Anti-Saccharomyces cerevisiae (ASCA) in patients with severe obesity undergoing bariatric surgery: 12-month follow-up.

Severe obesity is linked to a low-grade inflammatory process due to enlarged adipose tissue, resulting in elevated pro-inflammatory cytokines. Bariatric surgery induces anatomical changes, causing intestinal inflammation marked by anti-Saccharomyces cerevisiae (ASCA) antibodies. This study aimed to assess ASCA IgG/IgA levels preoperatively and 12 months post-surgery, correlating them with systemic inflammation markers (IL-6, CRP, MCP-1). Participants (BMI > 35 kg/m²) were recruited in South Brazil. Severe obesity individuals showed elevated IL-6 (p = 0.002), CRP (p<0.0001), and MCP-1 (p<0.0001) compared to lean controls. ASCA IgA was significantly higher in severe obesity (p = 0.0019). Post-surgery, ASCA IgG/IgA significantly decreased (p = 0.0046 and p<0.0001), along with IL-6, MCP-1, and CRP, confirming weight loss and reduced inflammation. Hypertrophic adipose tissue, producing pro-inflammatory cytokines, associates with increased intestinal inflammation. Bariatric surgery-induced anatomical changes contribute to long-term weight loss and reduced systemic and intestinal inflammation.