# Converted Macrophage Polarization and Expression of COL6α3—Early Predictors of Remodeling Processes in Adipose Tissue of Male Children

## TL;DR

This study explores how obesity in male children affects fat tissue by increasing macrophage activity and collagen gene expression, which may lead to inflammation and tissue remodeling.

## Contribution

The study identifies CD163+ macrophage polarization and COL6α3 expression as early indicators of ECM remodeling in adipose tissue of overweight children.

## Key findings

- Obese and overweight children showed higher CD163+ macrophage counts in SAT and VAT.
- COL6α3 gene expression was elevated in both SAT and VAT of overweight children.
- Increased CLSs and ECM remodeling were observed in adipose tissue of obese children.

## Abstract

Background/Objectives: Overweight and obesity in early childhood is a serious public health problem as in most cases it persists into adulthood and significantly affects the quality of life. The aim of this study was to investigate the mechanisms that trigger extracellular matrix (ECM) remodeling in the subcutaneous (SAT) and visceral (VAT) adipose tissue of male children in relation to their body weight. Methods: During elective abdominal surgery, SAT and VAT were acquired from 75 male subjects undergoing hernia repair (inguinal herniorrhaphy by Ferguson) or orchidopexy. Based on their Z-score, subjects were separated into two groups. The morphometry of both adipose tissue compartments was assessed after hematoxylin and eosin histological staining, immunohistochemistry to quantify CD163+ cells and the number of crown-like structures (CLSs), and real-time polymerase chain reaction to assess the relative gene expression for collagen VI subtype alpha 3 (COL6α3). Results: Obese and overweight individuals were found to have higher numbers of CD163+ cells, greater numbers of CLSs in VAT and SAT, and a higher expression of COL6α3 in both compartments. Conclusions: Obesity in childhood may lead to increased COL6α3 gene expression and promote the activation of macrophage polarization, compromise the structural integrity of the ECM, and thus influence the development of inflammatory processes.