Insulin plays an indispensable role in the management of hyperglycaemia that arises in a variety of settings, including Type I and II diabetes, gestational diabetes, as well as is in hyperglycaemia following a severe inflammatory insult. However, insulin receptors are also expressed on a range of cells that are not canonically implicated in glucose homeostasis. This includes immune cells, where the anti-inflammatory effects of insulin have been repeatedly reported. However, recent findings have also implicated a more involved role for insulin in shaping the immune response during an infection. This includes the ability of insulin to modulate immune cell differentiation and polarisation as well as the modulation of effector functions such as biocidal ROS production. Finally, inflammatory mediators can through both direct and indirect mechanisms also regulate serum insulin levels, suggesting that insulin may be co-opted by the immune system during an infection to direct immunological operations. Collectively, these observations implicate insulin as a bona fide immune-modulating hormone and suggest that a better understanding of insulin’s immunological function may aid in optimising insulin therapy in a range of clinical settings.

胰岛素在各种情况下发生的高血糖管理中起着不可或缺的作用，包括I型和II型糖尿病，妊娠糖尿病以及严重炎症引起的高血糖。但是，胰岛素受体也可以在一系列与葡萄糖稳态无关的细胞中表达。这包括免疫细胞，其中胰岛素的抗炎作用已被反复报道。但是，最近的发现也暗示胰岛素在感染过程中影响免疫反应的过程中起着更重要的作用。这包括胰岛素调节免疫细胞分化和极化的能力，以及调节效应子功能（例如杀生物ROS的能力）的能力。最后，炎性介质可以通过直接和间接机制调节血清胰岛素水平，这表明胰岛素在感染过程中可能被免疫系统选择直接免疫操作。总的来说，这些发现暗示胰岛素是一种真正的免疫调节激素，并表明对胰岛素的免疫功能的更好理解可能有助于在一系列临床环境中优化胰岛素治疗。