Autoantibodies production and immunological abnormalities after bariatric surgery

Abstract

Objective Bariatric surgery is a widely used procedure for the treatment of obesity. Our aim is to describe the main immunological changes in patients who undergo bariatric surgery. Methods A prospective study was conducted within a cohort of patients undergoing bariatric surgery and without previous evidence of systemic or organ-specific autoimmune diseases in whom 3 blood samples were collected – one day before surgery (Time 0), and 5 (Time 1) and 10 months (Time 2) after surgery. Results Thirty four obese patients underwent surgery (Time 0):30(88.24%) were women, mean age 38.3 years. When comparing Time 0 and Time 2, there were statistically significant changes in CD4+T cell count, with an increase from 1074/mL(IQR:860–1316) to 1217.5/mL(IQR:838–1510), p = 0.0002. The CD4/CD8 ratio increased from 2.2(IQR: 1.7–2.7) to 2.4(1.8–2.8), p = 0.0001. As for humoral variables, the C3 fraction of complement decreased from 164 ± 40.6 mg/dL to 112.4 ± 31.4 mg/dL( p < 0.001) and C4 decreased from 29.3 ± 10.1 mg/dL to 22.5 ± 7.1( p = 0.0009) at Time 2. Four patients with negative ANAs at baseline, showed positive ANAs at Time 2.One patient developed anti-citrullinated peptide antibodies >200 IU/mL at Time 2. Conclusions Patients undergoing bariatric surgery show immunological changes which might eventually lead to develop an autoimmune disease.

Total fecal IgA levels increase and natural IgM antibodies decrease after gastric bypass surgery

“…There are only a few reports on autoantibodies in blood samples in individuals undergoing RYGB surgery. A decrease in rheumatoid factor (RF) antibody levels and anti‐cardiolipin antibody levels has been reported [ 38 ], and it should be noted that a majority of RF antibodies are IgM isotype. Also, individuals developing anti‐nuclear antibodies with homogeneous and centriole patterns after the surgery have been reported [ 38 ].…”

“…A decrease in rheumatoid factor (RF) antibody levels and anti‐cardiolipin antibody levels has been reported [ 38 ], and it should be noted that a majority of RF antibodies are IgM isotype. Also, individuals developing anti‐nuclear antibodies with homogeneous and centriole patterns after the surgery have been reported [ 38 ]. A report of four patients developing systemic lupus erythematosus, antiphospholipid syndrome and rheumatoid arthritis within a year after the RYGB surgery [ 32 ] and a case report of a patient developing histiocytic necrotizing lymphadenitis after two years of surgery have been published, and these reports further emphasize the role of gut immune system in autoimmune diseases.…”

Selenium Deficiency Due to Diet, Pregnancy, Severe Illness, or COVID-19—A Preventable Trigger for Autoimmune Disease

“…According to the aforementioned definition of substitution versus supplementation, there is at present no scientific rationale for Se supplementation, but substitution is mandatory in case of suspected or diagnosed Se deficiency, both for avoiding health risks (e.g., AID) and for supporting the immune system of an already or not-yet diseased organism. [196] viral infection suppression [187] enhancement [197] cancer suppression [198] enhancement [199] (poly-)trauma suppression [200] enhancement [201] burn injury suppression [202] enhancement [203] smoking suppression [204] enhancement [205] surgery suppression [206] enhancement [207] transplantation suppression [190] enhancement [208] pregnancy suppression [82] enhancement [85] * out of many suitable references, one is chosen for reasons of space and clarity, with an apology to the authors of relevant studies not listed here. Admittedly, this overview is a biased selection intended to motivate and stimulate reflection.…”

Late Diagnosis of Infective Endocarditis: Clinical Case Report

“…Although IE is quite rare, it has a wide range of clinical manifestations and in some cases IE is diagnosed only at advanced stages. Normally, the human immune system can easily cope with low levels of bacteraemia, but immunosuppressive conditions (such as underwent bariatric surgery [5], chronic inflammations [6] and other diseases) and highly virulent microorganisms can cause IE. In the presence of bacteraemia, and especially sepsis, it is important to suspect this insidious disease and to initiate the necessary tests.…”