Department of Pediatrics, National Jewish Health, University of Colorado School of Medicine, Denver, Colo., USA.
Gerontology. 2014;60(2):99-107. doi: 10.1159/000355307. Epub 2013 Dec 3.
This review focuses on 3 allergic disorders of persons coming up against venerable age: asthma, allergic rhinitis, and atopic dermatitis. The prevalence of allergic diseases in the elderly ranges from 5 to 10% and appears to be rising. A gradual decline in immune function, termed immunosenescence, and age-related changes in tissue structure influence the development of these disorders. Common complications are comorbidities, polypharmacy, and adverse effects of drugs. The elderly have difficulty mounting protective immune responses against newly encountered antigens. The integrity of epithelial barriers is compromised, leading to a chronic, subclinical inflammatory state and an enhanced Th2 (allergic) immune response. Undiagnosed asthma is frequent in elderly persons (about 8%) and still more commonplace in those with respiratory symptoms. Poorly controlled asthma in the elderly undermines their functional status and leads to a loss of autonomy and social isolation that may delay seeking medical services. Aggravation of allergic rhinitis coincides with exacerbation of asthma, whereas treatment of nasal inflammation improves control of the asthma. Atopic dermatitis is a chronically relapsing inflammatory skin disease often associated with respiratory allergy.
本综述重点介绍了老年人中常见的 3 种过敏性疾病:哮喘、过敏性鼻炎和特应性皮炎。老年人过敏性疾病的患病率为 5%至 10%,且呈上升趋势。免疫功能逐渐下降,即免疫衰老,以及与年龄相关的组织结构变化,影响这些疾病的发生。常见的并发症有合并症、多种药物治疗和药物不良反应。老年人难以对新遇到的抗原产生保护性免疫反应。上皮屏障的完整性受损,导致慢性、亚临床炎症状态和增强的 Th2(过敏)免疫反应。未确诊的哮喘在老年人中很常见(约 8%),在有呼吸道症状的人群中更为常见。老年人哮喘控制不佳会损害其功能状态,并导致丧失独立性和社会隔离,从而可能延迟就医。过敏性鼻炎的恶化与哮喘的恶化同时发生,而治疗鼻腔炎症可改善哮喘的控制。特应性皮炎是一种慢性复发性炎症性皮肤病,常与呼吸道过敏有关。