Immune activity: Can it predict surgical recovery times?

The activity level of a subset of immune cells is a strong predictor of how quickly surgery patients bounce back from postsurgical fatigue and pain, according to new research from the Stanford University School of Medicine published in Science Translational Medicine.

Researchers studied a group of middle-aged and elderly patients undergoing first-time hip replacement surgery. They drew patient blood samples one hour before surgery, then one, 24 and 72 hours postsurgery, as well as again four to six weeks postsurgery. Patients also returned questionnaires on pain, fatigue and hip function every three days for six weeks after surgery.

Cytometric analysis of 35 immune cell markers revealed a significant relationship between immune system activity in the blood and self-reported pain and functionality. Researchers also discovered an immune system "signature" response to surgery — a sequence of increases and decreases in specific cell counts and cellular activity — that occurred in every patient, though at varying magnitudes. Cellular activity linked most closely with recovery times was due to myeloid-derived suppressor cells, which reduce inflammation.

The discovery may lead to personalized diagnostic blood tests to predict surgical recovery times or for immune system manipulation to speed recovery. "If we could predict recovery time before surgery even took place, we might be able to see who'd benefit from boosting their immune strength beforehand, or from presurgery interventions such as physical therapy. It might even help us decide when or if a patient should have surgery," said Brice Gaudilliere, MD, PhD, a lead author of the study, in a news release.

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