Department of Anesthesiology and Perioperative Medicine, Center for Clinical Single Cell Biomedicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
Center for Clinical Single Cell Biomedicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
Clin Transl Med. 2022 Jan;12(1):e663. doi: 10.1002/ctm2.663.
The number of patients receiving anaesthesia is increasing, but the impact of general anaesthesia on the patient's immune system remains unclear. The aim of the present study is to investigate dynamics of systemic immune cell responses to anaesthesia during perioperative period at a single-cell solution.
The peripheral blood mononuclear cells (PBMCs) and clinical phenomes were harvested and recorded 1 day before anaesthesia and operation, just after anaesthesia (0 h), and 24 and 48 h after anaesthesia. Single-cell sequencing of PBMCs was performed with 10× genomics. Subsequently, data analysis was performed with R packages: Seurat, clusterProfiler and CellPhoneDB.
We found that the cluster of CD56 NK cells changed at 0 h and the cluster of monocytes increased at 24 and 48 h after anaesthesia. The characteristic genes of CD56 NK cells were mainly enriched in the Jak-STAT signalling pathway and in cell adhesion molecules (24 h) and carbon metabolism (48 h). The communication between CD14 monocytes and other cells decreased substantially 0 and 48 h after operation. The number of plasma cells enriched in protein export in men was substantially higher than that in women, although the total number in patients decreased 24 h after operation. CD14 monocytes dominated that cell-cell communications appeared in females, while CD8 NKT cells dominated that cell-cell communications appeared in male. The number of plasma cells increased substantially in patients with major surgical trauma, with enrichments of pentose phosphate pathway. The communications between plasma cells with other cells varied between surgical severities and anaesthetic forms. The intravenous anaesthesia caused major alterations of cell types, including CD14 monocytes, plasmas cells and MAIT cells, as compared with inhalation anaesthesia.
We initially reported the roles of perioperative anaesthesia/surgery in temporal phenomes of circulating immune cells at a single-cell solution. Thus, the protection against immune cell changes would benefit the recovery from anaesthesia/surgery.
接受麻醉的患者数量正在增加，但全身麻醉对患者免疫系统的影响尚不清楚。本研究旨在通过单细胞解决方案，在围手术期研究全身免疫细胞对麻醉的反应动态。
采集并记录患者麻醉前 1 天和手术当天、麻醉后即刻（0 小时）以及麻醉后 24 小时和 48 小时的外周血单核细胞（PBMC）和临床表型。使用 10× Genomics 对 PBMC 进行单细胞测序。随后，使用 R 包：Seurat、clusterProfiler 和 CellPhoneDB 进行数据分析。
我们发现 CD56 NK 细胞簇在 0 小时发生变化，单核细胞簇在麻醉后 24 小时和 48 小时增加。CD56 NK 细胞的特征基因主要富集在 Jak-STAT 信号通路和细胞黏附分子（24 小时）和碳代谢（48 小时）。CD14 单核细胞与其他细胞之间的通讯在手术后 0 小时和 48 小时显著减少。男性富含蛋白输出的浆细胞数量明显高于女性，尽管术后 24 小时患者总数减少。CD14 单核细胞主导着女性细胞间通讯，而 CD8 NKT 细胞主导着男性细胞间通讯。大手术创伤患者的浆细胞数量明显增加，戊糖磷酸途径富集。不同手术严重程度和麻醉方式之间，浆细胞与其他细胞之间的通讯也存在差异。与吸入麻醉相比，静脉麻醉会引起 CD14 单核细胞、浆细胞和 MAIT 细胞等细胞类型的重大变化。
我们首次报道了围手术期麻醉/手术在循环免疫细胞时间表型中的作用。因此，针对免疫细胞变化的保护可能有助于从麻醉/手术中恢复。
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