Key result
Bariatric surgery shifts adaptive immunity to reduce chronic inflammation and improve insulin sensitivity.
Why the study?
To examine the interplay between adaptive immune system changes and improved insulin sensitivity in response to bariatric surgery-induced weight loss.
Does bariatric surgery improve adaptive immune system profiles and insulin resistance in severe obesity?
Does bariatric surgery improve adaptive immune system profiles and insulin resistance in severe obesity?
Bariatric surgery induces a shift in the adaptive immune system from a proinflammatory to an anti-inflammatory phenotype, which may drive the reduction in low-grade chronic inflammation and improvement in insulin sensitivity.
Answers are grounded in this paper and cite their sources.
Bariatric surgery-associated immune shifts may reduce inflammation in obesity; leaves open whether prospective trials will confirm causality or guide practice.
Low-grade chronic inflammation plays a pivotal role among other pathophysiological mechanisms involved in obesity. Innate and adaptive immune cells undergo systemic proinflammatory polarization that gives rise to an increased secretion of proinflammatory cytokines, which in turn leads to insulin resistance. Bariatric surgery is currently the most effective treatment for obesity, as it brings on significant weight loss, glucose metabolism improvement, and a decrease in systemic inflammation biomarkers. After bariatric surgery, several changes have been reported to occur in adaptive immunity, including reduction in CD4+ and CD8+ T cell counts, a decrease in the Th1/Th2 ratio, an increase in B regulatory cells, and reduction in proinflammatory cytokine secretion. Overall, there seems to be a major shift in several lymphocyte populations from a proinflammatory to an anti-inflammatory phenotype. Furthermore, increased antioxidant activity and reduced lipid and DNA oxidation products have been reported after bariatric surgery in circulating mononuclear cells. This paper highlights the shift in the adaptive immune system in response to weight loss and improved insulin sensitivity, as well as the interplay between immunological and metabolic adaptations as a result of bariatric surgery. Finally, based on data from research, we propose several mechanisms such as changes in adaptive immune cell phenotypes and their by-products, recruitment in adipose tissue, reduced oxidative stress, and modification in metabolic substrate availability as drivers to reduce low-grade chronic inflammation after bariatric surgery in severe obesity.
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Villarreal-Calderón et al. (2019) conducted a review in Obesity. Bariatric surgery was evaluated. Bariatric surgery induces a shift in adaptive immune cells from a proinflammatory to an anti-inflammatory phenotype, reducing low-grade chronic inflammation and improving insulin sensitivity.
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