title: The systemic inflammome of severe obesity before and after bariatric surgery.
abstract: BACKGROUND
  Obesity is associated with low-grade systemic inflammation. The "inflammome" is a network layout of the inflammatory pattern. The systemic inflammome of obesity has not been described as yet. We hypothesized that it can be significantly worsened by smoking and other comorbidities frequently associated with obesity, and ameliorated by bariatric surgery (BS). Besides, whether or not these changes are mirrored in the lungs is unknown, but obesity is often associated with pulmonary inflammation and bronchial hyperresponsiveness.
  
  
  OBJECTIVE
  We sought to: (1) describe the systemic inflammome of morbid obesity; (2) investigate the effects of sex, smoking, sleep apnea syndrome, metabolic syndrome and BS upon this systemic inflammome; and, (3) determine their interplay with pulmonary inflammation.
  
  
  METHODS
  We studied 129 morbidly obese patients (96 females; age 46 ± 12 years; body mass index [BMI], 46 ± 6 kg/m2) before and one year after BS, and 20 healthy, never-smokers, (43 ± 7 years), with normal BMI and spirometry.
  
  
  RESULTS
  Before BS, compared with controls, all obese subjects displayed a strong and coordinated (inflammome) systemic inflammatory response (adiponectin, C-reactive protein, interleukin (IL)-8, IL-10, leptin, soluble tumor necrosis factor-receptor 1(sTNF-R1), and 8-isoprostane). This inflammome was not modified by sex, smoking, or coexistence of obstructive sleep apnea and/or metabolic syndrome. By contrast, it was significantly ameliorated, albeit not completely abolished, after BS. Finally, obese subjects had evidence of pulmonary inflammation (exhaled condensate) that also decreased after BS.
  
  
  CONCLUSIONS
  The systemic inflammome of morbid obesity is independent of sex, smoking status and/or comorbidities, it is significantly reduced by BS and mirrored in the lungs.
authors.affiliation: Servei de Pneumologia (Institut Clínic del Tòrax), Hospital Clínic, Barcelona, Spain; Fundació Clínic per la Recerca Biomèdica, Hospital Clínic, Barcelona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Barcelona and Palma de Mallorca, Spain; Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: Ebymar
authors.initials: E
authors.lastname: Arismendi
authors.affiliation: Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain; Servei de Anestesiologia i Reanimació, Hospital Clínic, Barcelona, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Rivas
authors.affiliation: Servei de Pneumologia (Institut Clínic del Tòrax), Hospital Clínic, Barcelona, Spain; Fundació Clínic per la Recerca Biomèdica, Hospital Clínic, Barcelona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Barcelona and Palma de Mallorca, Spain; Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: Alvar
authors.initials: A
authors.lastname: Agustí
authors.affiliation: Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain; Biostatistics and Data Management Core Facility, Biostatistics Unit, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Ríos
authors.affiliation: CIBER Enfermedades Respiratorias (CIBERES), Barcelona and Palma de Mallorca, Spain; Pulmonology Department, Hospital del Mar, and Universitat Pompeu Fabra, Parc de Recerca Biomèdica de Barcelona (PRBB), Barcelona, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Barreiro
authors.affiliation: Fundació Clínic per la Recerca Biomèdica, Hospital Clínic, Barcelona, Spain; Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain; Servei de Endocrinologia (Institut Clínic de Malalties Digestives i Metabòliques), Hospital Clínic, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Vidal
authors.affiliation: Servei de Pneumologia (Institut Clínic del Tòrax), Hospital Clínic, Barcelona, Spain; Fundació Clínic per la Recerca Biomèdica, Hospital Clínic, Barcelona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Barcelona and Palma de Mallorca, Spain; Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: Robert
authors.initials: R
authors.lastname: Rodriguez-Roisin
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006801:Humans; D007249:Inflammation; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000473:pathology / Q000601:surgery*; D012737:Sex Factors; D012891:Sleep Apnea Syndromes / Q000150:complications
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein