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Vascular Risk Reduction in Obesity through Reduced Granulocyte Burden and Improved Angiogenic Monocyte Content
David A Hess1,2,3,4, Justin Z Trac5,2, Stephen A Glazer6,7
1Division of Vascular Surgery, Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
Insights
Bariatric surgery helps severe obesity by improving regenerative cell function and reducing inflammation. This supports better blood vessel repair and lowers cardiovascular risk.
Area of Science:
- Cardiovascular disease
- Metabolic health
- Regenerative medicine
Background:
- Chronic obesity is linked to "regenerative cell exhaustion" (RCE), impairing vessel repair and increasing cardiovascular risk.
- Aldehyde dehydrogenase activity in pro-vascular progenitor cells is a marker for RCE.
- Lifelong vessel maintenance is crucial for cardiovascular disease prevention.
Purpose of the Study:
- To investigate the impact of bariatric surgery on regenerative cell function and cardiovascular risk in severe obesity.
- To explore the potential of bariatric surgery to reverse RCE and improve vessel homeostasis.
Main Methods:
- Assessed aldehyde dehydrogenase activity in pro-vascular progenitor cells.
- Measured systemic inflammatory burden.
- Quantified pro-angiogenic macrophage precursor content.
Main Results:
- Observed an association between chronic obesity and RCE.
- Found reduced systemic inflammatory burden 3 months post-bariatric surgery.
- Noted improved pro-angiogenic macrophage precursor content after bariatric surgery.
Conclusions:
- Bariatric surgery may reverse RCE in patients with severe obesity.
- The procedure appears to restore a microenvironment conducive to vessel homeostasis.
- These effects suggest bariatric surgery can mitigate cardiovascular risk associated with morbid obesity.
Abstract:
Bariatric surgery, in addition to the benefit of sustained weight loss, can also reduce cardiometabolic risk and mortality. Lifelong vessel maintenance is integral to the prevention of cardiovascular disease. Using aldehyde dehydrogenase activity, an intracellular detoxifying enzyme present at high levels within pro-vascular progenitor cells, we observed an association between chronic obesity and "regenerative cell exhaustion" (RCE), a pathology whereby chronic assault on circulating regenerative cell types can result in adverse inflammation and diminished vessel repair. We also describe that, at 3 months following bariatric surgery, systemic inflammatory burden was reduced and pro-angiogenic macrophage precursor content was improved in subjects with severe obesity, suggesting the restoration of a microenvironment to support vessel homeostasis. These data suggest that bariatric surgery may reverse deleterious events that predispose patients with morbid obesity to cardiovascular risk.
