The proper functioning of the pathways that are involved in the sensing and management of nutrients is central to metabolic homeostasis and is therefore among the most fundamental requirements for survival. Metabolic systems are integrated with pathogen-sensing and immune responses, and these pathways are evolutionarily conserved. This close functional and molecular integration of the immune and metabolic systems is emerging as a crucial homeostatic mechanism, the dysfunction of which underlies many chronic metabolic diseases, including type 2 diabetes and atherosclerosis. In this Review we provide an overview of several important networks that sense and manage nutrients and discuss how they integrate with immune and inflammatory pathways to influence the physiological and pathological metabolic states in the body.The integration of metabolism and immunity (or of nutrient-and pathogen-sensing pathways) can be traced back to an evolutionary need for survival, which resulted in the co-development of the organ systems and signalling pathways that mediate these two processes 1 . The pressure to survive would have favoured energy efficiency and storage to prepare for times of food deprivation and for mounting a potent immune response to defend the host against infectious agents. However, the initiation and maintenance of immunity is a metabolically costly endeavour and cannot operate efficiently under conditions of energy deficit 2,3 . For example, fever is associated with a 7-13% increase in caloric energy consumption per 1°C increase in body temperature, the energy expenditure of which is estimated to equate to 9.4×10 6 joules; this is approximately the energy cost of a 70 kg person walking 45 km 4,5 . Sepsis can increase the human metabolic rate by 30-60% 6 . Furthermore, the production and maintenance of phagocytes during infection is thought to result in an energy consumption of approximately 7.9×10 5 joules 4 .It is also clear that starvation and malnutrition can impair immune function; a total reduction in body fat has been shown to result in a decrease in the energy that is available for immune responses in rodents 7 . In addition, conditions that trigger an immune response during starvation can severely reduce the survival of insects 8 . Therefore, immune defence is subject to a tradeoff between other energy-demanding processes, such as reproduction, thermoregulation and lactation. Interestingly, energy surplus (which is typical of individuals who are obese or suffer from metabolic syndrome) can also impair immune responses and induce chronic inflammation (see later). Therefore, a balanced energy flux and maintainance of favourable metabolic homeostasis are required for the proper functioning of the immune system. These processes may have been optimized through the close coordination and co-evolution of metabolic and immune responses, and of the organs that are involved in these processes.Correspondence to G.S.H. ghotamis@hsph.harvard.edu.
Competing interests statementThe author(s) declare(s) competi...