Cutaneous‐Delayed Hypersensitivity in Nursing Home and Geriatric Clinic Patients

Rodysill, Kirk J.; Hansen, Linda K.; O’Leary, James J.

doi:10.1111/j.1532-5415.1989.tb02640.x

Cited by 24 publications

(10 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Diminished immune responses among elderly individuals include demonstration of decreased delayed hypersensitivity, lower antibody titer in response to vaccination [11,12], low rates of seroconversion following vaccination, increased risk of death from influenza or pneumonia [13], and more frequent reemergence of tuberculosis [14] relative to younger individuals.…”

Section: Discussionmentioning

confidence: 99%

Renal transplant recipients over aged 60 have diminished immune activity and a low risk of rejection

et al. 2004

View full text Add to dashboard Cite

Strict consideration of the renal transplant candidate's chronologic age is generally supplanted by more subjective reflection on his (her) physiologic state. In the US, patients over 64 years old represented 9.0% of renal transplant recipients in the year 2000, yet little prior experience is available with which to guide the management of geriatric patients. Two hundred and forty six consecutive recipients of primary kidney transplants at the Yale-New Haven Organ Transplant Center between 1990 and 1995 were included in an outcome analysis. Age at transplantation ranged from 2 to 68 years; the study group consisted of the 16 (6.5%) over age 60. The immunosuppressive protocol was uniform for all patients. There was a disproportionately high use of cadaveric organs by older patients; only 1/16 (6.3%) received a living donor kidney. The overall rate of rejection within the first 90 days was 6.7% of cadaveric recipients over 60 versus 37.6% of younger recipients, P=0.001. Actual patient survival rates at 6 years were 100% of patients younger than 11 years versus 69% (11/16) of those older than 60 years. Death censored 5 year graft survival was 100% in older patients versus 85% among the younger patients. The older and younger patients received quantitatively equivalent immunosuppression, but acute rejection was uncommon in the former (6%) versus the younger cohort (34%). It seems logical to consider whether older renal transplant recipients may benefit from a less aggressive immunosuppression strategy.

show abstract

Section: Discussionmentioning

confidence: 99%

Renal transplant recipients over aged 60 have diminished immune activity and a low risk of rejection

et al. 2004

View full text Add to dashboard Cite

show abstract

“…The possibility of false negative responses was considered. It has been shown that age (both the very young and the very old) can be responsible for false negative TST reactivity [27], [28] but other causes of false negative results include immunosuppression [29], overwhelming TB infection [30], other viral [29], [31] or bacterial infections [32] and recent viral vaccinations [33], [34]. In our study the TST and blood collection were only performed on healthy children and HIV rates in infants are very low in The Gambia suggesting the lack of TST reactivity observed in some individuals was not due to false negative responses.…”

Section: Discussionmentioning

confidence: 99%

The Tuberculin Skin Test (TST) Is Affected by Recent BCG Vaccination but Not by Exposure to Non-Tuberculosis Mycobacteria (NTM) during Early Life

et al. 2010

View full text Add to dashboard Cite

The tuberculin skin test (TST) is widely used in TB clinics to aid Mycobacterium tuberculosis (M.tb) diagnosis, but the definition and the significance of a positive test in very young children is still unclear. This study compared the TST in Gambian children at 4½ months of age who either received BCG vaccination at birth (Group 1) or were BCG naïve (Group 2) in order to examine the role of BCG vaccination and/or exposure to environmental mycobacteria in TST reactivity at this age. Nearly half of the BCG vaccinated children had a positive TST (≥5 mm) whereas all the BCG naïve children were non-reactive, confirming that recent BCG vaccination affects TST reactivity. The BCG naïve children demonstrated in vitro PPD responses in peripheral blood in the absence of TST reactivity, supporting exposure to and priming by environmental mycobacterial antigens. Group 2 were then vaccinated at 4½ months of age and a repeat TST was performed at 20–28 months of age. Positive reactivity (≥5 mm) was evident in 11.1% and 12.5% infants from Group 1 and Group 2 respectively suggesting that the timing of BCG vaccination had little effect by this age. We further assessed for immune correlates in peripheral blood at 4½ months of age. Mycobacterial specific IFNγ responses were greater in TST responders than in non-responders, although the size of induration did not correlate with IFNγ. However the IFNγ: IL-10 ratio positively correlated with TST induration suggesting that the relationship between PPD induced IFNγ and IL-10 in the peripheral blood may be important in controlling TST reactivity. Collectively these data provide further insights into how the TST is regulated in early life, and how a positive response might be interpreted.

show abstract

“…T cells in DTH response and age-associated defects in T-cells, it is expected that aging would decrease DTH response. Indeed, the elderly individuals exhibit impaired DTH response (the number of positive responses and/or diameter of induration) [42][43], which are correlated with their greater morbidity and mortality [44][45][46].…”

Section: Source Of Immune Cellsmentioning

confidence: 99%

Nutritional modulation of age-related changes in the immune system and risk of infection

Pae

2017

Nutrition Research

View full text Add to dashboard Cite

The immune system undergoes some adverse alterations during aging, many of which have been implicated in the increased morbidity and mortality associated with infection in the elderly. In addition to intrinsic changes to the immune system with aging, the elderly are more likely to have poor nutritional status, which further impacts the already impaired immune function. Although the elderly often have low zinc serum levels, several manifestations commonly observed during zinc deficiency are similar to the changes in immune function with aging. In the case of vitamin E, although its deficiency is rare, the intake above recommended levels is shown to enhance immune functions in the elderly and to reduce the risk of acquiring upper respiratory infections in nursing home residents. Vitamin D is a critical vitamin in bone metabolism, and its deficiency is far more common, which has been linked to increased risk of infection as demonstrated in a number of observational studies including those in the elderly. In this review, we focus on zinc, vitamin E, and vitamin D, the 3 nutrients which are relatively well documented for their roles in impacting immune function and infection in the elderly, to discuss the findings in this context reported in both the observational studies and interventional clinical trials. A perspective will be provided based on the analysis of information under review.

show abstract

Cutaneous‐Delayed Hypersensitivity in Nursing Home and Geriatric Clinic Patients

Cited by 24 publications

References 29 publications

Renal transplant recipients over aged 60 have diminished immune activity and a low risk of rejection

Renal transplant recipients over aged 60 have diminished immune activity and a low risk of rejection

The Tuberculin Skin Test (TST) Is Affected by Recent BCG Vaccination but Not by Exposure to Non-Tuberculosis Mycobacteria (NTM) during Early Life

Nutritional modulation of age-related changes in the immune system and risk of infection

Contact Info

Product

Resources

About