scholarly journals Long-Term Improvement of Chronic Low-Grade Inflammation After Bariatric Surgery

2021 ◽  
Author(s):  
Anne Lautenbach ◽  
Fabian Stoll ◽  
Oliver Mann ◽  
Philipp Busch ◽  
Tobias B. Huber ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Low Grade ◽  
Strong Positive Correlation ◽  
Long Term Effects ◽  
Inflammatory Parameters ◽  
Inflammatory Status ◽  
Hs Crp ◽  
Low Grade Inflammation

Abstract Purpose Bariatric surgery (BS) was shown to improve inflammatory markers in previous short-term follow-up studies. The aim of the present study was to assess the long-term effects of BS on chronic low-grade inflammation markers related to severe obesity. Moreover, the meaning of the type of BS procedure as well as the remission of type 2 diabetes (T2D) for inflammatory status up to 4 years after BS was analyzed. Materials and Methods In a retrospective cohort study including 163 patients at baseline, inflammatory and metabolic parameters were assessed at 4 time points: before surgery (baseline), 6 months after surgery (visit 1), 2 years after surgery (visit 2), and 4 years after surgery (visit 3). Univariate regression analysis was used to identify variables that were thought to determine change in inflammatory parameters. Results CRP, hs-CRP, leucocytes, and ferritin significantly declined in the mid- and long-term according to the U-shaped curve of weight loss (p<0.001). Change in body mass index (BMI) at long-time follow-up showed a significant linear effect on change in leucocytes (B=0.082; p<0.001) and change in hs-CRP (B=0.03; p<0.05). There was a strong, positive correlation between T2D and hs-CRP at visit 2 (rs=0.195; p<0.05) and visit 3 (rs=0.36; p=0.001). With regard to type of surgery and gender, there were no significant differences in inflammatory parameters. Conclusion BS is able to reduce obesity-related chronic low-grade inflammation up to 4 years after surgical intervention. The improvement in metaflammation is related to the change in BMI and remission of T2D in the long-term. Graphical abstract

Long-Term Effects of Bariatric Surgery on Type II Diabetes, Hypertension and Hyperlipidemia: A Meta-Analysis and Meta-Regression Study with 5-Year Follow-Up

2014 ◽  
Vol 25 (3) ◽  
pp. 397-405 ◽  
Author(s):  
Cristian Ricci ◽  
Maddalena Gaeta ◽  
Emanuele Rausa ◽  
Emanuele Asti ◽  
Francesco Bandera ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Type Ii Diabetes ◽  
Meta Analysis ◽  
Type Ii ◽  
Long Term Effects ◽  
Meta Regression

scholarly journals Multiplex Bead Array Assay of a Panel of Circulating Cytokines and Growth Factors in Patients with Albuminuric and Non-Albuminuric Diabetic Kidney Disease

2020 ◽  
Vol 9 (9) ◽  
pp. 3006
Author(s):  
Vadim V. Klimontov ◽  
Anton I. Korbut ◽  
Nikolai B. Orlov ◽  
Maksim V. Dashkin ◽  
Vladimir I. Konenkov
Keyword(s):  
Growth Factors ◽  
Kidney Disease ◽  
Low Grade ◽  
Hs Crp ◽  
Low Grade Inflammation ◽  
Egfr Decline ◽  
Multiplex Bead ◽  
Circulating Cytokines

A panel of cytokines and growth factors, mediating low-grade inflammation and fibrosis, was assessed in patients with type 2 diabetes (T2D) and different patterns of chronic kidney disease (CKD). Patients with long-term T2D (N = 130) were classified into four groups: no signs of CKD; estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 without albuminuria; albuminuria and eGFR ≥60 mL/min/1.73 m2; albuminuria and eGFR <60 mL/min/1.73 m2. Thirty healthy subjects were acted as control. Twenty-seven cytokines and growth factors were assessed in serum by multiplex bead array assay. Serum hs-CRP, urinary nephrin, podocine, and WFDC2 were measured by ELISA. Patients with T2D showed elevated IL-1Ra, IL-6, IL-17A, G-CSF, IP-10, MIP-1α, and bFGF levels; concentrations of IL-4, IL-12, IL-15, INF-γ, and VEGF were decreased. IL-6, IL-17A, G-CSF, MIP-1α, and bFGF correlated negatively with eGFR; IL-10 and VEGF demonstrated negative associations with WFDC2; no relationships with podocyte markers were found. Adjusted IL-17A and MIP-1α were predictors of non-albuminuric CKD, IL-13 predicted albuminuria with preserved renal function, meanwhile, IL-6 and hsCRP were predictors of albuminuria with eGFR decline. Therefore, albuminuric and non-albuminuric CKD in T2D patients are associated with different pro-inflammatory shifts in the panel of circulating cytokines.

Non-Transferrin-Bound Iron, Iron Load and Hypoxia May Induce Low-Grade Inflammation in Patients with Thalassemia Intermedia.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4072-4072
Author(s):  
Antonios Kattamis ◽  
Emmanuel Kanavakis ◽  
Vassilios Ladis ◽  
Christos Kattamis ◽  
Ioannis Papassotiriou
Keyword(s):  
Clinical Chemistry ◽  
Graphite Furnace ◽  
Heme Iron ◽  
Tissue Hypoxia ◽  
Low Grade ◽  
Thalassemia Intermedia ◽  
Transfusion Therapy ◽  
Inflammatory Status ◽  
Hs Crp ◽  
Low Grade Inflammation

Abstract Abstract 4072 Poster Board III-1007 Background Inflammation is known to play an important role in the pathogenesis of thalassemia. Serum levels of pro-inflammatory cytokines such as IL-6 and TNF-a are known to be elevated in thalassemic patients, suggestive a low-grade inflammatory status. These levels are comparable to the ones observed in patients with diabetes, obesity and atherosclerosis. Altered redox status has also been shown in thalassemic erythrocytes. Reactive oxygen species (ROS) are generated in increased amounts after the precipitation of excess unmatched globin chains, the deposition of non-heme iron and hemichromes and the induced inflammation. In this study we assessed the levels and possible causes of inflammatory status in patients with thalassemia intermedia (TI). Patients and Methods Thirty-five patients with TI, 13 men and 22 women, aged 8-63 years were included in the study. None of the patients had received any transfusion therapy for at least 6 months prior of sampling, while 25/35 patients had been splenectomized. We measured the hematologic and biochemical parameters, including Hb, HbF ferritin and soluble transferrin receptors (sTfR) with standard methodology. Serum concentrations of non-transferrin bound iron (NTBI) were estimated using graphite furnace atomic absorption spectrometry. Determination of high-sensitivity CRP (hs-CRP or cardiophase-CRP) was performed using the Siemens Advia 1800 Clinical Chemistry System. Furthermore, we obtained P50 values from oxygen equilibrium curves (OEC) drawn in fresh whole blood. Oxygen delivery and release parameters were calculated using the “Siggaard–Andersen's Oxygen Status Algorithm”. Results hs-CRP levels were elevated 2.12±0.55 mg/L compared to lean control values 1.2±0.19 mg/L (p<0.008). Most of the patients (60 %) showed evidence of low-grade inflammation based on the hs-CRP levels. NTBI levels were significantly elevated (2.4±2.2micromol/L), with only 10/30 patients having levels <0.5micromol/L, which is proposed as normal limit. As accepted P50 values were indicative of relative tissue hypoxia (all patients demonstrate increase oxygen affinity). All of the patients showed evidence of increased eryhtropoeitic activity, as indicate by the elevated sTfR levels ranged from 4.0 to 22.9mg/L (3- to 19-fold increase of erythroid marrow activity). The main results of the evaluated correlations showed that: a) hs-CRP levels correlated positively with NTBI concentrations (r=0.741, p<0.0001), b) hs-CRP levels correlated positively with ferritin levels (r=0.522, p=0.004) and c) hs-CRP levels correlated negatively with P50 values (r=-0.409, p=0.03), while no correlation was found between hs-CRP levels and the degree of ineffective erythropoiesis expressed as sTfR concentrations (p> 0.223). Conclusions These findings demonstrate that patients with TI have a chronic low-grade inflammation. Similar inflammatory status has been also shown in patients with atherosclerosis, diabetes and obesity. The level of inflammation correlated with indexes of iron homoestasis, alteration of which is commonly observed in patients with TI. Thus, it seems plausible that the oxidative effects of NTBI and increased iron burden result in chronic inflammation in these patients. The observed negative correlation of inflammation and P50 is of interest, as it indicates possible involvement of tissue hypoxia in inflammation processes. Disclosures: Kattamis: Novartis: Consultancy, Honoraria, Speakers Bureau.

scholarly journals Inflammation-Related Mechanisms in Chronic Kidney Disease Prediction, Progression, and Outcome

2018 ◽  
Vol 2018 ◽  
pp. 1-16 ◽  
Author(s):  
Simona Mihai ◽  
Elena Codrici ◽  
Ionela Daniela Popescu ◽  
Ana-Maria Enciu ◽  
Lucian Albulescu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Gut Microbiota ◽  
Clinical Care ◽  
Low Grade ◽  
Public Health Burden ◽  
Inflammatory Status ◽  
Low Grade Inflammation ◽  
Gut Microbiota Dysbiosis

Persistent, low-grade inflammation is now considered a hallmark feature of chronic kidney disease (CKD), being involved in the development of all-cause mortality of these patients. Although substantial improvements have been made in clinical care, CKD remains a major public health burden, affecting 10–15% of the population, and its prevalence is constantly growing. Due to its insidious nature, CKD is rarely diagnosed in early stages, and once developed, its progression is unfortunately irreversible. There are many factors that contribute to the setting of the inflammatory status in CKD, including increased production of proinflammatory cytokines, oxidative stress and acidosis, chronic and recurrent infections, altered metabolism of adipose tissue, and last but not least, gut microbiota dysbiosis, an underestimated source of microinflammation. In this scenario, a huge step forward was made by the increasing progression of omics approaches, specially designed for identification of biomarkers useful for early diagnostic and follow-up. Recent omics advances could provide novel insights in deciphering the disease pathophysiology; thus, identification of circulating biomarker panels using state-of-the-art proteomic technologies could improve CKD early diagnosis, monitoring, and prognostics. This review aims to summarize the recent knowledge regarding the relationship between inflammation and CKD, highlighting the current proteomic approaches, as well as the inflammasomes and gut microbiota dysbiosis involvement in the setting of CKD, culminating with the troubling bidirectional connection between CKD and renal malignancy, raised on the background of an inflammatory condition.

scholarly journals Gut microbiota alterations in patients with persistent respiratory dysfunction three months after severe COVID-19

2021 ◽  
Author(s):  
Beate Vestad ◽  
Thor Ueland ◽  
Tori Vigeland Lerum ◽  
Tuva B Dahl ◽  
Kristian Holm ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Rrna Gene ◽  
Low Grade ◽  
Barrier Dysfunction ◽  
Gut Barrier ◽  
Respiratory Dysfunction ◽  
Low Grade Inflammation ◽  
Gut Microbiota Composition

Objective: Although COVID-19 is primarily a respiratory infection, mounting evidence suggests that the GI tract is involved in the disease, with gut barrier dysfunction and gut microbiota alterations being related to disease severity. Whether these alterations persist and could be related to long-term respiratory dysfunction is unknown. Design: From the NOR-Solidarity trial (n=181), plasma was collected during hospital admission and after three months, and analyzed for markers of gut barrier dysfunction and inflammation. At the three-month follow-up, pulmonary function was assessed by measuring diffusing capacity of the lungs for carbon monoxide (DLCO), and rectal swabs for gut microbiota analyses were collected (n= 97) and analysed by sequencing of the 16S rRNA gene. Results: Gut microbiota diversity was reduced in COVID-19 patients with persistent respiratory dysfunction, defined as DLCO below lower limit of normal three months after hospitalization. These patients also had an altered global gut microbiota composition, with reduced abundance of Erysipelotrichaceae UCG-003 and increased abundance of Flavonifractor and Veillonella, the latter potentially being linked to fibrosis. During hospitalization, increased plasma levels of lipopolysaccharide-binding protein (LBP) were strongly associated with respiratory failure, defined as pO2/fiO2-(P/F-ratio)<26.6 kPa. LBP levels remained elevated during and after hospitalization, and was associated with low-grade inflammation and persistent respiratory dysfunction after three months. Conclusion: Persistent respiratory dysfunction after COVID-19 is associated with reduced biodiversity and gut microbiota alterations, along with persistently elevated LBP levels. Our results point to a potential gut-lung axis that should be further investigated in relation to long-term pulmonary dysfunction and long COVID.

scholarly journals Bariatric surgery in adolescents with obesity - long term perspectives and potential alternatives

2021 ◽  
Author(s):  
Rana Halloun ◽  
Ram Weiss
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Severe Obesity ◽  
Lifestyle Modification ◽  
Perioperative Complications ◽  
Nutritional Deficiencies ◽  
Long Term Effects ◽  
Long Term Outcome

Background: Severe obesity among adolescent shows a worrisome trend in regard of its increasing prevalence and poses a great challenge for treatment. Conservative measures have modest effects on weight loss, usually fail in achieving a sustainable weight loss and resolution of comorbidities. This has led to greater utilization of bariatric surgery (BS) that offers a fast reduction in body mass index (BMI) with little perioperative complications. Despite the increasing utilization of BS, data is still insufficient, regarding their long-term outcome in adolescents. We review short and long-term effects of bariatric surgery and their implications on bone health and nutritional deficiencies in adolescents. In addition, we discuss possible pharmaceutical alternatives. Summary: BS results in a substantial weight loss of roughly 37% in the first-year post-operation and is superior to conservative measures in resolution of metabolic comorbidities. BS significantly improves health-related quality of life. Longer follow up, shows weight regain in 50% of patients. Furthermore, reduced bone mass and nutritional deficiencies were reported in up to 90% of patients. Most recently, alternative to BS became more relevant with approval of GLP-1 analogues use in adolescents. GLP-1 analogues are potent enough to induce moderate clinically meaningful weight loss and improvement of metabolic component. Key Messages: We conclude that obese adolescents without major obesity related complications may benefit from pharmacological interventions with lifestyle modification. We advise considering BS as treatment approach in adolescents with severe obesity and major obesity related complications with proper pre-operative preparation and post operative follow up in excellence centers.

Long-term effects of moderate protein diet on renal function and low-grade inflammation in older adults with type 2 diabetes and chronic kidney disease

Nutrition ◽  
2014 ◽  
Vol 30 (9) ◽  
pp. 1045-1049 ◽  
Author(s):  
Mauro Giordano ◽  
Tiziana Ciarambino ◽  
Pietro Castellino ◽  
Alessandro Cataliotti ◽  
Lorenzo Malatino ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Low Grade ◽  
Long Term Effects ◽  
Low Grade Inflammation

scholarly journals Relationship between the Plasma Proteome and Changes in Inflammatory Markers after Bariatric Surgery

Cells ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 2798
Author(s):  
Helene Fachim ◽  
Zohaib Iqbal ◽  
J. Martin Gibson ◽  
Ivona Baricevic-Jones ◽  
Amy E. Campbell ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Inflammatory Markers ◽  
Mass Spectra ◽  
Fold Change ◽  
Low Grade ◽  
Short Term ◽  
Theoretical Mass ◽  
Underlying Mechanisms ◽  
Low Grade Inflammation

Severe obesity is a disease associated with multiple adverse effects on health. Metabolic bariatric surgery (MBS) can have significant effects on multiple body systems and was shown to improve inflammatory markers in previous short-term follow-up studies. We evaluated associations between changes in inflammatory markers (CRP, IL6 and TNFα) and circulating proteins after MBS. Methods: Sequential window acquisition of all theoretical mass spectra (SWATH-MS) proteomics was performed on plasma samples taken at baseline (pre-surgery) and 6 and 12 months after MBS, and concurrent analyses of inflammatory/metabolic parameters were carried out. The change in absolute abundances of those proteins, showing significant change at both 6 and 12 months, was tested for correlation with the absolute and percentage (%) change in inflammatory markers. Results: We found the following results: at 6 months, there was a correlation between %change in IL-6 and fold change in HSPA4 (rho = −0.659; p = 0.038) and in SERPINF1 (rho = 0.714, p = 0.020); at 12 months, there was a positive correlation between %change in IL-6 and fold change in the following proteins—LGALS3BP (rho = 0.700, p = 0.036), HSP90B1 (rho = 0.667; p = 0.05) and ACE (rho = 0.667, p = 0.05). We found significant inverse correlations at 12 months between %change in TNFα and the following proteins: EPHX2 and ACE (for both rho = −0.783, p = 0.013). We also found significant inverse correlations between %change in CRP at 12 months and SHBG (rho = −0.759, p = 0.029), L1CAM (rho = −0.904, p = 0.002) and AMBP (rho = −0.684, p = 0.042). Conclusion: Using SWATH-MS, we identified several proteins that are involved in the inflammatory response whose levels change in patients who achieve remission of T2DM after bariatric surgery in tandem with changes in IL6, TNFα and/or CRP. Future studies are needed to clarify the underlying mechanisms in how MBS decreases low-grade inflammation.

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