title: Connecting type 1 and type 2 diabetes through innate immunity.
abstract: The escalating epidemic of obesity has driven the prevalence of both type 1 and 2 diabetes mellitus to historically high levels. Chronic low-grade inflammation, which is present in both type 1 and type 2 diabetics, contributes to the pathogenesis of insulin resistance. The accumulation of activated innate immune cells in metabolic tissues results in release of inflammatory mediators, in particular, IL-1β and TNFα, which promote systemic insulin resistance and β-cell damage. In this article, we discuss the central role of innate immunity and, in particular, the macrophage in insulin sensitivity and resistance, β-cell damage, and autoimmune insulitis. We conclude with a discussion of the therapeutic implications of this integrated understanding of diabetic pathology.
authors.affiliation: Department of Pathology, Stanford University School of Medicine, Stanford, California 94305, USA.
authors.forename: Justin I
authors.initials: JI
authors.lastname: Odegaard
authors.forename: Ajay
authors.initials: A
authors.lastname: Chawla
mesh_terms: D056704:Adaptive Immunity / Q000502:physiology; D000273:Adipose Tissue / Q000276:immunology / Q000503:physiopathology; D001402:B-Lymphocytes / Q000276:immunology; D016207:Cytokines / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology*; D003924:Diabetes Mellitus, Type 2 / Q000276:immunology*; D006801:Humans; D007113:Immunity, Innate; D058847:Inflammasomes / Q000502:physiology; D007249:Inflammation / Q000503:physiopathology; D018836:Inflammation Mediators / Q000276:immunology / Q000502:physiology*; D007333:Insulin Resistance / Q000276:immunology / Q000502:physiology*; D053583:Interleukin-1beta / Q000276:immunology; D007728:Kupffer Cells / Q000502:physiology; D008099:Liver / Q000503:physiopathology; D008264:Macrophages / Q000276:immunology / Q000502:physiology*; D009765:Obesity / Q000276:immunology / Q000503:physiopathology; D011972:Receptor, Insulin / Q000502:physiology; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology
chemical_list: D016207:Cytokines; D058847:Inflammasomes; D018836:Inflammation Mediators; D053583:Interleukin-1beta; D014409:Tumor Necrosis Factor-alpha; D011972:Receptor, Insulin