Impact of Bariatric Surgical Intervention on Peripheral Blood Neutrophil (PBN) Function in Obesity

• Published in: Obesity surgery Vol. 28; no. 6; pp. 1611 - 1621
• Main Authors: Roberts, Helen M., Grant, Melissa M., Hubber, Naomi, Super, Paul, Singhal, Rishi, Chapple, Iain L. C.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2018; Springer Nature B.V
• Subjects: Cytokines; Gastrointestinal surgery; Glucose; Hemoglobin; Medicine; Medicine & Public Health; Neutrophils; Obesity; Original Contributions; Surgery; Surgical outcomes; Very low-calorie diet (VLCD); Neutrophil extracellular traps (NETs); Cytokines; Reactive oxygen species (ROS); Peripheral blood neutrophil (PBN); Glycated haemoglobin (HbA1c); Chemotaxis
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-017-3063-1

Aim The aim of this study was to investigate the impact of weight loss following gastric band surgery on multiple measures of peripheral blood neutrophil (PBN) function. Material and Methods Twenty-three obese patients undergoing gastric band surgery were recruited to a longitudinal intervention study, alongside non-obese, healthy gender- and age-matched controls. Eighteen pairs of patients and controls completed all stages of the study. PBNs were isolated by density centrifugation and a comprehensive analysis of PBN function was undertaken at various stages of the patients’ bariatric surgical care pathway. Results Obese patients exhibited exaggerated PBN activity in response to various stimuli, characterised by higher reactive oxygen species (ROS) generation ( n  = 18, p  < 0.001) and release of pro-inflammatory cytokines ( n  = 10, p  < 0.05) and lower PBN extracellular trap (NET) formation ( n  = 18, p  < 0.01). PBN chemotactic accuracy was also impaired prior to surgery ( n  = 18, p  < 0.01). Weight loss was associated with normalised NET production and lower ROS production and cytokine release relative to healthy controls. However, chemotactic accuracy remained impaired in patients. Conclusions Weight loss following gastric band surgery was associated with a decrease in the pro-inflammatory activities of peripheral blood neutrophils (PBNs). A hyper-inflammatory PBN phenotype, involving excess ROS and cytokine release, reduced NET formation and chemotaxis, may lead to a reduced ability to eliminate infection, alongside inflammation-mediated tissue damage in obese individuals.