Wikby Anders, Ferguson Frederick, Forsey Rosalyn, Thompson Julie, Strindhall Jan, Löfgren Sture, Nilsson Bengt-Olof, Ernerudh Jan, Pawelec Graham, Johansson Boo
Department of Natural Science and Biomedicine, School of Health sciences, Jönköping University, Sweden.
J Gerontol A Biol Sci Med Sci. 2005 May;60(5):556-65. doi: 10.1093/gerona/60.5.556.
In the previous OCTO longitudinal study, we identified an immune risk phenotype (IRP) of high CD8 and low CD4 numbers and poor proliferative response. We also demonstrated that cognitive impairment constitutes a major predictor of nonsurvival. In the present NONA longitudinal study, we simultaneously examine in a model of allostatic load IRP and compromised cognition in 4-year survival in a population-based sample (n = 138, 86-94 years). Immune system measurements consisted of determinations of T-cell subsets, plasma interleukin 6 and cytomegalovirus and Epstein-Barr virus serology. Interleukin 2 responsiveness to concanavalin A, using data from the previous OCTO (octogenarians) immune study, hereafter OCTO immune, was also examined. Cognitive status was rated using a battery of neuropsychological tests. Logistic regression indicated that the IRP and cognitive impairment together predicted 58% of observed deaths. IRP was associated with late differentiated CD8+CD28-CD27- cells (p < .001), decreased interleukin 2 responsiveness (p < .05) and persistent viral infection (p < .01). Cognitive impairment was associated with increased plasma interleukin 6 (p < .001). IRP individuals with cognitive impairment were all deceased at the follow-up, indicating an allostatic overload.
在之前的八旬老人纵向研究中，我们确定了一种免疫风险表型（IRP），其特征为CD8细胞数量高、CD4细胞数量低且增殖反应差。我们还证明，认知障碍是生存情况不佳的主要预测因素。在本次九旬老人纵向研究中，我们在一个基于人群的样本（n = 138，年龄86 - 94岁）中，同时在一种应激负荷模型中研究了IRP和认知功能受损对4年生存率的影响。免疫系统测量包括T细胞亚群测定、血浆白细胞介素6以及巨细胞病毒和EB病毒血清学检测。还利用之前八旬老人（OCTO）免疫研究（以下简称OCTO免疫研究）的数据，检测了白细胞介素2对伴刀豆球蛋白A的反应性。使用一系列神经心理学测试对认知状态进行评分。逻辑回归分析表明，IRP和认知障碍共同预测了58%的观察到的死亡情况。IRP与晚期分化的CD8 + CD28 - CD27 - 细胞有关（p < 0.001）、白细胞介素2反应性降低（p < 0.05）以及持续性病毒感染有关（p < 0.01）。认知障碍与血浆白细胞介素6升高有关（p < 0.001）。有认知障碍的IRP个体在随访时均已死亡，表明存在应激负荷过载。
