Narrative review explores adipose tissue macrophage regulation for obesity and metabolic disorders

This publication is a narrative review focusing on the role of adipose tissue macrophages (ATMs) in obesity and metabolic disorders such as insulin resistance. It explores potential therapeutic strategies for targeted ATM regulation, including mitochondrial-targeted interventions, extracellular vesicle (EV)-mediated molecular delivery, probiotic/prebiotic modulation, probiotic extracellular vesicles, and nanotechnology-enabled precision interventions. The review synthesizes existing preclinical and early clinical evidence to outline how these approaches might modulate ATM function to improve metabolic health.

The authors present qualitative conclusions based on the reviewed literature, suggesting that these interventions could offer novel pathways for addressing obesity-related inflammation and insulin resistance. However, as a narrative review, it does not provide pooled effect sizes or systematic meta-analytic data, relying instead on a synthesis of available studies to highlight emerging concepts and mechanisms.

Limitations are not explicitly detailed in the source, but inherent constraints include the reliance on early-stage evidence and the absence of comprehensive clinical trial data. The practice relevance is not reported, so the findings should be interpreted cautiously as theoretical or experimental insights rather than established clinical recommendations. Further research is needed to validate these approaches in robust human studies.