Abstract
PURPOSE/INTRODUCTION: We have examined the immune status of elderly patients who underwent surgery for a hip fracture, an injury associated with poor postoperative outcomes, to identify specific immune defects.
METHODS: In a cohort observational study, 16 patients undergoing surgery for hip fractures had immune function evaluation prior to surgery, and then at 3 and 7 days postoperatively, using flow cytometry for phenotype and for monocyte and granulocyte phagocytic function and respiratory burst. Serum samples were stored and batch analyzed using a human cytokine 25-plex panel.
RESULTS: We report significant loss of innate immune function, related specifically to reduced granulocyte numbers by day 7 (P < .0001, flow cytometry; P < .05 white blood cells), and although granulocyte ability to take up opsonized Escherichia coli was increased (P < .05), the ability of those cells to generate a respiratory burst was reduced at days 3 and 7 (P < .05). Monocyte respiratory burst was also significantly reduced (P < .05). Serum cytokine levels indicated very poor T-cell function.
CONCLUSION: We have demonstrated that the antimicrobial immune response is profoundly reduced after surgery in elderly patients with hip fractures. The effect was sustained up to 7 days postoperatively, identifying these patients as particularly vulnerable to bacterial infections.
| Original language | English |
|---|---|
| Pages (from-to) | 295-302 |
| Number of pages | 8 |
| Journal | Geriatric orthopaedic surgery & rehabilitation |
| Volume | 6 |
| Issue number | 4 |
| Early online date | 21 Sep 2015 |
| DOIs | |
| Publication status | Published - Dec 2015 |
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Keywords
- cellular immunology
- monocytes
- innate immunity
- cytokines
- T cells
Cite this
Older Patients Are Immunocompromised by Cytokine Depletion and Loss of Innate Immune Function After HIP Fracture Surgery. / Sutherland, Alasdair G; Cook, Alistair; Miller, Clare; Duncan, Linda; Yuecel, Raif; Heys, Steven D; Hutchison, James D; Liversidge, Janet.
In: Geriatric orthopaedic surgery & rehabilitation, Vol. 6, No. 4, 12.2015, p. 295-302.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Older Patients Are Immunocompromised by Cytokine Depletion and Loss of Innate Immune Function After HIP Fracture Surgery
AU - Sutherland, Alasdair G
AU - Cook, Alistair
AU - Miller, Clare
AU - Duncan, Linda
AU - Yuecel, Raif
AU - Heys, Steven D
AU - Hutchison, James D
AU - Liversidge, Janet
N1 - Acknowledgments We are grateful to S. S. Baliga and S McKenna for help in recruiting participants for this study, and to Vijitha Sivarasa for technical help in setting up the assays. Funding This work was funded by Joint Action, the orthopaedic research appeal of the British Orthopaedic Association.
PY - 2015/12
Y1 - 2015/12
N2 - PURPOSE/INTRODUCTION: We have examined the immune status of elderly patients who underwent surgery for a hip fracture, an injury associated with poor postoperative outcomes, to identify specific immune defects.METHODS: In a cohort observational study, 16 patients undergoing surgery for hip fractures had immune function evaluation prior to surgery, and then at 3 and 7 days postoperatively, using flow cytometry for phenotype and for monocyte and granulocyte phagocytic function and respiratory burst. Serum samples were stored and batch analyzed using a human cytokine 25-plex panel.RESULTS: We report significant loss of innate immune function, related specifically to reduced granulocyte numbers by day 7 (P < .0001, flow cytometry; P < .05 white blood cells), and although granulocyte ability to take up opsonized Escherichia coli was increased (P < .05), the ability of those cells to generate a respiratory burst was reduced at days 3 and 7 (P < .05). Monocyte respiratory burst was also significantly reduced (P < .05). Serum cytokine levels indicated very poor T-cell function.CONCLUSION: We have demonstrated that the antimicrobial immune response is profoundly reduced after surgery in elderly patients with hip fractures. The effect was sustained up to 7 days postoperatively, identifying these patients as particularly vulnerable to bacterial infections.
AB - PURPOSE/INTRODUCTION: We have examined the immune status of elderly patients who underwent surgery for a hip fracture, an injury associated with poor postoperative outcomes, to identify specific immune defects.METHODS: In a cohort observational study, 16 patients undergoing surgery for hip fractures had immune function evaluation prior to surgery, and then at 3 and 7 days postoperatively, using flow cytometry for phenotype and for monocyte and granulocyte phagocytic function and respiratory burst. Serum samples were stored and batch analyzed using a human cytokine 25-plex panel.RESULTS: We report significant loss of innate immune function, related specifically to reduced granulocyte numbers by day 7 (P < .0001, flow cytometry; P < .05 white blood cells), and although granulocyte ability to take up opsonized Escherichia coli was increased (P < .05), the ability of those cells to generate a respiratory burst was reduced at days 3 and 7 (P < .05). Monocyte respiratory burst was also significantly reduced (P < .05). Serum cytokine levels indicated very poor T-cell function.CONCLUSION: We have demonstrated that the antimicrobial immune response is profoundly reduced after surgery in elderly patients with hip fractures. The effect was sustained up to 7 days postoperatively, identifying these patients as particularly vulnerable to bacterial infections.
KW - cellular immunology
KW - monocytes
KW - innate immunity
KW - cytokines
KW - T cells
U2 - 10.1177/2151458515605564
DO - 10.1177/2151458515605564
M3 - Article
VL - 6
SP - 295
EP - 302
JO - Geriatric orthopaedic surgery & rehabilitation
JF - Geriatric orthopaedic surgery & rehabilitation
SN - 2151-4585
IS - 4
ER -