Common Variable Immunodeficiency in Elderly Patients: A Long-Term Clinical Experience

Danieli, Maria Giovanna; Mezzanotte, Cristina; Verga, Jacopo Umberto; Menghini, Denise; Pedini, Veronica; Bilò, Maria Beatrice; Moroncini, Gianluca

doi:10.3390/biomedicines10030635

Cited by 2 publications

(1 citation statement)

References 37 publications

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“…In fact, some elderly experience some clinical symptoms and signs that suggest a mild impairment of the immune response. Clinicians must be aware of certain patterns such as recurrent infections, chronic diarrhea, malabsorption and coexistence of infection, autoimmunity and malignancy ( 60 ). The management of elderly people with possible deficiency in the immune response must include the distinction between a primary and a secondary immunodeficiency ( 61 ).…”

Section: Functional Assessment Of Immunosenescencementioning

confidence: 99%

Investigating population-level immunosenescence: From bench to bedside

2022

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The immune response is remodeled with aging in a process called immunosenescence. Some immunologists conceive immunosenescence as an adaptation of immunity to the aged immune-environment rather than a merely collapsed reactivity of immune cells against microbes and tumor cells. Others believe on an uninterrupted activation of the innate immune system with aging, leading to a low grade, sterile and chronic proinflammatory state called inflammaging. For instance, it is possible that chronic infection by cytomegalovirus leads to persistent production of viral load. This phenomenon offers periodic stimuli to the immune system that ultimately contribute to the remodeling of the immune response. If investigating immunosenescence at the cellular level is already a difficult task, considering the population level is much more complex. However, by studying immunosenescence at the population level, we can extract valuable results with viable applications. While studies with animal models allow scientists to deepen their understanding of the mechanisms of immunosenescence, studying large populations can bring practical innovations to medicine and the health system. Many researchers and funders have dedicated themselves to producing methods for the evaluation of immunosenescence on a large scale, aiming to elucidate new mechanisms by which diseases are established in the elderly. The description of how the immune response is remodeled with aging emerges as a new tool to identify the subset of subjects in which unhealthy aging is a matter of time, to help better individualize clinical management and select patients who may benefit. of early interventions. This review focuses on functional assays as valuable methods for measuring the remodeling of the immune response with aging and discuss their clinical impact. We also recall fundamental concepts for understanding the aging process of the immune response. In addition, we highlight future prospects for immunosenescence research.

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Section: Functional Assessment Of Immunosenescencementioning

confidence: 99%

Investigating population-level immunosenescence: From bench to bedside

2022

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Newly identified common variable immunodeficiency in an elderly patient with rheumatoid arthritis

Moskaletc,

Tchuksina

2023

Kazan Med J

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Common variable immunodeficiency is a group of heterogeneous diseases that are primary immunodeficiencies with a predominant lack of antibody synthesis. The most common manifestation is chronic infectious pathology of the respiratory tract, less often of the gastrointestinal tract, as well as septic arthritis. Non-infectious manifestations include autoimmune diseases, non-infectious diarrhea, cancer, benign lymphoid hyperplasia. In one patient, a combination of several syndromes is possible. Unlike most other primary immunodeficiencies that debut in early childhood, this pathology often manifests in the third or fourth decade of life, and sometimes later in apparently healthy people. Although the routine laboratory method for determining the concentration of the main classes of immunoglobulins makes it quite easy to identify patients with common variable immunodeficiency, often the diagnosis is made many years after the onset of the first clinical symptoms, when serious complications have already developed. The disease is characterized by a gradual onset, chronic progressive course and ineffectiveness of standard therapy. The main method of treatment is lifelong replacement therapy with intravenous immunoglobulins. The article considers a clinical case when an elderly patient with seronegative rheumatoid arthritis with a juvenile onset was diagnosed many years later. The results of immunological studies, including immunophenotyping of peripheral blood and bone marrow lymphocytes, are presented. Issues of differential diagnosis with secondary hypogammaglobulinemia and lymphoproliferative diseases are highlighted. It has been stated that until now, doctors of various specialties are not sufficiently familiar with the problem of primary immunodeficiencies, especially when it comes to adults, and non-infectious manifestations dominate in the clinical picture.

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Common Variable Immunodeficiency in Elderly Patients: A Long-Term Clinical Experience

Cited by 2 publications

References 37 publications

Investigating population-level immunosenescence: From bench to bedside

Investigating population-level immunosenescence: From bench to bedside

Newly identified common variable immunodeficiency in an elderly patient with rheumatoid arthritis

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