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Immediate variations in high-dimensional circulating immune cells following pancreatectomy
Jonathan Garnier1,2,3, Anaïs Palen1, Xavier Durand4,5
1Department of Surgical Oncology Institut Paoli-Calmettes Marseille France.
Clinical & Translational Immunology
|November 19, 2025
Summary
Pancreatic surgery significantly alters the immune system, decreasing T-cell and natural killer cell populations while increasing myeloid cells. Understanding these immune changes post-pancreatectomy is key for improving patient recovery.
Area of Science:
- Immunology
- Surgical Oncology
- Translational Medicine
Background:
- Pancreatic surgery is a high-risk procedure with significant morbidity and mortality.
- Understanding the impact of pancreatic surgery on the immune system is crucial for developing effective therapeutic strategies.
Purpose of the Study:
- To elucidate the immunomodulation following pancreatectomy.
- To analyze circulating immune subpopulations after pancreatic surgery.
Main Methods:
- Recruitment of patients for the IMMUNOPANC trial (NCT03978702).
- Utilized mass cytometry to analyze immune cell subpopulations.
- Integrated data using hierarchical-stochastic neighbour embedding clustering and Stabl algorithm.
Main Results:
- Observed a significant increase in myeloid cells (26% vs. 34%, P = 0.018) post-pancreatectomy.
- Natural killer (NK) cell proportions decreased on postoperative day one (POD1) (7% vs. 12%, P < 0.001).
- Both CD8+ and CD4+ T-cell proportions decreased significantly post-surgery (25% and 40%, P < 0.001), with transient alterations in NK cells, CD8+ T cells, and naive CD4+ T cells.
Conclusions:
- This study provides the first analysis of peripheral immune system dynamics after pancreatic surgery.
- The observed immune alterations may reflect the surgical response or lymphoid organ demargination.
- Understanding these postoperative immune trajectories is essential for restoring immunity and facilitating patient recovery.
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