scholarly journals Rodent vertical sleeve gastrectomy alters maternal immune health and fetoplacental development

2018 ◽  
Vol 132 (2) ◽  
pp. 295-312 ◽  
Author(s):  
Redin A. Spann ◽  
William J. Lawson ◽  
Gene L. Bidwell ◽  
C. Austin Zamarripa ◽  
Rodrigo O. Maranon ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Gestational Hypertension ◽  
The Body ◽  
Obese Women ◽  
Vertical Sleeve Gastrectomy ◽  
Fetal Demise ◽  
Maternal Immune System ◽  
Structural Abnormalities ◽  
Immune Health ◽  
Metalloproteinase 9

Bariatric surgery is increasingly employed to improve fertility and reduce obesity-related co-morbidities in obese women. Surgical weight loss not only improves the chance of conception but reduces the risk of pregnancy complications including pre-eclampsia, gestational diabetes, and macrosomia. However, bariatric procedures increase the incidence of intrauterine growth restriction (IUGR), fetal demise, thromboembolism, and other gestational disorders. Using our rodent model of vertical sleeve gastrectomy (VSG), we tested the hypothesis that VSG in diet-induced, obese dams would cause immune and placental structural abnormalities that may be responsible for fetal demise during pregnancy. VSG dams studied on gestational day (G) 19 had reduced circulating T-cell (CD3+ and CD8+) populations compared with lean or obese controls. Further, local interleukin (IL) 1β and IL 1 receptor antagonist (il1rn) cmRNA were increased in placenta of VSG dams. Placental barrier function was also affected, with increased transplacental permeability to small molecules, increased matrix metalloproteinase 9 expression, and increased apoptosis in VSG. Furthermore, we identified increased placental mTOR signaling that may contribute to preserving the body weight of the fetuses during gestation. These changes occurred in the absence of a macronutrient deficit or gestational hypertension in the VSG dams. In summary, previous VSG in dams may contribute to fetal demise by affecting maternal immune system activity and compromise placental integrity.

scholarly journals Splenectomy fails to attenuate immuno-hematologic changes after rodent vertical sleeve gastrectomy

2019 ◽  
Vol 244 (13) ◽  
pp. 1125-1135 ◽  
Author(s):  
Alexandra R Himel ◽  
Erin B Taylor ◽  
Charles L Phillips ◽  
Bradley A Welch ◽  
Redin A Spann ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
T Cells ◽  
Sleeve Gastrectomy ◽  
B Cells ◽  
Fat Mass ◽  
Peripheral Blood ◽  
Peripheral Blood Lymphocytes ◽  
Vertical Sleeve Gastrectomy ◽  
Immune Health

Bariatric surgery is on the rise for long-term weight loss and produces various positive metabolic health benefits. The mechanisms that produce surgical weight loss are not yet fully understood. Previous studies showed vertical sleeve gastrectomy prior to gestation resulted in reduced peripheral blood lymphocytes measured during pregnancy due to an undetermined etiology. Further, elevated splenic weight has been associated with vertical sleeve gastrectomy surgery. We hypothesized that perhaps altered splenic filtration was trapping circulating lymphocytes and thus reducing peripheral blood lymphocytes in circulation and contributing to increased spleen weight. We posited whether removal of the spleen concomitant with the stomach surgery may result in an improved immune phenotype. We evaluated female long Evans rats having received Sham surgery or vertical sleeve gastrectomy, with or without splenectomy to determine the contribution of the spleen on metabolic and immune factors after vertical sleeve gastrectomy. Vertical sleeve gastrectomy animals lost significant amounts of body mass and fat mass and ate less in comparison to Sham females during the first five post-operative weeks, but there was no specific effect of the loss of spleen on body mass, fat mass, or food intake. During the post-operative week 6, animals were euthanized and blood recovered for cell sorting of immune cells. There was a reduction in CD3+ total T cells, CD3/CD4+ helper T cells, and CD3/CD8+ cytotoxic T cells, main effect of both bariatric surgery ( P < 0.0001) and splenectomy ( P < 0.01). Furthermore, there was a significant increase in CD45RA+ B cells as a result of splenectomy ( P < 0.001), but a significant reduction in B cells as a result of VSG surgery ( P < 0.05). The changes in total T cells but not B cells were strongly correlated with fat mass. Further studies are needed to understand the cause of the immune changes after surgical weight loss. Impact statement Bariatric surgery and in particular vertical sleeve gastrectomy are the fastest growing means for robust amelioration of the comorbidities of obesity. The ramifications of the surgeries on immune health are of important consequence because of the connectivity of immunity with every organ system. The current work reports on the impact of the surgery on the spleen, thymus, and peripheral blood in a rodent model that mimics human surgical outcomes. We demonstrate altered immune health in the VSG rat.

Type 2 diabetes remission one year after bariatric surgery - a comparison between vertical sleeve gastrectomy and gastric bypass

2018 ◽  
Author(s):  
Ines Ferreira Barros ◽  
Silvia Paredes ◽  
Fernando Manso ◽  
Costa Jose Manuel Maia da ◽  
Aline Fernandes ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Diabetes Remission ◽  
Vertical Sleeve Gastrectomy ◽  
Type 2 Diabetes Remission ◽  
One Year

Portomesenteric thrombosis after robotic sleeve gastrectomy

2020 ◽  
Vol 13 (12) ◽  
pp. e236202
Author(s):  
Omkaar Jaikaran ◽  
Derek Lim ◽  
Brian Binetti ◽  
Vadim Meytes
Keyword(s):  
Sleeve Gastrectomy ◽  
Portal Vein ◽  
Methylenetetrahydrofolate Reductase ◽  
Splenic Vein ◽  
Subsequent Development ◽  
Obese Women ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis ◽  
Robotic Sleeve Gastrectomy ◽  
Compound Mutation

Portomesenteric thrombosis is an important but rarely reported complication following bariatric surgery. It has been suggested that the incidence of portal vein thrombosis is directly related to many risk factors inherent in the bariatric population as well as factors related to local and systemic effects of laparoscopic surgery. Possible aetiologies vary from systemic inherited hypercoagulable states to a direct inflammatory reaction of portosystemic vessels. Here we present a case report of a 47-year-old obese women who underwent a robotic sleeve gastrectomy with subsequent development of a main portal vein, complete right intrahepatic portal vein and splenic vein thrombosis ultimately found to have a compound mutation of the methylenetetrahydrofolate reductase C677T and A1298C alleles.

Comparative Effectiveness of Roux-en Y Gastric Bypass Versus Vertical Sleeve Gastrectomy for Sustained Remission of Type 2 Diabetes Mellitus

2021 ◽  
Vol 261 ◽  
pp. 407-416
Author(s):  
Richard D. Nudotor ◽  
Gregory Prokopowicz ◽  
Enoch J. Abbey ◽  
Aldo Gonzalez ◽  
Joseph K. Canner ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Gastric Bypass ◽  
Type 2 Diabetes Mellitus ◽  
Sleeve Gastrectomy ◽  
Comparative Effectiveness ◽  
Sustained Remission ◽  
Vertical Sleeve Gastrectomy

Impact of vertical sleeve gastrectomy on patients with preoperative gastroesophageal reflux disease

2016 ◽  
Vol 12 (7) ◽  
pp. S212-S213
Author(s):  
Jacqueline Paolino ◽  
Sajani Shah ◽  
Wesley Vosburg ◽  
Julie Kim ◽  
Adam Blau ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Vertical Sleeve Gastrectomy
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