Obesity, Morbid Clinical Trial
Official title:
Searching for Altered Gene Expression in the Endocrine Secretome Following Roux-en-Y Gastric Bypass Surgery
Examination of the molecular phenotype and composition of endocrine cells in the gastrointestinal tract correlated to analyses of blood for hormones/analytes before and after Roux-en-Y gastric bypass surgery in morbidly obese individuals both with and without type 2 diabetes
Enteroscopy was conducted during sedation with Propofol®. The pre-surgical sampling included
biopsies retrieved from the stomach and at the expected site of anastomosis. During RYGB
surgery, a ~1 cm gut tissue sample was removed at the site of anastomosis. The post-surgical
enteroscopy ~3 months after RYGB surgery included biopsies taken from the gastric pouch, the
alimentary limb, the biliopancreatic limb and common channel. One sample from each location
was immersion-fixated in formalin for subsequent histological analyses and one sample was
placed in a tube with RNA-preserving media for mRNA expression analysis. Remaining samples
were snap-frozen and stored at -80°C until further processing.
Enteroendocrine cells were identified and isolated from biopsies obtained at several sites
in the small intestine by using immunohistochemistry and laser capture technology. Isolated
individual enteroendocrine cells were extensively characterised by next generation
sequencing (Illumina NGS).
The participants also went through four mixed meal tests with blood sampling performed:
before an 8 % diet-induced weight loss was initiated and one week before/one week after/3
months after RYGB surgery. Blood was sampled at several specific time points.
The plasma, serum and urine collected from study participants before and after RYGB surgery
will be analysed for biomarkers/analytes and correlated with clinical data (weight, BMI,
waist/hip ratio, blood pressure) and molecular phenotype found in gut samples.
To study changes in gut bacteria (microbiota) composition stool samples were collected
during the study and will be analysed for microbiota composition by means of bacterial DNA
sequencing.
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