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

Figure 2

Potential mechanism of improvement in inflammatory status after bariatric surgery-induced weight loss. Obesity induces a systemic inflammatory status characterized by increases in C-reactive protein, proinflammatory cytokines such as TNF-α and IFN-γ, and an inflammatory infiltrate in adipose tissue (AT) and a decrease in circulating Treg lymphocytes. Inflammatory cytokines, among other mechanisms, induce insulin resistance in obesity. Bariatric surgery induces a significant weight loss that is associated with an increase in insulin sensitivity and a decrease in systemic inflammation. An important change in the lymphocyte phenotype is a decrease in the Th1/Th2 ratio after weight loss. It is possible that insulin effect on T cell differentiation may mediate inflammation resolution, at least partially.