The Immunophenotyping Changes of Peripheral CD4+ T Lymphocytes and Inflammatory Markers of Class III Obesity Subjects After Laparoscopic Gastric Sleeve Surgery – A Follow-Up Study

• Published in: Journal of inflammation research Vol. 14; pp. 1743 - 1757
• Main Authors: Rizk, Nasser M, Fadel, Amina, AlShammari, Wasaif, Younes, Noura, Bashah, Moataz
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 31.05.2021; Dove; Dove Medical Press
• Subjects: and follow up; Diagnosis; immunity; laparoscopic gastric sleeve; Laparoscopic surgery; Laparoscopy; Medical equipment and supplies industry; Medical test kit industry; Obesity; Original Research; peripheral cd4+ t-lymphocytes; T cells; t-regulatory cells; Tumor necrosis factor; United States; Qatar; T-regulatory cells; class III obesity; immunity; laparoscope gastric sleeve surgery; peripheral CD4+ T-lymphocytes; follow up
• ISSN: 1178-7031; 1178-7031
• DOI: 10.2147/JIR.S282189

Obesity is a chronic disorder characterized by a low-grade inflammatory state and immune cell irregularities. The study aimed to follow up on the changes in the peripheral CD4+ T lymphocytes and the pro-inflammatory cytokines; IL-6, TNF-alpha, MCP-1, and IL-10 at baseline and 12 weeks post-surgical intervention by the laparoscopic gastric sleeve (LGS) in morbidly obese patients (class III obesity subjects). A prospective longitudinal research included 24 class III obesity subjects with a BMI > 40 kg/m . The subjects were enrolled from the Metabolic/Surgical Department at Hamad Medical Corporation (HMC)-Qatar. Fasting blood samples were collected at admission to LGS for weight loss and after 12 weeks of LGS. The immunophenotype of CD4+ T-cell populations; naïve (CD45RA and CD27 ), central memory T cells (CD45RO and CD27 ), and effector memory (CD45RO and CD27 ) and T-regulatory cell (CD4+CD25+ FoxP3+) were identified using flow cytometry. Plasma pro-inflammatory cytokines and adipokines were evaluated. A control group of lean subjects was used to compare changes of T-regulatory and inflammatory biomarkers with postoperative changes in obese patients. The means (SD) of age and BMI of class III obesity subjects was 32.32 (8.36) years and 49.02 (6.28) kg/m respectively. LGS caused a significant reduction in BMI by 32%, p<0.0001. LGS intervention significantly decreased CD4+ T-lymphocytes and effector memory (TEM) cells but increased T-regulatory (Treg), naïve, and central memory (TCM) cells, with all values < 0.05. The increase of Treg cells postoperative is significantly lower compared to lean subjects, p < 0.05. A significant reduction of plasma IL-6, TNF-α, and MCP-1, but IL-10 significantly increased after LGS, with all <0.05. Adiponectin/leptin ratio improved after LGS by 2.9 folds, <0.0001. Weight loss by LGS accomplished a substantial rise of Treg and decreased EM T-lymphocytes with a shift from pro-inflammatory to the anti-inflammatory pattern.