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Furthermore, the short-chain fatty acids (SCFAs) that are produced by the fermentation of complex carbohydrates and dietary fibers by the gut microbiota appear to be pivotal regulatory metabolites. These metabolites can halt the recruitment and activation of macrophages and other white blood cells by reducing the synthesis of pro-inflammatory cytokines. SCFAs also may act on T-regulatory cells, leading them to suppress osteoclast differentiation via the secretion of anti-osteoclastic cytokines. Interestingly, gut-derived lipopolysaccharides are able to provoke generalized pro- inflammatory responses in their hosts as well as increased accumulation of adipose tissue-resident macrophages, shifting the polarization of alternatively activated M2 macrophages toward their pro-inflammatory M1 counterpart. Physical activity, however, may modulate the gut microbiome composition (especially Lactobacillus and Bifidobacterium species), enhancing mucosal immunity (Fig. 1). Proper fitness can enhance mucosal immunity by reducing detrimental LPS effects via the suppression of TLR signaling, increasing the Bacteroidetes-Firmicutes ratio, modifying the bile acid profile, and ameliorating the biosynthesis of SCFAs.
In this manuscript, we briefly review and discuss the impacts of metabolic inflammation on health. The state of chronic low-grade inflammation (metabolic syndrome)
is significantly mediated by increased pro-inflammatory macrophage activity, causing harm to various tissues, especially those of a musculoskeletal nature. Preparing the soil is an essential component of regenerative medicine as it allows medical experts to control the inflammatory status of a patient and prepare eligible anatomical structures for corresponding orthobiologic treatments. The strategies presented in this manuscript may prove to be effective, safe, and inexpensive modalities targeting meta-inflammation.
1. Azzini, G. O. M., Santos, G. S., Visoni, S. B. C., Azzini, V. O. M., Santos, R. G. dos, Huber, S. C., & Lana, J. F. (2020). Metabolic syndrome and subchondral bone alterations: The rise of osteoarthritis – A review. Journal of Clinical Orthopaedics and Trauma. https://doi. org/10.1016/j.jcot.2020.06.021 2. Li, C., Xu, M. M., Wang, K., Adler, A. J., Vella, A. T., & Zhou, B. (2018). Macrophage polarization and meta- inflammation. In Translational Research. trsl.2017.10.004 3. Santos Duarte Lana, J. F., Furtado da Fonseca, L., Mosaner, T., Tieppo, C. E., Marques Azzini, G. O., Ribeiro, L. L., Setti, T., & Purita, J. (2020). Bone marrow aspirate clot: A feasible orthobiologic. In Journal of Clinical Orthopaedics and Trauma. https:// 4. Shapiro, H., Lutaty, A., & Ariel, A. (2011). Macrophages, meta-inflammation, and immuno-metabolism. In TheScientificWorldJournal. 5. Gregor, M. F., & Hotamisligil, G. S. (2011). Inflammatory mechanisms in obesity. Annual Review of Immunology. annurev-immunol-031210-101322
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