Blunted inflammatory response is associated with a lower response to a weight loss dietary intervention in liver recipients

Abstract

Background & aims: Obesity is associated with chronic low-grade inflammation, and adipose tissue inflammation is required for fatty tissue remodeling. Interestingly, immunosuppressed patients, as liver transplant recipients, often experience excessive weight gain. We investigated how liver recipients' inflammatory response affects body weight loss induced by dietary treatment.

Methods: Overweight liver recipients were paired with non-transplanted subjects to compare their peripheral immune profiles.

Results: Transplanted patients had similar profiles of peripheral blood mononuclear cells compared to controls but lower CD8^lowCD56⁺CD16⁺NK cells and higher B lymphocytes. Patients showed lower serum concentrations of IFN-γ, TNF, IL-4, IL-2, and IL-10 and lower inflammatory responsiveness of peripheral blood mononuclear cells under inflammatory stimuli. Liver recipients paired with non-transplanted subjects followed a weight loss dietary plan for 6 months to verify body composition changes. After 3 and 6 months of nutritional follow-up, the control group lost more body weight than the liver recipient group. The control group decreased fat mass and waist circumference, which was not observed in transplanted patients.

Conclusion: Therefore, liver recipients under immunosuppressant treatment responded less to different inflammatory stimuli. This impaired inflammatory milieu might be implicated in the lack of response to weight loss dietary intervention. Inflammation may be essential to trigger the weight loss induced by dietary prescription.

Clinical trial registry: ClinicalTrials.gov identification number: NCT03103984.

Keywords: Cytokines; Immunosuppression; Liver transplantation; Obesity; Weight loss.