Boe D M, Boule L A, Kovacs E J
Division of GI, Endocrine and Tumor Surgery, Department of Surgery, Mucosal Inflammation Program, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA.
Clin Exp Immunol. 2017 Jan;187(1):16-25. doi: 10.1111/cei.12881. Epub 2016 Nov 2.
The world is undergoing an unprecedented shift in demographics, with the number of individuals over the age of 60 years projected to reach 2 billion or more by 2050, representing 22% of the global population. Elderly people are at a higher risk for chronic disease and more susceptible to infection, due in part to age-related dysfunction of the immune system resulting from low-grade chronic inflammation known as 'inflamm-ageing'. The innate immune system of older individuals exhibits a diminished ability to respond to microbial threats and clear infections, resulting in a greater occurrence of many infectious diseases in elderly people. In particular, the incidence of and mortality from lung infections increase sharply with age, with such infections often leading to worse outcomes, prolonged hospital stays and life-threatening complications, such as sepsis or acute respiratory distress syndrome. In this review, we highlight research on bacterial pneumonias and pulmonary viral infections and discuss age-related changes in innate immunity that contribute to the higher rate of these infections in older populations. By understanding more clearly the innate immune defects in elderly individuals, we can design age-specific therapies to address lung infections in such a vulnerable population.
世界正经历前所未有的人口结构转变,预计到2050年,60岁及以上的人口数量将达到20亿或更多,占全球人口的22%。老年人患慢性病的风险更高,更容易受到感染,部分原因是由于称为“炎症衰老”的低度慢性炎症导致免疫系统出现与年龄相关的功能障碍。老年人的先天免疫系统对微生物威胁作出反应和清除感染的能力减弱,导致老年人中许多传染病的发生率更高。特别是,肺部感染的发病率和死亡率随年龄急剧增加,此类感染往往导致更差的结果、延长住院时间以及危及生命的并发症,如败血症或急性呼吸窘迫综合征。在本综述中,我们重点介绍了关于细菌性肺炎和肺部病毒感染的研究,并讨论了先天免疫方面与年龄相关的变化,这些变化导致老年人群中这些感染的发生率更高。通过更清楚地了解老年人的先天免疫缺陷,我们可以设计针对特定年龄的疗法来应对这一脆弱人群中的肺部感染。