Immunosupportive therapies in aging

Abstract

The primary role of the immune system is to protect the organism against pathogens, but age-associated alterations to immunity increase the susceptibility of the elderly to infectious disease. The exact nature of these changes is still controversial, but the use of screening procedures, such as the SENIEUR protocol to exclude underlying illness, helped to better characterize the changes actually related to physiological aging rather than pathology. It is generally agreed that the most marked changes occur in the cellular immune response reflecting profound alterations in T cells. Much of this is due to thymic involution as well as changes in the proportions of T cell subpopulations resulting from antigen exposure, and altered T cell activation pathways. However, a body of data indicates that innate immune responses, including the critical bridge between innate and adaptive immunity, and antigen presenting capacity are not completely resistant to senescence processes. The consequences of all these alterations are an increased incidence of infections, as well as possibly cancers, autoimmune disorders, and chronic inflammatory diseases. The leading question is what, if anything, can we do to prevent these deleterious changes without dangerously dysregulating the precarious balance of productive immunity versus immunopathology? There are many potential new therapeutic means now available to modulate immunosenescence and many others are expected to be available shortly. One main problem in applying these experimental therapies is ethical: there is a common feeling that as ageing is not a disease; the elderly are not sick and therefore do not require adventurous therapies with unpredictable side-effects in mostly frail individuals. Animal models are not helpful in this context. In this chapter we will first briefly review what we think we know about human immunosenescence and its consequences for the health status of elderly individuals. We will then discuss possible interventions that might one day become applicable in an appropriate ethical environment.

Bladder cancer in the elderly

“…17,19,20,35-38 Declining T cell function is the most significant and best-characterized feature of immunosenescence. 27,35-38 The immune system is thought to play an important role in the development and progression of cancer. Weakening of individual components of this system is thought to compromise an individual's overall defense against the development and progression of cancer.…”

“…Deterioration of the immune system with aging includes a decrease in thymic mass with concomitant decrease in subpopulations of lymphocytes that comprise the thymus, decreased production in thymic hormones, a general decrease in subpopulations of antigen-processing and effector lymphocytes, and a decrease in antibody response. 35-38 This has been suggested to explain, at least in part, the increased vulnerability to the development of cancer as people age.…”

Good's Syndrome Accompanied by Agranulocytosis Following a Rapid Clinical Course

“…Immunodeficiency in elderly patients is most often secondary immunodeficiency, caused by malignant tumors, infectious diseases, malnutrition, metabolic diseases, and drugs (13). Care must therefore be taken in cases (such as patient of the present study), in whom primary immunodeficiency develops suddenly in old age, when it can be easily overlooked.…”

Faktor-Faktor Prediktor Serokonversi Pasca-Vaksinasi Influenza pada Lansia

“…Beberapa penelitian yang ada di antaranya menyebutkan bahwa peningkatan dosis vaksinasi, mempercepat jadwal vaksin, pemberian vaksin secara intradermal, vaksin-vaksin baru untuk infeksi kronis, adjuvan vaksin, probiotik, suplementasi diet dapat meningkatkan respons imun pada lansia. [4][5][6][7][8][9][10] Sampai saat ini, masih banyak penelitian yang dilakukan untuk mencari cara meningkatkan respon imun terhadap pemberian vaksinasi influenza pada lansia.…”