Confirming what has been long suspected, findings of a new study demonstrate that a patient’s immune response to surgery is strongly linked to his or her surgical recovery.
“We now have a strong lead regarding the biology that may drive recovery,” said Martin Angst, MD, professor of anesthesia, peri-operative and pain medicine at Stanford University School of Medicine in Stanford, Calif., and coauthor of the study, published in Science Translational Medicine. “This lead will provide the basis for developing diagnostic assays predicting recovery in individual patients, which will allow [for] counseling patients regarding their recovery so they can make respective arrangements, or allow for postponing surgeries to coincide with a more favorable immune profile.”
The study included 32 healthy patients between the ages of 50 and 80 years who underwent first-time hip replacement. To characterize the phenotypic and functional immune response to surgical trauma, researchers used mass cytometry to analyze blood samples taken from patients one hour prior to surgery and then at one hour, 24 hours, 72 hours, and six weeks following surgery.
The study found a wide variation—from days to several weeks—in the recovery time of the patients and concluded that 50% to 60% of that variation time was due to activity in a small subset monocytes shortly following surgery.
“Activity in these innate immune cells within 24 hours after surgery seems to set the stage in how patients recover days and weeks after surgery,” said Dr. Angst.
If confirmed in an independent patient cohort, the findings could ultimately lead to stratifying patients to interventions such as pre-operative exercise, dietary supplementation, and administration of immune-modulating medications to improve the patient’s “immune readiness” to recover from surgical trauma, said Dr. Angst.