选择性脊柱重建手术免疫反应的转录和蛋白质特征:衰老的影响和与创伤反应的比较
Jillian W Bonaroti1,2, Mehves Ozel1,2, Tianmeng Chen1,2
1From the Department of Surgery (Bonaroti, Ozel, Chen, Darby, Sun, Moheimani, Reitz, Kar, Zuckerbraun, Billiar), University of Pittsburgh, Pittsburgh, PA.
Journal of the American College of Surgeons
|December 14, 2023
概括
大型手术和多创伤都会诱导应激反应,但在时间和免疫细胞配置上有显著差异. 与年轻人相比,老年患者在手术后表现出较高的炎症和明显的免疫反应.
科学领域:
- 免疫学 免疫学 免疫学
- 手术应激反应手术应激反应
- 老年医学 老年医学
背景情况:
- 大型手术会引起类似于创伤的压力反应,类似于多创伤.
- 选择性手术已被提出作为研究多创伤免疫反应的模型.
- 研究了接受重大手术的不同年龄组的压力反应,并将其与多创伤患者进行了比较.
研究的目的:
- 为了比较重大选择性手术和多创伤之间的免疫和压力反应.
- 调查这些反应中的与年龄相关的差异.
- 确定选择性手术是否是多创伤研究的合适替代品.
主要方法:
- 与创伤患者进行脊柱重建手术的老年 (>65) 和年轻 (18-39) 患者进行比较.
- 使用单细胞RNA测序和蛋白质组分析分析了血液样本.
- 评估免疫细胞 (单细胞,自然杀手细胞) 的特征和血蛋白质的变化.
主要成果:
- 多创伤反应在4小时内达到峰值;手术反应在24小时内达到峰值.
- 两者都诱导了CD14单细胞的变化,炎症增加和MHC-class 2降低.
- 与年轻患者相比,老年患者表现出更高的炎症,抑制了自然杀手细胞和升高的衰老蛋白.
结论:
- 大型手术和多创伤在时间和细胞特征上启动了不同的免疫反应.
- 选择性手术不是适合多创伤免疫反应研究的替代模型.
- 年龄特定的免疫反应突显了选择性手术在研究患者特定结果中的实用性.
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