Can Bariatric Surgery Help to Prevent Autoimmunity?

BACKGROUND: Obesity has been linked to the development and progression of autoimmune diseases. AIM: To investigate the presence of autoantibodies in the sera of bariatric-surgery patients. METHODS: During the pre- and postoperative period, sera from 79 patients undergoing bariatric surgery were tested for the presence of antinuclear antibodies (ANA), Rheumatoid Factor (RF), IgG and IgM anticardiolipin antibodies, and anti-endomysial antibodies. Anti-dsDNA and ENA profiles were also determined in positive ANA sera. A chart review was used to obtain clinical, epidemiological, and anthropometric data. RESULTS: Preoperatively, 23/79 (29.1%) of the sera tested positive for ANA; postoperatively, this frequency decreased to 8/79 (10.1%) with p = 0.002 (OR = 3.6; 95%; CI = 1.4-8.3). The fine-speckled ANA pattern was the most common (73.9% preoperative and 87.3% postoperative). Preoperative ANA-positive and negative patients did not differ in epidemiological or anthropometric measurements (all p >0.05), but ANA-positive patients had lower serum vitamin D levels than the negatives (p = 0.002). RF positivity was found in 5/76 (6.5%) of preoperative sera and 3/76 (3.9%) of postoperative sera, with p = 0.71. Anti-ds-DNA, ENA profile, and anti-endomysial antibodies were all negative in all patients, both before and after surgery; anticardiolipin IgM was weakly positive in one postoperative sample. CONCLUSION: Positive ANA is common in obese patients undergoing bariatric surgery, and it decreases after weight loss.

Bariatric surgery results in restoration of physiological plasma levels of pentraxine-3.

Pentraxine-3 (PTX3) is a member of the humoral innate immune system and serves a role in protection against infections, inflammation control and matrix deposition. The aim of the present study was to measure the PTX3 levels in obese patients and its association with glycemic and lipid profiles, and to analyze the effects of weight loss provided by bariatric surgery in serum PTX3 levels. PTX3 was measured in 84 obese patients whom underwent bariatric surgery and 94 healthy controls. Lipid and glycemic profiles were determined using a clinical chemistry analyzer, and PTX3 levels were measured in patients prior to and following bariatric surgery using ELISA. PTX3 levels prior to surgery were significantly lower compared with the normal controls (median of 0.10 vs. 0.80 ng/ml; P<0.0001). Following surgery, the median weight loss was 33.1 kg, and the median PTX3 levels were significantly increased to 1.45 ng/ml compared with pre-surgery levels (P<0.001) and did not differ significantly from the control group levels (P=0.10). There were no correlations between PTX3 levels and total cholesterol, HDL and LDL, fasting glycemia, HbA1c and basal insulin levels. A significant positive correlation was observed between PTX3 levels and triglycerides levels in the post-operative period (ρ=0.26, P=0.01). In conclusion, obese patients had lower levels of PTX3 compared with the control patients, and the levels were restored to physiological levels following bariatric surgery which may be associated with the weight loss.