Immunometabolic network of childhood common obesity: multi-organ comorbidities mediated by gut microbiota-immune axis
- 1Hubei University of Chinese Medicine
- 2Hubei Provincial Hospital of Traditional Chinese Medicine, Affiliated Hospital of Hubei University of Chinese Medicine
- 3Jianghan University Affiliated Hubei Third People’s Hospital
Abstract
Childhood obesity has become a major global public health concern. It is an early-onset systemic immunometabolic disorder closely associated with multi-organ complications, including insulin resistance and cardiovascular disease (CVD). By linking adipose tissue immune remodeling with gut microbiota dysbiosis, this review proposes the gut microbiota-immune axis as an integrative framework connecting obesity-associated immunometabolic disturbances to multi-organ complications. It further explains how local pathological changes in adipose tissue may progressively develop into systemic inflammation and multi-organ damage. Mechanistically, adipocyte hypertrophy, oxidative stress, and lipolysis initiate local adipose tissue remodeling, characterized predominantly by pro-inflammatory M1 macrophage polarization and activation of the Th1/Th17 pathways. Concurrently, diet-induced gut dysbiosis impairs the intestinal barrier, promotes metabolic endotoxemia, and reduces short-chain fatty acid (SCFA) production. Adipose tissue immune remodeling and gut microbiota dysbiosis may establish a bidirectional immunometabolic feedback loop that sustains systemic metaflammation. This review examines the regulatory role of the gut microbiota-immune axis in obesity, delineates differences and evidence gaps between pediatric and adult obesity, and compares the shared and organ-specific mechanisms underlying various complications. Pediatric-specific biomarkers and emerging intervention strategies are also summarized. Collectively, these findings provide a conceptual basis for early risk screening in childhood obesity and for the prevention and management of obesity-related complications.
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BibTeX
@article{zhang2026immunometabolic,
title = {{Immunometabolic network of childhood common obesity: multi-organ comorbidities mediated by gut microbiota-immune axis}},
author = {Yujing Zhang and Ping Liu and Yanhui Peng and Yue Chen and Enze Lei and Jianzhong Liu},
journal = {Frontiers in Immunology},
year = {2026},
month = oct,
doi = {10.3389/fimmu.2026.1963905},
url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1963905/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Immunometabolic network of childhood common obesity: multi-organ comorbidities mediated by gut microbiota-immune axis
AU - Yujing Zhang
AU - Ping Liu
AU - Yanhui Peng
AU - Yue Chen
AU - Enze Lei
AU - Jianzhong Liu
PY - 2026
DA - 2026/10/26
JO - Frontiers in Immunology
DO - 10.3389/fimmu.2026.1963905
UR - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1963905/full
AB - Childhood obesity has become a major global public health concern. It is an early-onset systemic immunometabolic disorder closely associated with multi-organ complications, including insulin resistance and cardiovascular disease (CVD). By linking adipose tissue immune remodeling with gut microbiota dysbiosis, this review proposes the gut microbiota-immune axis as an integrative framework connecting obesity-associated immunometabolic disturbances to multi-organ complications. It further explains how local pathological changes in adipose tissue may progressively develop into systemic inflammation and multi-organ damage. Mechanistically, adipocyte hypertrophy, oxidative stress, and lipolysis initiate local adipose tissue remodeling, characterized predominantly by pro-inflammatory M1 macrophage polarization and activation of the Th1/Th17 pathways. Concurrently, diet-induced gut dysbiosis impairs the intestinal barrier, promotes metabolic endotoxemia, and reduces short-chain fatty acid (SCFA) production. Adipose tissue immune remodeling and gut microbiota dysbiosis may establish a bidirectional immunometabolic feedback loop that sustains systemic metaflammation. This review examines the regulatory role of the gut microbiota-immune axis in obesity, delineates differences and evidence gaps between pediatric and adult obesity, and compares the shared and organ-specific mechanisms underlying various complications. Pediatric-specific biomarkers and emerging intervention strategies are also summarized. Collectively, these findings provide a conceptual basis for early risk screening in childhood obesity and for the prevention and management of obesity-related complications.
SN - 1664-3224
ER -