Long-term effects of splenectomy on innate and adaptative immunity

Abstract

Abstract Purpose The aim of our study was to investigate the long-term effects of splenectomy on the immune response and to compare these effects in two groups of patients splenectomized for different reasons, autoimmune cytopenia or following trauma, and healthy non-splenectomized controls in a single-center cohort study. Methods Among 248 patients splenectomized for ITP or trauma between 1995 and 2015 at Dijon University Hospital, 15 patients randomly selected from the two groups and 10 matched controls (healthy non-splenectomized patients) were analyzed. Results Splenectomized patients in both ITP and trauma groups had a higher circulating cell count and percentage of B lymphocytes than controls, a significant decrease in memory B cells, memory IgM B cells, marginal zone B cells and switched memory B cells. On the other hand, we found no changes in the different T-cell subsets of patients splenectomized for ITP or trauma and controls, with the exception of an increase in circulating CD8+ central memory T cells in both splenectomized groups compared to controls. Interestingly, we also found a decrease in the phagocytosis capacity in the splenectomized ITP group, partially corrected by the addition of tuftsin, but no abnormalities in the oxidative functions. Conclusion In summary, we demonstrated long-term immunological consequences of splenectomy which did not differ according to the indication for splenectomy, ITP or trauma and noted a decline in phagocytic capacity.