Year in Review in 2017

Extracellular danger-associated molecular patterns signal to NOD-like receptors, but the exact signalling pathways remain unclear. The inflammasomes, a subgroup of these receptors, translate danger signals into inflammatory responses by maturing IL-1 and IL-18. In 2017, researchers reported novel functions of the mutual interaction between metabolism and the inflammasomes in health and disease.

Studies of rare growth disorders taken together with large-scale genetic studies of adult height variability have uncovered a large genetic network regulating childhood growth. Advances in technology and experimental model systems will help decipher the molecular mechanisms of this complex network and lead to novel treatment approaches for growth disorders.

Nutraceuticals are gaining legitimacy and their potential clinical role is expanding. Data from 2017 provides evidence for their possible use in type 2 diabetes mellitus, the metabolic syndrome, obesity, dyslipidaemia and osteoporosis. Ongoing high-quality research in this area might justify future selective implementation of nutraceuticals into general health practice.

The artificial pancreas — the automated closed-loop control of diabetes mellitus — made its first outpatient strides in 2011. In 2017, the results of long-term clinical trials on the artificial pancreas were published, the first hybrid commercial artificial pancreas system was approved and the artificial pancreas was tested under increasingly demanding conditions. Thus, artificial pancreas technology is here to stay.

Obesity and ageing are major worldwide health challenges associated with lifestyle changes and an increase in age-related diseases, characterized by chronic inflammation dubbed metaflammation and inflammaging. However, the mechanistic link between these inflammatory processes is still unknown. New findings in 2016 shed light on these issues and indicate common targets for intervention.

Neuroendocrine networks were previously perceived mainly as transcriptionally controlled, neural regulatory pathways that are centred at the hypothalamus. However, multisystemic circuits encompassing the brain and peripheral tissues have now been uncovered that involve nonneuronal cells and nontranscriptional regulatory mechanisms, with previously unidentified functions, such as reward and behaviour. Several developments in 2016 have helped to consolidate these new advances.

Adipose tissues have a central role in energy homeostasis, as they secrete adipokines and regulate energy storage and dissipation. Novel adipokines from white, brown and beige adipocytes have been identified in 2016. Identifying the specific receptors for each adipokine is pivotal for developing greater insights into the fat-derived signalling pathways that regulate energy homeostasis.

Type 2 diabetes mellitus (T2DM) is a major global health challenge. Development of more effective strategies for prevention and therapy depends on an improved understanding of its pathogenetic mechanisms. 2016 ends a period during which large-scale discovery of risk alleles for T2DM became routine and heralds a shift in research focus towards their exploitation to fuel mechanistic insights.

Although regular physical activity can prevent or reduce the risk of many age-related diseases, the molecular mechanisms underpinning the protective effects of exercise are largely unknown. In 2016, a series of studies demonstrated that crosstalk between tissues during exercise can protect against metabolic disease, cancer, retinal degeneration and memory loss. These studies provide a molecular basis for the concept of 'exercise as medicine'.