Interplay between the Adaptive Immune System and Insulin Resistance in Weight Loss Induced by Bariatric Surgery

Low-grade chronic inflammation plays a pivotal role among other pathophysiological mechanisms involved in obesity. Innate and adaptive immune cells undergo systemic proinflammatory polarization that gives rise to an increased secretion of proinflammatory cytokines, which in turn leads to insulin res...

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Bibliographic Details
Published in:Oxidative medicine and cellular longevity 2019, Vol.2019 (2019), p.1-14
Main Authors: Garcia-Rivas, Gerardo, Castillo, E. C., Rubio-Infante, Nestor, Ramos-González, Martín R., Cuéllar, Ricardo X., Villarreal-Calderón, José R., Elizondo-Montemayor, Leticia
Format: Article
Language:English
Subjects:
Adipocytes
Antigens
B cells
Body mass index
Care and treatment
Cytokines
Diabetes therapy
Gastrointestinal surgery
Glucose metabolism
Immune system
Inflammation
Insulin resistance
Lifestyles
Liver
Lymphocytes
Metabolism
Obesity
Physiological aspects
Psoriasis
Review
Rheumatoid arthritis
Surgery
T cell receptors
T cells
Type 2 diabetes
Weight control
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Summary:Low-grade chronic inflammation plays a pivotal role among other pathophysiological mechanisms involved in obesity. Innate and adaptive immune cells undergo systemic proinflammatory polarization that gives rise to an increased secretion of proinflammatory cytokines, which in turn leads to insulin resistance. Bariatric surgery is currently the most effective treatment for obesity, as it brings on significant weight loss, glucose metabolism improvement, and a decrease in systemic inflammation biomarkers. After bariatric surgery, several changes have been reported to occur in adaptive immunity, including reduction in CD4+ and CD8+ T cell counts, a decrease in the Th1/Th2 ratio, an increase in B regulatory cells, and reduction in proinflammatory cytokine secretion. Overall, there seems to be a major shift in several lymphocyte populations from a proinflammatory to an anti-inflammatory phenotype. Furthermore, increased antioxidant activity and reduced lipid and DNA oxidation products have been reported after bariatric surgery in circulating mononuclear cells. This paper highlights the shift in the adaptive immune system in response to weight loss and improved insulin sensitivity, as well as the interplay between immunological and metabolic adaptations as a result of bariatric surgery. Finally, based on data from research, we propose several mechanisms such as changes in adaptive immune cell phenotypes and their by-products, recruitment in adipose tissue, reduced oxidative stress, and modification in metabolic substrate availability as drivers to reduce low-grade chronic inflammation after bariatric surgery in severe obesity.
ISSN:1942-0900
1942-0994
DOI:10.1155/2019/3940739