Cheng Ni, MD, PhD |National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; Xiaoyan Liu, MD, MS; Bing Mu, MD, PhD; Peng Wang, MD, PhD; Naiyuan Tian, MD, PhD; Yi Tian, MD, PhD; Bowen Zhou, MD, PhD; Zizheng Suo, MD; Wenjie Xu, MD; Yuxiang Zheng, MD
Competition Sponsor: Chinese Academy of Medical Sciences
Awardee Year: 2023
With population aging and indication expansion, tumor surgery in elderly patients is becoming increasingly widespread. Our studies suggest that perioperative factors such as aging, surgery, anesthesia, and tumor treatment can lead to systemic inflammatory reactions, and participate in the occurrence of perioperative neurocognitive disorders (PND) through T cell pathway. PND includes various perioperative central nervous system (CNS) dysfunctions such as POD and POCD, which affect postoperative recovery and long-term outcomes of patients. However, the mechanisms by which perioperative factors affect systemic immune function and related major organ dysfunction such as PND are unclear. Feasible perioperative immune response-PND intervention targets and strategy are urgent clinical issues. Intelligent research and translational exploration based on this foundation also have important clinical values. The main project research contents include:
1. Study the dynamic changes of systemic immune function, and the activation and intercellular interaction mechanism of TEM cells under the synergistic effects of multiple perioperative factors.
2. Study systemic immune activation-TEM cross barrier mechanism, and establish the p53-PGC-1α-NRF-1 mitochondrial pathway and associated gene regulatory network for TEM activation. Then study the pathological process of mechanism of PND associated BBB injury-CNS inflammation.
3. Apply dexmedetomidine combined anesthesia and analgesia strategy to intervene the mitochondrial pathway and cross barrier effects of TEM cells on PND pathogenesis.
4. Establish an intelligent analysis model for systemic immune function, and a prediction model for PND and postoperative recovery. Provide an intelligent support system for the diagnosis and treatment of perioperative immune response related organ dysfunction.