Journal of Inflammation Research (May 2021)
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
Abstract
Nasser M Rizk,1– 3 Amina Fadel,1 Wasaif AlShammari,1 Noura Younes,4 Moataz Bashah5 1Biomedical Sciences Department-College of Health Sciences, QU Health—Qatar University; 2Biomedical Research Center, Qatar University; 3Biomedical and Pharmaceutical Research Unit, QU Health—Qatar University; 4Clinical Chemistry Lab, Hamad Medical Corporation, Doha, Qatar; 5Metabolic Unit, Surgery Department, Hammed Medical Corporation (HMC), Doha, QatarCorrespondence: Nasser M RizkBiomedical Sciences Department, College of Health Sciences- QU Health, Qatar University, Room E120- Building C01, P.O. Box: 2713, Doha, QatarEmail [email protected]: 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).Materials and Methods: A prospective longitudinal research included 24 class III obesity subjects with a BMI > 40 kg/m2. 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.Results: The means (SD) of age and BMI of class III obesity subjects was 32.32 (8.36) years and 49.02 (6.28) kg/m2, 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 p 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 p< 0.05. Adiponectin/leptin ratio improved after LGS by 2.9 folds, p< 0.0001.Conclusion: 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.Keywords: class III obesity, immunity, peripheral CD4+ T-lymphocytes, T-regulatory cells, follow up, laparoscope gastric sleeve surgery
