Metainflammation in Diabetic Coronary Artery Disease: Emerging Role of Innate and Adaptive Immune Responses

Figure 2

Role of adaptive immune response in triggering metainflammation associated with DM-CAD. CD4⁺ T-helper cells are the most well characterized work horses of the adaptive immune system which trigger metainflammation. Inflammation triggered by PRRs is translated to T cells by the APC-T cell interaction which results in the recruitment of these activated cells into pancreases, adipose, liver, and skeletal muscle reinforcing the metainflammation set by PRRs. Depending upon the relative proportions of these cell types pancreatic beta cell apoptosis and IR in insulin target tissues can get aggravated precipitating in Type-2 Diabetes. Long standing diabetes induces systemic inflammation leading to monocyte activation and endothelial dysfunction leading to the extravasation of monocytes and formation of atherosclerotic plaques.