Short-term impact of bariatric surgery on systemic inflammation in patients with asthma.

BACKGROUND: The systemic inflammatory environment in obesity contributes to increased asthma symptoms and diminished asthma control. Asthma patients that have undergone bariatric surgery report significant improvements in asthma symptoms and medication use, as early as 30 days following surgery. OBJECTIVES: To perform an exploratory pilot study investigating short-term changes in systemic inflammatory markers after bariatric surgery and their associations with improvements in lung function and bronchodilator responsiveness in participants with and without asthma. SETTING: Duke University Medical Center, Durham, NC, USA. METHODS: Serum cytokine levels, complete blood cell counts, and spirometry measurements pre- and post-bronchodilation were collected prospectively from asthma and non-asthma participants undergoing bariatric surgery at three time points: two weeks prior to surgery (baseline), 30-days and 90-days post-surgery. Comparison between asthma and non-asthma participants were performed at all time points. RESULTS: Six non-asthma and 7 asthma participants completed the study. Both asthma and non-asthma groups had similar reductions in body mass index (BMI) and serum leptin levels at 30- and 90-days post-surgery (p > 0.10). At 30-days post-surgery, serum C-reactive protein (CRP) was reduced in asthma participants (p = 0.03). Blood lymphocyte counts increased at 90-days after surgery in asthma compared to non-asthma participants (p = 0.02). Serum leptin was negatively associated with change in bronchodilator responsiveness at 30-days post-surgery (p = 0.07), and serum tumor necrosis factor alpha (TNFα) levels were associated with improved lung function at 90-days post-surgery (p = 0.04). CONCLUSION: Improved lung function and bronchodilator responsiveness are associated with early changes in serum inflammatory markers after bariatric surgery.

Duke Scholars

Author Jennifer Leigh Ingram Medicine, Pulmonary, Allergy, and Critical Care Medicine

Author Keri Anne Seymour Surgery, Minimally Invasive Surgery

Author Maragatha Kuchibhatla Biostatistics & Bioinformatics, Division of Biostatistics

Author Kunoor Jain-Spangler Surgery, Minimally Invasive Surgery