Keywords
insulin sensitivity
low triiodothyronine syndrome
hypothalamic-pituitary-adrenal axis
tissue repair
sarcopenia
How to Cite
Abstract
In press
Background. Traditionally, the termination of inflammation has been regarded as a passive decline of the pro-inflammatory response after elimination of the injurious stimulus. However, inflammation resolution is now recognized as an active process involving coordinated immune, neuroendocrine, and metabolic mechanisms required for tissue repair and recovery. This concept provides a basis for new approaches to treatment, metabolic support, and rehabilitation.
Aim. To analyze current concepts of inflammation resolution from an immunometabolic perspective and to substantiate the concept of immunometabolic resolution as a systemic process mediating the transition from adaptation to recovery.
Materials and Methods. A narrative review of studies indexed in PubMed, Scopus, Web of Science, MEDLINE, ScienceDirect, and Google Scholar between 2000 and 2025 was conducted. Studies addressing inflammation resolution, neuroendocrine regulation, tissue insulin sensitivity, thyroid adaptation, mitochondrial function, post-traumatic recovery, and metabolic disorders were analyzed. The study was conducted as a private initiative of the authors, without grant support or state registration of the research topic.
Research Ethics. Only sources that comply with current bioethical standards were selected for the analysis.
Results. Inflammation resolution is associated with a shift in functional priority from survival programs toward tissue repair and recovery. A key event in this transition is the reduction in energy demands of the innate immune system, accompanied by decreased cytokine activation, attenuation of Hypothalamic-Pituitary-Adrenal (HPA) axis activity, and redistribution of energy resources toward tissue repair. Resolution includes restoration of tissue insulin sensitivity, normalization of thyroid status and mitochondrial function, and a shift from predominantly glycolytic to oxidative metabolism. Delayed resolution may contribute to chronic allostatic overload, metabolic syndrome, sarcopenia, and impaired post-traumatic recovery.
Conclusions. The concept of immunometabolic resolution is proposed, according to which termination of inflammation represents an integrated process involving restoration of neuroendocrine regulation, energy metabolism, and functional integrity. Resolution enables the transition from adaptation to recovery and rehabilitation and may provide a target for metabolic support and rehabilitation strategies.
Keywords: endocrinology, insulin sensitivity, low triiodothyronine syndrome, hypothalamic-pituitary-adrenal axis, tissue repair, sarcopenia.
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