Nat. Rev. Endocrinol. doi: /nrendo

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Nat. Rev. Endocrinol. doi:10.1038/nrendo.2015.211 Figure 1 Interactions between gut microorganisms, host and metabolism during pathological conditions Figure 1 | Interactions between gut microorganisms, host and metabolism during pathological conditions. Obesity, diabetes mellitus and related disorders are associated with changes in gut-barrier function, which are characterized by an altered distribution and localization of tight-junction proteins. A 'leaky gut' exhibits increased translocation of gut-microbiota-derived components such as PAMPs, including LPS. Increased plasma levels of LPS (defined as metabolic endotoxaemia) trigger low-grade inflammation in various organs, such as the liver, skeletal muscle and adipose tissue, which leads to insulin resistance, macrophage infiltration, secretion of pro-inflammatory cytokines, and lipid accumulation in these tissues. Compounds such as the CB1 agonists AEA, LPS and cytokines have been described as 'gate openers', as they elicit gut permeability. Increased levels of AEA and decreased levels of OEA, PEA, SEA and other putative bioactive lipids have been associated with reduced thermogenic programme activity (browning) and increased levels of markers of inflammation (cytokine production and macrophage infiltration) in adipose tissue. AEA, N-arachidonoylethanolamide; CB1, cannabinoid receptor 1; LPS, lipopolysaccharides; NAPE-PLD, N-acylphosphatidylethanolamine-hydrolysing phospholipase D; OEA, N-oleoylethanolamine; PAMPs, pathogen-associated molecular pattern molecules; PEA, N-palmitoylethanolamine; SEA, N-stearoylethanolamine; TH1, type 1 T helper cells; TLR, Toll-like receptor. Cani, P. D. et al. (2015) Endocannabinoids — at the crossroads between the gut microbiota and host metabolism Nat. Rev. Endocrinol. doi:10.1038/nrendo.2015.211