Zhang Danfeng, Cheng Jing, Cao Donghua, Sheng Kai
Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China.
Cent Eur J Immunol. 2025;50(1):3-10. doi: 10.5114/ceji.2025.149291. Epub 2025 May 5.
This study aimed to investigate the mechanisms of innate immunosenescence in elderly patients with sepsis and to evaluate the potential application of innate immune modulation strategies in clinical management. Through a literature review, the characteristics of sepsis in the elderly, the aging mechanisms of the innate immune system, the impact of immunosenescence on susceptibility to sepsis, and clinical management strategies for sepsis in the elderly were analyzed. The incidence and mortality rates of sepsis in the elderly increase significantly with age, closely related to the severity of infection, the high prevalence of comorbidities, atypical symptoms, and a greater risk of multi-organ failure. Innate immunosenescence, including the decline in function of neutrophils, monocytes/macrophages, natural killer cells, and dendritic cells, is a key factor in the increased susceptibility to sepsis in the elderly. Immunomodulatory treatments, such as granulocyte colony-stimulating factor (G-CSF), interferon (IFN-), and granulocyte-macrophage colony-stimulating factor (GM-CSF), show potential in improving the prognosis of elderly patients with sepsis and reducing mortality rates. The management of sepsis in the elderly requires a comprehensive approach that takes into account age-related physiological and pathological changes, as well as early diagnosis and proactive intervention measures. Immunomodulatory strategies targeting the unique characteristics of immunosenescence in the elderly offer new avenues for improving survival rates and treatment outcomes in elderly patients with sepsis.
本研究旨在探讨老年脓毒症患者先天性免疫衰老的机制，并评估先天性免疫调节策略在临床管理中的潜在应用。通过文献综述，分析了老年脓毒症的特征、先天性免疫系统的衰老机制、免疫衰老对脓毒症易感性的影响以及老年脓毒症的临床管理策略。老年脓毒症的发病率和死亡率随年龄显著增加，与感染严重程度、合并症高患病率、非典型症状以及多器官功能衰竭的高风险密切相关。先天性免疫衰老，包括中性粒细胞、单核细胞/巨噬细胞、自然杀伤细胞和树突状细胞功能的下降，是老年脓毒症易感性增加的关键因素。免疫调节治疗，如粒细胞集落刺激因子（G-CSF）、干扰素（IFN-）和粒细胞-巨噬细胞集落刺激因子（GM-CSF），在改善老年脓毒症患者预后和降低死亡率方面显示出潜力。老年脓毒症的管理需要综合考虑与年龄相关的生理和病理变化以及早期诊断和积极干预措施的方法。针对老年免疫衰老独特特征的免疫调节策略为提高老年脓毒症患者的生存率和治疗效果提供了新途径。
