Inflammation and Immune System Alterations in Frailty

Xu, Yao; Li, Huifen; Leng, Sean X.

doi:10.1016/j.cger.2010.08.002

Cited by 174 publications

(147 citation statements)

References 52 publications

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“…As regard white blood cells count, we found significant increase in WBCs count (14.22 + 3.7 cmm) in frail group compared to both pre-frail (10.9 + 2.7 cmm) and non-frail (8.7 + 1.6 cmm) with significant elevation in pre-frail compared to nonfrail. This agrees with that obtained by Ruggiero et al Frailty is associated with increase in WBCs as well as CRP (which are recognized as an important markers of systemic inflammation), which suggests a role of inflammation in aging [19]. Interestingly, WBCs is the only biomarker in our study that showed significant difference between pre-frail and non-frail groups, suggesting that it may be useful for detection of pre-frailty, a suggestion that needs further studies to clarify.…”

Section: Methodssupporting

confidence: 82%

Study of Some Biomarkers in Frail Elderly

Abdelrahman¹,

Hussein²,

Deraz³

et al. 2013

Zagazig University Medical Journal

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Background: Frailty recognized as a common clinical syndrome associated wih a high rate of morbidity and mortality. Aim of the Study: This study aimed at assessing the value of determination of some biomarkers in identification and recruitment of frail elderly. The association between these biomarkers and stages of frailty were also assessed Subjects and Methods : A total number of 100 elderly subjects (above 65 years old) were included in the work divided into three groups : Group 1 (non-frail) included 34 subjects (19 males and 15 females), their ages ranged from 66.3 to 72.9 with mean 67.6 + 3.3 year; Group 2 (pre-frail) included 26 subjects (1 males and 15 females), their ages ranged from 65.5 to 73.1 with mean age of 69.3 + 3.8 year and Group 3 (frail) included 40 subjects (25 males and 15 females), their ages ranged from 67.9+ to 78.3 with mean age of 73.1+5.2 year.All subjects of this study were subjected to : thorough clinical examination, Anthropometric measures (including mid upper arm circumference, mid calf circumference, body mass index), Timed get-up-and-go test, hand grip strengh test and laboratory investigations (including complete blood picture, serum albumin, serum alanine transferase, INR. Prothrombin time and partial thromboplastin time, Cholesterol and C-reactive protein.Results: In our study; frailty recorded higher prevalence than most of epidemiological studies. Regarding CRP, there was significant increase in CRP level in frail group (27.4 + 8.1 mg/l) compared to both pre-frail (14.3 + 4.5 pg/ml) and non-frail groups (7.5 + 5.5 pg/ml). Regarding cholesterol, there was significant decrease in cholesterol level in frail group (125.7 + 54.9) compared to both pre-frail (168.1 + 17.2) and non-frail (165.3 + 29.7) groups. Regarding TGUGT, it was prolonged in frail group compared to both pre-frail and non-frail groups. Conclusions: There is high prevalence of frailty among studied elderly population, the causes of which need further studies to unravel. The changes in biomarkers noticed in our frail elderly may suggest its use in diagnosis and follow up of frailty, a suggestion that still in its infancy and needs further more studies to verify.

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Section: Methodssupporting

confidence: 82%

Study of Some Biomarkers in Frail Elderly

Abdelrahman¹,

Hussein²,

Deraz³

et al. 2013

Zagazig University Medical Journal

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“…The increased risk of infection following TKA in patients with RA compared with patients with OA persisted after adjusting for systematic differences between these groups in terms of health status (comorbidity and frailty) (53). In addition to being a source of considerable morbidity, each infected arthroplasty is estimated to cost Ͼ$30,000, on average, to manage (16).…”

Section: Discussionmentioning

confidence: 99%

Increased Risk of Complications Following Total Joint Arthroplasty in Patients With Rheumatoid Arthritis

Ravi

Croxford

Hollands

et al. 2014

Arthritis & Rheumatology

158

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Objective. Most of the evidence regarding complications following total hip arthroplasty (THA) and total knee arthroplasty (TKA) are based on patients with osteoarthritis (OA); less is known about outcomes in rheumatoid arthritis (RA). Using a validated algorithm for identifying patients with RA, we undertook this study to compare the rates of complications among THA and TKA recipients between those with RA and those without RA.Methods. In patients who underwent a first primary elective THA or TKA between 2002 and 2009, those with RA were identified using a validated algorithm: a hospitalization with a diagnosis code for RA or 3 physician billing claims with a diagnosis code for RA, with at least 1 claim by a specialist (rheumatologist, orthopedic surgeon, or internist) in a 2-year period. Recipients with diagnostic codes suggesting an inflammatory arthritis, but not meeting RA criteria, were classified as having inflammatory arthritis. All remaining patients were deemed to have OA. Cox proportional hazards models, censored on death, were used to determine the relationship between the type of arthritis and the occurrence of specific complications, adjusting for potential confounders (age, sex, comorbidity, and provider volume).Results. We identified 43,997 eligible THA recipients (3% with RA) and 71,793 eligible TKA recipients (4% with RA). Total joint arthroplasty recipients with RA had higher age and sex-standardized rates of dislocation following THA (2.45%, compared with 1.21% for recipients with OA) and higher age and sex-standardized rates of infection following TKA (1.26%, compared with 0.84% for recipients with OA). Controlling for potential confounders, recipients with RA remained at increased risk of dislocation within 2 years of THA (adjusted hazard ratio [HR] 1.91, P ‫؍‬ 0.001) and remained at increased risk of infection within 2 years of TKA (adjusted HR 1.47, P ‫؍‬ 0.03) relative to recipients with OA.Conclusion. Patients with RA are at higher risk of dislocation following THA and are at higher risk of infection following TKA relative to those with OA. Further research is warranted to elucidate explanations for these findings, including the roles of medication profile, implant choice, postoperative antibiotic protocol, and method of rehabilitation following joint replacement.

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“…Therefore, elevated IFN-γ may play an important role in the development of low-grade inflammation in the IL-10 tm/tm frail mouse. Although IL-10 and IFN-γ levels have not been extensively studied in human population studies on aging and frailty, in part because of limitations in measuring serum samples that have been stored for long periods of time, investigators have reported significant elevations in macrophages and other inflammatory cells in frail compared to non-frail humans (Leng et al 2009;Yao et al 2011). The chronic inflammatory pathway activation observed in frail, older adults is likely multifactorial and stems from chronic disease states, altered body composition, and increased production of free radicals rather than a deficit in IL-10 ( Walston et al 2006).…”

Section: Discussionmentioning

confidence: 99%

Inflammation and mortality in a frail mouse model

Qin

et al. 2011

AGE

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Mice homozygous for targeted deletion of the interleukin 10 gene (Il-10) have been partially characterized as a model for human frailty. These mice have increased serum interleukin (IL)-6 in midlife, skeletal muscle weakness, and an altered skeletal muscle gene expression profile compared to age and sex-matched C57BL/6 (B6) control mice. In order to further characterize for use as a frailty model, we evaluated the evolution of inflammatory pathway activation, endocrine change, and mortality in these mice. Serum was collected in groups of ageand sex-matched B6.129P2-Il10 tm1Cgn /J (IL-10 tm/tm ) mice and B6 control mice at age 12, 24, 48, 72, and 90 weeks. Cytokines including IL-6, interleukin 1 beta (IL-1β), tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), chemokine (C-X-C motif) ligand 1 (KC), IL-12, and IL-10 were measured using electro-chemiluminescent multiplex immunoassay and insulin-like growth factor 1 (IGF-1) was measured using solid-phase enzyme-linked immunosorbent assay. A separate longitudinal cohort was monitored from age 35 weeks to approximately 100 weeks. Survival was evaluated by Kaplan-Meier survival estimates and detailed necropsy information was gathered in a subset of mice that died or were sacrificed. In IL-10 tm/tm mice compared to B6 controls, serum IL-6, IL-1β, TNF-α, IFN-γ, KC levels were significantly elevated across the age groups, serum mean IGF-1 levels were higher in the 48-week-old groups, and overall mortality rate was significantly higher. The quadratic relationship between IGF-1 and age was significantly different between the two strains of mice. Serum IL-6 was positively associated with IGF-1 but the effect was significantly larger in IL-10 tm/tm mice. These findings provide additional rationale for the use of the IL-10 tm/tm mouse as a model for frailty and for lowgrade inflammatory pathway activation.

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Inflammation and Immune System Alterations in Frailty

Cited by 174 publications

References 52 publications

Study of Some Biomarkers in Frail Elderly

Study of Some Biomarkers in Frail Elderly

Increased Risk of Complications Following Total Joint Arthroplasty in Patients With Rheumatoid Arthritis

Inflammation and mortality in a frail mouse model

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