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Aesthetic Plastic Surgery
Published in: Aesthetic Plastic Surgery 1/2022

01-02-2022 | Obesity | Original Article

M1 Polarized Macrophages Persist in Skin of Post-Bariatric Patients after 2 Years

Authors: Carlo Amaral, Juliana Rodrigues da Costa, Matheus Oliveira Costa, João Paulo Verbicario, Leonardo Dias, Natale F. Gontijo-de-Amorim, Luiz Charles-de-Sá, Christina Maeda Takiya

Published in: Aesthetic Plastic Surgery | Issue 1/2022

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Abstract

Background

Obesity is considered a condition of systemic chronic inflammation. Under this condition, adipose tissue macrophages switch from an M2 (anti-inflammatory) activation pattern to an M1 (proinflammatory) activation pattern.

Objective

The study aimed to verify the profile of skin macrophage activation after bariatric surgery as well as the role of MMP-1 in extracellular tissue remodeling.

Methods

This is a prospective, controlled and comparative study with 20 individuals split into two groups according to their skin condition: post-bariatric and eutrophic patients. Histological and morphometric analyses based on hematoxylin-eosin, picrosirius red (collagen), orcein (elastic fiber systems), and alcian blue (mast cells)-stained sections and immunohistochemical analysis (CD68, iNOS, and mannose receptor) for macrophages and metalloproteinase-1 were performed.

Results

Post-bariatric skin showed an increase in inflammation, angiogenesis, CD68, M1 macrophages (P< 0.001), and mast cells (P< 0.01); a decrease in M2 macrophages (P< 0.01); and a significant decrease in the collagen fiber network (P< 0.001). MMP-1 was increased in the papillary dermis of post-bariatric skin and decreased in the epidermis compared to eutrophic skin (P< 0.05).

Conclusion

This study shows that post-bariatric skin maintains inflammatory characteristics for two years. Mast cells and M1 macrophages maintain and enhance the remodeling of the dermal extracellular matrix initiated during obesity in part due to the presence of MMP-1 in the papillary dermis.

EBM Level IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266 .
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Metadata
Title
M1 Polarized Macrophages Persist in Skin of Post-Bariatric Patients after 2 Years
Authors
Carlo Amaral
Juliana Rodrigues da Costa
Matheus Oliveira Costa
João Paulo Verbicario
Leonardo Dias
Natale F. Gontijo-de-Amorim
Luiz Charles-de-Sá
Christina Maeda Takiya
Publication date
01-02-2022
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 1/2022
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-021-02649-x

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