The metabolite itaconate has emerged as an important immunoregulator with roles in antibacterial defence, inhibition of inflammation and, more recently, as an inhibitory factor in obesity. Itaconate is one of the most upregulated metabolites in inflammatory macrophages. It is produced owing to the disturbance of the tricarboxylic acid cycle and the diversion of aconitate to itaconate via the enzyme aconitate decarboxylase 1. In immunology, initial studies concentrated on the role of itaconate in inflammatory macrophages where it was shown to be inhibitory, but this has expanded as the impact of itaconate on other cell types is starting to emerge. This review focuses on itaconate as a key immunoregulatory metabolite and describes its diverse mechanisms of action and its many impacts on the immune and inflammatory responses and in cancer. We also examine the clinical relevance of this immunometabolite and its therapeutic potential for immune and inflammatory diseases.

代谢物衣康酸已成为一种重要的免疫调节剂，在抗菌防御、抑制炎症方面发挥作用，最近还作为肥胖的抑制因子。衣康酸是炎症巨噬细胞中上调最多的代谢物之一。它的产生是由于三羧酸循环的紊乱以及乌头酸通过乌头酸脱羧酶 1 转移为衣康酸。在免疫学中，最初的研究集中在衣康酸在炎症巨噬细胞中的作用，在炎症巨噬细胞中它被证明具有抑制作用，但这随着衣康酸对其他细胞类型的影响开始显现，这种影响也在扩大。本综述重点关注衣康酸作为一种关键的免疫调节代谢物，并描述其不同的作用机制及其对免疫和炎症反应以及癌症的许多影响。我们还研究了这种免疫代谢物的临床相关性及其对免疫和炎症疾病的治疗潜力。