Guidi L, Tricerri A, Frasca D, Vangeli M, Errani A R, Bartoloni C
Istituto di Medicina Interna e Geriatria, Università Cattolica del S. Cuore, Roma, Italia.
Gerontology. 1998;44(5):247-61. doi: 10.1159/000022021.
The senescence of the immune system is a complex phenomenon, characterized by impairment of several lymphocyte activities and generally considered a state of immune dysregulation. Aging is a condition associated with many social changes likely to induce psychological stress, which is often perceived as uncontrollable and can lead, in some cases, to clinically relevant depression. In the recent years a growing interest has been raised for the study of bidirectional interactions between the central nervous system and the immunological network (psychoneuroimmunology).
We analyzed the possibility that chronic psychological distress and depression could worsen some immune functions in the aged. We postulate the neuroendocrine mechanisms of psychoimmune interaction, analyzing both the human and animal studies focused on aging.
The data from the literature reviewed suggest a significant impact of affective disorders on immune functions in the elderly subjects. This psychoimmune imbalance appears particularly important when the studies are carried out in otherwise healthy aged people.
Here we reviewed the relationships between psychological stress and depression and immunological functions, with particular regard to those aspects pertinent to the aging process. The clinical relevance of these interactions remains to be elucidated, but the high frequency in the aged of autoimmune, infectious, and neoplastic diseases suggests to focus on the psychoneuroimmune interactions in the old age. We also propose some outlines for future studies concerning psychoneuroimmunology and aging.
免疫系统的衰老 是一种复杂的现象，其特征是多种淋巴细胞活性受损，通常被认为是一种免疫失调状态。衰老与许多可能引发心理压力的社会变化相关，这种压力常被视为无法控制，在某些情况下可导致具有临床意义的抑郁症。近年来，人们对中枢神经系统与免疫网络之间的双向相互作用（心理神经免疫学）的研究兴趣日益浓厚。
我们分析了慢性心理困扰和抑郁症可能会使老年人的某些免疫功能恶化的可能性。我们假定了心理免疫相互作用的神经内分泌机制，分析了针对衰老的人体和动物研究。
综述文献中的数据表明，情感障碍对老年受试者的免疫功能有重大影响。当在其他方面健康的老年人中进行研究时，这种心理免疫失衡显得尤为重要。
在此，我们综述了心理压力和抑郁症与免疫功能之间的关系，特别关注与衰老过程相关的那些方面。这些相互作用的临床相关性仍有待阐明，但自身免疫性、感染性和肿瘤性疾病在老年人中的高发病率表明，应关注老年期的心理神经免疫相互作用。我们还为未来关于心理神经免疫学与衰老的研究提出了一些纲要。
