Emerging mechanisms of obesity-associated immune dysfunction.

Obesity is associated with a wide range of complications, including type 2 diabetes mellitus, cardiovascular disease, hypertension and nonalcoholic fatty liver disease. Obesity also increases the incidence and progression of cancers, autoimmunity and infections, as well as lowering vaccine responsiveness. A unifying concept across these differing diseases is dysregulated immunity, particularly inflammation, in response to metabolic overload. Herein, we review emerging mechanisms by which obesity drives inflammation and autoimmunity, as well as impairing tumour immunosurveillance and the response to infections. Among these mechanisms are obesity-associated changes in the hormones that regulate immune cell metabolism and function and drive inflammation. The cargo of extracellular vesicles derived from adipose tissue, which controls cytokine secretion from immune cells, is also dysregulated in obesity, in addition to impairments in fatty acid metabolism related to inflammation. Furthermore, an imbalance exists in obesity in the biosynthesis and levels of polyunsaturated fatty acid-derived oxylipins, which control a range of outcomes related to inflammation, such as immune cell chemotaxis and cytokine production. Finally, there is a need to investigate how obesity influences immunity using innovative model systems that account for the heterogeneous nature of obesity in the human population. In this Review, the emerging cellular and molecular mechanisms by which obesity impairs key aspects of immunity are discussed, including changes in the abundance of key hormones, dysregulation of adipose-tissue-derived extracellular vesicles and dysregulation of polyunsaturated fatty acid metabolism. Key points: Obesity dysregulates immunity through differing mechanisms, which contribute to a range of secondary complications. Obesity influences the level and function of nutritionally regulated hormones that regulate signalling pathways that mediate immune cell metabolism and function and drive inflammation. Expansion of adipose tissue dysregulates the abundance and composition of extracellular vesicles, which carry a wide range of cargo that can affect the activity of immune cells and lipid metabolism. Increased adiposity dysregulates polyunsaturated fatty acid metabolism; notably, the concentration of oxylipins synthesized from polyunsaturated fatty acids, which control a range of outcomes related to inflammation, is imbalanced in obesity. Investigating immunity in obesity requires translation from inbred rodents to humans; one approach is to use Diverse Outbred and Collaborative Cross mouse populations that can model the heterogeneous nature of human obesity. [ABSTRACT FROM AUTHOR]