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巨细胞病毒与人类免疫衰老

Cytomegalovirus and human immunosenescence.

作者信息

Pawelec Graham, Derhovanessian Evelyna, Larbi Anis, Strindhall Jan, Wikby Anders

机构信息

Center for Medical Research, University of Tübingen Medical School, Tübingen, Germany.

出版信息

Rev Med Virol. 2009 Jan;19(1):47-56. doi: 10.1002/rmv.598.

Abstract

'Immunosenescence' is an imprecise term used to describe deleterious age-associated changes to immune parameters observed in all mammals studied so far. Primarily anecdotal evidence implies that failing immunity is responsible for the increased incidence and severity of infectious disease in old people. However, there is a serious dearth of accurate hard data concerning the actual cause of death in the elderly and the contribution thereto of the multitude of age-associated alterations measured in the immune system. Cross-sectional studies comparing those currently young with those currently old reveal a large number of differences in the distribution of immune cell types in the blood, and to some extent the functional integrity of those cells. Many of these parameters differ markedly between individuals infected with CMV and uninfected people, regardless of infection with other persistent herpesviruses. The adaptive arm of immunity appears to be more seriously affected than the innate arm, particularly the T lymphocytes. However, cross-sectional studies suffer the disadvantage that like is not being compared with like, because the conditions applied during the entire life course of the currently elderly were different from those applied now to the young. These differences in environment, nutrition, pathology and possibly genetics, rather than merely age, may be expected to influence the parameters studied. Moreover, pathogen exposure of the currently elderly was also different from contemporary exposure, probably including CMV. Some of the problems associated with cross-sectional studies can be overcome by performing longitudinal studies, as pointed out in an earlier analysis of the Baltimore Longitudinal Ageing study looking at lymphocyte numbers. However, longitudinal studies are challenging in humans. Nonetheless, the pioneering Swedish OCTO/NONA studies of the very elderly which for the first time included a range of immune parameters, have identified a set of immune parameters predicting mortality at 2, 4 and 6 year follow-up; CMV infection makes a material contribution to this so-called 'immune risk profile (IRP)'. Whether the IRP is informative in younger individuals and the mechanism of the CMV effect is discussed in this review.

摘要

“免疫衰老”是一个不精确的术语,用于描述迄今在所有研究过的哺乳动物中观察到的与年龄相关的免疫参数有害变化。主要的传闻证据表明,免疫力下降是老年人传染病发病率和严重程度增加的原因。然而,关于老年人实际死因以及免疫系统中测量的众多与年龄相关的变化对其的贡献,严重缺乏准确的确凿数据。比较当前年轻人和老年人的横断面研究揭示了血液中免疫细胞类型分布以及这些细胞在一定程度上的功能完整性存在大量差异。无论是否感染其他持续性疱疹病毒,许多这些参数在感染巨细胞病毒(CMV)的个体和未感染个体之间都有显著差异。免疫的适应性分支似乎比先天性分支受到更严重的影响,尤其是T淋巴细胞。然而,横断面研究存在一个缺点,即并非同类相比,因为当前老年人一生所经历的条件与现在年轻人所经历的条件不同。这些环境、营养、病理以及可能的基因差异,而非仅仅是年龄差异,可能会影响所研究的参数。此外,当前老年人接触病原体的情况也与当代不同,可能包括CMV。正如早期对巴尔的摩纵向衰老研究中淋巴细胞数量分析所指出的,通过进行纵向研究可以克服一些与横断面研究相关的问题。然而,纵向研究在人类中具有挑战性。尽管如此,瑞典对高龄老人进行的开创性OCTO/NONA研究首次纳入了一系列免疫参数,已经确定了一组在2年、4年和6年随访中预测死亡率的免疫参数;CMV感染对这种所谓的“免疫风险谱(IRP)”有重要影响。本文综述讨论了IRP在较年轻个体中是否具有参考价值以及CMV作用的机制。

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