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Born in France, Dr. Gaudilliere studied Engineering at Ecole Polytechnique before completing an MD-PhD degree from the Harvard-MIT Health Sciences and Technology program and a postdoctoral fellowship at Stanford University (Dr. Garry Nolan laboratory). Research in the Gaudilliere lab combines high parameter mass cytometry (suspension and imaging mass cytometry) with other proteomics approaches to study how the human immune system responds and adapts to physiological or pathological stressors. Ongoing studies focus on several clinical scenarios including, 1) immune mechanisms of surgical recovery and complications (NIGMSR35), 2) pregnancy and preterm birth (NICHDP01, DDCF, BMGF, ITI, MOD), 3) immune dysfunction and outcomes prediction in patients with COVID19 (Fast Grant, CEND award).Dr. Gaudilliere is a Board-Certified Anesthesiologist and works clinically in the operating room 25% of his time.
The advent of high dimensional flow cytometry has revolutionized our ability to study and visualize the human immune system. Our group combines high parameter mass cytometry (a.k.a Cytometry by Time of Flight Mass Spectrometry, CyTOF), with advanced bio-computational methods to study how the human immune system responds and adapts to acute physiological perturbations. The laboratory currently focuses on two clinical scenarios: surgical trauma and pregnancy. Deep immune profiling of patients undergoing and recovering from surgery: Using high dimensional mass cytometry, we have recently shown that the signaling behavior of specific innate immune cells measured before surgery in patients blood was strongly associated with surgical recovery. Prospective validation of reported immune correlates of surgical recovery are underway. Ongoing work in humans and animal models focuses on the mechanisms by which pre-operative habilitation interventions may alter a patient’s immune state to improve recovery after surgery. Deep Immune profiling of normal and preterm pregnancy: Our group is an integral component of a multi-disciplinary effort aiming at understanding the mechanisms of preterm birth, and identifying predictive factors of premature delivery. We have now developed a pipeline and the analytical framework to integrate the single-cell analysis of immune signaling networks by mass cytometry and proteomic profiling of secreted serum factors with the precise phenotyping of pregnancy-related clinical outcomes. In a pilot cross-sectional study of non-pregnant women, we identified candidate immune signatures that differentiated women with a history of preterm or term pregnancies. Longitudinal studies in pregnant patients are ongoing to validate these findings.
Immune Modulation by Enhanced vs Standard Prehabilitation Program Before Major Surgery
Over 30 million surgeries are performed annually in the US. Up to 30% of surgical patients
experience delayed surgical recovery, marked by prolonged post-surgical pain, opioid
consumption, and functional impairment, which contributes $8 billion annually to US health
care costs. Novel interventions that improve the resolution of pain, minimize opioid
exposure, and accelerate functional recovery after surgery are urgently needed.
Multi-modal pre-operative optimization programs (or "prehab") integrating exercise,
nutrition, and stress reduction have been shown to safely and effectively improve outcomes
after surgery. However, no objective biological markers assess prehab effectiveness and are
able to tailor prehab programs to individual patients. Surgery is a profound immunological
perturbation, during which a complex network of innate and adaptive immune cells is mobilized
to organize the recovery process of wound healing, tissue repair, and pain resolution. As
such, the in-depth assessment of a patient's immune system before surgery is a promising
approach to tailor prehab programs to modifiable biological markers associated with surgical
recovery. The primary goal of this clinical trial is to determine the effect of a
personalized prehab program on patients immunological status before surgery.
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Detection of Immune Changes as a Result of Surgical Trauma in Human Subject
Surgical trauma triggers a massive inflammatory response. Over time, both the innate and
adaptive branches of the immune system are affected by surgical trauma. The purpose of this
study to characterize the cellular and molecular mechanisms immune response to surgical
trauma. Additionally, detailed information about patients' recovery profile will be recorded
over a period of 6 weeks, with the eventual goal of linking immune responses to recovery
Immune-modulation Effects of an Arginine Rich Nutritional Supplement in Surgical Patients
The primary objective of this study is to characterize the immune-modulatory effects of
arginine-rich nutritional supplements in patients undergoing surgery. Numerical and
functional changes of all circulating immune cells will be assessed with mass cytometry.
Stanford is currently not accepting patients for this trial.
For more information, please contact Julian Silva, MA, 650-724-9341.