Alterations in Mast Cell and Macrophage Infiltration, as Well as Micro Vessel Density

Официальное название

Understanding Alterations in Mast Cell and Macrophage Infiltration, as Well as Micro Vessel Density, May Throw Light on the Early Events Leading to Gastric Carcinogenesis in Obesity

Обзор

Obesity is a global health problem that has reached epidemic proportions, affecting more than one billion people worldwide and significantly increasing the risk of multiple comorbidities, including type 2 diabetes, cardiovascular diseases, and cancer (World Health Organization, 2024). Increasing evidence suggests that chronic low-grade inflammation associated with obesity plays a critical role in the development of obesity-related malignancies, including gastric cancer. Adipose tissue dysfunction in obesity leads to the recruitment and activation of various immune cells, such as macrophages and mast cells, which contribute to a pro-inflammatory microenvironment through the release of cytokines, growth factors, and angiogenic mediators.

Подробное описание

In the gastric mucosa, this inflammatory micro environment associated with obesity may promote epithelial proliferation, DNA damage, and neovascularization, establishing conditions favorable for early carcinogenic transformation. Mast cells presence at the periphery and infiltrating tumors, argues for their role in the modulation of tumor biology it has been implicated in tumor progression through their ability to release histamine, tryptase, and vascular endothelial growth factor (VEGF), thereby enhancing angiogenesis and stromal remodeling. Similarly, macrophages especially those exhibiting an M2-like phenotype can facilitate tissue remodeling and angiogenesis, further supporting tumor initiation. The number and phenotype of macrophages vary at different stages of tumor progression. The number of macrophages markedly increases during the early stages of tumor growth.

Despite the growing recognition of the link between obesity, inflammation, and cancer, few studies have explored the immunopathological changes occurring in the gastric mucosa of obese patients before overt malignancy. Bariatric surgery provides a unique opportunity to study these changes in human gastric tissue. Understanding alterations in mast cell and macrophage infiltration, as well as microvessel density, may throw light on the early events leading to gastric carcinogenesis in obesity.

Вмешательства

• Процедура bariatric surgery laparoscopic sleeve gastrectomy
  Adipose tissue macrophages (ATMs), mast cells positive for tryptase (MCPT), and microvascular density (MVD) were assessed by immunohistochemistry. Quantitative assessment was performed using a light microscope. For each GTO and NT tissue section, five highly immunostained areas ("hot spots") were identified at low magnification.
• Процедура lean control patients undergoing endoscopic biopsy for benign or malignant gastric conditions.
  Adipose tissue macrophages (ATMs), mast cells positive for tryptase (MCPT), and microvascular density (MVD) were assessed by immunohistochemistry. Quantitative assessment was performed using a light microscope. For each GTO and NT tissue section, five highly immunostained areas ("hot spots") were identified at low magnification.

Первичные конечные точки

• Immunohistochemistry [Срок оценки: Baseline]
• Immunohistochemistry [Срок оценки: Baseline]
• Immunohistochemistry [Срок оценки: Baseline]
• Morphometric Analysis [Срок оценки: Baseline]
• Morphometric analysis [Срок оценки: Baseline]

Критерии участия

Критерии включения

• Adult patients undergoing bariatric surgery (laparoscopic sleeve gastrectomy).
• BMI > 35 kg/m²
• All participants underwent preoperative evaluation, including blood tests and assessment by a multidisciplinary team (nutritionist, psychiatrist, endocrinologist, radiologist, anesthesiologist, and surgeon).

Критерии исключения

• Patients with secondary causes of obesity, such as Cushing's syndrome or polycystic ovary syndrome (PCOS).
• Patients with malignant gastric conditions or previous gastric surgery.
• Patients with systemic inflammatory diseases, autoimmune disorders, or chronic infections that may influence immune cell infiltration.
• Patients with incomplete clinical data or poor-quality tissue samples.
• Patients taking anti-inflammatory, immunosuppressive, or corticosteroid therapy within the last 3 months before sampling.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Модель наблюдения

Когортное

Центры проведения

Египет · 1 центр

• The surgical department of Medical Research Institute Hospital, Alexandria University — Alexandria

Идентификаторы

NCT: NCT07448896 · Mast cells obesity

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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