Diabetes, Metabolic Syndrome and Obesity (Feb 2024)
The Impact of Obesity on the Host–Pathogen Interaction with Influenza Viruses – Novel Insights: Narrative Review
Abstract
Victor Daniel Miron,1,2 Anca Cristina Drăgănescu,1,2 Daniela Pițigoi,1,2 Victoria Aramă,1,2 Adrian Streinu-Cercel,1,2,* Oana Săndulescu1,2,* 1Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; 2National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, Bucharest, Romania*These authors contributed equally to this workCorrespondence: Anca Cristina Drăgănescu, Department of Pediatrics, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, No. 1 Dr. Calistrat Grozovici Street, Bucharest, 021105, Romania, Email [email protected]: After exposure to a viral pathogen, the host–pathogen interaction is essential to determine whether or not infection will ensue, and what the clinical outline of the infection will be. Recent research has shown that the patient with obesity presents a set of particular pathophysiological changes that lead to higher severity of viral infections, and this is particularly true for infection with influenza viruses. Herein, we describe the main metabolic, endocrine, and immune dysregulations that occur in the presence of obesity and their impact on driving intra-host viral diversity, leading to heightened severity and virulence of influenza. We show that obesity is linked to modified responses of both the innate and adaptive immune systems during viral infections, including influenza. Due to chronic inflammation and metabolic, endocrine, and signaling pathway disruptions, individuals with obesity have a suboptimal immune response. This results in longer illness duration, increased virus shedding, higher risk of hospitalization and complications, and greater mortality rates. Additionally, they may have a blunted response to vaccination and a higher likelihood of genetic mutation selection. Understanding the intricate interplay between obesity and viral pathogenesis is crucial for developing efficacious therapeutic approaches and public health policies, particularly in light of the escalating worldwide incidence of obesity.Keywords: influenza, obesity, severity, metabolic syndrome, inflammation
