How Does Inflammation‐Induced Hyperglycemia Cause Mitochondrial Dysfunction in Immune Cells?. (10th April 2019) - van Niekerk, Gustav
Abstract : Inflammatory mediators have an established role in inducing insulin resistance and promoting hyperglycemia. In turn, hyperglycemia has been argued to drive immune cell dysfunction as a result of mitochondrial dysfunction. Here, the authors review the evidence challenging this view. First, it is pointed out that inflammatory mediators are known to induce altered mitochondrial function. In this regard, critical care patients suffer both an elevated inflammatory tone as well as hyperglycemia, rendering it difficult to distinguish between the effects of inflammation and hyperglycemia. Second, emerging evidence indicates that a decrease in mitochondrial respiration and an increase in reactive oxygen species (ROS) production are not necessarily manifestations of pathology, but adaptations taking shape as the mitochondria is abdicating its adenosine triphosphate (ATP)‐producing function (which is taken over by glycolysis) and instead becomes "retooled" for an immunological role. Collectively, these observations challenge the commonly held belief that acute hyperglycemia induces mitochondrial damage leading to immune cell dysfunction. Abstract : It is often claimed that hyperglycemia adversely affects immune cell function, typically through inducing mitochondrial dysfunction as manifesting through a decline in adenosine triphosphate (ATP) production and an increase in reactive oxygen species (ROS). However, evidence instead suggests that a) inflammatory mediators, and not glucose, cause these changes, and b) that these changes can be adaptive.