POM-T
Research type
Research Study
Full title
Characterisation of T cell function after surgery.
IRAS ID
270481
Contact name
Gareth Ackland
Contact email
Sponsor organisation
Joint Research Management Office (JRMO) Queen Mary University of London
Duration of Study in the UK
2 years, 7 months, 2 days
Research summary
Research Summary
More than 1.6 million individuals aged >70 years undergo surgery each year in the UK, yet many struggle to return to independent function suffering increased complications after surgery, including wound infections, reduced kidney function, difficulty with their mobility. These common complications, which occur in more than 25% of those >70 years old, lead to distressing and prolonged stays in hospital. For older individuals who leave hospital, complications after surgery are associated with much shorter life expectancy. The reasons for why postoperative complications in older people lead to delayed recovery and/or early death remain unclear.
Inflammation is a key factor in causing long-term health problems. When older individuals suffer from complications after surgery, the immune system becomes dysfunctional. This leads to higher levels of inflammation and long-term health problems, including frailty. Alterations in white blood cell count because of increased inflammation are a well recognised feature of ageing, however, it is often thought to be irrelevant. We don’t think this is the case, we believe that a low WBC count is a major cause of complication following surgery. Indeed we think that higher levels of inflammation that occur during ageing cause the loss of white blood count. We know that surgery causes the energy production of a particularly type of white blood cell called a T-lymphocyte to be reduced to levels that render the cells dysfunctional and prone to dying. We also know that T-lymphocytes from older people display the same reduced energy level, what we would like to find out is whether older people with lower white blood cell counts display these energy changes delaying, full recovery and independent function.
In this study, we will measure the amount of inflammation in patients with low white cell counts before and after surgery. We will also look at changes in the energy usage in T-lymphocytes in people with low white blood counts and see if T-lymphocyte insufficiency contributes to incomplete recovery after surgery. If we can show that T-lymphocytes are damaged in patients with low white cell counts, there are a number of potential treatments that may reverse- or even prevent- these changes happening after surgery. If we can help restore the energy function of the immune system we hope to improve the chances recovering fully after major surgery.Summary of Results
Older surgical patients are at an increased risk of developing infections, impeding their recovery, which is driven by the dampening of the immune system. We have shown that a subset of white blood cells, called T-cells, need to use the amino acid glutamine to maintain their function following surgery. As glutamine metabolism declines with age, a lack of glutamine may drive T-cell dysfunction. This research helps to drive our understanding of immune cell recovery following surgery and ultimately benefit the recovery of older patients.
Has the registry been updated to include summary results?: No
If yes - please enter the URL to summary results:
If no – why not?: Study is not a registry.
Did you follow your dissemination plan submitted in the IRAS application form (Q A51)?: Yes
If yes, describe or provide URLs to disseminated materials: Study data has been presented at multiple conferences, manuscript is in preparation.
If pending, date when dissemination is expected:
If no, explain why you didn't follow it:
Have participants been informed of the results of the study?: Pending
If yes, describe and/or provide URLs to materials shared and how they were shared:
If pending, date when feedback is expected: 01/06/2024
If no, explain why they haven't:
Have you enabled sharing of study data with others?: Yes
If yes, describe or provide URLs to how it has been shared: Sharing is enabled, however no data has been shared yet.
If no, explain why sharing hasn't been enabled:
Have you enabled sharing of tissue samples and associated data with others?: Yes
If yes, describe or provide a URL: Sharing is enabled, however no tissue samples have been shared yet.
If no, explain why:REC name
London - Surrey Borders Research Ethics Committee
REC reference
19/LO/1973
Date of REC Opinion
16 Jan 2020
REC opinion
Further Information Favourable Opinion