Clinical Need for Rehabilitation Protocols Before and After Obesity Metabolic Surgery

The CAPS-OB clinical study, led by the 'Fundación Biomédica Galicia Sur,' aims to validate the synergistic effects of combined physical exercise and respiratory physiotherapy for four and eight weeks before and after obesity metabolic surgery ('Bariatric Surgery') in patients. While obesity metabolic surgery currently constitutes a massive global market of approximately $2.8 billion annually, post-operative pulmonary complications and exacerbation of pre-existing conditions remain major contributors to increased healthcare costs. This study goes beyond existing simple Enhanced Recovery After Surgery (ERAS) protocols, seeking to proactively enhance patients' physiological baseline fitness, thereby preventing adverse effects at the source, shortening hospital stays, and maximizing healthcare efficiency.

Potential for Personalized Treatment Through Non-Invasive Genomic Analysis

A key innovative aspect of this study is the investigation of the impact of pre- and post-operative exercise on patients' epigenetic changes. Researchers will conduct precise analyses of the correlation between methylation ('DNA Methylation') genetic markers in adipose or muscle tissue obtained during the invasive surgical procedure and non-invasive blood and saliva samples. This means that patients can track the metabolic improvement effects of exercise treatment in real-time through a simple liquid biopsy ('Liquid Biopsy') without undergoing painful tissue biopsies. This approach is expected to provide important scientific baseline data for the bioventure and precision medicine industries to develop companion diagnostic kits for monitoring obesity and metabolic diseases in the future.

Scalability to the MASH Companion Diagnostic Market

Furthermore, this study focuses on changes in gene expression patterns in the liver tissue of patients with non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated steatohepatitis (MASH). Given that a significant proportion of obese patients also suffer from severe fatty liver disease, the study aims to elucidate the molecular biological mechanisms by which pre-operative exercise interventions inhibit intrahepatic fat accumulation and inflammatory responses. In particular, the researchers intend to develop an algorithm that can predict the progression of MASH or responsiveness to exercise therapy based on biomarker analysis performed before exercise. This could lead to a highly attractive business model in the non-invasive MASH diagnostic market, which is currently valued at approximately $1.68 billion in 2025 and is growing at a rate of over 22% per year.

Strategic Value of Diverse Evaluation Metrics in a Competitive Environment

The researchers have set myokines, exerkines, and metabolomics profiles as diverse evaluation indicators, rather than simply measuring total weight loss. In the current MASH treatment area, numerous new drug pipelines are competing, led by Madrigal's Rezdiffra, the first approved drug. However, there is a lack of quantitative indicators for the synergistic effects of combining patients' lifestyle improvements and physiotherapy. The multi-omics data obtained through this clinical trial can serve as a benchmark for demonstrating the therapeutic benefits provided by the combined exercise-physiotherapy regimen compared to drug treatment alone.