Autoantibodies production and immunological abnormalities after bariatric surgery.

OBJECTIVE: Bariatric surgery is a widely used procedure for the treatment of obesity. Our aim is to describe the main immunological changes in patients who undergo bariatric surgery. METHODS: A prospective study was conducted within a cohort of patients undergoing bariatric surgery and without previous evidence of systemic or organ-specific autoimmune diseases in whom 3 blood samples were collected - one day before surgery (Time 0), and 5 (Time 1) and 10 months (Time 2) after surgery. RESULTS: Thirty four obese patients underwent surgery (Time 0):30(88.24%) were women, mean age 38.3 years. When comparing Time 0 and Time 2, there were statistically significant changes in CD4+T cell count, with an increase from 1074/mL(IQR:860-1316) to 1217.5/mL(IQR:838-1510),p = 0.0002. The CD4/CD8 ratio increased from 2.2(IQR: 1.7-2.7) to 2.4(1.8-2.8), p = 0.0001. As for humoral variables, the C3 fraction of complement decreased from 164 ±â€¯40.6 mg/dL to 112.4 ±â€¯31.4 mg/dL(p < 0.001) and C4 decreased from 29.3 ±â€¯10.1 mg/dL to 22.5 ±â€¯7.1(p = 0.0009) at Time 2. Four patients with negative ANAs at baseline, showed positive ANAs at Time 2.One patient developed anti-citrullinated peptide antibodies >200 IU/mL at Time 2. CONCLUSIONS: Patients undergoing bariatric surgery show immunological changes which might eventually lead to develop an autoimmune disease.

La expresión de CD64 en neutrófilos, procalcitonina y presepsina sérica son útiles para diferenciar infección de actividad en pacientes con lupus eritematoso sistémico y respuesta inflamatoria patients with systemic lupus erythematosus and inflammatory response / CD64 expression in neutrophils, Procalcitonin and serum presepsina are useful for differentiating infection activity in patients with systemic lupus erythematosus and inflammatory response

Introducción: La diferenciación entre actividad lúpica de infecciones en pacientes con lupus eritematoso sistémico (LES) es difícil debido a una presentación clínica similar. El objetivo es evaluar la utilidad de una serie de biomarcadores para diferenciar infecciones de actividad en pacientes con LES admitidos con respuesta inflamatoria sistémica (SIRS). Métodos: Pacientes con LES y SIRS que consultaron al servicio de urgencias fueron seleccionados. Se realizaron mediciones de diferentes marcadores como procalcitonina, expresión de CD64 de neutrófilos y presepsina al ingreso y fueron comparados con la presencia o no de infección, la cual se consideró presente con cultivos positivos y/o evidencia microbiológica por PCR. Se calculó la sensibilidad y especificidad de cada biomarcador y puntos de corte usando curvas ROC.