Copyright ©2010 Baishideng. All rights reserved.
World J Diabetes. May 15, 2010; 1(2): 27-35
Published online May 15, 2010. doi: 10.4239/wjd.v1.i2.27
Exacerbation of chronic inflammatory diseases by infectious agents: Fact or fiction?
Cheng-Ming Wang, Bernhard Kaltenboeck
Cheng-Ming Wang, Ross University School of Veterinary Medicine, PO Box 334, Basseterre, St. Kitts, West Indies
Bernhard Kaltenboeck, Department of Pathobiology, College of Veterinary Medicine, Auburn University, 270 Greene Hall, Auburn, AL 36849-5519, United States
Author contributions: Wang CM and Kaltenboeck B structured the outline of this article; and Wang CM drafted this manuscript and both authors did the final editing.
Correspondence to: Cheng-Ming Wang, DVM, MSc, PhD, Assistant Professor, Ross University School of Veterinary Medicine, PO Box 334, Basseterre, St. Kitts, West Indies. chwang@rossvet.edu.kn
Telephone: +869-4654161 Fax: +869-4651203
Received: November 20, 2009
Revised: March 27, 2010
Accepted: April 3, 2010
Published online: May 15, 2010

Chronic inflammatory diseases caused by obesity represent critical public health concerns worldwide. In these diseases such as metabolic syndrome, diabetes and atherosclerosis, adipose tissue acts as an endocrine organ that releases large quantities of inflammatory mediators into circulation. Besides classically recognized effectors on the development of obesity and resultant conditions, infection has attracted attention as an enhancer of chronic inflammatory diseases. Infectious diseases have long been associated with obesity, metabolic syndrome, diabetes and atherosclerosis. However, the infectious hypothesis for chronic inflammatory diseases has been challenged by inconclusive clinical trials. Nevertheless, the large body of evidence accumulated over decades on the association of infectious diseases with obesity, diabetes and cardiovascular disease should not be disregarded. Instead, re-formulation of hypotheses of the mechanisms by which microbes affect obesity-associated diseases may be required with an emphasis on the early events in the progression of such diseases and the multifactorial nature of pathogen-host interactions. This review focuses on pathogens that directly promote obesity and on pathogens that cause chronic infections and thereby enhance metabolic diseases in obese patients. A new perspective on the interaction between infections and obesity-related diseases may improve management of chronic inflammatory diseases that rank high among global threats to human health.

Keywords: Chronic inflammatory diseases, Obesity, Diabetes, Adenovirus-36, Chlamydia pneumoniae