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1.
Front Immunol ; 15: 1375138, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38812501

RESUMO

Objectives: The effects of cold exposure on whole-body metabolism in humans have gained increasing attention. Brown or beige adipose tissues are crucial in cold-induced thermogenesis to dissipate energy and thus have the potential to combat metabolic disorders. Despite the immune regulation of thermogenic adipose tissues, the overall changes in vital immune cells during distinct cold periods remain elusive. This study aimed to discuss the overall changes in immune cells under different cold exposure periods and to screen several potential immune cell subpopulations on thermogenic regulation. Methods: Cibersort and mMCP-counter algorithms were employed to analyze immune infiltration in two (brown and beige) thermogenic adipose tissues under distinct cold periods. Changes in some crucial immune cell populations were validated by reanalyzing the single-cell sequencing dataset (GSE207706). Flow cytometry, immunofluorescence, and quantitative real-time PCR assays were performed to detect the proportion or expression changes in mouse immune cells of thermogenic adipose tissues under cold challenge. Results: The proportion of monocytes, naïve, and memory T cells increased, while the proportion of NK cells decreased under cold exposure in brown adipose tissues. Conclusion: Our study revealed dynamic changes in immune cell profiles in thermogenic adipose tissues and identified several novel immune cell subpopulations, which may contribute to thermogenic activation of adipose tissues under cold exposure.


Assuntos
Tecido Adiposo Marrom , Temperatura Baixa , Termogênese , Termogênese/imunologia , Animais , Camundongos , Tecido Adiposo Marrom/imunologia , Tecido Adiposo Marrom/metabolismo , Camundongos Endogâmicos C57BL , Masculino , Tecido Adiposo Bege/metabolismo , Tecido Adiposo Bege/imunologia , Tecido Adiposo/imunologia , Tecido Adiposo/metabolismo , Células Matadoras Naturais/imunologia , Células Matadoras Naturais/metabolismo , Monócitos/imunologia , Monócitos/metabolismo
2.
Sci Rep ; 11(1): 2752, 2021 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-33531584

RESUMO

Neurogenic fever (NF) after subarachnoid hemorrhage (SAH) is a major cause of morbidity that is associated with poor outcomes and prolonged stay in the neurointensive care unit (NICU). Though SAH is a much more common cause of fever than sepsis in the NICU, it is often a diagnosis of exclusion, requiring significant effort to rule out an infectious source. NF does not respond to standard anti-pyretic medications such as COX inhibitors, and lack of good medical therapy has led to the introduction of external cooling systems that have their own associated problems. In a rodent model of SAH, we measured the effects of injecting whole blood, blood plasma, or erythrocytes on the sympathetic nerve activity to brown adipose tissue and on febrile thermogenesis. We demonstrate that following SAH the acute activation of brown adipose tissue leading to NF, is not dependent on PGE2, that subarachnoid space injection of whole blood or erythrocytes, but not plasma alone, is sufficient to trigger brown adipose tissue thermogenesis, and that activation of adenosine A1 receptors in the CNS can block the brown adipose tissue thermogenic component contributing to NF after SAH. These findings point to a distinct thermogenic mechanism for generating NF, compared to those due to infectious causes, and will hopefully lead to new therapies.


Assuntos
Tecido Adiposo Marrom/metabolismo , Eritrócitos/imunologia , Febre/imunologia , Receptor A1 de Adenosina/metabolismo , Hemorragia Subaracnóidea/complicações , Tecido Adiposo Marrom/imunologia , Animais , Modelos Animais de Doenças , Febre/etiologia , Febre/fisiopatologia , Humanos , Masculino , Ratos , Hemorragia Subaracnóidea/imunologia , Hemorragia Subaracnóidea/fisiopatologia , Termogênese/imunologia
4.
JCI Insight ; 6(3)2021 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-33351782

RESUMO

Interleukin-10 (IL-10) is a critical cytokine used by immune cells to suppress inflammation. Paradoxically, immune cell-derived IL-10 can drive insulin resistance in obesity by suppressing adipocyte energy expenditure and thermogenesis. However, the source of IL-10 necessary for the suppression of adipocyte thermogenesis is unknown. We show here that CD4+Foxp3+ regulatory T cells (Tregs) are a substantial source of IL-10 and that Treg-derived IL-10 can suppress adipocyte beiging. Unexpectedly, Treg-specific loss of IL-10 resulted in increased insulin sensitivity and reduced obesity in high-fat diet-fed male mice. Mechanistically, we determined that Treg-specific loss of the transcription factor Blimp-1, a driver of IL-10 expression by Tregs, phenocopied the Treg-specific IL-10-deficient mice. Loss of Blimp-1 expression in Tregs resulted in reduced ST2+KLRG1+, IL-10-secreting Tregs, particularly in the white adipose tissue. Blimp-1-deficient mice were protected from glucose intolerance, insulin resistance, and diet-induced obesity, through increased white adipose tissue browning. Taken together, our data show that Blimp-1-regulated IL-10 secretion by Tregs represses white adipose tissue beiging to maintain adipose tissue homeostasis.


Assuntos
Resistência à Insulina/imunologia , Resistência à Insulina/fisiologia , Interleucina-10/imunologia , Obesidade/etiologia , Fator 1 de Ligação ao Domínio I Regulador Positivo/fisiologia , Linfócitos T Reguladores/imunologia , Linfócitos T Reguladores/fisiologia , Tecido Adiposo Bege/imunologia , Tecido Adiposo Bege/metabolismo , Tecido Adiposo Branco/imunologia , Tecido Adiposo Branco/metabolismo , Animais , Dieta Hiperlipídica/efeitos adversos , Intolerância à Glucose/imunologia , Intolerância à Glucose/metabolismo , Interleucina-10/deficiência , Interleucina-10/genética , Masculino , Camundongos , Camundongos Knockout , Camundongos Transgênicos , Obesidade/imunologia , Obesidade/fisiopatologia , Fator 1 de Ligação ao Domínio I Regulador Positivo/deficiência , Fator 1 de Ligação ao Domínio I Regulador Positivo/genética , Termogênese/imunologia , Termogênese/fisiologia
5.
J Exp Med ; 218(2)2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33104171

RESUMO

ILC2s are present in adipose tissue and play a critical role in regulating adipose thermogenesis. However, the mechanisms underlying the activation of adipose-resident ILC2s remain poorly defined. Here, we show that IL-33, a potent ILC2 activator, stimulates phosphorylation of AMPK at Thr172 via TAK1 in primary ILC2s, which provides a feedback mechanism to inhibit IL-33-induced NF-κB activation and IL-13 production. Treating ILC2s with adiponectin or an adiponectin receptor agonist (AdipoRon) activated AMPK and decreased IL-33-NF-κB signaling. AdipoRon also suppressed cold-induced thermogenic gene expression and energy expenditure in vivo. In contrast, adiponectin deficiency increased the ILC2 fraction and activation, leading to up-regulated thermogenic gene expression in adipose tissue of cold-exposed mice. ILC2 deficiency or blocking ILC2 function by neutralization of the IL-33 receptor with anti-ST2 diminished the suppressive effect of adiponectin on cold-induced adipose thermogenesis and energy expenditure. Taken together, our study reveals that adiponectin is a negative regulator of ILC2 function in adipose tissue via AMPK-mediated negative regulation of IL-33 signaling.


Assuntos
Proteínas Quinases Ativadas por AMP/imunologia , Adiponectina/imunologia , Imunidade Inata/imunologia , Interleucina-33/imunologia , Linfócitos/imunologia , Transdução de Sinais/imunologia , Tecido Adiposo/imunologia , Animais , Retroalimentação , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , NF-kappa B/imunologia , Fosforilação/imunologia , Células Th2/imunologia , Termogênese/imunologia
6.
Proc Natl Acad Sci U S A ; 117(50): 32029-32037, 2020 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-33257580

RESUMO

Disease tolerance, the capacity of tissues to withstand damage caused by a stimulus without a decline in host fitness, varies across tissues, environmental conditions, and physiologic states. While disease tolerance is a known strategy of host defense, its role in noninfectious diseases has been understudied. Here, we provide evidence that a thermogenic fat-epithelial cell axis regulates intestinal disease tolerance during experimental colitis. We find that intestinal disease tolerance is a metabolically expensive trait, whose expression is restricted to thermoneutral mice and is not transferable by the microbiota. Instead, disease tolerance is dependent on the adrenergic state of thermogenic adipocytes, which indirectly regulate tolerogenic responses in intestinal epithelial cells. Our work has identified an unexpected mechanism that controls intestinal disease tolerance with implications for colitogenic diseases.


Assuntos
Tecido Adiposo Marrom/metabolismo , Colite/imunologia , Neoplasias do Colo/imunologia , Resistência à Doença , Infecções por Enterobacteriaceae/imunologia , Adipócitos/metabolismo , Tecido Adiposo Marrom/citologia , Animais , Azoximetano/administração & dosagem , Comunicação Celular , Citrobacter rodentium/patogenicidade , Colite/induzido quimicamente , Colite/microbiologia , Colite/patologia , Neoplasias do Colo/induzido quimicamente , Neoplasias do Colo/patologia , Sulfato de Dextrana/toxicidade , Infecções por Enterobacteriaceae/induzido quimicamente , Infecções por Enterobacteriaceae/microbiologia , Infecções por Enterobacteriaceae/patologia , Células Epiteliais/metabolismo , Feminino , Humanos , Mucosa Intestinal/citologia , Mucosa Intestinal/imunologia , Mucosa Intestinal/patologia , Masculino , Camundongos , Neoplasias Experimentais/induzido quimicamente , Neoplasias Experimentais/imunologia , Neoplasias Experimentais/patologia , Termogênese/imunologia
7.
Acta Biochim Biophys Sin (Shanghai) ; 52(7): 768-775, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32445465

RESUMO

Interleukin-33 (IL-33) is produced by various types of cells under physical or pathological conditions. As a multifunctional partner in health and disease, current evidence reveals that IL-33 also participates in several metabolic processes. IL-33 has been proven to contribute to regulating the activity of ST2+ group 2 innate lymphoid cells and regulatory T cells in adipose, which leads to the shift of insulin sensitivity and glucose clearance in glucose metabolism, thermogenesis, and adipocyte beiging in adipose metabolism. In this review, we briefly summarize the biological characteristics of Il-33 and discuss its regulatory function in glucose and adipose metabolism. By clarifying the underlying mechanism of IL-33, we highlight the crosstalk between immune response and metabolic processes mediated by IL-33.


Assuntos
Tecido Adiposo , Glucose , Resistência à Insulina/imunologia , Interleucina-33 , Termogênese/imunologia , Tecido Adiposo/imunologia , Tecido Adiposo/metabolismo , Animais , Glucose/imunologia , Glucose/metabolismo , Humanos , Interleucina-33/imunologia , Interleucina-33/metabolismo , Linfócitos T Reguladores/imunologia , Linfócitos T Reguladores/metabolismo
9.
Cell Metab ; 27(5): 954-961, 2018 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-29719233

RESUMO

Immune cells were recently found to have an unexpected involvement in controlling the thermogenic activity of brown and beige adipose tissue. Here, we review how macrophages, eosinophils, type 2 innate lymphoid cells, and T lymphocytes are linked to this process. In particular, the recruitment of alternatively activated macrophages and eosinophils is associated with brown fat activation and white fat browning. Conversely, pro-inflammatory immune cell recruitment represses the thermogenic activity of brown and beige adipose tissues via cytokines that inhibit noradrenergic signaling. Macrophages also influence the noradrenergic tone by degrading norepinephrine locally and by inhibiting sympathetic innervation over time.


Assuntos
Tecido Adiposo Bege/imunologia , Tecido Adiposo Marrom/imunologia , Eosinófilos/imunologia , Macrófagos/imunologia , Linfócitos T/imunologia , Termogênese/imunologia , Adipócitos Bege/citologia , Adipócitos Bege/imunologia , Adipócitos Marrons/citologia , Adipócitos Marrons/imunologia , Tecido Adiposo Bege/citologia , Tecido Adiposo Marrom/citologia , Tecido Adiposo Branco/imunologia , Animais , Citocinas/imunologia , Metabolismo Energético , Humanos , Camundongos , Norepinefrina/imunologia
10.
Nat Immunol ; 18(6): 665-674, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28459435

RESUMO

Tissue macrophages provide immunological defense and contribute to the establishment and maintenance of tissue homeostasis. Here we used constitutive and inducible mutagenesis to delete the nuclear transcription regulator Mecp2 in macrophages. Mice that lacked the gene encoding Mecp2, which is associated with Rett syndrome, in macrophages did not show signs of neurodevelopmental disorder but displayed spontaneous obesity, which was linked to impaired function of brown adipose tissue (BAT). Specifically, mutagenesis of a BAT-resident Cx3Cr1+ macrophage subpopulation compromised homeostatic thermogenesis but not acute, cold-induced thermogenesis. Mechanistically, malfunction of BAT in pre-obese mice with mutant macrophages was associated with diminished sympathetic innervation and local titers of norepinephrine, which resulted in lower expression of thermogenic factors by adipocytes. Mutant macrophages overexpressed the signaling receptor and ligand PlexinA4, which might contribute to the phenotype by repulsion of sympathetic axons expressing the transmembrane semaphorin Sema6A. Collectively, we report a previously unappreciated homeostatic role for macrophages in the control of tissue innervation. Disruption of this circuit in BAT resulted in metabolic imbalance.


Assuntos
Tecido Adiposo Marrom/imunologia , Macrófagos/imunologia , Proteína 2 de Ligação a Metil-CpG/genética , Sistema Nervoso Simpático/metabolismo , Termogênese/imunologia , Adipócitos Marrons , Tecido Adiposo Marrom/inervação , Tecido Adiposo Marrom/metabolismo , Animais , Axônios/metabolismo , Receptor 1 de Quimiocina CX3C , Metabolismo Energético/imunologia , Citometria de Fluxo , Homeostase , Immunoblotting , Macrófagos/metabolismo , Camundongos , Mutagênese Sítio-Dirigida , Proteínas do Tecido Nervoso/metabolismo , Norepinefrina/metabolismo , Obesidade/genética , Reação em Cadeia da Polimerase em Tempo Real , Receptores de Superfície Celular/metabolismo , Receptores de Quimiocinas/metabolismo , Semaforinas/metabolismo
11.
Nat Med ; 23(5): 623-630, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28414329

RESUMO

Adaptive thermogenesis is the process of heat generation in response to cold stimulation. It is under the control of the sympathetic nervous system, whose chief effector is the catecholamine norepinephrine (NE). NE enhances thermogenesis through ß3-adrenergic receptors to activate brown adipose tissue and by 'browning' white adipose tissue. Recent studies have reported that alternative activation of macrophages in response to interleukin (IL)-4 stimulation induces the expression of tyrosine hydroxylase (TH), a key enzyme in the catecholamine synthesis pathway, and that this activation provides an alternative source of locally produced catecholamines during the thermogenic process. Here we report that the deletion of Th in hematopoietic cells of adult mice neither alters energy expenditure upon cold exposure nor reduces browning in inguinal adipose tissue. Bone marrow-derived macrophages did not release NE in response to stimulation with IL-4, and conditioned media from IL-4-stimulated macrophages failed to induce expression of thermogenic genes, such as uncoupling protein 1 (Ucp1), in adipocytes cultured with the conditioned media. Furthermore, chronic treatment with IL-4 failed to increase energy expenditure in wild-type, Ucp1-/- and interleukin-4 receptor-α double-negative (Il4ra-/-) mice. In agreement with these findings, adipose-tissue-resident macrophages did not express TH. Thus, we conclude that alternatively activated macrophages do not synthesize relevant amounts of catecholamines, and hence, are not likely to have a direct role in adipocyte metabolism or adaptive thermogenesis.


Assuntos
Adipócitos/metabolismo , Tecido Adiposo/metabolismo , Macrófagos/imunologia , Norepinefrina/metabolismo , Receptores Adrenérgicos beta 3/metabolismo , Termogênese/imunologia , Tirosina 3-Mono-Oxigenase/genética , Adaptação Fisiológica , Adipócitos/efeitos dos fármacos , Tecido Adiposo/efeitos dos fármacos , Tecido Adiposo Marrom/efeitos dos fármacos , Tecido Adiposo Marrom/metabolismo , Tecido Adiposo Branco/efeitos dos fármacos , Tecido Adiposo Branco/metabolismo , Animais , Western Blotting , Composição Corporal/imunologia , Catecolaminas/metabolismo , Diferenciação Celular , Meios de Cultivo Condicionados , Metabolismo Energético/genética , Citometria de Fluxo , Imunofluorescência , Perfilação da Expressão Gênica , Interleucina-4/imunologia , Interleucina-4/farmacologia , Macrófagos/efeitos dos fármacos , Camundongos , Camundongos Knockout , Receptores de Superfície Celular/genética , Termogênese/genética , Proteína Desacopladora 1/genética
12.
J Exp Med ; 209(3): 427-31, 2012 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-22412174

RESUMO

Macrophages play pleiotropic, niche-specific roles in all tissues and organs. As immune sentinels, tissue macrophages regulate immune activation and inflammation; in turn, their function is modulated by inflammatory mediators deriving from such activation. Recent papers have established unanticipated roles for interleukin 4 and the alternative activation of tissue macrophages in the organismal response to diverse environmental stressors.


Assuntos
Macrófagos/imunologia , Macrófagos/fisiologia , Animais , Sistema Nervoso Central/imunologia , Sistema Nervoso Central/fisiologia , Eosinófilos/imunologia , Humanos , Interleucina-13/imunologia , Interleucina-4/imunologia , Ativação de Macrófagos/imunologia , Ativação de Macrófagos/fisiologia , Obesidade/imunologia , Obesidade/fisiopatologia , Estresse Fisiológico , Termogênese/imunologia , Termogênese/fisiologia
13.
J. physiol. biochem ; 63(4): 317-328, oct.-dic. 2007. ilus, tab
Artigo em En | IBECS | ID: ibc-72021

RESUMO

The aim of the present work was to assess whether changes in adipose tissue geneexpression related with adipogenesis and/or thermogenesis could be involved in themechanism conferring susceptibility or resistance to develop obesity in high-fat fedoutbreed rats. For this purpose, male Wistar rats were fed with standard laboratorydiet (control group) or high fat diet. After 15 days, two groups of rats with significantdifferences on body weight gain in response to the high fat diet were characterizedand identified as diet-induced obesity (DIO) and diet resistant (DR) rats. A significantincrease in visceral white adipose tissue (WAT) PPARã and aP2 (p<0.05)mRNA levels associated to a decrease in RARã expression (p<0.05) was observed inDIO rats, suggesting an increase of adipogenesis. Furthermore, our data showed amarked increase in brown adipose tissue (BAT) of UCP1 mRNA in DIO animals(p<0.01) (without affecting PGC-1á gene expression), whereas no changes werefound in WAT UCP2 gene expression. All these data suggest that the variationsfound in the expression pattern of PPARã, aP2 and RARã by high-fat diet could beinvolved, at least in part, in the differences in body weight gain and adiposityobserved between DR and DIO animals. The compensatory adaptations through theincrease in energy expenditure by changes on the expression levels of UCP1 seem notto be enough to avoid the obesity onset in the DIO group (AU)


No disponible


Assuntos
Animais , Ratos , Masculino , Obesidade/fisiopatologia , Obesidade/veterinária , Gorduras na Dieta/metabolismo , Gorduras na Dieta/uso terapêutico , Peso Corporal/fisiologia , Termogênese/fisiologia , Interleucina-11/fisiologia , Tecido Adiposo/fisiologia , Peso Corporal , Termogênese , Termogênese/imunologia
14.
Auton Neurosci ; 85(1-3): 102-10, 2000 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-11189016

RESUMO

Partial elimination of vagal sensory afferents by subdiaphragmatic vagal section has variously been reported to eliminate, to reduce, or to have no effect on fever produced by peripheral lipopolysaccharide and interleukin-1beta (IL-1beta). However, to adequately test the idea that vagal afferents convey immune information to the brain, all vagal input to the central nervous system must be eliminated. This was accomplished by bilateral electrolytic lesions of the nucleus tractus solitarius (NTS). Reflex bradycardia evoked by intravenous phenylbiguanide was eliminated in NTS-lesioned rats, verifying the lesion's effectiveness. IL-1beta (2 microg/kg) was given to conscious, unrestrained rats via an indwelling intraperitoneal catheter and produced rapid fever (approximately 1 degree C) with an onset latency of 15 min and peak response at 30 min, with a second, smaller peak at 130 min. NTS lesions attenuated the first fever peak, with a lesser, non-significant effect on the second peak. The thermogenic capacity of NTS-lesioned rats was evaluated using 3 different strategies: (1) thermogenesis evoked by CNS injections of prostaglandin E2, (2) 3 h exposure to a 4 degrees C environment, and (3) heat production of intrascapular brown fat produced by intravenous infusion of the beta3-adrenergic agonist BRL 37344. NTS-lesioned rats were equivalent, or even superior to control animals in their thermogenic response to these non-immune-related stimuli. Therefore, the impaired febrile response of NTS-lesioned rats to IL-1beta cannot be attributed to reduced thermogenic capacity. Finally, these results suggest that fever elicited by intraperitoneal IL-1beta is, at least in part, dependent on the integrity of NTS neurons, but also that mechanisms independent of vagal afferent projections to the NTS must also play a role in immune-to-brain signaling.


Assuntos
Febre/patologia , Interleucina-1/farmacologia , Núcleo Solitário/imunologia , Núcleo Solitário/patologia , Nervo Vago/imunologia , Tecido Adiposo Marrom/fisiopatologia , Agonistas Adrenérgicos beta/farmacologia , Animais , Biguanidas/farmacologia , Bradicardia/induzido quimicamente , Temperatura Baixa , Denervação , Dinoprostona/farmacologia , Etanolaminas/farmacologia , Febre/induzido quimicamente , Febre/imunologia , Hipoglicemiantes/farmacologia , Injeções Intraperitoneais , Masculino , Neuroimunomodulação/efeitos dos fármacos , Neuroimunomodulação/fisiologia , Neurônios Aferentes/imunologia , Ratos , Ratos Long-Evans , Termogênese/imunologia , Nervo Vago/citologia
15.
Auton Neurosci ; 85(1-3): 72-7, 2000 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-11189029

RESUMO

Peripheral interleukin-1beta has been implicated in the initiation of fever responses, yet the pathways by which it influences brain function are still unclear. Sectioning the abdominal vagus has been reported to inhibit fever after intraperitoneal administration of interleukin-1beta, suggesting that vagal afferents participate in signaling the brain to mount a fever response to interleukin-1beta. However, the inhibitory effect of subdiaphragmatic vagotomy could be due to alterations in pharmacokinetics such that the intraperitoneally injected cytokine does not reach the general circulation in sufficient quantities to activate the brain via blood-borne signaling. We measured both fever and plasma levels of interleukin-1beta in vagotomized and sham-operated rats after intraperitoneal administration of 1 microg/kg human recombinant interleukin-1beta to determine whether vagotomy reduces fever and levels of circulating interleukin-1beta after intraperitoneal injection. Plasma levels of human recombinant and endogenous rat interleukin-1beta were measured in separate enzyme-linked immunosorbent assays. While intraperitoneal administration of human recombinant interleukin-1beta elevated plasma levels of this cytokine similarly in vagotomized and sham-operated animals, only sham-operated rats responded with fever. Plasma levels of endogenous rat interleukin-1beta were unchanged by any treatment. These results demonstrate that the blockade of intraperitoneal interleukin-1beta-induced fever after subdiaphragmatic vagotomy cannot be accounted for by alterations of interleukin-1beta levels in the general circulation.


Assuntos
Febre/imunologia , Interleucina-1/sangue , Interleucina-1/imunologia , Vagotomia/métodos , Nervo Vago/imunologia , Animais , Diafragma , Febre/sangue , Manobra Psicológica , Humanos , Injeções Intraperitoneais , Interleucina-1/farmacologia , Masculino , Ratos , Ratos Sprague-Dawley , Proteínas Recombinantes/farmacologia , Termogênese/imunologia , Nervo Vago/cirurgia
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