Fig. 3

Implications of obese adipose tissue upon the immune system and immune checkpoint proteins. The dysregulation of the secretion of adipokines, free fatty acids and pro-inflammatory cytokines by the adipose tissue from individuals with obesity has a number of implications upon the immune system. These factors regulate both the proliferation of T cells, as well as their exhaustion, via modulation of PD-1 and PD-L1 expression, also affecting the antitumor immune response against cancer and immune checkpoint inhibitor immunotherapy. The polarization of macrophages from a M2 to a M1 profile induces changes in inflammatory cytokines production, often resulting in a ‘cytokine storm’, an event of uncontrolled inflammation which results in toxicity and failure of different organs