T Cell Aging: An Important Target for Perioperative Immunomodulation

Although T cells are crucially involved in maintaining immune function, their roles change with age. Furthermore, T cell aging has a unique onset and progression mechanism and several clinical indicators have been developed to detect it. Moreover, perioperative pain and stressful stimuli could affect the body's immune status, influencing patients' recovery. This article examines how preoperative and intraoperative complications influence T cell aging. These factors include conditions such as hypertension, diabetes, acute respiratory distress syndrome, hypoxemia, depression, pain, obesity, neurologic diseases, tumors, autoimmune diseases, as well as aspects like anesthetic modalities, types of surgery, and medications. This analysis could help identify groups at a high risk of perioperative T cell aging. For example, elderly cancer patients with multiple chronic diseases may be the most affected by T cell aging. We also discuss the effects of T cell aging on postoperative phenomena such as neurological dysfunction and recovery quality. Based on insights from this discussion, we deduced that prehabilitation, pharmacological treatment, and adoptive neuro-immunotherapy could modulate T cell aging in the perioperative period, thus improving clinical prognosis.