Published online May 15, 2023. doi: 10.4239/wjd.v14.i5.494
Peer-review started: December 28, 2022
First decision: February 20, 2023
Revised: March 6, 2023
Accepted: March 30, 2023
Article in press: March 30, 2023
Published online: May 15, 2023
Processing time: 138 Days and 8.3 Hours
Obesity and overweight are widespread issues in adults, children, and adolescents globally, and have caused a noticeable rise in obesity-related complications such as type 2 diabetes mellitus (T2DM). Chronic low-grade inflammation is an important promotor of the pathogenesis of obesity-related T2DM. This proinflammatory activation occurs in multiple organs and tissues. Immune cell-mediated systemic attack is considered to contribute strongly to impaired insulin secretion, insulin resistance, and other metabolic disorders. This review focused on highlighting recent advances and underlying mechanisms of immune cell infiltration and inflammatory responses in the gut, islet, and insulin-targeting organs (adipose tissue, liver, skeletal muscle) in obesity-related T2DM. There is current evidence that both the innate and adaptive immune systems contribute to the development of obesity and T2DM.
Core Tip: Obesity is closely associated with the occurrence and development of insulin resistance and type 2 diabetes mellitus (T2DM). Previous studies have demonstrated the important role of immune cell infiltration and inflammatory response in obesity-related T2DM. This review presents immune responses in the gut with respect to metabolic challenges. We also highlight the effects of immune attacks and proinflammatory shifts on insulin-secreting and targeting organs.