Castle S C
University of California at Los Angeles School of Medicine and Geriatric Research Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA.
Clin Infect Dis. 2000 Aug;31(2):578-85. doi: 10.1086/313947. Epub 2000 Sep 14.
Immunosenescence is the state of dysregulated immune function that contributes to the increased susceptibility to infection of the elderly. Extensive studies of inbred laboratory animals and very healthy elderly humans have identified changes in immunity; these studies have identified limited phenotypic and functional changes in the T cell component of adaptive immunity. However, no compelling scientific evidence has shown that these changes have direct relevance to the common infections seen in the aged population. This perspective will attempt to shed light on this dilemma. First, it will review clinically relevant infections in the elderly, focusing on influenza and influenza virus vaccination and how chronic illness contributes to increased risk and severity of infection and/or failed vaccine response. Second, key changes in immunity will be reviewed, keeping a perspective of the impact of confounding variables in addition to age but focusing on age-related changes in the interaction of the innate and acquired components of immunity. If the goal is to prevent serious infections in the elderly, it appears that the field of geriatric immunology and/or infectious diseases is faced with the tremendous challenge of studying a very diverse population, including mildly immunocompromised/chronically ill individuals and very healthy elderly.
免疫衰老指的是免疫功能失调的状态，这种状态会导致老年人更容易受到感染。对近交系实验动物和非常健康的老年人进行的广泛研究已经确定了免疫方面的变化；这些研究已经确定了适应性免疫的T细胞成分中有限的表型和功能变化。然而，没有令人信服的科学证据表明这些变化与老年人群中常见的感染有直接关联。本观点将试图阐明这一困境。首先，它将回顾老年人临床上相关的感染，重点关注流感和流感病毒疫苗接种，以及慢性病如何导致感染风险和严重程度增加和/或疫苗反应失败。其次，将回顾免疫方面的关键变化，除了年龄之外，还要考虑混杂变量的影响，但重点关注免疫的先天和后天成分相互作用中与年龄相关的变化。如果目标是预防老年人的严重感染，那么老年免疫学和/或传染病领域似乎面临着研究非常多样化人群的巨大挑战，这些人群包括轻度免疫受损/慢性病患者和非常健康的老年人。
