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

<h3>Purpose </h3><p dir="ltr">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). </p><h3>Materials and Methods </h3><p dir="ltr">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. </p><h3>Results </h3><p dir="ltr">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. </p><h3>Conclusion </h3><p dir="ltr">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.</p><h2>Other Information</h2><p dir="ltr">Published in: Journal of Inflammation Research<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.2147/jir.s282189" target="_blank">https://dx.doi.org/10.2147/jir.s282189</a></p>