title: Anti-inflammatory agents to treat or prevent type 2 diabetes, metabolic syndrome and cardiovascular disease.
abstract: BACKGROUND
  There is a growing body of evidence to suggest that chronic silent inflammation is a key feature in abdominal obesity, metabolic syndrome, type 2 diabetes (T2DM) and cardiovascular disease (CVD). These observations suggest that pharmacological strategies, which reduce inflammation, may be therapeutically useful in treating obesity, type 2 diabetes and associated CVD.
  
  
  METHODS
  The article covers novel strategies, using either small molecules or monoclonal antibodies. These strategies include: approaches targeting IKK-b-NF-kB (salicylates, salsalate), TNF-α (etanercept, infliximab, adalimumab), IL-1β (anakinra, canakinumab) and IL-6 (tocilizumab), AMP-activated protein kinase activators, sirtuin-1 activators, mammalian target of rapamycin inhibitors and C-C motif chemokine receptor 2 antagonists.
  
  
  CONCLUSIONS
  The available data supports the concept that targeting inflammation improves insulin sensitivity and β-cell function; it also ameliorates glucose control in insulin-resistant patients with inflammatory rheumatoid diseases as well in patients with metabolic syndrome or T2DM. Although promising, the observed metabolic effects remain rather modest in most clinical trials. The potential use of combined anti-inflammatory agents targeting both insulin resistance and insulin secretion appears appealing but remains unexplored. Large-scale prospective clinical trials are underway to investigate the safety and efficacy of different anti-inflammatory drugs. Further evidence is needed to support the concept that targeting inflammation pathways may represent a valuable option to tackle the cardiometabolic complications of obesity.
authors.affiliation: University of Liege and Division of Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, Virology and Immunology Unit, GIGA-ST , CHU Liège, Liège , Belgium.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Esser
authors.forename: Nicolas
authors.initials: N
authors.lastname: Paquot
authors.forename: André J
authors.initials: AJ
authors.lastname: Scheen
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control; D015195:Drug Design; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000188:drug therapy*; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control; D009765:Obesity / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D000893:Anti-Inflammatory Agents; D007328:Insulin
keywords: IL-1; TNF-α; cardiovascular disease; inflammation; insulin resistance; salsalate; type 2 diabetes mellitus