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. 2022 Jan-Dec;14(1):2031696.
doi: 10.1080/19490976.2022.2031696.

Compensatory intestinal antibody response against pro-inflammatory microbiota after bariatric surgery

Torsten P M Scheithauer  1 , Mark Davids  1 , Maaike Winkelmeijer  1 , Xanthe Verdoes  1 , Ömrüm Aydin  1   2 , Maurits de Brauw  2 , Arnold van de Laar  2 , Abraham S Meijnikman  1   2 , Victor E A Gerdes  1 , Daniël van Raalte  1   3 , Hilde Herrema  1 , Max Nieuwdorp  1   2   3
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Compensatory intestinal antibody response against pro-inflammatory microbiota after bariatric surgery

Torsten P M Scheithauer et al. Gut Microbes. 2022 Jan-Dec.

Abstract

Obesity and type 2 diabetes (T2D) are growing burdens for individuals and the health-care system. Bariatric surgery is an efficient, but drastic treatment to reduce body weight, normalize glucose values, and reduce low-grade inflammation. The gut microbiome, which is in part controlled by intestinal antibodies, such as IgA, is involved in the development of both conditions. Knowledge of the effect of bariatric surgery on systemic and intestinal antibody response is limited. Here, we determined the fecal antibody and gut microbiome response in 40 T2D and non-diabetic (ND) obese individuals that underwent bariatric surgery (N = 40). Body weight, fasting glucose concentrations and inflammatory parameters decreased after bariatric surgery, whereas pro-inflammatory bacterial species such as lipopolysaccharide (LPS), and flagellin increased in the feces. Simultaneously, concentrations of LPS- and flagellin-specific intestinal IgA levels increased with the majority of pro-inflammatory bacteria coated with IgA after surgery. Finally, serum antibodies decreased in both groups, along with a lower inflammatory tone. We conclude that intestinal rearrangement by bariatric surgery leads to expansion of typical pro-inflammatory bacteria, which may be compensated by an improved antibody response. Although further evidence and mechanistic insights are needed, we postulate that this apparent compensatory antibody response might help to reduce systemic inflammation by neutralizing intestinal immunogenic components and thereby enhance intestinal barrier function after bariatric surgery.

Keywords: Immunoglobulin; bariatric surgery; flagellin; gut microbiome; lipopolysaccharide.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Bariatric surgery improves systemic inflammation in humans.
Figure 2.
Figure 2.
Bariatric surgery induces a more pro-inflammatory gut microbiome one year after RYGB surgery.
Figure 3.
Figure 3.
Bariatric surgery increases fecal LPS, flagellin and IgA against both bacterial compounds.
Figure 4.
Figure 4.
Bariatric surgery changes the IgA coating of intestinal bacteria.
See this image and copyright information in PMC

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