Department of Doctoral Studies, Riga Stradins University, Riga, Latvia.
Joint Laboratory, Pauls Stradins Clinical University Hospital, Riga, Latvia.
Int J Obes (Lond). 2023 Oct;47(10):970-978. doi: 10.1038/s41366-023-01344-y. Epub 2023 Jul 18.
BACKGROUND/OBJECTIVES: Obesity-associated metabolic dysfunction and inflammation can be ameliorated by bariatric surgery. While obesity is also linked to impaired B cell activation, differentiation, and persistence in response to infection and vaccination little is known about post-operative immune B cell compartment and to what extent dysregulation in B cell pathways can be reversed. To bridge this gap in knowledge, we carried out in-depth evaluation of B cell composition in individuals with obesity prior to and following bariatric surgery compared to lean controls.
SUBJECTS/METHODS: We recruited individuals with obesity (BMI at least 35 kg/m) before bariatric surgery (n = 21) and followed them up 6 months post-operatively (n = 17). As controls we recruited age- and sex-matched lean (BMI < 25) individuals (n = 18). We carried out comprehensive immunophenotyping of peripheral blood B cells as well as interrogated their association with inflammatory and metabolic parameters.
In obesity the balance of antigen-inexperienced and memory B cells in the peripheral blood is altered, with an expansion of naïve and a reduction in total memory B cells. 6 months following bariatric surgery this balance is restored. However, post-operative patients are uniquely characterised by an increase in B cell subsets associated with chronic inflammation - CD11cCXCR5IgDCD27 double negative 2 (DN2) B cells and CD27CD38 plasmablasts. Correlations between B cells subsets, inflammatory and metabolic parameters were distinct in lean people and individuals with obesity pre- and post-bariatric surgery.
Bariatric surgery patients display a unique B cell profile 6 months post-operatively; this bears minimal resemblance to that of pre-operative patients and only partially overlaps with that of lean controls. Post-operative differences in the B cell compartment compared to lean controls are detected despite global amelioration of inflammation and restoration of metabolic health. Collectively, this indicates that bariatric surgery creates a specific immunometabolic state with potential implications for health outcomes.
背景/目的：减重手术可以改善与肥胖相关的代谢功能障碍和炎症。虽然肥胖也与感染和疫苗接种后 B 细胞的激活、分化和持续存在受损有关，但对于手术后免疫 B 细胞群以及 B 细胞通路的失调在多大程度上可以逆转，人们知之甚少。为了弥补这一知识空白，我们对肥胖患者在接受减重手术前后与瘦对照组进行了深入的 B 细胞组成评估。
受试者/方法：我们招募了 21 名肥胖患者（BMI 至少为 35kg/m），在接受减重手术前进行评估，并在术后 6 个月（n=17）进行随访。作为对照组，我们招募了年龄和性别匹配的瘦（BMI<25）个体（n=18）。我们对外周血 B 细胞进行了全面免疫表型分析，并探讨了它们与炎症和代谢参数的关系。
在肥胖中，外周血中未成熟和记忆 B 细胞的平衡被改变，幼稚 B 细胞增加，总记忆 B 细胞减少。6 个月后减重手术后，这种平衡得到恢复。然而，术后患者的特征是与慢性炎症相关的 B 细胞亚群增加——CD11cCXCR5IgDCD27 双阴性 2（DN2）B 细胞和 CD27CD38 浆母细胞。在瘦人和肥胖患者术前和术后，B 细胞亚群与炎症和代谢参数之间的相关性是不同的。
减重手术后患者 6 个月后表现出独特的 B 细胞表型；这与术前患者的表型几乎没有相似之处，仅部分与瘦对照组重叠。与瘦对照组相比，尽管炎症得到全面改善，代谢健康得到恢复，但仍能检测到术后 B 细胞群的差异。总的来说，这表明减重手术创造了一种特定的免疫代谢状态，可能对健康结果产生影响。
