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Adipose tissue derived bacteria are associated with inflammation in obesity and type 2 diabetes
Open accessAbstract
Objective Bacterial translocation to various organs including human adipose tissue (AT) due to increased intestinal permeability remains poorly understood. We hypothesised that: (1) bacterial presence is highly tissue specific and (2) related in composition and quantity to immune inflammatory and metabolic burden. Design We quantified and sequenced the bacterial 16S rRNA gene in blood and AT samples (omental, mesenteric and subcutaneous) of 75 subjects with obesity with or without type 2 diabetes (T2D) and used catalysed reporter deposition (CARD) – fluorescence in situ hybridisation (FISH) to detect bacteria in AT. Results Under stringent experimental and bioinformatic control for contaminants, bacterial DNA was detected in blood and omental, subcutaneous and mesenteric AT samples in the range of 0.1 to 5 pg/µg DNA isolate. Moreover, CARD-FISH allowed the detection of living, AT-borne bacteria. Proteobacteria and Firmicutes were the predominant phyla, and bacterial quantity was associated with immune cell infiltration, inflammatory and metabolic parameters in a tissue-specific manner. Bacterial composition differed between subjects with and without T2D and was associated with related clinical measures, including systemic and tissues-specific inflammatory markers. Finally, treatment of adipocytes with bacterial DNA in vitro stimulated the expression of TNFA and IL6 . Conclusions Our study provides contaminant aware evidence for the presence of bacteria and bacterial DNA in several ATs in obesity and T2D and suggests an important role of bacteria in initiating and sustaining local AT subclinical inflammation and therefore impacting metabolic sequelae of obesity.
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“Gut microbiota composition and functionality are altered in obesity, skewing towards increased abundance of Proteobacteria and Firmicutes.100”
From Definition and diagnostic criteria of clinical obesity (2025) · cites this paper as [100]
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“Increased intestinal permeability to bacterial products such as lipopolysaccharide (a potent inflammatory stimulus) also occurs more frequently in people with obesity.100”
From Definition and diagnostic criteria of clinical obesity (2025) · cites this paper as [100]
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Self-citationJacobs, J. P., Goudarzi, M., Lagishetty, V., Li, D., Mak, T. D., Tong, M., Ruegger, P. M., Haritunians, T., Landers, C. J., Fleshner, P. R., et al. (2022) · Genome Medicine · doi:10.1186/s13073-022-01099-7 · Cited by 29
“The potential importance of the mucosal microbiota in obesity is supported by reports that obese individuals have increased intestinal permeability and translocation of gut microbes into the mesenteric adipose tissue [91, 92].”
BackgroundHallmarks of Severe COVID-19 Pathogenesis: A Pas de Deux Between Viral and Host Factors
Rovito, R., Augello, M., Ben-Haim, A., Bono, V., Monforte, A. D., & Marchetti, G. C. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.912336 · Cited by 27
The Gut-Peritoneum Axis in Peritoneal Dialysis and Peritoneal Fibrosis
Stepanova, N. (2023) · Kidney Medicine · doi:10.1016/j.xkme.2023.100645 · Cited by 26
Gut mucosal and adipose tissues as health targets of the immunomodulatory mechanisms of probiotics
Ashaolu, T. J., & Fernández‐Tomé, S. (2021) · Trends in Food Science & Technology · doi:10.1016/j.tifs.2021.04.040 · Cited by 25
Role of the Gut Microbiome in Beta Cell and Adipose Tissue Crosstalk: A Review
Martínez‐Montoro, J. I., Damas-Fuentes, M., Fernández‐García, J. C., & Tinahones, F. J. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.869951 · Cited by 28
“Once more, mesenteric adipose tissue presented the highest bacterial quantity, whichwas associatedwith adipose tissue inflammation, and adipose tissuemicrobiota composition was different between subjects with andwithout diabetes (116).”
BackgroundRigorous Plasma Microbiome Analysis Method Enables Disease Association Discovery in Clinic
Luo, Z., Alekseyenko, A. V., Ogunrinde, E., Li, M., Li, Q., Huang, L., Tsao, B. P., Kamen, D. L., Oates, J. C., Li, Z., et al. (2021) · Frontiers in Microbiology · doi:10.3389/fmicb.2020.613268 · Cited by 25
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Weight cycling based on altered immune microenvironment as a result of metaflammation
Li, W., & Chen, W. (2023) · Nutrition & Metabolism · doi:10.1186/s12986-023-00731-6 · Cited by 26
Gut-bacteria derived membrane vesicles and host metabolic health: a narrative review
Verbunt, J., Jocken, J. W. E., Blaak, E. E., Savelkoul, P. H. M., & Stassen, F. R. M. (2024) · Gut Microbes · doi:10.1080/19490976.2024.2359515 · Cited by 23
Altamura, S., Lombardi, F., Palumbo, P., Cinque, B., Ferri, C., Pinto, R. D., & Pietropaoli, D. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms252413633 · Cited by 23
Creeping fat exhibits distinct Inflammation-specific adipogenic preadipocytes in Crohn’s disease
Hwang, N., Kang, D., Shin, S., Yoon, B. K., Chun, J., Kim, J. W., & Fang, S. (2023) · Frontiers in Immunology · doi:10.3389/fimmu.2023.1198905 · Cited by 21
Comprehensive insights: unraveling the mechanisms of gut commensals in glucose metabolism regulation
Li, Z., Nie, Q., & Nie, S. (2023) · Science China Life Sciences · doi:10.1007/s11427-023-2455-y · Cited by 22
“Furthermore, the translocation of gut bacteria into human adipose tissue has also been observed, with the total bacterial load significantly correlating with cytokine levels and metabolic phenotypes (Massier et al., 2020).”
Bacteria-driven bio-therapy: From fundamental studies to clinical trials
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“Different reports have shown that the level of circulating LPS is the key factor linking the GM with the inflammation of AT, resulting in an increase in the number of cells positive for the inflammation marker F4/80 in AT [10,15,16].”
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Kidney microbiota dysbiosis contributes to the development of hypertension
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“In addition to the microorganisms that normally inhabit barrier tissues, such as the gastrointestinal tract, bacterial signals have been observed in host organs and tissues that were previously considered sterile, such as the placenta,(12) brain,(13) and adipose tissues associated with proinflammatory cytokines.(14) B…”
BackgroundInflammatory crosstalk between saturated fatty acids and gut microbiota–white adipose tissue axis
Jamar, G., & Pisani, L. P. (2022) · European Journal of Nutrition · doi:10.1007/s00394-022-03062-z · Cited by 22
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The gut microbiota in experimental abdominal aortic aneurysm
Xiao, J., Wei, Z., Yang, C., Dai, S., Wang, X., & Shang, Y. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1051648 · Cited by 20
“Multiple compelling pieces of evidence have demonstrated that the composition and function of the gut microbiota can alter host homeostasis and result in obesity, inflammation, cardiovascular disease, and other diseases (1, 2).”
BackgroundGut Microbiota and Adipose Tissue Microenvironment Interactions in Obesity
Wang, C., Yi, Z., Ye, J., Shen, Z., Yang, F., & Zhu, S. (2023) · Metabolites · doi:10.3390/metabo13070821 · Cited by 23
Thrum, S., Sommer, M., Raulien, N., Gericke, M. T., Massier, L., Kovacs, P. L., Krasselt, M., Landgraf, K., Körner, A., Dietrich, A., et al. (2022) · International Journal of Obesity · doi:10.1038/s41366-022-01135-x · Cited by 19
“In view of the recently revealed presence of bacteria and bacterial DNA in AT in obesity [51, 52], it therefore appears feasible that the required ‘first signal’ for NLRP3 inflammasome activation is provided to ATM in obesity.”
BackgroundSelf-citationSchwenger, K. J. P., Copeland, J. K., Ghorbani, Y., Chen, L., Comelli, E. M., Guttman, D. S., Fischer, S. E., Jackson, T. D., Okrainec, A., & Allard, J. P. (2025) · Microbiome · doi:10.1186/s40168-024-02004-7 · Cited by 19
“These studies did not assess MASLD [9, 17].”
Jia, D., Yaping, H., Wang, Y., Xue, M., Zhu, L., Xia, F., Li, Y., Gao, Y. M., Li, L., Chen, S., et al. (2022) · Current Pharmaceutical Design · doi:10.2174/1381612828666220428093207 · Cited by 19
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“At the phylum level, the abundance of Firmicutes in the intestines of rats in the model group was increased, which is the same as the distribution trend of intestinal bacterial species in patients with T2DM reported in the literature (Massier et al., 2020).”
ResultYao, S., Yang, X., Wu, W., Jiang, Q., Deng, S., Zheng, B., Chen, L., Chen, Y., & Xiang, X. (2022) · Food Bioscience · doi:10.1016/j.fbio.2022.102340 · Cited by 17
Gao, X., Sun, C., Zhang, Y., Hu, S., & Li, D. (2022) · Food & Function · doi:10.1039/d2fo02570a · Cited by 17
Adipose tissue–gut microbiome crosstalk in inflammation and thermogenesis
Mauney, E. E., Wibowo, M. C., Tseng, Y., & Kostic, A. D. (2024) · Trends in Endocrinology and Metabolism · doi:10.1016/j.tem.2024.10.004 · Cited by 18
Zuo, G., Li, M.-H., Guo, X., Wang, L., Yao, Y., Huang, J., Liu, Z., & Lin, Y. (2025) · Food Research International · doi:10.1016/j.foodres.2025.116207 · Cited by 18
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Fang, W., Wang, K., Wen, S., Zhou, F., Ouyang, J., Zhang, S., Zeng, H., Hara, Y., Huang, J., & Liu, Z. (2025) · Phytomedicine · doi:10.1016/j.phymed.2025.157314 · Cited by 15
Cai, G., Zhang, X., Jiao, J., Du, W., & Yan, M. (2025) · Current Issues in Molecular Biology · doi:10.3390/cimb47090750 · Cited by 17
“In the context of obesity and T2DM, LPS exposure in adipocytes may contribute to cell death and the formation of crown-like structures in inflamed adipose tissue [49].”
Batitucci, G., de Almeida, O. G. G., Martinis, E. C. P. D., Solar, I., Cintra, D. E., & de Freitas, E. C. (2024) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00310.2023 · Cited by 17
Metadata
- Authors
- Massier, L., Chakaroun, R., Tabei, S., Crane, A., Didt, K. D., Fallmann, J., von Bergen, M., Haange, S.-B., Heyne, H., Stumvoll, M., Gericke, M., Dietrich, A., Blüher, M., Musat, N., & Kovacs, P.
- Affiliations
- University Hospital Leipzig (DE)
- IFB Adiposity Diseases (DE)
- Leipzig University (DE)
- Department of Molecular Systems Biology, Helmholtz Center for Environmental Research GmbH – UFZ, Leipzig, Germany
- Helmholtz Centre for Environmental Research (DE)
- Broad Institute (US)
- Medical Department III – Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
- Corresponding author
- Kovacs, Peter
- ORCID
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2020-04-21
- Volume
- 69
- Issue
- 10
- Pages
- 1796-1806
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- OpenAlex
- W3017206405
- Cited by
- 194
- References
- 63
- Citations by year
- 2026: 15 · 2025: 24 · 2024: 28 · 2023: 34 · 2022: 44 · 2021: 34 · 2020: 15
- FWCI
- 22.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- EFRE – Europe funds Saxony (ProVIS)
- Federal Ministry of Education and Research (BMBF), Germany (FKZ: 01EO1501; AD2-060E, AD2-06E95, AD2-K7-117)
- Deutsche Forschungsgemeinschaft (Projektnummer 209933838 – SFB 1052; B01, B03)
- 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 › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Keywords
- bacterial translocation, obesity, type 2 diabetes, adipose tissue inflammation, intestinal permeability, bacterial DNA contamination, omental adipose tissue, mesenteric adipose tissue, subcutaneous adipose tissue, immune cell infiltration, Proteobacteria, Firmicutes, TNF-α, interleukin-6, adipocyte inflammation
- MeSH terms
- Firmicutes, Bacillota, Adipose Tissue, Cells, Cultured, Diabetes Mellitus, Type 2, DNA, Bacterial, Female, Humans, Inflammation, Intestinal Mucosa, Male, Middle Aged, Obesity, RNA, Ribosomal, 16S, Tumor Necrosis Factor-alpha, Interleukin-6, Bacterial Translocation, Proteobacteria
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