Characterization of Human Intestinal Macrophages in Metabolic Disease
Condition: Metabolic Disease
MeSH terms: Metabolic Diseases
Study type: Observational

Summary: 
      This is a prospective, observational study aiming at improving the understanding of the
      pathophysiology of metabolic disease. As inflammation has been recognized as a key
      characteristic of metabolic disease but its starting point is still unknown, the
      investigators' aim is to characterize intestinal macrophages from human gut biopsies taken in
      diagnostic endoscopies of the gastrointestinal tract or in bariatric surgeries for clinical
      reasons.
    

Detailed description: 
      Metabolic disease including obesity and diabetes has reached epidemic proportions in the past
      years. Besides classical risk factors such as unhealthy diet and physical inactivity, smoking
      and air pollution have also emerged as unexpected risk factors for type 2 Diabetes.

      Inflammation has been reported as key characteristic of metabolic disease and is predictive
      of future cardiovascular events. However, the starting point of chronic low-grade
      inflammation is not known.

      As the gastrointestinal tract first comes into contact with dietary components, but
      potentially also air pollution/ smoke particles ingested upon mucociliary clearance from the
      lung, the gut could be the starting point of inflammation in metabolic disease.

      The aim of this study is to characterize intestinal macrophages in obese versus lean subjects
      and smokers versus non-smokers to translate the principal investigator's preclinical findings
      to human disease and assess whether an inflammatory shift prevails in human intestinal
      macrophages in metabolic disease. Additionally, to assess whether intestinal macrophage
      subpopulations can be altered deliberately by nutritional intervention, the investigators
      will assess intestinal macrophages from subjects scheduled for bariatric surgery that will be
      on a calorie-restricted diet during the last 2 to 4 weeks prior to surgery.

      The macrophages originate from human gut samples. As patients will undergo diagnostic
      endoscopy of the gastrointestinal tract or bariatric surgery for clinical reasons and the
      standard of care will not be changed by the study, there will be no additional interventions
      to patients by their participation in the study. Additionally, three EDTA and one serum blood
      tube for the analysis of inflammatory cells and markers in the blood will be taken as well as
      a single stool sample. The investigators' goal is to recruit in total 150 patients as it will
      be a pilot study in a first step.
    

Intervention name(s): tissue samples, blood and stool sample
Intervention type(s): Procedure
Intervention description(s): Tissue samples from gastroscopy/colonoscopy.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        All patients planned for diagnostic endoscopy of the gastrointestinal tract or bariatric
        surgery at the University Hospital of Basel, the doctor's Office MagenDarm Basel or the
        Department of Visceral Surgery, Hospital Lindenhof of Bern will be screened for study
        participation, contacted and informed about the study if suitable to all inclusion and
        exclusion criterias.