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

Abstract

BackgroundThe 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.ObjectivesTo 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.SettingDuke University Medical Center, Durham, NC, USA.MethodsSerum 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.ResultsSix 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).ConclusionImproved lung function and bronchodilator responsiveness are associated with early changes in serum inflammatory markers after bariatric surgery.