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19РОЛЬ ПРОВОСПАЛИТЕЛЬНЫХ ЦИТОКИНОВ ПРИ МЕТАБОЛИЧЕСКОМ
СИНДРОМЕ
Усманова Умида Иминжановна Олимов Дилшодбек Махамадвалиевич
Андижанский государственный медицинский институт
Статья охватывает литературные данные информирующие взаимосвяь провоспалительных цитокинов и ожирения. Изучение патофизиологических механизмов, лежащих в основе ожирения, имеет решающее значение для разработки эффективных терапевтических стратегий борьбы с этим заболеванием, вызывающим множество патологий, включая развитие «провоспалительного состояния». В связи с этим, исследование провоспалительных цитокинов имеет особую значимость в развитие метаболического синдрома.
Ключевые слова: провоспалительные цитокины, ожирение,
инсулинорезистентность, жировая ткань,антиоксидантные ферменты.
THE ROLE OF PROINFLAMMA TOR Y CYTOKINES IN METABOLIC SYNDROME
The article covers the literature data informing the relationship of proinflammatory cytokines and obesity. The study of the pathophysiological mechanisms underlying obesity is crucial for the development of effective therapeutic strategies to combat this disease, which causes many pathologies, including the development of a "pro-inflammatory condition". In this regard, the study of proinflammatory cytokines is of particular importance in the development of metabolic syndrome.
Keywords: proinflammatory cytokines, obesity, insulin resistance, adipose tissue,antioxidant enzymes.
METABOLIK SINDROMDA YALLIG'LANISHGA QARSHISITOKINLARNING ROLI
Maqolada yallig'lanishga qarshi sitokinlar va semirishning ozaro bog'liqligi to'g'risida adabiy ma'lumotlar keltirilgan. Semirib ketish asosidagi patofiziologik mexanizmlarni o'rganish ko'plab patologiyalarni, shu jumladan "yallig'lanishga qarshi holat"ni rivojlantirishni o'z ichiga olgan ushbu kasallik bilan kurashishda effektiv terapevtik strategiyasini ishlab chiqishda hal qiluvchi ahamiyatga ega. Shuning uchun yallig'lanishga qarshi sitokinlarni o'rganish metabolik sindromning rivojlanishida alohida ahamiyatga ega.
Kalit so'zlar: yallig'lanishga qarshi sitokinlar, semirish, insulin qarshiligi, yog' to'qimasi, antioksidant fermentlar.
Obesity is a chronic metabolic disease caused by excessive accumulation of fat deposits . The global spread of obesity is growing rapidly every year. With obesity, violations of the activity of most organs and systems of the human body occur. Adolescents and persons of able-bodied reproductive age are increasingly obese. Metabolic syndrome is a condition characterized by obesity, insulin resistance, hypertension and hyperlipidemia, which leads to the development of a number of diseases, including type 2 diabetes mellitus, cardiovascular diseases, non-alcoholic steatohepatitis and cancer [1, 2]. These metabolic diseases are the leading causes of death at present [12]. Thus, obesity appears to be a public health and clinical medicine problem all over the world [9].
In clinical practice, obesity is diagnosed if the body mass index (BMI) exceeds 30 kg/m2 [4]. BMI is the most common indicator for assessing obesity, at the same time it is not accurate enough, since obesity is estimated only on the basis of a person's weight, without taking into account muscle mass. People with the same BMI may have completely different health conditions and risk factors [6]. In people with an athletic physique, the definition of BMI is a low-informative indicator due to the fact that most people with such a physique have activities associated with physical labor or active physical training, the result of which is an increase in muscle mass [1].
The main function of adipose tissue is to store excess energy, however, in addition, adipose tissue is an endocrine organ that secretes a large range of proinflammatory cytokines and adipokines, while inducing a state of chronic subinflammation. Adipose tissue is a key link in metabolic communications, regulates the reproduction process, coordinates the functions of the immune system, controls the sensitivity of tissues to insulin, vascular tone, bone metabolism and hematopoiesis; provides thermoregulation [8]. The study of the pathophysiological mechanisms underlying obesity is crucial for the development of effective therapeutic strategies to combat with this disease, which causes many pathologies, including the development of a "pro-inflammatory condition".Interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-a) are pro-inflammatory cytokines that affect the development of obesity, as well as concomitant diseases, which include hypertension, type 2 diabetes mellitus (DM2) and metabolic disorders. Antiinflammatory cytokines are involved in the regulation of energy balance, lipid and carbohydrate metabolism [5].Among proinflammatory cytokines, IL-6 is key in the activation of the immune response. IL-6 serves as a factor of lymphocyte differentiation and synthesis of acute phase proteins in the liver, has an effect on hormonal changes in endocrinological disorders [13]. It is assumed that IL-6 can affect the increase in the level of free fatty acids. IL-6 concentration is increased in patients with impaired lipid metabolism and insulin resistance .A number of researchers claim that during the beginning of physical exercises there is a marked increase in the concentration of IL-6 in muscle tissue. Skeletal muscles may be an important target of the action of this cytokine [11]. Studies by M.A. Febbraio et al. It has been shown that IL-6 can promote the capture and utilization of glucose by working muscles [10].
Thus, IL-6 promotes weight loss, as it has a lipolytic effect, in addition, it plays an important role in the development of an inflammatory reaction and is able to induce the development of peripheral insulin resistance in the liver and adipose tissue [7]. The leading mechanism of cell damage is an increased content of reactive oxygen species (ROS). IL-6 induces the production of ROS, causing oxidative stress (OS) [13]. OS is the process of cell damage as a result of oxidation. Since adipose tissue is an organ that secretes adipokines, which, in turn, generate ROS, adipose tissue is considered an independent factor in the formation of systemic OS. There are several mechanisms by which obesity causes OS [11]. The first of these is mitochondrial and peroxisomal fatty acid oxidation, which can produce ROS in oxidation reactions, while another mechanism is excessive oxygen consumption, which generates free radicals in the mitochondrial respiratory chain, which is found in combination with oxidative phosphorylation in mitochondria [12]. Lipid-rich foods are also capable of generating ROS, as they can alter oxygen metabolism. It was found that with an increase in adipose tissue, the activity of antioxidant enzymes, such as superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GP), significantly decreases [8].
In this regard, a systemic increase in the level of IL-6 will lead to adverse consequences. Chronic elevation of IL-6 levels in blood plasma is associated with obesity and insulin resistance, however, decreased secretion and impaired action of IL-6 are proven risk factors for obesity TNF-a, like IL-6, is a proinflammatory cytokine characterized by a wide range of functions, which also include cytotoxic and cytostatic action against cancer cells . TNF-a is secreted mainly by macrophages and lymphocytes in response to cell damage caused by infection or malignant transformation [13]. However, it can also be secreted by many other types of cells and tissues, for example by adipocytes
Conclusions. The analysis of the literature has shown that interleukins are involved in the development of obesity. Proinflammatory cytokines are expressed in obesity. Since inflammation is an adaptive and, importantly, energy-consuming process, the rapid mobilization of accumulated energy reserves by cytokines, such as interleukins, is crucial in an inflammatory response.
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