Dynamics of circulating microparticles in obesity after weight loss

Abstract

A definitive relationship between adiposity and MP production is yet to be demonstrated. The aim of our study was to prospectively evaluate the levels of microparticles (MP) in a group of 20 III degree obese patients before and after weight loss. Plasma levels of annexin V-MP, endothelial-derived MP, platelet-derived MP (CD61+ and P-Selectin+), leukocyte-derived MP, tissue factor-bearing (TF+) and CD36+MP were prospectively measured in 20 patients with III degree obesity (BMI ≥ 40 kg/m(2)) before (T0) and 3 (T3) and 12 (T12) months after sleeve gastrectomy (SLG). Obese patients had lost 18 % of their body weight at T3 and 41 % at T12. We find that considering all MP, except for endothelial-derived MP, which had significantly decreased at T3, all MP subtypes had significantly decreased at T12. At T12, subjects showed a higher median level of all types of MP, except endothelial-derived MP, compared to T3, but without a statistically significant difference. The percentages of reduction of all the MP were significantly correlated with the percentage of reduction of BMI. The reductions of leukocyte-derived, TF+ and CD36+MP were significantly correlated with the reduction of leptin. Moreover, the reductions of leukocyte-derived and CD36+MP were significantly correlated with hs-CRP decrease. The decrease of BMI post-SLG in morbid obesity was matched with a decrease of circulating MP of endothelial, platelet, leukocyte origin, TF+ and CD36+. A trend of slight increase in all MP subtypes, except endothelial-derived, was detected 12 months after gastrectomy, indicating a possible underlying slow low-grade inflammatory/hypercoagulability state from adipose tissue before the potential overt weight gain.

Bariatric surgery reduces CD36-bearing microvesicles of endothelial and monocyte origin

“…An interesting observation in the present study was that CD36+ MVs did not differ significantly from baseline to the three-month follow-up. This result is in contrast to a study conducted by Campello et al, in which CD36+ MVs decreased significantly from baseline to three and twelve-months follow-up visits [ 39 ]. Interestingly, although CD36+ MVs were unaltered, a significant decrease was seen in sCD36 in the present cohort.…”

“…Studies that have previously examined the impact of bariatric surgery on EMV concentrations have yielded conflicting results. In line with the present study, both Campello et al [ 39 ] and Cheng et al [ 40 ] reported that levels of various phenotypes of MVs including platelet MVs, EMVs and MMVs decreased significantly in obese subjects after bariatric surgery. Conversely, Stepanian et al [ 34 ] reported no differences in platelet MVs and EMVs one year after subjects had undergone bariatric surgery, which was later supported by a study conducted by Witczak et al [ 31 ].…”

“…Levels of platelet MVs seem to correlate with body composition [ 33 ], plasma lipids [ 35 ], and hyperglycaemia [ 36 ], all attributing to oxidative stress [ 37 ]. These parameters also seem to affect several other MV phenotypes including leukocyte MVs [ 38 , 39 ], EMVs [ 33 ], and MMVs [ 35 ]. Thus, it can be inferred that the improvements observed in body composition, plasma lipid profile, and insulin sensitivity result in decreased activation of platelets, leukocytes, vascular endothelial cells, and monocytes/macrophages, which in turn could explain the significant reduction in PS+ MVs.…”

Bariatric Surgery Is Accompanied by Changes in Extracellular Vesicle-Associated and Plasma Fatty Acid Binding Protein 4

“…Identification of more precise changes pertaining to adipobiology that take place following between clinical studies evaluating changes in circulating EVs are limited by the fact that establishing a gold standard method for EV isolation to be adopted across laboratories has only recently been a focus of the International Society of Extracellular Vesicles (ISEV) [26], although our adopted approach is one of the most commonly accepted protocols that we have introduced to yield consistent samples and results. This approach was not used in the studies by other authors [22][23][24] and similarly the EV analysis in the studies we cited was performed by flow cytometry which is typically not sensitive enough to detect EVs of exosomal origin and differs from our immunophenotyping method which we adapted for EV analysis specifically [14,15].…”

Monitoring of Hypercoagulability by Thromboelastography in Bariatric Surgery

“…The same study also showed that obese patients had a significantly higher median peak thrombin and increased median endogenous thrombin potential compared to controls [11]. The same group of researchers has shown that after sleeve gastrectomy, the decrease of BMI in morbidly obese subjects was matched with a decrease of circulating microparticles of endothelial, platelet, and leukocyte origin [12]. …”