Understanding the mechanisms behind adipose tissue remodeling after bariatric surgery

The objective of a new study was to explore the crucial role of adipose tissue in obesity and its response to weight loss––particularly through bariatric surgery. 

Adipose tissue, which stores excess energy, undergoes significant alterations in obesity, characterized by inflammation and fibrosis. Bariatric surgery serves as a model to examine how adipose tissue remodels after weight loss – triggering metabolic and fibro-inflammatory changes. Despite successful weight reduction, inflammation and fibrosis often persist, as indicated by shifts in immune cell activity, changes in cytokine profiles, and the accumulation of extracellular matrix (ECM), which impair normal adipose tissue function.

Adipose progenitors, a diverse group of mesenchymal stromal cells, play a pivotal role in fibrosis development by differentiating into myofibroblasts and contributing to ECM deposition. Notably, a subpopulation of these progenitors with high CD9 expression (CD9high) is linked to fibrosis and insulin resistance in human obesity. The continued presence of fibrosis after weight loss is problematic, correlating with ongoing metabolic dysfunction even when glucose tolerance improves.

Understanding the mechanisms behind adipose tissue remodeling and fibrosis after weight loss is essential for developing effective obesity treatments. The complex relationship between adipose tissue, inflammation, and fibrosis highlights the need for further research to clarify these mechanisms and create targeted therapies for obesity-related complications. 

Source: Lecoutre S, Rebière C, Marcelin G, et al. InAnnales d'Endocrinologie 2024 Jun 1 (Vol. 85, No. 3, pp. 175-178). Elsevier Masson.