Taselaar Annick Elianna, Wijngaarden Leontine Henriëtte, Klaassen René Alexander, van der Harst Erwin, Dunkelgrun Martin, Kuijper Tjallingius Martijn, Ambagtsheer Gisela, Hendriks Tessa, de Bruin Ron Wilhelmus Frederik, Litjens Nicolle Helena Renier
Department of Surgery, Erasmus MC, Erasmus MC Transplant Institute, University Medical Center, Rotterdam, Netherlands; Department of Surgery, Maasstad Hospital, Rotterdam, Netherlands.
Department of Surgery, Erasmus MC, Erasmus MC Transplant Institute, University Medical Center, Rotterdam, Netherlands; Department of Surgery, Maasstad Hospital, Rotterdam, Netherlands.
Surg Obes Relat Dis. 2025 Jul;21(7):806-818. doi: 10.1016/j.soard.2024.12.025. Epub 2025 Jan 10.
Morbid obesity is associated with aging of the immune system, a phenomenon known as "inflammaging," characterized by increased numbers of various immune cell subsets.
To evaluate the long-term effects of bariatric surgery on immune cell subsets in patients with obesity and to determine the impact of metabolic syndrome on these changes.
High-volume bariatric center, Netherlands.
This prospective cohort study included patients with obesity, with and without metabolic syndrome, as well as lean controls. Peripheral blood samples were collected preoperatively (T0) and at various time points up to 18 months postoperatively (T18). Flow cytometry was used to measure absolute numbers of T cells, B cells, natural killer (NK) cells, and monocyte subsets, with adjustments for age and cytomegalovirus (CMV) serostatus.
At T0, patients with obesity had elevated numbers of CD4+ CD31 naïve T cells, CD8+ terminally differentiated effector memory RA T cells, double-negative B cells, plasmablasts, NK cells, and monocytes compared with lean controls. CD8+ central memory T cells were decreased in patients with obesity. While most immune cell subsets gradually normalized by T18, some subsets, including T cells, B cells, and NK cells, that were initially elevated, decreased during follow-up and ultimately ended up lower than those in lean controls at T12 or T18. Metabolic syndrome did not affect these outcomes. COVID-19-related disruptions reduced the number of patients assessed over time.
Bariatric surgery restores the harmful effects of morbid obesity on the composition of innate and adaptive immune cell subsets in the long-term for patients with obesity, both with and without metabolic syndrome.
病态肥胖与免疫系统衰老有关，这一现象被称为“炎症衰老”，其特征是各种免疫细胞亚群数量增加。
评估减肥手术对肥胖患者免疫细胞亚群的长期影响，并确定代谢综合征对这些变化的影响。
荷兰大容量减肥中心。
这项前瞻性队列研究纳入了患有肥胖症的患者，包括有和没有代谢综合征的患者，以及瘦对照组。在术前（T0）和术后长达18个月的不同时间点（T18）采集外周血样本。采用流式细胞术测量T细胞、B细胞、自然杀伤（NK）细胞和单核细胞亚群的绝对数量，并对年龄和巨细胞病毒（CMV）血清学状态进行校正。
在T0时，与瘦对照组相比，肥胖患者的CD4+CD31幼稚T细胞、CD8+终末分化效应记忆RA T细胞、双阴性B细胞、浆母细胞、NK细胞和单核细胞数量升高。肥胖患者的CD8+中央记忆T细胞减少。虽然大多数免疫细胞亚群在T18时逐渐恢复正常，但一些最初升高的亚群，包括T细胞、B细胞和NK细胞，在随访期间减少，最终在T12或T18时低于瘦对照组。代谢综合征不影响这些结果。与COVID-19相关的干扰随着时间的推移减少了评估的患者数量。
减肥手术长期恢复了病态肥胖对肥胖患者（无论有无代谢综合征）固有和适应性免疫细胞亚群组成的有害影响。
