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. 2021 Jan 7;11:619951. doi: 10.3389/fimmu.2020.619951

Figure 9.

Figure 9

A new working model: Extended high fat diet feeding overcomes the deficiency of proinflammatory miR155, generates CD95+ adipose tissue macrophages and secretes miR155 independent-, or miR155-suppressed proinflammatory cytokines/adipokines (second wave of inflammation), promotes aortic endothelial cell activation and increases atherosclerosis, which makes MHO transition to delayed MUO. (A) MHO is an intermediate stage in the development of delayed MUO. (A1) in the presence of wild-type miR155, cardiovascular metabolic disease risk factors accelerate the progression of MHO from metabolically healthy lean; (A2) In the absence of miR155, development of MUO need to go through an intermediate stage of MHO. (B) (B1) Adipocyte (pale yellow with light blue nuclei)-secreted and macrophage-secreted TNFα (red dots) may promote CD95+CD86- macrophage phenotype (green). This macrophage subset together with peripheral blood CD95+ monocytes/macrophages may secrete pro-inflammatory cytokines and chemokines into the circulation (yellow dots), which in turn induce aortic EC activation, shown by ICAM1 upregulation (B2, gray dots). The CD95+ monocytes/macrophages in aortas may also secrete proinflammatory cytokines and contribute to EC activation (B2b). (C) Over time, EC activation progresses towards atherosclerosis development (B3, bright yellow). Red dots: TNFα. Yellow dots: pro-inflammatory cytokines/chemokines/other molecules.