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巨细胞病毒感染:人类T细胞免疫衰老的驱动力

Cytomegalovirus infection: a driving force in human T cell immunosenescence.

作者信息

Koch Sven, Larbi Anis, Ozcelik Dennis, Solana Rafael, Gouttefangeas Cécile, Attig Sebastian, Wikby Anders, Strindhall Jan, Franceschi Claudio, Pawelec Graham

机构信息

Department of Immunology, University of Tübingen, Auf der Morgenstelle 15, D-72076, Tübingen, Germany.

出版信息

Ann N Y Acad Sci. 2007 Oct;1114:23-35. doi: 10.1196/annals.1396.043.

Abstract

The human immune system evolved to defend the organism against pathogens, but is clearly less well able to do so in the elderly, resulting in greater morbidity and mortality due to infectious disease in old people, and higher healthcare costs. Many age-associated immune alterations have been reported over the years, of which probably the changes in T cell immunity, often manifested dramatically as large clonal expansions of cells of limited antigen specificity together with a marked shrinkage of the T cell antigen receptor repertoire, are the most notable. It has recently emerged that the common herpesvirus, cytomegalovirus (CMV), which establishes persistent, life-long infection, usually asymptomatically, may well be the driving force behind clonal expansions and altered phenotypes and functions of CD8 cells seen in most old people. In those few who are not CMV-infected, another even more common herpesvirus, the Epstein-Barr virus, appears to have the same effect. These virus-driven changes are less marked in "successfully aged" centenarians, but most marked in people whom longitudinal studies have shown to be at higher risk of death, that is, those possessing an "immune risk profile" (IRP) characterized by an inverted CD4:8 ratio (caused by the accumulation primarily of CD8(+) CD28(-) cells). These findings support the hypothesis that persistent herpesviruses, especially CMV, act as chronic antigenic stressors and play a major causative role in immunosenescence and associated mortality.

摘要

人类免疫系统进化的目的是保护机体抵御病原体,但在老年人中其防御能力明显下降,导致老年人因传染病而出现更高的发病率和死亡率,以及更高的医疗成本。多年来已报道了许多与年龄相关的免疫改变,其中T细胞免疫的变化可能最为显著,通常表现为具有有限抗原特异性的细胞大量克隆性扩增,同时T细胞抗原受体库显著缩小。最近发现,常见的疱疹病毒——巨细胞病毒(CMV),能建立持续终身的感染,通常无症状,很可能是大多数老年人中CD8细胞克隆性扩增以及表型和功能改变的背后驱动力。在少数未感染CMV的人中,另一种更常见的疱疹病毒——爱泼斯坦-巴尔病毒,似乎也有同样的作用。这些由病毒驱动的变化在“成功老龄化”的百岁老人中不太明显,但在纵向研究显示死亡风险较高的人群中最为明显,即那些具有以CD4:8比值倒置(主要由CD8(+) CD28(-)细胞积累所致)为特征的“免疫风险谱”(IRP)的人。这些发现支持了这样一种假说,即持续性疱疹病毒,尤其是CMV,作为慢性抗原应激源,在免疫衰老及相关死亡率中起主要致病作用。

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