A Transcriptomic Approach to Understand Patient Susceptibility to Pneumonia After Abdominal Surgery.

Area of Science:

• Immunology
• Genomics
• Surgical Complications

Background:

• Postoperative pneumonia is a significant cause of mortality in major abdominal surgery patients.
• Identifying predictive biomarkers for infection risk is crucial for patient management.

Purpose of the Study:

• To characterize immune pathway and gene network alterations after major abdominal surgery.
• To identify transcriptomic patterns predictive of postoperative pneumonia.

Main Methods:

• Whole-blood RNA sequencing was performed on 150 patients undergoing major abdominal surgery at multiple postoperative time points.
• Transcriptomic analysis was conducted on patients who developed pneumonia versus those who remained infection-free.

Main Results:

• Surgery induced significant gene expression changes, including innate immune activation and adaptive immune suppression.
• Preoperative neutrophil degranulation signatures and postoperative Sepsis Response Signature (SRSq) scores predicted pneumonia development.
• These signatures showed predictive value in independent surgical and trauma cohorts.

Conclusions:

• Major abdominal surgery profoundly impacts immune pathways, with distinct patterns observed in patients developing pneumonia.
• Preoperative and early postoperative transcriptomic signatures hold promise for predicting pneumonia risk.