High-Dimensional Analysis of Postsplenectomy Peripheral Immune Cell Changes

Abstract

Although the consequences of splenectomy are well understood in mice, much less is known about the immunologic changes that occur following splenectomy in humans. We sought to characterize the circulating immune cell populations of patients before and after elective splenectomy to determine if these changes are related to postsplenectomy survival outcomes. Retrospective clinical information was collected from 95 patients undergoing elective splenectomy compared with 91 patients undergoing pancreaticoduodenectomy (Whipple procedure). We further analyzed peripheral blood from five patients in the splenectomy group, collected before and after surgery, using single-cell cytometry by time-of-flight mass spectrometry. We compared pre-and postsplenectomy data to characterize both the major and minor immune cell populations in significantly greater detail. Compared with patients undergoing a Whipple procedure, splenectomized patients had significant and long-lasting elevated counts of lymphocytes, monocytes, and basophils. Cytometry by time-of-flight mass spectroscopy analysis demonstrated that the elevated lymphocytes primarily consisted of naive CD4 + T cells and a population of activated CD25 + CD56 + CD4 + T cells, whereas the elevated monocyte counts were mainly mature, activated monocytes. We also observed a significant increase in the expression of the chemokine receptors CCR6 and CCR4 on several cellular populations. Taken together, these data indicate that significant immunological changes take place following splenectomy. Whereas other groups have compared splenectomized patients to healthy controls, this study compared patients undergoing elective splenectomy to those undergoing a similar major abdominal surgery. Overall, we found that splenectomy results in significant long-lasting changes in circulating immune cell populations and function. ImmunoHorizons, 2020, 4: 82-92.

Effects of Splenectomy on Natural Killer Cell Levels in β‐Thalassemia Major Patients

“…Although CD4 + T lymphocytes were high in the patient group (especially those with splenectomy), CD8 + T lymphocyte levels were similar to the control group. Similar to our results, Borgers et al showed that naïve CD4 + T lymphocyte rates increased in splenectomized patients [20].…”

“…Similar to our results, Borgers et al. showed that naïve CD4 + T lymphocyte rates increased in splenectomized patients [ 20 ].…”

“…Excessive destruction of RBCs and extramedullary hematopoiesis in patients with β‐TM causes splenomegaly, which increases the need for transfusion. In these cases, splenectomy is performed to reduce the frequency of blood transfusion [ 20 ]. In our study, 54% of the patients had splenectomy.…”

Unilateral Cervical Vagotomy Modulates Immune Cell Profiles and the Response to a Traumatic Brain Injury

“…Studies in other CNS injury models, including stroke, have also demonstrated the ability of the spleen to modulate functional and physiological outcomes [ 51 , 52 , 54 , 55 , 56 ]. Thus, the splenic immune response is capable of both improving or exacerbating outcomes to brain injuries, and a splenectomy does not appear to be a desirable clinical therapy [ 57 ]. Alternatively, vagus nerve manipulations have the potential to selectively target immune outcomes in a number of neurological and neurodegenerative disorders and have been demonstrated to be highly tolerable [ 47 , 48 , 49 , 58 , 59 ].…”

Disseminated lymph node tuberculosis after splenectomy: an unusual case report in an adolescent

“…The effect of TS on immune function has been investigated extensively. Borgers and colleagues collected peripheral blood before and after splenectomy to carry out single-cell cytometry based on time-of-flight mass spectrometry [ 16 ]. They showed that splenectomy induced significant long-term changes in the populations and functions of circulating immune cells.…”