The effect of obesity on disease activity of inflammatory rheumatic diseases

One of the most recent scientific fields is the interaction between the immune system and metabolic processes. These interactions increasingly involve intracellular and extracellular signaling molecules and their receptors as well as molecularmechanisms that are used by both systems. The result of these intensive interactions is characterized by the term"metaflammation" and involves in particular, the ubiquitous adipose tissue present throughout the body. The links identified to date between the immune system and metabolism play a greater role in inflammatory rheumatic joint diseases than previously thought. In general, a markedly high body mass index (BMI) in particular, is associated with increased inflammatory activity and this is independent of the underlying disease entity. A higher BMI at the beginning of an immunomodulatory therapy also causes a more difficult response to the medication. Thus, the current scientific objective is to identify the individual "immuno-metabolic" pathways in order to apply the medications specifically to the site of action. Furthermore, all newer therapeutic agents, especially those specifically acting against individual immunologicalmolecules, should be systematically analyzed with respect to their metabolic concomitant effects and their influence on metabolic comorbidities.