The effect of laparoscopic greater curvature plication on peripheral blood lymphocyte subsets (CD4+, CDS+ T cells) in morbidly obese patients

Abstract

Background: Bariatric surgery is the only and effective treatment for morbid obesity and it can also improve the obesity-related comorbidities. However, the effect ofbariatric surgery on immune status is still unclear. In our study we investigated the relationship between surgical weight loss and peripheral blood lymphocyte percentages. Methods: Morbidly obese patients (n=20, age range 25-50 years, body mass index [BMIJ range (37-45kgfm2) who had undergone laparoscopic greater curvature plication LGCP (were enrolled in a prospective study to determine the percentages of their peripheral blood T cells (CD4+, and CD8+ T cells) before and (4 months) postoperatively using flow cytometry. The data were expressed as the percentage oftotallymphocytes±the standard error ofthe mean. Results: A decrease in the BMI occurred at 4months postoperatively with loss of weight of (31.20±1.2%). PreoperativeBMJwas 44.71±4.3 (range 37-45kg fm2)and postoperative EM!was 31.80±1.1(range 24-33kg fm2).The mean percentage ofCD4+ T lymphocytes preoperatively was 38.2±1.5 and postoperatively was 29.3±2.6 p <0.05 (which is statistically significant) so there is postoperative decrease in the percentage ofCD4+T lymphocytes, the mean percentage ofCD8+ T lymphocytes preoperatively was 17.3±1.8 and postoperatively was 9.5±1.7p < 0.05 (which is statistically significant) so there is postoperative decrease in the percentage ofCD8+ T lymphocytes. Conclusion: This study found that weight loss after LGCP in morbidly obese patients showed attenuated activation of circulating immune cells (decrease in CD4+ T helper cells percentage and decrease in CD8+ killer T cells percentage) and more regulation of chronic inflammation in morbidly obese patients.