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Reddy P, Lent-Schochet D, Ramakrishnan N, McLaughlin M, Jialal I. Metabolic syndrome is an inflammatory disorder: A conspiracy between adipose tissue and phagocytes. Clin Chim Acta 2019; 496:35-44. [PMID: 31229566 DOI: 10.1016/j.cca.2019.06.019] [Citation(s) in RCA: 159] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 06/18/2019] [Accepted: 06/19/2019] [Indexed: 12/14/2022]
Abstract
Metabolic syndrome (MetS) describes a cluster of cardio-metabolic factors that predispose to type 2 diabetes mellitus (T2DM) and atherosclerotic cardiovascular disease (ASCVD). While 35% of Americans suffer from this disorder, the specific pathways related to this disease are largely underexplored. The prevailing consensus is that inflammatory pathways contribute to the pathogenesis of this disease, and therefore new research has uncovered how inflammation plays a critical role in the development and progression of MetS. The purpose of this review is to understand the role of major inflammatory mechanisms and their role in MetS. Our review identifies that adipose tissue (AT) contributes to the inflammatory pathways through the release of pro-inflammatory adipokines such as leptin and chemerin and dysregulation of anti-inflammatory adiponectin. Chemokines and cytokines deriving from monocytes are also altered and promote inflammation and insulin resistance. Circulating inflammatory biomarkers including C-reactive protein (CRP), fibrinogen, Serum amyloid A (SAA), cytokines, and chemokines have also been linked to the pathogenesis of MetS. Researchers have identified the significance of CRP levels in predicting future sequelae of MetS such as ASCVD. Mast cells in subcutaneous adipose tissue (SAT) promote both inflammation and fibrosis. Thus, both AT and phagocyte activity define MetS as an inflammatory disorder.
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Affiliation(s)
- Priya Reddy
- California Northstate University, College of Medicine, Elk Grove, CA 95757, USA
| | | | - Neeraj Ramakrishnan
- California Northstate University, College of Medicine, Elk Grove, CA 95757, USA
| | - Matthew McLaughlin
- California Northstate University, College of Medicine, Elk Grove, CA 95757, USA
| | - Ishwarlal Jialal
- California Northstate University, College of Medicine, Elk Grove, CA 95757, USA; VA Medical Center, Mather, CA 95757, USA.
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4
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Schüssler-Fiorenza Rose SM, Contrepois K, Moneghetti KJ, Zhou W, Mishra T, Mataraso S, Dagan-Rosenfeld O, Ganz AB, Dunn J, Hornburg D, Rego S, Perelman D, Ahadi S, Sailani MR, Zhou Y, Leopold SR, Chen J, Ashland M, Christle JW, Avina M, Limcaoco P, Ruiz C, Tan M, Butte AJ, Weinstock GM, Slavich GM, Sodergren E, McLaughlin TL, Haddad F, Snyder MP. A longitudinal big data approach for precision health. Nat Med 2019; 25:792-804. [PMID: 31068711 PMCID: PMC6713274 DOI: 10.1038/s41591-019-0414-6] [Citation(s) in RCA: 234] [Impact Index Per Article: 46.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 03/06/2019] [Indexed: 12/31/2022]
Abstract
Precision health relies on the ability to assess disease risk at an individual level, detect early preclinical conditions and initiate preventive strategies. Recent technological advances in omics and wearable monitoring enable deep molecular and physiological profiling and may provide important tools for precision health. We explored the ability of deep longitudinal profiling to make health-related discoveries, identify clinically relevant molecular pathways and affect behavior in a prospective longitudinal cohort (n = 109) enriched for risk of type 2 diabetes mellitus. The cohort underwent integrative personalized omics profiling from samples collected quarterly for up to 8 years (median, 2.8 years) using clinical measures and emerging technologies including genome, immunome, transcriptome, proteome, metabolome, microbiome and wearable monitoring. We discovered more than 67 clinically actionable health discoveries and identified multiple molecular pathways associated with metabolic, cardiovascular and oncologic pathophysiology. We developed prediction models for insulin resistance by using omics measurements, illustrating their potential to replace burdensome tests. Finally, study participation led the majority of participants to implement diet and exercise changes. Altogether, we conclude that deep longitudinal profiling can lead to actionable health discoveries and provide relevant information for precision health.
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Affiliation(s)
- Sophia Miryam Schüssler-Fiorenza Rose
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
- Spinal Cord Injury Service, Veteran Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Kévin Contrepois
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Kegan J Moneghetti
- Stanford Cardiovascular Institute, Stanford University, Stanford, CA, USA
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Medicine, St Vincent's Hospital, University of Melbourne, Melbourne, Australia
| | - Wenyu Zhou
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Tejaswini Mishra
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Samson Mataraso
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, CA, USA
- Department of Bioengineering, University of California, Berkeley, Berkeley, CA, USA
| | - Orit Dagan-Rosenfeld
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Ariel B Ganz
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Jessilyn Dunn
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
- Mobilize Center, Stanford University, Stanford, CA, USA
| | - Daniel Hornburg
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Shannon Rego
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Dalia Perelman
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Sara Ahadi
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - M Reza Sailani
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Yanjiao Zhou
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
- Department of Medicine, University of Connecticut Health, Farmington, CT, USA
| | - Shana R Leopold
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - Jieming Chen
- Bakar Computational Health Sciences Institute and Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Melanie Ashland
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Jeffrey W Christle
- Stanford Cardiovascular Institute, Stanford University, Stanford, CA, USA
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Monika Avina
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Patricia Limcaoco
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Camilo Ruiz
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Marilyn Tan
- Division of Endocrinology, Stanford University School of Medicine, Stanford, CA, USA
| | - Atul J Butte
- Bakar Computational Health Sciences Institute and Department of Pediatrics, University of California, San Francisco, CA, USA
| | | | - George M Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Erica Sodergren
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - Tracey L McLaughlin
- Division of Endocrinology, Stanford University School of Medicine, Stanford, CA, USA
| | - Francois Haddad
- Stanford Cardiovascular Institute, Stanford University, Stanford, CA, USA.
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
| | - Michael P Snyder
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA.
- Stanford Cardiovascular Institute, Stanford University, Stanford, CA, USA.
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5
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Marimuthu R, Francis H, Dervish S, Li SCH, Medbury H, Williams H. Characterization of Human Monocyte Subsets by Whole Blood Flow Cytometry Analysis. J Vis Exp 2018. [PMID: 30394370 PMCID: PMC6235554 DOI: 10.3791/57941] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Monocytes are key contributors in various inflammatory disorders and alterations to these cells, including their subset proportions and functions, can have pathological significance. An ideal method for examining alterations to monocytes is whole blood flow cytometry as the minimal handling of samples by this method limits artifactual cell activation. However, many different approaches are taken to gate the monocyte subsets leading to inconsistent identification of the subsets between studies. Here we demonstrate a method using whole blood flow cytometry to identify and characterize human monocyte subsets (classical, intermediate, and non-classical). We outline how to prepare the blood samples for flow cytometry, gate the subsets (ensure contaminating cells have been removed), and determine monocyte subset expression of surface markers - in this example M1 and M2 markers. This protocol can be extended to other studies that require a standard gating method for assessing monocyte subset proportions and monocyte subset expression of other functional markers.
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Affiliation(s)
- Rekha Marimuthu
- Department of Surgery, Vascular Biology Research Centre, Westmead Hospital; Westmead Clinical School, Department of Surgery, The University of Sydney
| | - Habib Francis
- Department of Surgery, Vascular Biology Research Centre, Westmead Hospital; Westmead Clinical School, Department of Surgery, The University of Sydney
| | - Suat Dervish
- Westmead Research Hub, Westmead Institute for Medical Research
| | - Stephen C H Li
- Institute for Clinical Pathology and Medical Research, Westmead Hospital
| | - Heather Medbury
- Department of Surgery, Vascular Biology Research Centre, Westmead Hospital; Westmead Clinical School, Department of Surgery, The University of Sydney;
| | - Helen Williams
- Department of Surgery, Vascular Biology Research Centre, Westmead Hospital; Westmead Clinical School, Department of Surgery, The University of Sydney
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