Interplay between the Adaptive Immune System and Insulin Resistance in Weight Loss Induced by Bariatric Surgery

Table 2

Summary of changes in lymphocyte populations and cytokine secretion observed after bariatric surgery-induced weight loss.

Population	Intervention	Main findings	Ref
13 subjects; T2D or IGT; Age: 35-65	12 weeks of DCR (860-1434 kcal/day) followed by LGB	↓ Th1/Th2 after DCR; changes maintained 12 weeks after LGB	[77]
15 subjects; T2D or IGT; Age: 35-65	LGB	↓ T cells and Th1/Th2, associated with lower FG, glucose AUC, and improved insulin secretion	[78]
9 subjects; BMI: 35-38; Age: 45-61	RYGB	3 months after: B cells lose the capacity to support production of IL-17 and IFN-γ by T cells	[79]
20 subjects; BMI: 37-45; Age: 25-50	Laparoscopic greater curvature plication	4 months after: ↓ CD4+ and CD8+ T cells and leptin	[80]
8 subjects; With T2DM; Mean age: 41.3	RYGB	3 months after: Tfh cells secreted: ↓ IFN-γ, IL-2, IL-4, and IL-17 and ↑ IL-10. Tfh IL-10+ promoted Breg cell differentiation and predicted better clinical response	[83]
69 subjects; 25% T2DM; 30 subjects; T2DM; 67% obese	RYGB	↑ MAIT cells (potentially explained by ↓ peripheral infiltration); IL-17 remains	[41]
27 women; 55.5% obese	RYGB	3 months after: ↓ IR, CRP, leptin, and T cells; ↑ TNF-α	[84]
58 subjects; Nondiabetic; 63.8% IR; Age: 18-60	6 weeks of VLCD followed by BPD	1 year after BPD: ↓ T cells and B cells in IR subjects; Correlation: changes in CD8+ and HOMA index	[81]
20 women; BMI: 36.4-68.2; Age: 25-90	LGB and RYGB	Correlation: changes from baseline in BMI and CD4+ cells only in the RYGB group at 3 months	[82]

DCR: dietary caloric restriction; BMI: body mass index; T2DM: type 2 diabetes mellitus; IR: insulin resistance; LGB: laparoscopic gastric banding; RYGB: Roux-en-Y gastric bypass; VLCD: very low-calorie diet; BDP: biliopancreatic diversion; ↓: decrease; ↑: increase; FG: fasting glucose; MAIT: mucosal-associated invariant T cells; IR: insulin resistance; CRP: C-reactive protein; Ref: reference.