Journal of Immunology Research

Journal of Immunology Research / 2019 / Article
Special Issue

Inflammation and Dysmetabolism in Systemic Autoimmune Diseases

View this Special Issue

Editorial | Open Access

Volume 2019 |Article ID 5438287 | 2 pages |

Inflammation and Dysmetabolism in Systemic Autoimmune Diseases

Received15 Jan 2019
Accepted26 May 2019
Published22 Jul 2019

Despite advances in pathogenic and clinical knowledge, rheumatic diseases are still burdened by high morbidity, accrual of irreversible organ damage with development of disability, and increased mortality [14]. In the few last decades, interest in the metabolic aspects of rheumatic diseases has gradually increased. The impact of dysmetabolism on rheumatic diseases is complex and extends from pathogenesis to clinical manifestations and potential therapeutic targets.

Metabolic syndrome (MeS) is a cluster of metabolic disorders that includes visceral adipose tissue accumulation, insulin-resistance, alteration in blood cholesterol components and apolipoproteins, and systemic inflammation [5, 6]. The incidence and prevalence of metabolic syndrome is increased in several systemic autoimmune diseases with possible impact on cardiovascular complication and damage accrual [79]. One of the possible links between metabolism, MeS, and inflammation is adipokines, a group of cytokines mainly produced by adipose tissue. Consistent literature data clearly demonstrated the involvement of adipokines in autoimmunity and several systemic autoimmune diseases. In this issue, P. Ruscitti et al. deeply reviewed the role of adipokines in the atherogenesis and MeS development in patients with rheumatoid arthritis.

Interleukin-6 (IL-6) is the prototype of a molecular link between inflammation, autoimmunity, metabolism, and adipose tissue [5]. In this issue, A. Laudisio et al. analyzed the impact of olfactory dysfunction on frailty and mortality of elderly patients and demonstrated that this relation could be mediated by IL-6.

Particularly interesting are the implications of Western diet in rheumatic diseases. Polyunsaturated fatty acids (PUFAs) are members of the family of fatty acids, with a wide spectrum of immunological functions: n-6 PUFAs have predominantly proinflammatory features, while n-3 PUFAs seem to exert anti-inflammatory and proresolving properties. We recently reviewed the literature on PUFA in rheumatoid arthritis, showing that n-3-PUFA supplementation could represent an interesting therapeutic option [10]. D-Series resolvins are a product of the metabolism of n-3 PUFA. Crescent data demonstrated the involvement of D-series resolvins and, in particular, resolvin-D1 in immune homeostasis. In general, resolvin-D1 seems to downregulate the production of proinflammatory cytokines from T helper 1 and T helper 17 lymphocytes and to promote the differentiation of T regulatory cells. However, only few data are available on the role of resolvins in systemic autoimmune diseases. In a paper published in this special issue, L. Navarini et al. demonstrated a marked reduction of resolvin-D1 levels in patients affected by Systemic Lupus Erythematosus (SLE) compared to the general population, especially in association with low complement levels. These findings suggest a specific role of bioactive lipids in SLE [11].

Another relevant topic in the field of relation between inflammation and metabolism is represented by bile acids. Bile acids play a pivotal role in intestinal absorption of fatty acids and in delivery of fatty acids to the apical membrane of enterocytes. K. Uchiyama et al. presented in this special issue a review of the available evidences on the implication of dietary lipids and fatty acids malabsorption in Crohn disease.

Overall, crescent data demonstrated the involvement of metabolism in several aspects of systemic autoimmune diseases with interesting implication for disease prevention, optimization of disease management, and drug development.

Conflicts of Interest

The editors declare that they have no conflicts of interest regarding the publication of this special issue.

Antonella Afeltra
Antonio Abbate
Gabriele Valentini
Roberto Giacomelli


  1. R. Giacomelli, A. Afeltra, A. Alunno et al., “Guidelines for biomarkers in autoimmune rheumatic diseases - evidence based analysis,” Autoimmunity Reviews, vol. 18, no. 1, pp. 93–106, 2019. View at: Publisher Site | Google Scholar
  2. F. Cacciapaglia, L. Navarini, P. Menna, E. Salvatorelli, G. Minotti, and A. Afeltra, “Cardiovascular safety of anti-TNF-alpha therapies: facts and unsettled issues,” Autoimmunity Reviews, vol. 10, no. 10, pp. 631–635, 2011. View at: Publisher Site | Google Scholar
  3. A. Afeltra, A. Gigante, D. P. E. Margiotta et al., “The involvement of T regulatory lymphocytes in a cohort of lupus nephritis patients: a pilot study,” Internal and Emergency Medicine, vol. 10, no. 6, pp. 677–683, 2015. View at: Publisher Site | Google Scholar
  4. M. Vadacca, D. Margiotta, D. Sambataro et al., “BAFF/APRIL pathway in Sjögren syndrome and systemic lupus erythematosus: relationship with chronic inflammation and disease activity,” Reumatismo, vol. 62, no. 4, pp. 259–265, 2010. View at: Publisher Site | Google Scholar
  5. V. Abella, M. Scotece, J. Conde et al., “Adipokines, metabolic syndrome and rheumatic diseases,” Journal of Immunology Research, vol. 2014, Article ID 343746, 14 pages, 2014. View at: Publisher Site | Google Scholar
  6. L. S. Sperling, J. I. Mechanick, I. J. Neeland et al., “The CardioMetabolic Health Alliance: working toward a new care model for the metabolic syndrome,” Journal of the American College of Cardiology, vol. 66, no. 9, pp. 1050–1067, 2015. View at: Publisher Site | Google Scholar
  7. D. P. E. Margiotta, F. Basta, G. Dolcini et al., “Physical activity and sedentary behavior in patients with systemic lupus erythematosus,” PLoS One, vol. 13, no. 3, article e0193728, 2018. View at: Publisher Site | Google Scholar
  8. D. P. E. Margiotta, F. Basta, G. Dolcini, V. Batani, L. Navarini, and A. Afeltra, “The relation between, metabolic syndrome and quality of life in patients with systemic lupus erythematosus,” PLoS One, vol. 12, no. 11, article e0187645, 2017. View at: Publisher Site | Google Scholar
  9. S. Fasano, D. P. Margiotta, L. Navarini et al., “Primary prevention of cardiovascular disease in patients with systemic lupus erythematosus: case series and literature review,” Lupus, vol. 26, no. 14, pp. 1463–1472, 2017. View at: Publisher Site | Google Scholar
  10. L. Navarini, A. Afeltra, G. Gallo Afflitto, and D. P. E. Margiotta, “Polyunsaturated fatty acids: any role in rheumatoid arthritis?” Lipids in Health and Disease, vol. 16, no. 1, 2017. View at: Publisher Site | Google Scholar
  11. L. Navarini, T. Bisogno, P. Mozetic et al., “Endocannabinoid system in systemic lupus erythematosus: first evidence for a deranged 2-arachidonoylglycerol metabolism,” The International Journal of Biochemistry & Cell Biology, vol. 99, pp. 161–168, 2018. View at: Publisher Site | Google Scholar

Copyright © 2019 Antonella Afeltra et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

More related articles

649 Views | 311 Downloads | 0 Citations
 PDF  Download Citation  Citation
 Download other formatsMore
 Order printed copiesOrder

Related articles

We are committed to sharing findings related to COVID-19 as quickly and safely as possible. Any author submitting a COVID-19 paper should notify us at to ensure their research is fast-tracked and made available on a preprint server as soon as possible. We will be providing unlimited waivers of publication charges for accepted articles related to COVID-19. Sign up here as a reviewer to help fast-track new submissions.