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Erschienen in: Diabetologia 3/2014

01.03.2014 | Article

Local proliferation of macrophages in adipose tissue during obesity-induced inflammation

verfasst von: Julia Haase, Ulrike Weyer, Kerstin Immig, Nora Klöting, Matthias Blüher, Jens Eilers, Ingo Bechmann, Martin Gericke

Erschienen in: Diabetologia | Ausgabe 3/2014

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Abstract

Aims/hypothesis

Obesity is frequently associated with low-grade inflammation of adipose tissue (AT), and the increase in adipose tissue macrophages (ATMs) is linked to an increased risk of type 2 diabetes. Macrophages have been regarded as post-mitotic, but recent observations have challenged this view. In this study, we tested the hypothesis that macrophages proliferate within AT in diet-induced obesity in mice and humans.

Methods

We studied the expression of proliferation markers by immunofluorescence, PCR and flow cytometry in three different models of mouse obesity as well as in humans (n = 239). The cell fate of dividing macrophages was assessed by live imaging of AT explants.

Results

We show that ATMs undergo mitosis within AT, predominantly within crown-like structures (CLS). We found a time-dependent increase in ATM proliferation when mice were fed a high-fat diet. Upregulation of CD206 and CD301 in proliferating ATMs indicated preferential M2 polarisation. Live imaging within AT explants from mice revealed that macrophages emigrate out of the CLS to become resident in the interstitium. In humans, we confirmed the increased expression of proliferation markers of CD68+ macrophages in CLS and demonstrated a higher mRNA expression of the proliferation marker Ki67 in AT from obese patients.

Conclusions/interpretation

Local proliferation contributes to the increase in M2 macrophages in AT. Our data confirm CLS as the primary site of proliferation and a new source of ATMs and support a model of different recruitment mechanisms for classically activated (M1) and alternatively activated (M2) macrophages in obesity.
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Literatur
1.
Zurück zum Zitat James WP (2008) WHO recognition of the global obesity epidemic. Int J Obes 32(Suppl 7):S120–S126CrossRef James WP (2008) WHO recognition of the global obesity epidemic. Int J Obes 32(Suppl 7):S120–S126CrossRef
2.
Zurück zum Zitat Olshansky SJ, Passaro DJ, Hershow RC et al (2005) A potential decline in life expectancy in the United States in the 21st century. N Engl J Med 352:1138–1145PubMedCrossRef Olshansky SJ, Passaro DJ, Hershow RC et al (2005) A potential decline in life expectancy in the United States in the 21st century. N Engl J Med 352:1138–1145PubMedCrossRef
3.
4.
Zurück zum Zitat Weisberg SP, McCann D, Desai M, Rosenbaum M, Leibel RL, Ferrante AW (2003) Obesity is associated with macrophage accumulation in adipose tissue. J Clin Investig 112:1796–1808PubMedCrossRef Weisberg SP, McCann D, Desai M, Rosenbaum M, Leibel RL, Ferrante AW (2003) Obesity is associated with macrophage accumulation in adipose tissue. J Clin Investig 112:1796–1808PubMedCrossRef
5.
Zurück zum Zitat Nishimura S, Manabe I, Nagasaki M et al (2009) CD8+ effector T cells contribute to macrophage recruitment and adipose tissue inflammation in obesity. Nat Med 15:914–920PubMedCrossRef Nishimura S, Manabe I, Nagasaki M et al (2009) CD8+ effector T cells contribute to macrophage recruitment and adipose tissue inflammation in obesity. Nat Med 15:914–920PubMedCrossRef
6.
Zurück zum Zitat Winer DA, Winer S, Shen L et al (2011) B cells promote insulin resistance through modulation of T cells and production of pathogenic IgG antibodies. Nat Med 17:610–617PubMedCentralPubMedCrossRef Winer DA, Winer S, Shen L et al (2011) B cells promote insulin resistance through modulation of T cells and production of pathogenic IgG antibodies. Nat Med 17:610–617PubMedCentralPubMedCrossRef
7.
Zurück zum Zitat Liu J, Divoux A, Sun J et al (2009) Genetic deficiency and pharmacological stabilization of mast cells reduce diet-induced obesity and diabetes in mice. Nat Med 15:940–945PubMedCentralPubMedCrossRef Liu J, Divoux A, Sun J et al (2009) Genetic deficiency and pharmacological stabilization of mast cells reduce diet-induced obesity and diabetes in mice. Nat Med 15:940–945PubMedCentralPubMedCrossRef
8.
Zurück zum Zitat Elgazar-Carmon V, Rudich A, Hadad N, Levy R (2008) Neutrophils transiently infiltrate intra-abdominal fat early in the course of high-fat feeding. J Lipid Res 49:1894–1903PubMedCrossRef Elgazar-Carmon V, Rudich A, Hadad N, Levy R (2008) Neutrophils transiently infiltrate intra-abdominal fat early in the course of high-fat feeding. J Lipid Res 49:1894–1903PubMedCrossRef
9.
Zurück zum Zitat Strissel KJ, Stancheva Z, Miyoshi H et al (2007) Adipocyte death, adipose tissue remodeling, and obesity complications. Diabetes 56:2910–2918PubMedCrossRef Strissel KJ, Stancheva Z, Miyoshi H et al (2007) Adipocyte death, adipose tissue remodeling, and obesity complications. Diabetes 56:2910–2918PubMedCrossRef
10.
Zurück zum Zitat Cinti S (2005) Adipocyte death defines macrophage localization and function in adipose tissue of obese mice and humans. J Lipid Res 46:2347–2355PubMedCrossRef Cinti S (2005) Adipocyte death defines macrophage localization and function in adipose tissue of obese mice and humans. J Lipid Res 46:2347–2355PubMedCrossRef
11.
Zurück zum Zitat Cinti S (2009) Reversible physiological transdifferentiation in the adipose organ. Proc Nutr Soc 68:340PubMedCrossRef Cinti S (2009) Reversible physiological transdifferentiation in the adipose organ. Proc Nutr Soc 68:340PubMedCrossRef
12.
Zurück zum Zitat Fujisaka S, Usui I, Ikutani M et al (2013) Adipose tissue hypoxia induces inflammatory M1 polarity of macrophages in an HIF-1alpha-dependent and HIF-1alpha-independent manner in obese mice. Diabetologia 56:1403–1412PubMedCrossRef Fujisaka S, Usui I, Ikutani M et al (2013) Adipose tissue hypoxia induces inflammatory M1 polarity of macrophages in an HIF-1alpha-dependent and HIF-1alpha-independent manner in obese mice. Diabetologia 56:1403–1412PubMedCrossRef
13.
Zurück zum Zitat Bluher M, Bashan N, Shai I et al (2009) Activated Ask1-MKK4-p38MAPK/JNK stress signaling pathway in human omental fat tissue may link macrophage infiltration to whole-body Insulin sensitivity. J Clin Endocrinol Metab 94:2507–2515PubMedCrossRef Bluher M, Bashan N, Shai I et al (2009) Activated Ask1-MKK4-p38MAPK/JNK stress signaling pathway in human omental fat tissue may link macrophage infiltration to whole-body Insulin sensitivity. J Clin Endocrinol Metab 94:2507–2515PubMedCrossRef
14.
Zurück zum Zitat Morris DL, Cho KW, Delproposto JL et al (2013) Adipose tissue macrophages function as antigen presenting cells and regulate adipose tissue CD4+ T cells in mice. Diabetes 62(8):2762–2772PubMedCrossRef Morris DL, Cho KW, Delproposto JL et al (2013) Adipose tissue macrophages function as antigen presenting cells and regulate adipose tissue CD4+ T cells in mice. Diabetes 62(8):2762–2772PubMedCrossRef
15.
Zurück zum Zitat Deng T, Lyon CJ, Minze LJ et al (2013) Class II major histocompatibility complex plays an essential role in obesity-induced adipose inflammation. Cell Metab 17:411–422PubMedCrossRef Deng T, Lyon CJ, Minze LJ et al (2013) Class II major histocompatibility complex plays an essential role in obesity-induced adipose inflammation. Cell Metab 17:411–422PubMedCrossRef
16.
Zurück zum Zitat Lumeng CN, Deyoung SM, Bodzin JL, Saltiel AR (2007) Increased inflammatory properties of adipose tissue macrophages recruited during diet-induced obesity. Diabetes 56:16–23PubMedCrossRef Lumeng CN, Deyoung SM, Bodzin JL, Saltiel AR (2007) Increased inflammatory properties of adipose tissue macrophages recruited during diet-induced obesity. Diabetes 56:16–23PubMedCrossRef
17.
Zurück zum Zitat Osborn O, Olefsky JM (2012) The cellular and signaling networks linking the immune system and metabolism in disease. Nat Med 18:363–374PubMedCrossRef Osborn O, Olefsky JM (2012) The cellular and signaling networks linking the immune system and metabolism in disease. Nat Med 18:363–374PubMedCrossRef
18.
Zurück zum Zitat Lumeng CN, DelProposto JB, Westcott DJ, Saltiel AR (2008) Phenotypic switching of adipose tissue macrophages with obesity is generated by spatiotemporal differences in macrophage subtypes. Diabetes 57:3239–3246PubMedCrossRef Lumeng CN, DelProposto JB, Westcott DJ, Saltiel AR (2008) Phenotypic switching of adipose tissue macrophages with obesity is generated by spatiotemporal differences in macrophage subtypes. Diabetes 57:3239–3246PubMedCrossRef
19.
Zurück zum Zitat Aron-Wisnewsky J, Tordjman J, Poitou C et al (2009) Human adipose tissue macrophages: m1 and m2 cell surface markers in subcutaneous and omental depots and after weight loss. J Clin Endocrinol Metab 94:4619–4623PubMedCrossRef Aron-Wisnewsky J, Tordjman J, Poitou C et al (2009) Human adipose tissue macrophages: m1 and m2 cell surface markers in subcutaneous and omental depots and after weight loss. J Clin Endocrinol Metab 94:4619–4623PubMedCrossRef
20.
Zurück zum Zitat Hotamisligil GS, Shargill NS, Spiegelman BM (1993) Adipose expression of tumor necrosis factor-alpha: direct role in obesity-linked insulin resistance. Science 259:87–91PubMedCrossRef Hotamisligil GS, Shargill NS, Spiegelman BM (1993) Adipose expression of tumor necrosis factor-alpha: direct role in obesity-linked insulin resistance. Science 259:87–91PubMedCrossRef
21.
Zurück zum Zitat Ye J, McGuinness OP (2013) Inflammation during obesity is not all bad: evidence from animal and human studies. Am J Physiol Endocrinol Metab 304:E466–E477PubMedCrossRef Ye J, McGuinness OP (2013) Inflammation during obesity is not all bad: evidence from animal and human studies. Am J Physiol Endocrinol Metab 304:E466–E477PubMedCrossRef
22.
Zurück zum Zitat Klöting N, Fasshauer M, Dietrich A et al (2010) Insulin-sensitive obesity. Am J Physiol Endocrinol Metab 299:E506–E515PubMedCrossRef Klöting N, Fasshauer M, Dietrich A et al (2010) Insulin-sensitive obesity. Am J Physiol Endocrinol Metab 299:E506–E515PubMedCrossRef
23.
Zurück zum Zitat Yona S, Kim KW, Wolf Y et al (2013) Fate mapping reveals origins and dynamics of monocytes and tissue macrophages under homeostasis. Immunity 38:79–91PubMedCentralPubMedCrossRef Yona S, Kim KW, Wolf Y et al (2013) Fate mapping reveals origins and dynamics of monocytes and tissue macrophages under homeostasis. Immunity 38:79–91PubMedCentralPubMedCrossRef
24.
Zurück zum Zitat Jenkins SJ, Ruckerl D, Cook PC et al (2011) Local macrophage proliferation, rather than recruitment from the blood, is a signature of TH2 inflammation. Science 332:1284–1288PubMedCentralPubMedCrossRef Jenkins SJ, Ruckerl D, Cook PC et al (2011) Local macrophage proliferation, rather than recruitment from the blood, is a signature of TH2 inflammation. Science 332:1284–1288PubMedCentralPubMedCrossRef
25.
Zurück zum Zitat Xu H, Barnes GT, Yang Q et al (2003) Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. J Clin Invest 112:1821–1830PubMedCentralPubMedCrossRef Xu H, Barnes GT, Yang Q et al (2003) Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. J Clin Invest 112:1821–1830PubMedCentralPubMedCrossRef
26.
Zurück zum Zitat Harman-Boehm I, Bluher M, Redel H et al (2007) Macrophage infiltration into omental versus subcutaneous fat across different populations: effect of regional adiposity and the comorbidities of obesity. J Clin Endocrinol Metab 92:2240–2247PubMedCrossRef Harman-Boehm I, Bluher M, Redel H et al (2007) Macrophage infiltration into omental versus subcutaneous fat across different populations: effect of regional adiposity and the comorbidities of obesity. J Clin Endocrinol Metab 92:2240–2247PubMedCrossRef
27.
Zurück zum Zitat Chakaroun R, Raschpichler M, Kloting N et al (2012) Effects of weight loss and exercise on chemerin serum concentrations and adipose tissue expression in human obesity. Metab Clin Exp 61:706–714PubMedCrossRef Chakaroun R, Raschpichler M, Kloting N et al (2012) Effects of weight loss and exercise on chemerin serum concentrations and adipose tissue expression in human obesity. Metab Clin Exp 61:706–714PubMedCrossRef
28.
Zurück zum Zitat Youn BS, Bang SI, Kloting N et al (2009) Serum progranulin concentrations may be associated with macrophage infiltration into omental adipose tissue. Diabetes 58:627–636PubMedCrossRef Youn BS, Bang SI, Kloting N et al (2009) Serum progranulin concentrations may be associated with macrophage infiltration into omental adipose tissue. Diabetes 58:627–636PubMedCrossRef
29.
Zurück zum Zitat Nishimura S, Manabe I, Nagasaki M et al (2008) In vivo imaging in mice reveals local cell dynamics and inflammation in obese adipose tissue. J Clin Investig 118:710–721PubMed Nishimura S, Manabe I, Nagasaki M et al (2008) In vivo imaging in mice reveals local cell dynamics and inflammation in obese adipose tissue. J Clin Investig 118:710–721PubMed
30.
Zurück zum Zitat Oh DY, Morinaga H, Talukdar S, Bae EJ, Olefsky JM (2012) Increased macrophage migration into adipose tissue in obese mice. Diabetes 61:346–354PubMedCrossRef Oh DY, Morinaga H, Talukdar S, Bae EJ, Olefsky JM (2012) Increased macrophage migration into adipose tissue in obese mice. Diabetes 61:346–354PubMedCrossRef
31.
Zurück zum Zitat Hashimoto D, Chow A, Noizat C et al (2013) Tissue-resident macrophages self-maintain locally throughout adult life with minimal contribution from circulating monocytes. Immunity 38:792–804PubMedCrossRef Hashimoto D, Chow A, Noizat C et al (2013) Tissue-resident macrophages self-maintain locally throughout adult life with minimal contribution from circulating monocytes. Immunity 38:792–804PubMedCrossRef
32.
Zurück zum Zitat Bourlier V, Zakaroff-Girard A, Miranville A et al (2008) Remodeling phenotype of human subcutaneous adipose tissue macrophages. Circulation 117:806–815PubMedCrossRef Bourlier V, Zakaroff-Girard A, Miranville A et al (2008) Remodeling phenotype of human subcutaneous adipose tissue macrophages. Circulation 117:806–815PubMedCrossRef
33.
Zurück zum Zitat Sasmono RT, Oceandy D, Pollard JW et al (2003) A macrophage colony-stimulating factor receptor-green fluorescent protein transgene is expressed throughout the mononuclear phagocyte system of the mouse. Blood 101:1155–1163PubMedCrossRef Sasmono RT, Oceandy D, Pollard JW et al (2003) A macrophage colony-stimulating factor receptor-green fluorescent protein transgene is expressed throughout the mononuclear phagocyte system of the mouse. Blood 101:1155–1163PubMedCrossRef
34.
Zurück zum Zitat Crisan M, Yap S, Casteilla L et al (2008) A perivascular origin for mesenchymal stem cells in multiple human organs. Cell Stem Cell 3:301–313PubMedCrossRef Crisan M, Yap S, Casteilla L et al (2008) A perivascular origin for mesenchymal stem cells in multiple human organs. Cell Stem Cell 3:301–313PubMedCrossRef
36.
Zurück zum Zitat Prodinger C, Bunse J, Kruger M et al (2011) CD11c-expressing cells reside in the juxtavascular parenchyma and extend processes into the glia limitans of the mouse nervous system. Acta Neuropathol 121:445–458PubMedCrossRef Prodinger C, Bunse J, Kruger M et al (2011) CD11c-expressing cells reside in the juxtavascular parenchyma and extend processes into the glia limitans of the mouse nervous system. Acta Neuropathol 121:445–458PubMedCrossRef
37.
Zurück zum Zitat Handel-Fernandez ME, Lopez DM (2000) Isolation of macrophages from tissues, fluids, and immune response sites. In: Paulnock DM (ed) Macrophages. Oxford University Press, Oxford Handel-Fernandez ME, Lopez DM (2000) Isolation of macrophages from tissues, fluids, and immune response sites. In: Paulnock DM (ed) Macrophages. Oxford University Press, Oxford
38.
Zurück zum Zitat Feng B, Jiao P, Nie Y et al (2011) Clodronate liposomes improve metabolic profile and reduce visceral adipose macrophage content in diet-induced obese mice. PLoS ONE 6:e24358PubMedCentralPubMedCrossRef Feng B, Jiao P, Nie Y et al (2011) Clodronate liposomes improve metabolic profile and reduce visceral adipose macrophage content in diet-induced obese mice. PLoS ONE 6:e24358PubMedCentralPubMedCrossRef
39.
Zurück zum Zitat Patsouris D, Li P-P, Thapar D, Chapman J, Olefsky JM, Neels JG (2008) Ablation of CD11c-positive cells normalizes insulin sensitivity in obese insulin resistant animals. Cell Metab 8:301–309PubMedCentralPubMedCrossRef Patsouris D, Li P-P, Thapar D, Chapman J, Olefsky JM, Neels JG (2008) Ablation of CD11c-positive cells normalizes insulin sensitivity in obese insulin resistant animals. Cell Metab 8:301–309PubMedCentralPubMedCrossRef
40.
Zurück zum Zitat Gutierrez DA, Kennedy A, Orr JS et al (2011) Aberrant accumulation of undifferentiated myeloid cells in the adipose tissue of CCR2-deficient mice delays improvements in insulin sensitivity. Diabetes 60:2820–2829PubMedCrossRef Gutierrez DA, Kennedy A, Orr JS et al (2011) Aberrant accumulation of undifferentiated myeloid cells in the adipose tissue of CCR2-deficient mice delays improvements in insulin sensitivity. Diabetes 60:2820–2829PubMedCrossRef
41.
Zurück zum Zitat Kanda H, Tateya S, Tamori Y et al (2006) MCP-1 contributes to macrophage infiltration into adipose tissue, insulin resistance, and hepatic steatosis in obesity. J Clin Invest 116:1494–1505PubMedCentralPubMedCrossRef Kanda H, Tateya S, Tamori Y et al (2006) MCP-1 contributes to macrophage infiltration into adipose tissue, insulin resistance, and hepatic steatosis in obesity. J Clin Invest 116:1494–1505PubMedCentralPubMedCrossRef
42.
Zurück zum Zitat Kamei N, Tobe K, Suzuki R et al (2006) Overexpression of monocyte chemoattractant protein-1 in adipose tissues causes macrophage recruitment and insulin resistance. J Biol Chem 281:26602–26614PubMedCrossRef Kamei N, Tobe K, Suzuki R et al (2006) Overexpression of monocyte chemoattractant protein-1 in adipose tissues causes macrophage recruitment and insulin resistance. J Biol Chem 281:26602–26614PubMedCrossRef
43.
Zurück zum Zitat Nara N, Nakayama Y, Okamoto S et al (2007) Disruption of CXC motif chemokine ligand-14 in mice ameliorates obesity-induced insulin resistance. J Biol Chem 282:30794–30803PubMedCrossRef Nara N, Nakayama Y, Okamoto S et al (2007) Disruption of CXC motif chemokine ligand-14 in mice ameliorates obesity-induced insulin resistance. J Biol Chem 282:30794–30803PubMedCrossRef
44.
Zurück zum Zitat Chavey C, Lazennec G, Lagarrigue S et al (2009) CXC ligand 5 is an adipose-tissue derived factor that links obesity to insulin resistance. Cell Metab 9:339–349PubMedCentralPubMedCrossRef Chavey C, Lazennec G, Lagarrigue S et al (2009) CXC ligand 5 is an adipose-tissue derived factor that links obesity to insulin resistance. Cell Metab 9:339–349PubMedCentralPubMedCrossRef
45.
Zurück zum Zitat Maumus M, Sengenes C, Decaunes P et al (2008) Evidence of in situ proliferation of adult adipose tissue-derived progenitor cells: influence of fat mass microenvironment and growth. J Clin Endocrinol Metab 93:4098–4106PubMedCrossRef Maumus M, Sengenes C, Decaunes P et al (2008) Evidence of in situ proliferation of adult adipose tissue-derived progenitor cells: influence of fat mass microenvironment and growth. J Clin Endocrinol Metab 93:4098–4106PubMedCrossRef
46.
Zurück zum Zitat Schulz C, Gomez Perdiguero E, Chorro L et al (2012) A lineage of myeloid cells independent of Myb and hematopoietic stem cells. Science 336:86–90PubMedCrossRef Schulz C, Gomez Perdiguero E, Chorro L et al (2012) A lineage of myeloid cells independent of Myb and hematopoietic stem cells. Science 336:86–90PubMedCrossRef
47.
Zurück zum Zitat Ji Y, Sun S, Xia S, Yang L, Li X, Qi L (2012) Short term high fat diet challenge promotes alternative macrophage polarization in adipose tissue via natural killer T cells and interleukin-4. J Biol Chem 287:24378–24386PubMedCrossRef Ji Y, Sun S, Xia S, Yang L, Li X, Qi L (2012) Short term high fat diet challenge promotes alternative macrophage polarization in adipose tissue via natural killer T cells and interleukin-4. J Biol Chem 287:24378–24386PubMedCrossRef
48.
Zurück zum Zitat El-Wakkad A, Hassan Nel M, Sibaii H, El-Zayat SR (2013) Proinflammatory, anti-inflammatory cytokines and adiponkines in students with central obesity. Cytokine 61:682–687PubMedCrossRef El-Wakkad A, Hassan Nel M, Sibaii H, El-Zayat SR (2013) Proinflammatory, anti-inflammatory cytokines and adiponkines in students with central obesity. Cytokine 61:682–687PubMedCrossRef
49.
Zurück zum Zitat Zeyda M, Farmer D, Todoric J et al (2007) Human adipose tissue macrophages are of an anti-inflammatory phenotype but capable of excessive pro-inflammatory mediator production. Int J Obes (Lond) 31:1420–1428CrossRef Zeyda M, Farmer D, Todoric J et al (2007) Human adipose tissue macrophages are of an anti-inflammatory phenotype but capable of excessive pro-inflammatory mediator production. Int J Obes (Lond) 31:1420–1428CrossRef
50.
Zurück zum Zitat Wentworth JM, Naselli G, Brown WA et al (2010) Pro-inflammatory CD11c+CD206+ adipose tissue macrophages are associated with insulin resistance in human obesity. Diabetes 59:1648–1656PubMedCrossRef Wentworth JM, Naselli G, Brown WA et al (2010) Pro-inflammatory CD11c+CD206+ adipose tissue macrophages are associated with insulin resistance in human obesity. Diabetes 59:1648–1656PubMedCrossRef
Metadaten
Titel
Local proliferation of macrophages in adipose tissue during obesity-induced inflammation
verfasst von
Julia Haase
Ulrike Weyer
Kerstin Immig
Nora Klöting
Matthias Blüher
Jens Eilers
Ingo Bechmann
Martin Gericke
Publikationsdatum
01.03.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Diabetologia / Ausgabe 3/2014
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-013-3139-y

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