of rapamycin (mTOR) is a
crucial regulatory node that links nutrient availability to macrophage autophagic
flux. A more precise understanding of the metabolic substrates and triggers for
macrophage autophagy may allow therapeutic manipulation of this pathway. These
observations underscore the complexity of the field "immunometabolism", validate
its importance, and raise many fascinating and important questions for future
study.