Obesity is likely to become a major worldwide epidemic in the 21st
century. Clinical evidence demonstrates exaggerated inflammatory responses and
an enhanced tissue injury in obese subjects with cardiovascular disease, sepsis,
thrombosis and allergic diseases. Emerging evidence suggests that obesity per se is
associated with a systemic inflammatory response that is characterized by
endothelial cell dysfunction, oxidative stress, and the activation of circulating
immune cells. A large number of cytokine-like substances (adipokines) produced
by adipose tissue have been implicated in the systemic inflammatory response
associated with obesity. Insulin resistance also appears to contribute to the
inflammatory phenotype observed in obesity. There is emerging evidence from
experimental and clinical studies that implicate the microvasculature as a major
target for the deleterious effects of obesity-induced inflammation, and that the
altered microvascular responses underlie the exaggerated injury responses to
cardiovascular disease, sepsis, thrombosis and allergic diseases in obese subjects.
