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Individuals with obesity and type 2 diabetes have additional immune dysfunction compared with obese individuals who are metabolically healthy
  1. Caroline Richard1,
  2. Michael Wadowski1,
  3. Susan Goruk1,
  4. Lisa Cameron2,
  5. Arya M Sharma3,
  6. Catherine J Field1
  1. 1 Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
  2. 2 Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada
  3. 3 Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
  1. Correspondence to Dr Caroline Richard; cr5{at}


Objective The objective of the current study was to compare the responses to different ex vivo immunogenic challenges between immune cells derived from metabolically healthy subjects with obesity and subjects with obesity and type 2 diabetes.

Research design and methods We recruited 10 metabolically healthy subjects with obesity (Edmonton Obesity Staging System (EOSS) stage 0) and 9 subjects with obesity and type 2 diabetes (EOSS stage 2) aged between 21 years and 70 years and matched for body mass index. Peripheral blood mononuclear cells (PBMCs) were isolated and immune cell phenotypes and ex vivo cytokine production after phytohaemagglutinin (PHA, a T cell mitogen) stimulation were determined. Neutrophil oxidative burst activity was assessed in whole blood.

Results PBMCs from subjects with stage 2 obesity produced significantly less interleukin (IL)-2, IL-6 and tumour necrosis factor α after PHA stimulation than PBMCs from subjects with stage 0 obesity (all, p<0.05). Subjects with stage 2 obesity also had higher proportions of cytotoxic T cells, activated helper T cells (CD4+CD278+) and inflammatory monocytes (CD14+CRTh2+, all p<0.05). Poststimulation, neutrophils from subjects with stage 2 obesity produced significantly more free radicals, were larger and more granular and had a lower stimulation index (all p<0.05).

Conclusions Our results suggest that compared with obese individuals metabolically healthy individuals with obesity and type 2 diabetes have an impaired neutrophil function and T cell response on challenge despite having a T cell population expressing more activation markers which may be partly responsible for the increased prevalence of infection reported in this population.

  • immunology
  • type 2 diabetes
  • obesity
  • inflammation
  • metabolically healthy subjects

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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  • Contributors CJF, LC and AMS designed and obtained funding for this study. MW was responsible for the screening of participants, coordinated the study and was responsible for the laboratory analysis with the help of SG. CR performed the statistical analyses, analysed the data and wrote the manuscript, which was reviewed critically by all authors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Human Research Ethics Board of the University of Alberta.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement This was a pilot study and there are no additional variables that have been measured in this study that are not presented in this article.

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