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Polymorphonuclear (PMN) function after small intestinal shunt operation for morbid obesity

J Palmblad, D Hallberg, L Engstedt

    British Journal of Haematology
    |January 1, 1980
    PubMed
    Summary

    Small intestinal shunt surgery for obesity improved polymorphonuclear (PMN) granulocyte bactericidal capacity in patients. This enhanced immune function normalized after surgery, despite initial high PMN adherence.

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    Area of Science:

    • Immunology
    • Bariatric Surgery
    • Metabolic Disorders

    Background:

    • Extremely obese patients often exhibit impaired immune cell function, specifically reduced polymorphonuclear (PMN) granulocyte bactericidal capacity.
    • Elevated PMN adherence has also been observed in individuals with severe obesity.

    Purpose of the Study:

    • To investigate the impact of small intestinal shunt surgery on blood PMN granulocyte functions in massively overweight patients.
    • To assess changes in PMN bactericidal capacity and adherence following significant weight loss.

    Main Methods:

    • Prospective study of 10 massively overweight patients undergoing small intestinal shunt operation.
    • Evaluation of PMN functions (bactericidal capacity and adherence) preoperatively and for 9 months postoperatively.

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  • Utilized both standard and a novel in vitro assay for assessing PMN bactericidal capacity.

    • Main Results:

    • PMN bactericidal capacity significantly increased within 2-4 months post-surgery, reaching normal levels and sustained throughout the follow-up period.
    • PMN adherence initially decreased postoperatively but returned to preoperative levels.
    • The novel in vitro assay demonstrated enhanced PMN killing more effectively than the standard assay.

    Conclusions:

    • Small intestinal shunt surgery normalizes the impaired PMN killing function in extremely obese individuals.
    • While bactericidal capacity improves, high PMN adherence in obese patients may persist post-surgery.
    • Immune function recovery was not directly correlated with the amount of weight lost.