Immune Complex Glomerulonephritis and Dermal Vasculitis Following Intestinal Bypass for Morbid Obesity

Gamble, Charles N.; Kimchi, Asher; Depner, Thomas A.; Christensen, Danis J.

doi:10.1093/ajcp/77.3.347

Cited by 13 publications

(2 citation statements)

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“…Alternatively, this may reflect a response to microbial dysbiosis in the upper gastrointestinal tract. In fact, tissue deposition of properdin and bacterial antigen-antibody complexes has been reported as a part of systemic immune complex disease and has responded to immunosuppressive therapy (15).…”

Section: G718mentioning

confidence: 99%

Proteomics in gastroparesis: unique and overlapping protein signatures in diabetic and idiopathic gastroparesis

Grover

Dasari

Bernard

et al. 2019

American Journal of Physiology-Gastrointestinal and Liver Physi

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Macrophage-based immune dysregulation plays a critical role in development of delayed gastric emptying in diabetic mice. Loss of anti-inflammatory macrophages and increased expression of genes associated with pro-inflammatory macrophages has been reported in full-thickness gastric biopsies from gastroparesis patients. We aimed to determine broader protein expression (proteomics) and protein-based signaling pathways in gastric biopsies of diabetic (DG) and idiopathic gastroparesis (IG) patients. Additionally, we determined correlations between protein expressions, gastric emptying, and symptoms. Full-thickness gastric antrum biopsies were obtained from nine DG patients, seven IG patients, and five nondiabetic controls. Aptamer-based SomaLogic tissue scan that quantitatively identifies 1,305 human proteins was used. Protein fold changes were computed, and differential expressions were calculated using Limma. Ingenuity pathway analysis and correlations were carried out. Multiple-testing corrected P < 0.05 was considered statistically significant. Seventy-three proteins were differentially expressed in DG, 132 proteins were differentially expressed in IG, and 40 proteins were common to DG and IG. In both DG and IG, “Role of Macrophages, Fibroblasts and Endothelial Cells” was the most statistically significant altered pathway [DG false discovery rate (FDR) = 7.9 × 10−9; IG FDR = 6.3 × 10−12]. In DG, properdin expression correlated with GCSI bloating ( r = −0.99, FDR = 0.02) and expressions of prostaglandin G/H synthase 2, protein kinase C-ζ type, and complement C2 correlated with 4 h gastric retention ( r = −0.97, FDR = 0.03 for all). No correlations were found between proteins and symptoms or gastric emptying in IG. Protein expression changes suggest a central role of macrophage-driven immune dysregulation in gastroparesis, specifically, complement activation in diabetic gastroparesis. NEW & NOTEWORTHY This study uses SOMAscan, a novel proteomics assay for determination of altered proteins and associated molecular pathways in human gastroparesis. Seventy-three proteins were changed in diabetic gastroparesis, 132 in idiopathic gastroparesis compared with controls. Forty proteins were common in both. Macrophage-based immune dysregulation pathway was most significantly affected in both diabetic and idiopathic gastroparesis. Proteins involved in the complement and prostaglandin synthesis pathway were associated with symptoms and gastric emptying delay in diabetic gastroparesis.

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Section: G718mentioning

confidence: 99%

Proteomics in gastroparesis: unique and overlapping protein signatures in diabetic and idiopathic gastroparesis

Grover

Dasari

Bernard

et al. 2019

American Journal of Physiology-Gastrointestinal and Liver Physi

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“…From an immunological perspective, some immunemediated manifestations related to intestinal bypass (BP) surgeries have been described. These are mainly associated with jejunoileal BP, including arthritis, immune complex glomerulonephritis, cutaneous vasculitis, pericarditis, Raynaud's phenomenon, psoriasis and pyoderma gangrenosum [3][4][5]. The Bowel-associated Dermatosis-Arthritis Syndrome (BADAS), described in 1979 by Dicken and Seehafer, is one of the manifestations better associated with intestinal BP [6,7].…”

Section: Introductionmentioning

confidence: 99%

Axial Spondyloarthritis after bariatric surgery: a 7-year retrospective analysis

2019

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Background: In recent decades, obesity has become a public health problem in many countries. The objective of this study was to evaluate the main joint and extra-articular manifestations related to spondyloarthritis (SpA) after bariatric surgery (BS) in a retrospective cohort. Methods: Demographic, clinical, laboratory and imaging data from nine patients whose SpA symptoms started after a BS have been described. Modified New York (mNY) criteria for ankylosing spondylitis (AS) and the Assessment of Spondyloarthritis International Society (ASAS) criteria for axial (ax-SpA) and peripheral (p-SpA) spondyloarthritis were applied. Results: The mean weight reduction after BS was 49.3 ± 21.9 kg. The BS techniques were Roux-en-Y gastric bypass (n = 8; 88.9%) and biliopancreatic diversion with duodenal switch (n = 1; 11.1%). Four (44.4%) patients had no axial or peripheral pain complaints before BS, while the other four (44.4%) had sporadic non-inflammatory back pain that had been attributed to obesity. One patient (11.1%) had persistent chronic back pain. In all nine cases, patients reported back pain onset or pattern (intensity or night pain) change after BS (mean time 14.7 ± 18 months). In addition, 8 of them (88.9%) were human leukocyte antigen (HLA)-B27 positive. All nine patients could be classified according to ASAS criteria as ax-SpA and five (55.6%) patients were classified as AS, according to the mNY criteria. Conclusion: Our data highlight a temporal link between SpA onset symptoms and the BS, suggesting a possible causal plausibility between the two events.

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Vasculitis and Neutrophilic Vascular Reactions

Barham¹,

Jorizzo²,

Grattan³

et al. 2004

Rook's Textbook of Dermatology

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Immune Complex Glomerulonephritis and Dermal Vasculitis Following Intestinal Bypass for Morbid Obesity

Cited by 13 publications

References 0 publications

Proteomics in gastroparesis: unique and overlapping protein signatures in diabetic and idiopathic gastroparesis

Proteomics in gastroparesis: unique and overlapping protein signatures in diabetic and idiopathic gastroparesis

Axial Spondyloarthritis after bariatric surgery: a 7-year retrospective analysis

Vasculitis and Neutrophilic Vascular Reactions

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