Harnessing The Immune Response To Predict Recovery From Surgery

The global volume of surgery is on the rise and despite significant advances in care, the act of surgery still comes with a risk of postoperative illness or death. Taking a novel approach focused on the immune response to surgery, translational research scientist Dr Kathryn Hally is on a quest to find immunological biomarkers that can be used to predict an adverse recovery from surgery.

The University of Otago lecturer has just been awarded a $249,000 Emerging Researcher First Grant from the Health Research Council of New Zealand (HRC) to help develop her skills and leadership in the field of surgical immunology. She is one of 17 researchers receiving a combined $4.2 million in HRC funding designed to support early career researchers in establishing independent research careers.

Working with patients undergoing vascular and orthopaedic surgery, Dr Hally will use cutting-edge technology to measure in an in-depth and granular way how their immune system responds to surgery, and whether that response can be mapped against how well patients recover.

“Surgery isn’t risk-free,” says Dr Hally. “Moreover, the risk of adverse postoperative recovery is not shared equally across our population. Older patients, patients of Māori descent, and patients with comorbidities have a disproportionately higher risk of postoperative complications.”

She says the immune response to surgery is a key pathophysiological mechanism that can contribute to adverse outcomes, but it’s not yet fully understood how the immune response is altered in individuals who go on to experience poorer recovery from surgery.

“The immune response to surgery is a complex interplay between some immune mechanisms that are hyperactivated and some that are dampened down, and we’re not really sure how any of those particular pathways are related to patient outcomes,” says Dr Hally. “We’re going to try and characterise some of these well-known hyper-inflammatory and immune-suppressed pathways and link them to how well patients report themselves to be recovering from their surgery.”

Using blood samples taken from patients just before, during and after surgery, Dr Hally’s team will use advanced cell analysis techniques to identify unique immune signatures, at various time-points during hospitalisation, that correlate with a patient’s recovery and progress.

The goal is to build risk prediction models for adverse postoperative recovery, taking into account blood-based biomarkers as well as patient characteristics such as age, ethnicity and comorbidities that might predispose individuals to poorer outcomes.

This research draws on previous studies in this field, most of which have reported on broad immunological biomarkers and their correlation with postoperative recovery. But Dr Hally’s team aims to create more detailed biomarker panels that help advance the field further.

“We’re trying to characterise a number of distinct functional immune pathways and, over time, track an increase or decrease in those particular functions in response to surgery.”

The first step is discovering what the immune response looks like, especially in Aotearoa New Zealand’s unique population which hasn’t been studied in this way previously.

“If predictive immunological biomarkers are identified, then in the long run this could mean better support for patients because we would be able to pre-empt adverse outcomes,” she says.

“The idea is to eventually detect high-risk patients as early as possible, then start to intervene as early as possible with treatment options that help ensure they don’t go on to have an adverse recovery from their surgery.”

Dr Hally says this research will develop a pipeline for blood-based biomarker discovery, and in future could extend beyond vascular and orthopaedic surgery and into a range of major and minor surgeries.

Chief Executive of the Health Research Council, Professor Sunny Collings, says this emerging researcher grant will help create a multidisciplinary research group in surgical immunology as well as generate knowledge for clinicians and other researchers.

“Research grants of this size and significance can make the difference to an early career researcher who is shaping an independent research stream. Supporting New Zealand researchers with highly specialised skills is good for our people’s health and great for the sector, both of which benefit from the findings, collaboration, and capability built throughout the research process.”

See below for the full list of 2023 Emerging Researcher First Grant recipients. To read lay summaries about any of these research projects once the embargo has lifted, go to hrc.govt.nz/resources/research-repository and filter by proposal type ‘Emerging Researcher First Grant’ and year ‘2023’.

Please note, the recipients of the HRC’s Rangahau Hauora Māori Emerging Researcher First Grants and Pacific Emerging Researcher First Grants will be announced in June.

2023 Health Research Council Emerging Researcher First Grant recipients

General category

Dr Veronica Boyle, The University of Auckland
Genomics and Functional Metabolomics of Phaeochromocytomas and Paragangliomas
36 months, $246,918

Dr Alistair Brown, Research Trust of Victoria University of Wellington
Building a synthetic biology pipeline to develop nucleoside therapeutics
24 months, $250,000

Dr Teodora Georgescu, University of Otago
Prolactin-mediated suppression of fever during pregnancy
36 months, $250,000

Dr Kathryn Hally, University of Otago
Harnessing the immune system for predicting adverse postoperative recovery
36 months, $249,214

Dr Alice Hyun Min Kim, University of Otago
The effects of climate variability on the risk of enteric diseases
36 months, $249,968

Dr Nicola Ludin, The University of Auckland
Sleep, Mental Health and Wellbeing for young people: An online RCT of apps
24 months, $244,755

Dr Deborah Raphael, The University of Auckland
The adaptation of a web-based psychosocial intervention for cancer survivors
24 months, $245,102

Dr Jeanette Rapson, The University of Auckland
Vegetables as first foods for babies, e tamariki, kai o huawhenua i te tuatahi
24 months, $250,000

Dr Mak Sarwar, University of Otago
Novel targeted therapeutic strategy for ovarian cancer treatment
36 months, $249,959

Dr Ilana Seager van Dyk, Massey University
Affirming Cognitive Behaviour Therapy for Rainbow Youth and Whānau in Aotearoa
36 months, $250,000

Dr Sarah Stewart, Auckland University of Technology
The relationship between physical activity and gout flares
36 months, $249,824

Dr Rachael Sumner, The University of Auckland
Toward profiling and treating neurosteroid withdrawal in catamenial epilepsy
36 months, $249,985

Dr Natalia Yewdall, University of Canterbury
Unravelling the role of protein oligomerisation in acute myeloid leukemia
36 months, $250,000

Dr Amber Young, University of Otago
Protecting hapū māmā and pēpi from vaccine preventable diseases
36 months, $249,998

Health Delivery category

Dr Lisa Daniels, University of Otago
Maternal perception vs actual breast milk supply: is there a difference?
36 months, $249,454

Rebecca Findlay, The University of Auckland

Prevalence of refractive error and access to eye care for New Zealand children

36 months, $249,931

Dr Annie Wong, University of Otago
Circulating tumour DNA in hastening the diagnosis of lung cancer
36 months, $250,000

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