Volume 13 Supplement 2

Kitasato Symposium 2011: Translational prospects for cytokines in 2011

Open Access

Adipocytokines and autoimmunity

Arthritis Research & Therapy201113(Suppl 2):O8


Published: 16 September 2011

By definition, adipo(cyto)kines are cytokine-like mediators produced mainly by adipose tissue. In the human body, they participate in regulating a variety of physiological functions related to energy metabolism [1] and inflammation [2]. Increased or decreased adipokine levels are associated with autoimmune diseases including diabetes mellitus type 1 (DMT1) [3], rheumatoid arthritis (RA) [4, 5], ankylosing spondylitis (AS) [6], systemic sclerosis (SSc) [7], systemic lupus erythematosus (SLE) [8] and Behçet's disease [912].

In vitro data suggest that adipokines may contribute to the progression of RA as they are potent inducers of proinflammatory cytokines, chemokines and matrix metalloproteinases (MMP) in RA effector cells [1316].

SSc also appears to be associated with adipokines. Contrary to RA, in which substantial intraarticular degradation of extracellular matrix occurs, SSc is characterized by excessive fibrosis. In vitro data and data from animal models of fibrosis point towards a dual role of the adipokine adiponectin as presented by numerous groups at the EULAR congress in London, specifically an antifibrotic effect in later stages of SSc and a profibrotic effect in earlier stages, which appears to be induced by proinflammatory cytokines. Likewise, leptin is involved in the development of liver fibrosis [1719].

So far, no or only little functional information is available regarding the role of adipokines in other autoimmune diseases. Serum level and clinical correlation analyses, however, suggest an association with adipokines.

In AS, elevated resistin serum levels have been found, while adiponectin levels remained unchanged [6, 20]. On the other hand, leptin is discussed controversially in AS. Serum levels were decreased in AS according to two studies [20, 21], while they were increased according to another [22]. Also, while correlations of leptin with parameters of inflammation (C-reactive protein, IL-6) and disease activity (Bath Ankylosing Spondylitis Disease Activity Index) have been found by Park et al. [22], no such correlations could be found by Toussirout et al. [20]. Interestingly, peripheral blood mononuclear cells (PBMC) from AS patients express and secrete more leptin, IL-6 and TNF-α than PBMC from control subjects. Additionally, stimulation of PBMC from AS patients with exogenous leptin led to a significantly increased IL-6 and TNF-α production [23]. Hence, leptin might be involved in the pathogenesis of AS.

In SLE, resistin, for example, has been shown to be associated with general inflammation and bone loss, suggesting a proinflammatory and disease-promoting function [24].

However, the exact role of adipokines especially in SSc, AS and SLE is still unclear and will require further investigation. Also, further research is warranted to show whether adipokines may represent potential therapeutic targets in this diseases.

Authors’ Affiliations

Department of Internal Medicine and Rheumatology, Justus-Liebig University Gießen


  1. Rajala MW, Scherer PE: Minireview: The adipocyte--at the crossroads of energy homeostasis, inflammation, and atherosclerosis. Endocrinology. 2003, 144: 3765-3773. 10.1210/en.2003-0580.View ArticlePubMedGoogle Scholar
  2. Neumann E, Frommer KW, Vasile M, Muller-Ladner U: Adipocytokines as driving forces in rheumatoid arthritis and related inflammatory diseases?. Arthritis Rheum. 2011, 63: 1159-1169. 10.1002/art.30291.View ArticlePubMedGoogle Scholar
  3. Galler A, Gelbrich G, Kratzsch J, Noack N, Kapellen T, Kiess W: Elevated serum levels of adiponectin in children, adolescents and young adults with type 1 diabetes and the impact of age, gender, body mass index and metabolic control: a longitudinal study. Eur J Endocrinol. 2007, 157: 481-489. 10.1530/EJE-07-0250.View ArticlePubMedGoogle Scholar
  4. Schäffler A, Ehling A, Neumann E, Herfarth H, Tarner I, Schölmerich J, Müller-Ladner U, Gay S: Adipocytokines in synovial fluid. JAMA. 2003, 290: 1709-1710. 10.1001/jama.290.13.1709-c.View ArticlePubMedGoogle Scholar
  5. Laurberg TB, Frystyk J, Ellingsen T, Hansen IT, Jorgensen A, Tarp U, Hetland ML, Horslev-Petersen K, Hornung N, Poulsen JH: Plasma adiponectin in patients with active, early, and chronic rheumatoid arthritis who are steroid- and disease-modifying antirheumatic drug-naive compared with patients with osteoarthritis and controls. J Rheumatol. 2009, 36: 1885-1891. 10.3899/jrheum.080907.View ArticlePubMedGoogle Scholar
  6. Kocabas H, Kocabas V, Buyukbas S, Melikoglu MA, Sezer I, Butun B: The serum levels of resistin in ankylosing spondylitis patients: a pilot study. Rheumatol Int. 2010, [Epub]Google Scholar
  7. Kotulska A, Kucharz EJ, Brzezinska-Wcislo L, Wadas U: A decreased serum leptin level in patients with systemic sclerosis. Clin Rheumatol. 2001, 20: 300-302. 10.1007/s100670170053.View ArticlePubMedGoogle Scholar
  8. Harle P, Pongratz G, Weidler C, Buttner R, Scholmerich J, Straub RH: Possible role of leptin in hypoandrogenicity in patients with systemic lupus erythematosus and rheumatoid arthritis. Ann Rheum Dis. 2004, 63: 809-816. 10.1136/ard.2003.011619.PubMed CentralView ArticlePubMedGoogle Scholar
  9. Ozgen M, Koca SS, Dagli N, Balin M, Ustundag B, Isik A: Serum adiponectin and vaspin levels in rheumatoid arthritis. Arch Med Res. 2010, 41: 457-463. 10.1016/j.arcmed.2010.08.012.View ArticlePubMedGoogle Scholar
  10. Sezen H, Okumus S, Pehlivan Y, Dilli I, Tarakcioglu M, Onat AM: Visfatin Levels in Behcet's Disease. Inflammation. 2011, [Epub]Google Scholar
  11. Yalcindag FN, Yalcindag A, Batioglu F, Caglayan O, Kisa U, Ozdemir O: Evaluation of serum resistin levels in patients with ocular and non-ocular Behcet's disease. Can J Ophthalmol. 2008, 43: 473-475. 10.3129/I08-081.View ArticlePubMedGoogle Scholar
  12. Evereklioglu C, Inaloz HS, Kirtak N, Doganay S, Bulbul M, Ozerol E, Er H, Ozbek E: Serum leptin concentration is increased in patients with Behcet's syndrome and is correlated with disease activity. Br J Dermatol. 2002, 147: 331-336. 10.1046/j.1365-2133.2002.04703.x.View ArticlePubMedGoogle Scholar
  13. Ehling A, Schaffler A, Herfarth H, Tarner IH, Anders S, Distler O, Paul G, Distler J, Gay S, Scholmerich J: The potential of adiponectin in driving arthritis. J Immunol. 2006, 176: 4468-4478.View ArticlePubMedGoogle Scholar
  14. Frommer KW, Zimmermann B, Meier FM, Schroder D, Heil M, Schäffler A, Büchler C, Steinmeyer J, Brentano F, Gay S: Adiponectin-mediated changes in effector cells involved in the pathophysiology of rheumatoid arthritis. Arthritis Rheum. 2010, 62: 2886-2899. 10.1002/art.27616.View ArticlePubMedGoogle Scholar
  15. Bokarewa M, Nagaev I, Dahlberg L, Smith U, Tarkowski A: Resistin, an adipokine with potent proinflammatory properties. J Immunol. 2005, 174: 5789-5795.View ArticlePubMedGoogle Scholar
  16. Brentano F, Schorr O, Ospelt C, Stanczyk J, Gay RE, Gay S, Kyburz D: Pre-B cell colony-enhancing factor/visfatin, a new marker of inflammation in rheumatoid arthritis with proinflammatory and matrix-degrading activities. Arthritis Rheum. 2007, 56: 2829-2839. 10.1002/art.22833.View ArticlePubMedGoogle Scholar
  17. Ikejima K, Takei Y, Honda H, Hirose M, Yoshikawa M, Zhang YJ, Lang T, Fukuda T, Yamashina S, Kitamura T, Sato N: Leptin receptor-mediated signaling regulates hepatic fibrogenesis and remodeling of extracellular matrix in the rat. Gastroenterology. 2002, 122: 1399-1410. 10.1053/gast.2002.32995.View ArticlePubMedGoogle Scholar
  18. Saxena NK, Ikeda K, Rockey DC, Friedman SL, Anania FA: Leptin in hepatic fibrosis: evidence for increased collagen production in stellate cells and lean littermates of ob/ob mice. Hepatology. 2002, 35: 762-771. 10.1053/jhep.2002.32029.PubMed CentralView ArticlePubMedGoogle Scholar
  19. Wang J, Leclercq I, Brymora JM, Xu N, Ramezani-Moghadam M, London RM, Brigstock D, George J: Kupffer cells mediate leptin-induced liver fibrosis. Gastroenterology. 2009, 137: 713-723. 10.1053/j.gastro.2009.04.011.PubMed CentralView ArticlePubMedGoogle Scholar
  20. Toussirot E, Streit G, Nguyen NU, Dumoulin G, Le Huede G, Saas P, Wendling D: Adipose tissue, serum adipokines, and ghrelin in patients with ankylosing spondylitis. Metabolism. 2007, 56: 1383-1389. 10.1016/j.metabol.2007.05.009.View ArticlePubMedGoogle Scholar
  21. Sari I, Demir T, Kozaci LD, Akar S, Kavak T, Birlik M, Onen F, Akkoc N: Body composition, insulin, and leptin levels in patients with ankylosing spondylitis. Clin Rheumatol. 2007, 26: 1427-1432. 10.1007/s10067-006-0509-6.View ArticlePubMedGoogle Scholar
  22. Park MC, Lee SW, Choi ST, Park YB, Lee SK: Serum leptin levels correlate with interleukin-6 levels and disease activity in patients with ankylosing spondylitis. Scand J Rheumatol. 2007, 36: 101-106. 10.1080/03009740600991760.View ArticlePubMedGoogle Scholar
  23. Park MC, Chung SJ, Park YB, Lee SK: Pro-inflammatory effect of leptin on peripheral blood mononuclear cells of patients with ankylosing spondylitis. Joint Bone Spine. 2009, 76: 170-175. 10.1016/j.jbspin.2008.04.018.View ArticlePubMedGoogle Scholar
  24. Almehed K, d'Elia HF, Bokarewa M, Carlsten H: Role of resistin as a marker of inflammation in systemic lupus erythematosus. Arthritis Res Ther. 2008, 10: R15-10.1186/ar2366.PubMed CentralView ArticlePubMedGoogle Scholar


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