Dysfunctional immune-privilege in morbid XXXX : implications and effect of gastric bypass surgery.

@entity1 @entity32 @entity404 @entity2940 @entity28 @entity5 @entity1197 @entity2737 @entity1196 @entity12 @entity8729 @entity405 @entity7986
BACKGROUND: Despite the epidemiological evidence linking @entity28 and @entity5 , there has never been a causal link. We believe the @entity32 present in @entity28 may predispose the @entity28 to @entity5 through Fas-receptor over-expression and @entity1196 under-expression in leukocytes, and elevated @entity12 secretion in @entity5 affecting the morbidly @entity28 . METHODS: Leukocytes from 25 @entity1 having gastric bypass surgery were compared to 15 normal controls preoperatively and at 1, 3, 6, and 12 months postoperatively using flow cytometry to measure CD3, @entity404 , @entity405 , @entity2940 , @entity8729 ( @entity1196 ), @entity7986 , and @entity1197 ( @entity1197 ) expression on T lymphocytes, B lymphocytes, natural killer cells, and neutrophils. RESULTS: The percentage of @entity1197 + T cells was significantly elevated from controls (69.4% vs 56%, P = 0.005). This difference persisted through 1 month postoperatively. Furthermore, expression of @entity1197 per cell, was significantly greater in these @entity1 than that of the controls (80.2 vs 62.6 gmf, P = 0.018) preoperatively, and this continued to 1 month. Polymorphonuclear cells also displayed a similar elevation in @entity1197 gmf expression preoperatively (54.1 vs 40.7 gmf, P = 0.023) which normalized by 3 months. Natural killer cells did not display elevated numbers of @entity1197 gmf preoperatively, but they did experience a significant decline by 12 months. Additionally, there was significant reduction in the number of naiveT cells [(T cells without @entity1196 ( @entity1196 )], when compared to normals preoperatively (41.8% vs 51.3%, P = 0.001). There was no statistical difference between the postoperative @entity1 and the controls by 3 months. @entity7986 was not different at baseline from controls in T or B cells, but there was a significant decrease by 12 months. CONCLUSION: The reduced expression of @entity1196 combined with the elevated levels of @entity1197 suggests that morbid @entity28 predisposes @entity1 to sites of immune privilege. This could be the mechanism for increased rates of @entity5 and @entity2737 seen in @entity28 . Surgically-induced weight loss eliminates these risk factors.
