Cited by 439Adipokines, Inflammation, and Metabolic DiseasesGut microbiota and healthObesity, Physical Activity, Diet

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The impact of obesity on the immune response to infection

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Milner, J. Justin, Beck, Melinda A.·2012·Proceedings of The Nutrition Society

DOI 10.1017/s0029665112000158PMC PMC4791086

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Abstract

There is strong evidence indicating that excess adiposity negatively impacts immune function and host defence in obese individuals. This is a review of research findings concerning the impact of obesity on the immune response to infection, including a discussion of possible mechanisms. Obesity is characterised by a state of low-grade, chronic inflammation in addition to disturbed levels of circulating nutrients and metabolic hormones. The impact of these metabolic abnormalities on obesity-related comorbidities has undergone intense scrutiny over the past decade. However, relatively little is known of how the immune system and host defence are influenced by the pro-inflammatory and excess energy milieu of the obese. Epidemiological data suggest obese human subjects are at greater risk for nosocomial infections, especially following surgery. Additionally, the significance of altered immunity in obese human subjects is emphasised by recent studies reporting obesity to be an independent risk factor for increased morbidity and mortality following infection with the 2009 pandemic influenza A (H1N1) virus. Rodent models offer important insight into how metabolic abnormalities associated with excess body weight can impair immunity. However, more research is necessary to understand the specific aspects of immunity that are impaired and what factors are contributing to reduced immunocompetence in the obese. Additionally, special consideration of how infection in this at-risk population is managed is required, given that this population may not respond optimally to antimicrobial drugs and vaccination. Obesity impacts millions globally, and greater understanding of its associated physiological disturbances is a key public health concern.

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Authors: Milner, J. J., & Beck, M. A.
Affiliations: University of North Carolina at Chapel Hill (US)
Corresponding author: Beck, Melinda A.
ORCID: Milner, J. Justin
Beck, Melinda A.
Venue: Proceedings of The Nutrition Society
Publisher: Cambridge University Press (CUP)
Published: 2012-03-14
Volume: 71
Issue: 2
Pages: 298-306
ISSN: 0029-6651 (ISSN-L)
1475-2719
DOI: 10.1017/s0029665112000158
PMC: PMC4791086
OpenAlex: W1988508853
Cited by: 439
References: 139
Citations by year: 2026: 14 · 2025: 13 · 2024: 21 · 2023: 37 · 2022: 37 · 2021: 70 · 2020: 51 · 2019: 32 · 2018: 30 · 2017: 21 · 2016: 27 · 2015: 30 · 2014: 26 · 2013: 19 · 2012: 11
FWCI: 3.43
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.cambridge.org/core/terms (unspecified)
Locations: Proceedings of The Nutrition Society (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
UNC Libraries
Funders: National Institutes of Health
National Institute of Allergy and Infectious Diseases (R01AI078090)
National Institute of Diabetes and Digestive and Kidney Diseases (P30DK056350)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords: obesity, immune response to infection, host defense, low-grade inflammation, metabolic hormones, nosocomial infections, postoperative infection, 2009 pandemic influenza A (H1N1), immunocompetence, rodent models, vaccine response, obesity-related comorbidities
MeSH terms: Animals, Cross Infection, Humans, Immune System, Immunity, Infections, Inflammation, Influenza, Human, Obesity

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The impact of obesity on the immune response to infection

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