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When serving as demonstrator at the Veterinary School of the University of Pennsylvania during the 1970s, I was frequently required to remove all that nasty, messy adipose tissue to enable the students to see the “real” structures beneath. The anatomy textbooks devoted only a few lines to what was sometimes the most abundant tissue in the body. Many readers are probably familiar with the attitudes thus embodied. Lipids and adipose tissue are seen as at best superfluous or ugly, often indicative of an indolent or intemperate lifestyle, and sometimes positively harmful. They are the agents of retribution for the modern lifestyle, turning self-indulgence and sloth into debility and death, and above all, compared with the mathematical sophistication of genes and proteins, adipose tissue is dull. All adipocytes look alike and respond mindlessly to blood borne orders such as insulin, cortisol, and glucagon. The ideal adipocytes know their duties and their place: they should mop up excess lipids in the blood and mould themselves into gaps and smooth contours to form rounded breasts, thighs and cheeks, perhaps fill a few internal spaces not required by more important tissues, but otherwise keep quiet and make themselves as small as possible until starvation calls them to attention.
The immune system is seen as diverse, sophisticated and noble, its cells sacrificing themselves for the benefit of the whole body. The cardiovascular system is the crowning achievement of vertebrates, ingeniously accommodating abrupt changes in the pressure and composition of blood, sealing off wounds, maintaining water balance, etc. For these intricate and important tissues, forming permanent liaisons with adipose tissue is surely to marry beneath them, yet several independent lines of research during the 1990s suggest that such improbable alliances are widespread, ancient, and essential.
Adipocytes' progress from obscurity began in 1987 with the isolation of …
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