Obesity is associated with alterations in metabolism, immune function, inflammation and microbiome, however the inter-relationship between these factors remains ill-defined. Blacktown Public Hospital has recently implemented a large healthy weight and bariatric surgical program, which provides the ideal environment to address the poorly understood, but essential aspect of obesity. Samples obtained pre- and post-bariatric surgery will be used to understand how obesity and metabolic syndrome cause immune dysregulation promoting subsequent development of obesity related complications in liver, gut and cardiovascular system.
 
National statistics from Australian sources predict that normal-weight adults will constitute less than a third of the population by 2025, and that the prevalence of obesity will have increased by 65%. Bariatric surgery targets individuals with a body mass index (BMI) above 35, and significantly reduces stomach size by resection, diversion or banding. Patients achieve significant weight loss, resolution of diabetic state, improvement in cardiovascular risk factors and reduction in mortality. This project will examine the effects of bariatric surgery and subsequent weight loss on systemic, as well as liver and intestinal immune activity and dysregulation. In particular, how rapid weight loss alleviates chronic inflammation and immune exhaustion associated with obesity. Changes in microbiome and intestinal permeability will also be examined with respect to liver inflammation and immunopathology. This project will possess a strong clinical and translational focus, relating immune parameters to clinical outcomes. In vitro analysis of immune cell phenotypes will be performed by flow cytometry, RNAseq and primary liver and intestinal cell culture will be used to elucidate pathological mechanisms.

Student level: PhD
Supervisor: Professor Golo Ahlenstiel