Farheen Saba, Agrawal Sudhanshu, Zubair Swaleha, Agrawal Anshu, Jamal Fauzia, Altaf Ishrat, Kashif Anwar Abu, Umair Syed Mohammad, Owais Mohammad
Interdisciplinary Biotechnology Unit, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, India.
Division of Basic and Clinical Immunology, Department of Medicine, University of California, Irvine, Irvine, CA, United States.
Front Aging. 2021 Dec 16;2:748591. doi: 10.3389/fragi.2021.748591. eCollection 2021.
During the last 2 years, the entire world has been severely devastated by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic (COVID-19) as it resulted in several million deaths across the globe. While the virus infects people indiscriminately, the casualty risk is higher mainly in old, and middle-aged COVID-19 patients. The incidences of COVID-19 associated co-morbidity and mortality have a great deal of correlation with the weakened and malfunctioning immune systems of elderly people. Presumably, due to the physiological changes associated with aging and because of possible comorbidities such as diabetes, hypertension, obesity, cardiovascular, and lung diseases, which are more common in elderly people, may be considered as the reason making the elderly vulnerable to the infection on one hand, and COVID-19 associated complications on the other. The accretion of senescent immune cells not only contributes to the deterioration of host defense, but also results in elevated inflammatory phenotype persuaded immune dysfunction. In the present review, we envisage to correlate functioning of the immune defense of older COVID-19 patients with secondary/super infection, increased susceptibility or aggravation against already existing cancer, infectious, autoimmune, and other chronic inflammatory diseases. Moreover, we have discussed how age-linked modulations in the immune system affect therapeutic response against administered drugs as well as immunological response to various prophylactic measures including vaccination in the elderly host. The present review also provides an insight into the intricate pathophysiology of the aging and the overall immune response of the host to SARS-CoV-2 infection. A better understanding of age-related immune dysfunction is likely to help us in the development of targeted preemptive strategies for deadly COVID-19 in elderly patients.
在过去两年里，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行（新冠肺炎）给整个世界带来了严重破坏，导致全球数百万人死亡。虽然该病毒不分青红皂白地感染人群，但伤亡风险主要在老年和中年新冠肺炎患者中更高。新冠肺炎相关合并症和死亡率的发生率与老年人免疫系统功能减弱和功能失调有很大关联。据推测，由于与衰老相关的生理变化以及糖尿病、高血压、肥胖症、心血管疾病和肺部疾病等可能的合并症在老年人中更为常见，一方面这些可能被视为老年人易受感染的原因，另一方面也是新冠肺炎相关并发症的原因。衰老免疫细胞的积累不仅导致宿主防御功能恶化，还会导致炎症表型升高，进而引发免疫功能障碍。在本综述中，我们设想将老年新冠肺炎患者的免疫防御功能与继发/超级感染、对已存在癌症、感染性、自身免疫性和其他慢性炎症性疾病的易感性增加或病情加重联系起来。此外,我们还讨论了免疫系统中与年龄相关的调节如何影响老年宿主对所用药物的治疗反应以及对包括疫苗接种在内的各种预防措施的免疫反应。本综述还深入探讨了衰老的复杂病理生理学以及宿主对SARS-CoV-2感染的整体免疫反应。更好地理解与年龄相关的免疫功能障碍可能有助于我们为老年患者制定针对致命性新冠肺炎的靶向预防策略。
