Merani Shahzma, Pawelec Graham, Kuchel George A, McElhaney Janet E
Health Sciences North Research Institute, Sudbury, ON, Canada.
Second Department of Internal Medicine, University of Tübingen Medical Center, Tübingen, Germany.
Front Immunol. 2017 Jul 17;8:784. doi: 10.3389/fimmu.2017.00784. eCollection 2017.
The number of people over the age of 60 is expected to double by 2050 according to the WHO. This emphasizes the need to ensure optimized resilience to health stressors in late life. In older adults, influenza is one of the leading causes of catastrophic disability (defined as the loss of independence in daily living and self-care activities). Influenza vaccination is generally perceived to be less protective in older adults, with some studies suggesting that the humoral immune response to the vaccine is further impaired in cytomegalovirus (CMV)-seropositive older people. CMV is a β-herpes virus infection that is generally asymptomatic in healthy individuals. The majority of older adults possess serum antibodies against the virus indicating latent infection. Age-related changes in T-cell-mediated immunity are augmented by CMV infection and may be associated with more serious complications of influenza infection. This review focuses on the impact of aging and CMV on immune cell function, the response to influenza infection and vaccination, and how the current understanding of aging and CMV can be used to design a more effective influenza vaccine for older adults. It is anticipated that efforts in this field will address the public health need for improved protection against influenza in older adults, particularly with regard to the serious complications leading to loss of independence.
根据世界卫生组织的数据，到2050年，60岁以上的人口数量预计将翻一番。这凸显了确保老年人在晚年对健康压力源具备最佳恢复力的必要性。在老年人中，流感是导致灾难性残疾（定义为日常生活和自我护理活动中失去独立性）的主要原因之一。人们普遍认为流感疫苗对老年人的保护作用较小，一些研究表明，巨细胞病毒（CMV）血清阳性的老年人对疫苗的体液免疫反应会进一步受损。CMV是一种β疱疹病毒感染，在健康个体中通常无症状。大多数老年人拥有针对该病毒的血清抗体，表明存在潜伏感染。CMV感染会加剧与年龄相关的T细胞介导免疫变化，并且可能与流感感染的更严重并发症有关。本综述重点关注衰老和CMV对免疫细胞功能、对流感感染和疫苗接种的反应的影响，以及如何利用目前对衰老和CMV的认识来设计一种对老年人更有效的流感疫苗。预计该领域的努力将满足改善老年人流感防护的公共卫生需求，特别是针对导致失去独立性的严重并发症方面。
