Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Sezione di Pneumologia, University of Palermo, Villa Sofia-Cervello Hospital, Palermo, Italy.
Respir Med. 2011 May;105(5):651-8. doi: 10.1016/j.rmed.2010.12.014. Epub 2011 Jan 8.
Aging is associated with modifications of the immune system, defined as immunosenescence. This could contribute to a reduced prevalence of allergic disease in the elderly population. In this regard, atopy has rarely been considered in the clinical assessment of the geriatric respiratory patient. This article is a review of the available literature assessing the impact of age on atopy. In the majority of papers, we found a lower prevalence of atopy in the most advanced ages, both in healthy subjects and in individuals affected by allergic respiratory diseases. Unfortunately, no large, longitudinal studies performed in the general population have been conducted to further explore this observation. Although available data seem to favor the decline of allergen sensitization with age, the prevalence of allergic sensitizations in the elderly population with respiratory symptoms is substantial enough to warrant evaluation of the atopic condition. From a clinical perspective, allergic reactions in older adults can have the same or even worse manifestations compared to young people. For this reasons, the evaluation of the atopic condition also in the geriatric patient is recommended. Thus, the role of atopy as it pertains to the diagnosis, therapy (adoption of preventive measure such as removal of environmental allergen or immunotherapy), and prognosis (influence on morbidity and mortality) of chronic respiratory illnesses in the elderly is addressed.
衰老是与免疫系统的改变相关的，这被定义为免疫衰老。这可能导致老年人中过敏疾病的患病率降低。在这方面，特应性在老年呼吸病患者的临床评估中很少被考虑。本文综述了评估年龄对特应性影响的现有文献。在大多数论文中，我们发现特应性在最年长的年龄组中，无论是在健康受试者还是在患有过敏性呼吸道疾病的个体中，其患病率都较低。不幸的是，尚未进行大规模的、针对普通人群的纵向研究来进一步探讨这一观察结果。尽管现有数据似乎支持过敏原致敏随年龄下降，但有呼吸道症状的老年人群中过敏致敏的患病率相当高，有必要评估特应性状况。从临床角度来看，老年人的过敏反应与年轻人一样，甚至更严重。出于这些原因，建议对老年患者也进行特应性状况的评估。因此，本文探讨了特应性与慢性呼吸道疾病在老年人中的诊断、治疗（如采用去除环境过敏原或免疫疗法等预防措施）和预后（对发病率和死亡率的影响）的关系。
