Giunta Sergio
Clinical Laboratory & Molecular Diagnostics, Geriatric Hospital INRCA-IRCCS, Via Montagnola 81-60100, Ancona, Italy.
Immun Ageing. 2006 Dec 16;3:12. doi: 10.1186/1742-4933-3-12.
The low-grade, chronic, systemic inflammatory state that characterizes the aging process (inflammaging) results from late evolutive-based expression of the innate immune system. Inflammaging is characterized by the complex set of five conditions which can be described as 1. low-grade, 2. controlled, 3. asymptomatic, 4. chronic, 5. systemic, inflammatory state, and fits with the antagonistic pleiotropy theory on the evolution of aging postulating that senescence is the late deleterious effect of genes (pro-inflammatory versus anti-inflammatory) that are beneficial in early life. Evolutionary programming of the innate immune system may act via selection on these genetic traits. Here I propose that the already acquired knowledge in this field may pave the way to a new chapter in the pathophysiology of autoimmunity: the auto-innate-immunity syndromes. Indeed, differently from the well known chapter of conventional autoimmune diseases and syndromes where the main actor is the adaptive immunity, inflammaging may constitute the subclinical paradigm of a new chapter of autoimmunity, namely that arising from an autoimmune inflammatory response of the innate-immune-system, an old actor of immunity and yet a new actor of autoimmunity, also acting as a major determinant of elderly frailty and age-associated diseases.
以衰老过程为特征的低度、慢性、全身性炎症状态(炎症衰老)源于基于进化后期的固有免疫系统表达。炎症衰老的特征是一组复杂的五种情况,可描述为:1. 低度,2. 可控,3. 无症状,4. 慢性,5. 全身性炎症状态,这与衰老进化的拮抗多效性理论相符,该理论假定衰老是在生命早期有益的基因(促炎与抗炎)的后期有害作用。固有免疫系统的进化编程可能通过对这些遗传特征的选择起作用。在此我提出,该领域已获得的知识可能为自身免疫病理生理学的新篇章铺平道路:自身固有免疫综合征。的确,与以适应性免疫为主要因素的传统自身免疫疾病和综合征这一众所周知的篇章不同,炎症衰老可能构成自身免疫新篇章的亚临床范例,即源于固有免疫系统的自身免疫炎症反应,固有免疫系统是免疫的一个老角色,但却是自身免疫的一个新角色,也是老年衰弱和与年龄相关疾病的主要决定因素。