Advanced Bariatric and Metabolic Surgery by C. Huang

By C. Huang

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These data suggest a counter regulatory role of apelin signaling to that of the angiotensin with regard to blood pressure regulation in humans. 7 Cathepsin S Cathepsins are endopeptidase cysteine proteases that are secreted by inflammatory cells. , (2010) suggested that cathepsin S is one of the most dysregulated genes in adipose tissue of obese subjects since its expression and circulating levels positively correlated with BMI. , 2010). It has been suggested that cathepsin S is the link between obesity and inflammation in obesity (Taleb and Clement, 2007) but all the studies to date are correlative.

2010) found a high correlation between circulating cathepsin S and c-reactive protein [CRP] but what this means is unclear since both are inflammatory response proteins made by the liver. It is perhaps better to describe the elevations in cathepsin S seen in obesity as a response to the inflammation with no proof yet for any type of causal relationship. 8 CD14 CD14 is a glycolipid-anchored membrane protein that functions as a receptor for the complex of lipopolysaccharide binding protein plus lipopolysaccharide and is also released into the circulation.

The consensus is that circulating resistin is not derived from adipose tissue but is involved in inflammation under some conditions. Clearly in humans, resistin is not an important factor released by fat cells that links insulin resistance and obesity. , 2011). Like leptin, but unlike most putative adipokines, it is expressed exclusively in the fat cells of human adipose tissue (Fain, 2010). , 2006). , (2011) suggested that the evidence for an association between obesity and circulating as well as adipose tissue levels of RBP4 is not a consistent finding in clinical studies.

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