Effect of bariatric surgery on systemic and adipose tissue inflammation

Sams, Valerie G.; Blackledge, Camille; Wijayatunga, Nadeeja; Barlow, Patrick B.; Mancini, Matthew; Mancini, Gregory J.; Moustaid‐Moussa, Naima

doi:10.1007/s00464-015-4638-3

Cited by 59 publications

(46 citation statements)

References 24 publications

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“…TNFα concentrations at 2 weeks, 6 months, and/or 13 months after laparoscopic RYGB (LRYGB), were indistinguishable from pre-surgical/baseline levels in two independent studies [35, 39]. A third study of samples from subjects undergoing LRYGB showed TNFα significantly increased 3 months post-surgery compared to baseline, while recapitulating the other studies’ findings of no change in TNFα in comparison at 6 and 12 month post-surgery [36].…”

Section: The Impact Of Bariatric Surgery On Diabetogenic Inflammamentioning

confidence: 84%

“…Taken together, these data indicate that acute phase proteins change more predictably than TNFα, IL-6, or other cytokines measured (MCP-1, IL-8 etc. [39, 58–60] following bariatric surgery (Figure 1). One exception to the variability in cytokine responses to bariatric surgery is adiponectin, a generally anti-inflammatory cytokine made by adipocytes, which uniformly increases post- surgery [36, 61].…”

Section: The Impact Of Bariatric Surgery On Diabetogenic Inflammamentioning

confidence: 99%

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The impact of bariatric surgery on inflammation: quenching the fire of obesity?

Hafida

Mirshahi²,

Nikolajczyk

2016

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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Structured Abstract Purpose of the review Numerous lines of evidence support the likelihood that inflammation drives the transition from obese/metabolically healthy to obese/type 2 diabetes (T2D). Given the temporal flexibility of inflammation in obesity-associated T2D, investigators have hypothesized that a precipitous drop in diabetogenic cytokines is critical for rapid “T2D remission” following surgery but prior to significant weight loss. We review the evidence that changes in diabetogenic cytokines play a role in outcomes of bariatric surgery, including weight loss and improved glycemic control. Recent Findings A 2016 indication for bariatric surgery to treat T2D integrates the large body of data showing short-term metabolic improvement. Parameters that account for improved glycemic control prior to significant weight loss, T2D recidivism over the long term, or failure of surgery to remit T2D in some patients are incompletely understood. Summary We review the evidence that changes in diabetogenic cytokines play a role in outcomes of bariatric surgery, including improved glycemic control. We brainstorm future research directions that may improve surgical results.

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Section: The Impact Of Bariatric Surgery On Diabetogenic Inflammamentioning

confidence: 84%

Section: The Impact Of Bariatric Surgery On Diabetogenic Inflammamentioning

confidence: 99%

The impact of bariatric surgery on inflammation: quenching the fire of obesity?

Hafida

Mirshahi²,

Nikolajczyk

2016

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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“…Even within three months of surgery the expression of genes involved in macrophage recruitment, as well as histological detection of ATM in adipose tissue, have exhibited reductions [46]. Correspondingly, gene expression of the insulin sensitizing adipokine, adiponection, increases during this time frame [47]. Paradoxically, however, while Xu et al [44] observed improvements at three months after surgery in circulating high-molecular weight adiponectin and 5′ adenosine monophosphate-activated protein kinase (AMPK) activation, along with reductions in malonyl-CoA and oxidative stress in subcutaneous adipose tissue, there were no changes in the expression of inflammatory markers.…”

Section: Discussionmentioning

confidence: 99%

The short-term and long-term effects of bariatric/metabolic surgery on subcutaneous adipose tissue inflammation in humans

et al. 2017

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Context The mechanisms mediating the short- and long-term improvements in glucose homeostasis following bariatric/metabolic surgery remain incompletely understood. Objective To investigate whether a reduction in adipose tissue inflammation plays a role in the metabolic improvements seen after bariatric/metabolic surgery, both in the short-term and longer-term. Design Fasting blood and subcutaneous abdominal adipose tissue were obtained before (n=14), at one month (n=9), and 6–12 months (n=14) after bariatric/metabolic surgery from individuals with obesity who were not on insulin or anti-diabetes medication. Adipose tissue inflammation was assessed by a combination of whole-tissue gene expression and flow cytometry-based quantification of tissue leukocytes. Results One month after surgery, body weight was reduced by 13.5±4.4 kg (p<0.001), with improvements in glucose tolerance reflected by a decrease in area-under-the-curve (AUC) glucose in 3-h oral glucose tolerance tests (−105±98 mmol/L*min; p=0.009) and enhanced pancreatic β-cell function (insulinogenic index: +0.8±0.9 pmol/mmol; p=0.032), but no change in estimated insulin sensitivity (Matsuda insulin sensitivity index [ISI]; p=0.720). Furthermore, although biomarkers of systemic inflammation and pro-inflammatory gene expression in adipose tissue remained unchanged, the number of neutrophils increased in adipose tissue 15–20 fold (p<0.001), with less substantial increases in other leukocyte populations. By the 6–12 month follow-up visit, body weight was reduced by 34.8±10.8 kg (p<0.001) relative to baseline, and glucose tolerance was further improved (AUC glucose −276±229; p<0.001) along with estimated insulin sensitivity (Matsuda ISI: +4.6±3.2; p<0.001). In addition, improvements in systemic inflammation were reflected by reductions in circulating C-reactive protein (CRP; −2.0±5.3 mg/dL; p=0.002), and increased serum adiponectin (+1,358±1,406 pg/mL; p=0.003). However, leukocyte infiltration of adipose tissue remained elevated relative to baseline, with pro-inflammatory cytokine mRNA expression unchanged, while adiponectin mRNA expression trended downward (p=0.069). Conclusion Both the short- and longer-term metabolic improvements following bariatric/metabolic surgery occur without significant reductions in measures of adipose tissue inflammation, as assessed by measuring the expression of genes encoding key mediators of inflammation and by flow cytometric immunophenotyping and quantification of adipose tissue leukocytes.

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“…Sams et al [21] found a significant and rapid increase in subcutaneous adipose anti-inflammatory cytokines (e.g. adiponectin) by enzyme-linked immunosorbent assay already 2 weeks following RYGBP, potentially contributing to systemic inflammation reduction.…”

Section: Bs and Inflammationmentioning

confidence: 99%

“…On the contrary, systemic and adipose-tissue inflammation seems to decrease following bariatric procedures both at the biochemical and at the clinical level. These changes supposedly promote risk reduction in obesity-associated comorbid conditions including T2DM, cardiovascular diseases, infections, and cancer [20,21,22,23]. …”

Section: Bs and Inflammationmentioning

confidence: 99%

Does Gastric Surgery (Such as Bariatric Surgery) Impact the Risk of Intestinal Inflammation?

2016

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Background: The prevalence of morbid obesity and inflammatory bowel disease (IBD) is on the rise in association with a Western lifestyle. Both conditions are characterized by chronic inflammation. Bariatric surgery (BS) is a recommended and widely used approach to address severe obesity and its related comorbidities. Roux-en-Y gastric bypass (RYGBP) and sleeve gastrectomy (SG) are the most frequently performed procedures worldwide. Evidence is scarce on outcomes of BS in IBD patients. Summary: Systemic and adipose-tissue inflammation seems to decrease following BS. Different studies observed decreased serum levels of inflammatory markers (CRP, IL-6, MCP-1, and TNF-α) along with a reduction of insulin resistance both after RYGBP and SG. Several authors documented postbariatric improvement of concomitant chronic inflammatory diseases (rheumatoid arthritis, systemic lupus erythematosus, gout, and psoriasis). There are only few retrospective case series on outcomes of BS in IBD patients. These studies reported safety and feasibility of BS and improvement in IBD status, manifested by prolonged disease remission and decreased use of pharmacotherapy. Weight loss outcomes were excellent and similar to those of non-IBD patients. The preferred surgical approach for morbidly obese IBD patients is SG in order to avoid potential drawbacks of RYGBP, such as malabsorption, intestinal manipulation, and augmentation of technical difficulties for future IBD surgery. Seven cases of newly diagnosed IBD after BS have been reported, which are more likely to result from postoperative intestinal microbial dysbiosis than from directly induced inflammation. Key Messages: This review summarizes the outcomes of BS in IBD patients. SG is the preferable technique for morbidly obese IBD patients, who have potentially a double benefit from BS: weight loss and IBD remission. Further research is necessary to clarify the common pathophysiology of chronic inflammation in morbid obesity and in IBD. Postbariatric changes in gut microbiota should also be assessed to understand whether they promote IBD development or not.

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Effect of bariatric surgery on systemic and adipose tissue inflammation

Cited by 59 publications

References 24 publications

The impact of bariatric surgery on inflammation: quenching the fire of obesity?

The impact of bariatric surgery on inflammation: quenching the fire of obesity?

The short-term and long-term effects of bariatric/metabolic surgery on subcutaneous adipose tissue inflammation in humans

Does Gastric Surgery (Such as Bariatric Surgery) Impact the Risk of Intestinal Inflammation?

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