Department of Respiratory Medicine, Saitama Medical University, Saitama 350-0495, Japan.
Allergy Center, Saitama Medical University, Saitama 350-0495, Japan.
Biomolecules. 2022 Oct 11;12(10):1456. doi: 10.3390/biom12101456.
Prevalence of asthma in older adults is growing along with increasing global life expectancy. Due to poor clinical consequences such as high mortality, advancement in understanding the pathophysiology of asthma in older patients has been sought to provide prompt treatment for them. Age-related alterations of functions in the immune system and lung parenchyma occur throughout life. Alterations with advancing age are promoted by various stimuli, including pathobionts, fungi, viruses, pollutants, and damage-associated molecular patterns derived from impaired cells, abandoned cell debris, and senescent cells. Age-related changes in the innate and adaptive immune response, termed immunosenescence, includes impairment of phagocytosis and antigen presentation, enhancement of proinflammatory mediator generation, and production of senescence-associated secretory phenotype. Immnunosenescence could promote inflammaging (chronic low-grade inflammation) and contribute to late-onset adult asthma and asthma in the elderly, along with age-related pulmonary disease, such as chronic obstructive pulmonary disease and pulmonary fibrosis, due to lung parenchyma senescence. Aged patients with asthma exhibit local and systemic type 2 and non-type 2 inflammation, associated with clinical manifestations. Here, we discuss immunosenescence's contribution to the immune response and the combination of type 2 inflammation and inflammaging in asthma in the elderly and present an overview of age-related features in the immune system and lung structure.
随着全球预期寿命的延长，老年人群中哮喘的患病率也在不断增加。由于预后较差，如死亡率高，因此人们一直在努力深入了解老年患者哮喘的病理生理学，以便为他们提供及时的治疗。免疫系统和肺实质的功能随着年龄的增长而发生变化，这种变化贯穿人的一生。随着年龄的增长，各种刺激因素（包括共生菌、真菌、病毒、污染物以及源自受损细胞、废弃细胞碎片和衰老细胞的损伤相关分子模式）会促进这些改变。先天和适应性免疫反应的年龄相关性改变，称为免疫衰老，包括吞噬作用和抗原呈递受损、促炎介质生成增强以及衰老相关分泌表型的产生。免疫衰老可能会促进炎症衰老（慢性低度炎症），并导致老年人群中的迟发性成人哮喘和老年哮喘，以及与年龄相关的肺部疾病，如慢性阻塞性肺疾病和肺纤维化，这是由于肺实质衰老所致。患有哮喘的老年患者表现出局部和全身的 2 型和非 2 型炎症，与临床表现相关。在这里，我们讨论了免疫衰老对免疫反应的贡献，以及 2 型炎症和炎症衰老在老年哮喘中的组合，并概述了免疫系统和肺结构的年龄相关性特征。
