Hamostaseologie 2015; 35(03): 279-283
DOI: 10.5482/HAMO-14-11-0068
Review
Schattauer GmbH

Tissue factor pathways linking obesity and inflammation

Extrinsische Gerinnungsaktivierung an der Schittstelle von Entzündung und Adipositas
W. Ruf
1   University Medical Center, Center for Thrombosis and Hemostasis, Mainz, Rhineland-Palitinate, Germany
,
F. Samad
2   San Diego Biomedical Research Institute, San Diego, California, USA
› Author Affiliations

The investigators are supported by NIH grants HL71146 and HL104232 (FS), HL77753 and HL31950 (WR), and the Humboldt Foundation of Germany (WR).
Further Information

Publication History

received: 16 November 2014

accepted in revised form: 13 January 2015

Publication Date:
28 December 2017 (online)

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Summary

Obesity is a major cause for a spectrum of metabolic syndrome-related diseases that include insulin resistance, type 2 diabetes, and steatosis of the liver. Inflammation elicited by macrophages and other immune cells contributes to the metabolic abnormalities in obesity. In addition, coagulation activation following tissue factor (TF) upregulation in adipose tissue is frequently found in obese patients and particularly associated with diabetic complications. Genetic and pharmacological evidence indicates that TF makes significant contributions to the development of the metabolic syndrome by signaling through G protein-coupled protease activated receptors (PARs). Adipocyte TF-PAR2 signaling contributes to diet-induced obesity by decreasing metabolism and energy expenditure, whereas hematopoietic TF-PAR2 signaling is a major cause for adipose tissue inflammation, hepatic steatosis and inflammation, as well as insulin resistance. In the liver of mice on a high fat diet, PAR2 signaling increases transcripts of key regulators of gluconeogenesis, lipogenesis and inflammatory cytokines. Increased markers of hepatic gluconeogenesis correlate with decreased activation of AMP-activated protein kinase (AMPK), a known regulator of these pathways and a target for PAR2 signaling. Clinical markers of a TF-induced prothrombotic state may thus indicate a risk in obese patient for developing complications of the metabolic syndrome.

Zusammenfassung

Adipositas führt zu extrinsischer Gerinnungsaktivierung durch den zellständigen Rezeptor Tissue Factor (TF) im Fettgewebe. Studien in Mausmodellen belegen, dass TF und der durch die von TF-assozierten Proteasen stimulierten Protease Activated Receptors 2 (PAR2) in der Entwicklung der Adipositas und deren pathologischen Konsequenzen eine wesentliche Rolle spielen. Inhibierung von TF und der TF-PAR2-Signaltransduktionswege verbessern nicht nur die Thromboseneigung, sondern auch das Entzündungsgeschehen im Fettgewebe und die Entwicklung von Diabetes und Leberdysfunktion.