Metainflammation in Diabetic Coronary Artery Disease: Emerging Role of Innate and Adaptive Immune Responses

Abstract

Globally, noncommunicable chronic diseases such as Type-2 Diabetes Mellitus (T2DM) and Coronary Artery Disease (CAD) are posing a major threat to the world. T2DM is known to potentiate CAD which had led to the coining of a new clinical entity named diabetic CAD (DM-CAD), leading to excessive morbidity and mortality. The synergistic interaction between these two comorbidities is through sterile inflammation which is now being addressed as metabolic inflammation or metainflammation, which plays a pivotal role during both early and late stages of T2DM and also serves as a link between T2DM and CAD. This review summarises the current concepts on the role played by both innate and adaptive immune responses in setting up metainflammation in DM-CAD. More specifically, the role played by innate pattern recognition receptors (PRRs) like Toll-like receptors (TLRs), NOD1-like receptors (NLRs), Rig-1-like receptors (RLRs), and C-type lectin like receptors (CLRs) and metabolic endotoxemia in fuelling metainflammation in DM-CAD would be discussed. Further, the role played by adaptive immune cells (Th1, Th2, Th17, and Th9 cells) in fuelling metainflammation in DM-CAD will also be discussed.

Trauma exposure and stress‐related disorders in African‐American women with diabetes mellitus

“…Additionally, individuals with PTSD and MDD display altered sensitivity to glucocorticoids that can lead to increases in abdominal fat and insulin resistance . Inflammation and neuroendocrine dysfunction are also risk factors for type 2 diabetes . While this dysregulation of the HPA axis and inflammatory system has been implicated in increased risk for metabolic disorders in those with psychopathology, prospective longitudinal studies are necessary to elucidate the causal mechanisms underlying increased risk for type 2 diabetes following the development of MDD and PTSD.…”

Ellagic Acid Reduces High Glucose-Induced Vascular Oxidative Stress Through ERK1/2/NOX4 Signaling Pathway

“…Together with oxidative stress effects, inflammation also plays a crucial role in the vascular complications in diabetic populations [63]. Studies have demonstrated that there is an increase in serum and tissue inflammatory markers and mediators in the hyperglycemic state [64], and that hypoglycemic agents exert an anti-inflammatory effect in diabetic patients [65]. EA itself has been studied for its anti-inflammatory effects and previous studies have shown that EA suppressed the production of cytokines, prostaglandins, and other inflammatory markers [66].…”

Cell Type-Specific Immunomodulation Induced by Helminthes: Effect on Metainflammation, Insulin Resistance and Type-2 Diabetes

“…3 This is now being addressed as metabolic inflammation or metainflammation and plays a pivotal role during both early and late stages of T2DM and also serves as a link between T2DM and coronary artery disease (CAD). 4 IR typically starts as an organ-specific inflammation affecting the major organs of insulin action, namely, adipose tissue (AT), skeletal muscles, and liver. With disease progression, the inflammation becomes more systemic and starts affecting the blood vessels, leading to endothelial dysfunction-a prestage for vasculopathies.…”