Perioperative medicine & outcomes
Whole Blood Transcriptomic Response to Perioperative Dexamethasone in Total Knee Arthroplasty: A Targeted Panel Analysis
Authors' conclusion
Perioperative dexamethasone in TKA induced differential expression of genes related to IL6-JAK/STAT3-signalling as estimated by the Immunology V2 panel. This, however, is not supported by the literature or a rank-based interpretation of the most differentially expressed genes and was most likely due to technical reasons.
Study context
- Population
- Patients undergoing total knee arthroplasty (TKA)
- Participants
- 63 patients
- Comparison
- Perioperative dexamethasone vs placebo
- Dexamethasone (DXM)n = 46
- Placebon = 17reference
- Outcome
- Whole-blood transcript levels (579 transcripts), differential expression and pathway enrichment
- Follow-up
- Before surgery and POD1
Methodological detailsplacebo-controlled, transcriptomic sub-study, targeted panel (Nanostring nCounter Immunology V2)
- Placebo-controlled
- Transcriptomic sub-study
- Targeted panel (Nanostring nCounter Immunology V2)
Main finding
As reported in the abstract
Differential gene expression with dexamethasone
- Genes differentially expressed with dexamethasone (|log2 fold change| > 0.5, p-adj < 0.05)
- 113
- Up-regulation of IL6/JAK-STAT3-signalling (Over-Representation Analysis (ORA)), p-adj
- 0.016
- Down-regulation of allograft-rejection pathway (ORA), p-adj
- 0.032
Further findings
Granulocyte fraction · POD1
p-adj = 0.048
Immune response to surgery
- Genes differentially expressed
- 169
- Only allograft rejection pathway significant (ORA), p-adj
- 0.016
Cell type deconvolution, dexamethasone effect
- Granulocyte fraction increased (69.6% vs. 73.6%), p-adj = 0.005
- B- and Plasma-cell fraction reduced (10.1% vs. 8.4%), p-adj = 0.016
Original publication
Whole Blood Transcriptomic Response to Perioperative Dexamethasone in Total Knee Arthroplasty: A Targeted Panel Analysis. Acta Anaesthesiol Scand. Published 13 May 2026. doi:10.
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