scholarly journals SUN-540 Inflammasome Components After Bariatric Surgery: Novel Targets for a Chronic Disease

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Aura D Herrera-Martinez ◽  
Vicente Herrero Aguayo ◽  
Prudencio Sez ◽  
Juan L López-Cánovas ◽  
Fernando L-López ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Chronic Disease ◽  
Severe Obesity ◽  
The Body ◽  
Inflammasome Activation ◽  
Type2 Diabetes ◽  
Biochemical Evaluation ◽  
First Time ◽  
Metabolic Comorbidities

Abstract Background: Obesity is a metabolic chronic disease with important associated morbidity and mortality. Bariatric surgery (BS) is the most effective treatment for keeping long-term weight loss in severe obesity and consequently decreases obesity-related complications including inflammation. Aim: to explore changes in the inflammasome components after BS and their relations with clinical and biochemical parameters at baseline and six months after surgery. Patients and methods: 22 patients that underwent BS (sleeve gastrectomy and roux-en-Y gastric bypass) were included. Epidemiological, clinical, anthropometric and biochemical evaluation was performed. Four groups of inflammasome components and inflammatory associated factors were evaluated: NOD-like receptors; inflammasome activation components; cytoquines and inflammation/apoptosis related components; and cell-cycle and DNA-damage regulators. Clinical-molecular correlations and associations were for the first time performed in a cohort of patients with morbid obesity that underwent BS. Results: The four groups of inflammasome components were dysregulated after BS. The mRNA expression of several factors was markedly decreased after BS, specially CXCL3, CCL8, TLR4, NLRC4 and NLRP12. Most changes were independent of the performed surgical technique. Inflammasome components displayed several clinical and biochemical correlations including the presence of baseline metabolic comorbidities (type2 diabetes, dyslipidemia and hypetension) and the body composition. Conclusion: the regulation of several inflammasome system components may explain the improvement and reversion of some obesity-related comorbidities after BS.

scholarly journals Nutritional profile of patients in a multidisciplinary treatment program for severe obesity and preoperative bariatric surgery

2014 ◽  
Vol 27 (suppl 1) ◽  
pp. 31-34 ◽  
Author(s):  
Fernanda Cristina Carvalho Mattos MAGNO ◽  
Monique Silveira da SILVA ◽  
Larissa COHEN ◽  
Luciana d´Abreu SARMENTO ◽  
Eliane Lopes ROSADO ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Severe Obesity ◽  
Personal Information ◽  
Dietary Assessment ◽  
Multidisciplinary Treatment ◽  
Statistical Treatment ◽  
Caloric Intake ◽  
The Body ◽  
Food Record ◽  
Anthropometric Data

BACKGROUND: Along with the augmentation in obesity rates in recent years, the demand for bariatric surgery has startlingly increased. Nutritional counseling in the preoperative period is very important because it contributes to higher success rate in the post-operative period. AIM: To assess the nutritional status of patients in a multidisciplinary program for the treatment of severe obesity and pre-operatively for bariatric surgery, characterizing the consumption of healthy nutrients. METHODS: A retrospective analysis of 30 patients was conducted. Personal information, anthropometric data and dietary assessment by 24-hour food record were collected. The analysis of energy intake was performed in Dietpro 5.1 Professional(r) program. The statistical treatment of the caloric intake was performed by an ANOVA test with Bonferroni´s post hoc and for anthropometric data the paired t test was used. RESULTS: From the total, 73% of the patients were women and 27% male, mean age was 48.4+12.9 and 49.8+8.1, respectively. A lower weight in the 5th appointment was observed when compared with the 1st one. There was a reduction in caloric intake in the 2nd, 3rd, 4th and 5th appointments when compared with the 1st. It was observed that in the 5th appointment more than 50% of the patients underwent six meals a day. There was an increase in the consumption of fruit along the appointments and 72.2% of patients consumed 1-2 servings of fruit a day. Vegetables intake was high in all appointments in the pre-operative period and, although low, the whole grain products consumption has increased during the pre-operative period achieving 30% of the study population. CONCLUSION: There was a decrease in body weight, a trend in the decrease of the body mass index and waist circumference and quantitative and qualitative improvement of food consumption.

Dysregulation of components of the inflammasome machinery after bariatric surgery: novel targets for a chronic disease

2021 ◽  
Author(s):  
Vicente Herrero-Aguayo ◽  
Prudencio Sáez-Martínez ◽  
Juan L López-Cánovas ◽  
Juan J Prados-Carmona ◽  
María D Alcántara-Laguna ◽  
...  
Keyword(s):  
Gene Expression ◽  
Type 2 Diabetes ◽  
Cell Cycle ◽  
Bariatric Surgery ◽  
Dna Damage ◽  
Chronic Disease ◽  
Lipid Accumulation ◽  
Hepg2 Cells ◽  
Metabolic Comorbidities

Abstract Background Obesity is a metabolic-chronic disease with important associated morbidities and mortality. Bariatric-surgery is the most effective treatment for maintaining long-term weight-loss in severe obesity and consequently for decreasing obesity-related complications, including chronic inflammation. Aim To explore changes in components of the inflammasome-machinery after bariatric-surgery and their relations with clinical/biochemical-parameters at baseline and six-months after bariatric-surgery. Patients and methods 22 patients with morbid-obesity that underwent bariatric-surgery (sleeve-gastrectomy and roux-en-Y gastric bypass) were included. Epidemiological/clinical/anthropometric/biochemical evaluation was performed at baseline and six-months after bariatric-surgery. Inflammasome-components and inflammatory-associated factors [NOD-like-receptors (NLRs); inflammasome-activation-components; cytokines and inflammation/apoptosis-related components; and cell-cycle and DNA-damage regulators) were evaluated in peripheral-blood mononuclear-cells (PBMCs) at baseline and six-months after bariatric-surgery. Clinical-molecular correlations/associations were analyzed. Functional parameters (lipid-accumulation/viability/apoptosis) were analyzed in response to specific inflammasome-components silencing in liver HEPG2-cells-). Results A profound dysregulation of inflammasome-components after bariatric-surgery was found, especially in NOD-like-receptors, cell-cycle and DNA-damage regulators. Several components were associated to baseline metabolic comorbidities including type-2-diabetes (CCL2/CXCR1/SIRT1), hypertension (AIM2/ASC/P2RX7) and dyslipidemia (CXCL3/NLRP7), and displayed changes in their molecular profile six-months after bariatric-surgery. Gene-expression fingerprint of certain factors (NLRC4/NLRP12/CXCL3/CCL8/TLR4) accurately differentiated pre- and post-operative PBMCs. Most changes were independent of the performed surgical technique. Silencing of NLRC4/NLRP12- resulted in altered lipid-accumulation, apoptosis-rate and cell-viability in HEPG2-cells. Conclusion Bariatric-surgery induces a profound alteration in gene-expression pattern of components of the inflammasome-machinery in PBMCs. Expression and changes of certain inflammasome-components are associated to baseline metabolic comorbidities, including type-2-diabetes, and may be related to the improvement and reversion of some obesity-related comorbidities after bariatric-surgery.

scholarly journals Morbid Obesity: treatment with Bioenterics Intragastric Balloon (BIB), psychological and nursing care: our experience

Open Medicine ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. 407-412
Author(s):  
Luigi Sivero ◽  
Giuseppe Galloro ◽  
Simona Ruggiero ◽  
Donato Alessandro Telesca ◽  
Teresa Russo ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Chronic Disease ◽  
Nursing Care ◽  
Intragastric Balloon ◽  
Severe Obesity ◽  
Intermediate Group ◽  
Bioenterics Intragastric Balloon ◽  
The World ◽  
Immediate Surgery

AbstractObesity is considered a chronic disease, difficult to treat, and is the first cause of death in the world that is predictable. The surgical approach is limited to patients with severe obesity but there is an intermediate group who are not candidates for immediate surgery. The BioEnterics Intragastric Balloon (BIB) is recommended for weight reduction as a bridge to bariatric surgery.All patients in the study underwent a psychological evaluation prior to placement of the BIB.

scholarly journals Long-Term Weight Outcomes after Bariatric Surgery: A Single Center Saudi Arabian Cohort Experience

2021 ◽  
Vol 10 (21) ◽  
pp. 4922
Author(s):  
Assim A. Alfadda ◽  
Mohammed Y. Al-Naami ◽  
Afshan Masood ◽  
Ruba Elawad ◽  
Arthur Isnani ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Saudi Arabia ◽  
Weight Regain ◽  
Severe Obesity ◽  
Successful Outcome ◽  
Post Surgery ◽  
Weight Outcomes

Background: Obesity is considered a global chronic disease requiring weight management through lifestyle modification, pharmacotherapy, or weight loss surgery. The dramatic increase in patients with severe obesity in Saudi Arabia is paralleled with those undergoing bariatric surgery. Although known to be beneficial in the short term, the long-term impacts of surgery within this group and the sustainability of weight loss after surgery remains unclear. Objectives: We aimed to assess the long-term weight outcomes after bariatric surgery. Setting: The study was conducted at King Khalid University Hospital (KKUH), King Saud University Medical City (KSUMC) in Riyadh, Saudi Arabia. Methods: An observational prospective cohort study on adult patients with severe obesity undergoing bariatric surgery (sleeve gastrectomy (SG) or Roux-en Y gastric bypass (RYGB)) during the period between 2009 and 2015 was conducted. Weight loss patterns were evaluated pre- and post-surgery through clinical and anthropometric assessments. Absolute weight loss was determined, and outcome variables: percent excess weight loss (%EWL), percent total weight loss (%TWL), and percent weight regain (%WR), were calculated. Statistical analysis using univariate and multivariate general linear modelling was carried out. Results: A total of 91 (46 males and 45 females) patients were included in the study, with the majority belonging to the SG group. Significant weight reductions were observed at 1 and 3 years of follow-up (p < 0.001) from baseline. The %EWL and %TWL were at their maximum at 3 years (72.4% and 75.8%) and were comparable between the SG and RYGB. Decrements in %EWL and %TWL and increases in %WR were seen from 3 years onwards from bariatric surgery until the study period ended. The yearly follow-up attrition rate was 20.8% at 1 year post-surgery, 26.4% at year 2, 31.8% at year 3, 47.3% at year 4, 62.6% at year 5, and 79.1% at end of study period (at year 6). Conclusion: The major challenge to the successful outcome of bariatric surgery is in maintaining weight loss in the long-term and minimizing weight regain. Factors such as the type of surgery and gender need to be considered before and after surgery, with an emphasis on the need for long-term follow-up to enssure the optimal benefits from this intervention.

scholarly journals Chronic Sulfasalazine Treatment in Mice Induces System xc− - Independent Adverse Effects

2021 ◽  
Vol 12 ◽  
Author(s):  
Lise Verbruggen ◽  
Lindsay Sprimont ◽  
Eduard Bentea ◽  
Pauline Janssen ◽  
Azzedine Gharib ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Therapeutic Potential ◽  
Negative Impact ◽  
Chronic Administration ◽  
Systemic Circulation ◽  
The Body ◽  
Ample Evidence ◽  
Anti Inflammatory ◽  
First Time

Despite ample evidence for the therapeutic potential of inhibition of the cystine/glutamate antiporter system xc− in neurological disorders and in cancer, none of the proposed inhibitors is selective. In this context, a lot of research has been performed using the EMA- and FDA-approved drug sulfasalazine (SAS). Even though this molecule is already on the market for decades as an anti-inflammatory drug, serious side effects due to its use have been reported. Whereas for the treatment of the main indications, SAS needs to be cleaved in the intestine into the anti-inflammatory compound mesalazine, it needs to reach the systemic circulation in its intact form to allow inhibition of system xc−. The higher plasma levels of intact SAS (or its metabolites) might induce adverse effects, independent of its action on system xc−. Some of these effects have however been attributed to system xc− inhibition, calling into question the safety of targeting system xc−. In this study we chronically treated system xc− - deficient mice and their wildtype littermates with two different doses of SAS (160 mg/kg twice daily or 320 mg/kg once daily, i.p.) and studied some of the adverse effects that were previously reported. SAS had a negative impact on the survival rate, the body weight, the thermoregulation and/or stress reaction of mice of both genotypes, and thus independent of its inhibitory action on system xc−. While SAS decreased the total distance travelled in the open-field test the first time the mice encountered the test, it did not influence this parameter on the long-term and it did not induce other behavioral changes such as anxiety- or depressive-like behavior. Finally, no major histological abnormalities were observed in the spinal cord. To conclude, we were unable to identify any undesirable system xc−-dependent effect of chronic administration of SAS.

scholarly journals Bariatric Surgery and Hypertension

2021 ◽  
Vol 10 (18) ◽  
pp. 4049
Author(s):  
Elisenda Climent ◽  
Anna Oliveras ◽  
Juan Pedro-Botet ◽  
Albert Goday ◽  
David Benaiges
Keyword(s):  
Blood Pressure ◽  
Bariatric Surgery ◽  
Arterial Hypertension ◽  
Severe Obesity ◽  
Surgical Techniques ◽  
Target Organs ◽  
Cardiovascular Morbidity And Mortality ◽  
Short And Long Term ◽  
Pathophysiologic Mechanisms

A clear pathogenetic association exists between obesity and arterial hypertension, becoming even more evident in subjects with severe obesity. Bariatric surgery has proved to be the most effective treatment for severe obesity, with its benefits going beyond weight loss. The present review aimed to determine the effects of bariatric surgery on arterial hypertension evident in short- and long-term follow-ups. Moreover, the differences between surgical techniques regarding hypertension remission are described as well as the possible pathophysiologic mechanisms involved. In addition, the effects of bariatric surgery beyond blood pressure normalization are also analyzed, including those on target organs and cardiovascular morbidity and mortality.

scholarly journals Should bariatric surgery be performed in adolescents?

2017 ◽  
Vol 176 (4) ◽  
pp. D1-D15 ◽  
Author(s):  
Andrew J Beamish ◽  
Thomas Reinehr
Keyword(s):  
Bariatric Surgery ◽  
Severe Obesity ◽  
Treatment Strategies ◽  
Adolescent Obesity ◽  
Nutritional Deficiencies ◽  
Therapeutic Outcomes ◽  
Compliance To Treatment ◽  
Adolescent Bariatric Surgery

Adolescent obesity has markedly increased worldwide in both its extent and prevalence in recent decades and obesity prevention strategies are failing. As a result, effective treatment strategies are urgently needed. As behavioral and pharmacological treatment approaches have only moderate effects in severe obesity, bariatric surgery has begun to emerge as a treatment option. In this debate article, we offer arguments opposing and supporting bariatric surgery in the treatment of severe obesity in adolescents. Bariatric surgery has superior therapeutic outcomes with respect to weight loss and resolution of comorbid diseases over other existing treatments. However, long-term outcomes after bariatric surgery in adolescents are only just beginning to emerge. Furthermore, the procedures are generally considered irreversible, apart from gastric banding. Most importantly, not all adolescents seem to benefit greatly from bariatric surgery and we are not yet able to reliably identify those who stand to gain the greatest benefit. The authors agree that adolescent bariatric surgery should be offered exclusively within formal adolescent obesity programs, delivered by specialist multidisciplinary child/adolescent obesity teams, and within specialist centers, in order to optimize outcomes and minimize potential detrimental effects. Patients and their family/carers must be educated regarding the benefits and risks, potential side effects, expected changes in eating behavior and the lifelong requirement for regular medical follow-up after surgery. Before embarking upon a surgical treatment pathway in adolescents with severe obesity, it may also be beneficial to ensure compliance to treatment is demonstrated, in order to minimize the risk of nutritional deficiencies and associated potential complications.

scholarly journals Bariatric Surgery for Severe Obesity

2009 ◽  
Vol 22 (2) ◽  
pp. 319-323
Author(s):  
PK Biswas ◽  
I Mahmood
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Severe Obesity ◽  
Cost Effective ◽  
Organ System ◽  
The Body ◽  
Main Stream ◽  
Surgical Specialty ◽  
Co Morbidity

Obesity is a chronic, relapsing, debilitating, life-long disease. It is defined as a body mass index (BMI) of 30 kg/m2 or more, affects 1.7 billion people world-wide. It is a complex, multifactorial chronic disease. Its medical treatment is not effective, and costly. Obesity is the harbinger of many diseases that affects many organ system of the body. Bariatric surgery is long lasting, cost-effective, and reduces co-morbidity efficiently. The procedures are, adjustable gastric banding, Rou x-en-Y gastric bypass, biliopancreatic diversion with duodenal switch, and vertical banded gastroplasty, of which Roux-en-Y gastric bypass is the gold standard. Indications are BMI >40 kg/m2 or BMI >35 kg/m2 with co-morbidity. Lifelong follow-up is required for appropriate weight loss. Bariatric surgery should be considered as a main stream of surgical specialty and should be practiced in our context.TAJ 2009; 22(1): 319-323

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