Bariatric surgery-induced weight loss reduces B cell activating cytokines and IgG immunoglobulins related to autoimmunity

Surg Endosc. 2021 Sep;35(9):5147-5158. doi: 10.1007/s00464-020-08004-6. Epub 2020 Sep 28.

Abstract

Background: Obesity is associated with a chronic inflammatory state and autoimmune diseases, but little is known about the role of B cells in this context and the changes in B cell activation factors during obesity and after weight loss. To test whether bariatric-surgery-induced weight loss ameliorates the systemic inflammatory state associated with B cell activation molecules.

Methods: We conducted a prospective observational study in patients treated with bariatric surgery. Anthropometric and body composition measurements were performed preoperatively and at 6 months of follow-up post surgery. The patients were tested for a biochemical profile, plasmatic immunoglobulin G (IgG), cytokines (including specific B cell activating cytokines), and adipokines serum levels RESULTS: The patients' weight loss was accounted for mostly by fat mass (52.9%). We observed a significant reduction in total plasmatic IgG levels (p = 0.001), which could be associated with decreased B cell activity. Accordingly, there was a significant decrease in the B cell activating factors such as APRIL, BAFF, and soluble CD40L and a general improvement in the inflammatory markers hs-CRP, IL-1β, IL-12, IL-18, and IFN-γ.

Conclusions: These findings point toward reduced B cell activity after weight loss due to bariatric surgery. Moreover, they could be the initial link among the systemic inflammatory factors, and B cell activation in this inflammatory context that leads to IgG production and, potentially, to autoimmunity in patients with severe obesity.

Keywords: Autoimmunity; B cells; Bariatric surgery; IgG antibodies; Weight loss.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autoimmune Diseases*
  • Autoimmunity
  • B-Lymphocytes
  • Bariatric Surgery*
  • Cytokines
  • Humans
  • Immunoglobulin G
  • Obesity, Morbid*
  • Weight Loss

Substances

  • Cytokines
  • Immunoglobulin G