Berrut Gilles, de Decker Laure
Pôle hospitalo-universitaire de gérontologie clinique, CHU Nantes, France.
Geriatr Psychol Neuropsychiatr Vieil. 2015 Sep;13 Suppl 2:7-14. doi: 10.1684/pnv.2015.0548.
Immunosenescence is a progressive deterioration of the immune system with ageing. A multifactorial condition, including multimorbidities and environmental factors in the elderly, increases the frailty risks. Some infection and nutritional factors contribute to the onset of decline of response to infection. The epithelial barrier is the front line against infection. The renewal capacity of hematopoietic stem cells is reduced and provide in turn decrease of immune cells like lymphocytes, antigen-presenting dendritic cells, and phagocytes. The cellular immunity decreases considering the low cytotoxicity of natural killer. The impairment of dendritic cells alters both non-adaptive and humoral immunities. The reduction of antibody producing B-cells alters humoral production and the diversity of immunoglobulins and their affinity. Somme evidence suggests that retained function of both innate and acquired immunity in the elderly is correlated with health status. CMV might play a part in the process of immunosenescence. CMV status is included in the immune risk profile. Some factors like nutritional status and inflammatory biomarkers should be added to define a immune risk profile in the elderly.
免疫衰老指免疫系统随年龄增长而逐渐衰退。这是一种多因素导致的状况,包括老年人的多种疾病和环境因素,会增加衰弱风险。一些感染和营养因素会导致对感染的反应能力下降。上皮屏障是抵御感染的第一道防线。造血干细胞的更新能力降低,进而导致淋巴细胞、抗原呈递树突状细胞和吞噬细胞等免疫细胞数量减少。鉴于自然杀伤细胞的低细胞毒性,细胞免疫功能下降。树突状细胞功能受损会改变非适应性免疫和体液免疫。产生抗体的B细胞数量减少会改变体液产生以及免疫球蛋白的多样性和亲和力。一些证据表明,老年人先天免疫和后天免疫的保留功能与健康状况相关。巨细胞病毒(CMV)可能在免疫衰老过程中起作用。CMV状态被纳入免疫风险评估中。应加入营养状况和炎症生物标志物等一些因素来定义老年人的免疫风险评估。