The immune risk phenotype is associated with IL-6 in the terminal decline stage: Findings from the Swedish NONA immune longitudinal study of very late life functioning

Wikby, Anders; Nilsson, Bengt J.; Forsey, Rosalyn; Thompson, Julie M.; Strindhall, Jan; Löfgren, Sture; Ernerudh, Jan; Pawelec, Graham; Ferguson, Frederick G.; Johansson, Boo

doi:10.1016/j.mad.2006.04.003

Cited by 239 publications

(174 citation statements)

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“…This may be due partly to the younger age of the patients with B‐CLL compared with studies of healthy elderly people, which have focused predominantly on those between 70 and 100 years of age 11, 28, 29. In addition, the detrimental impact of chronic HCMV on the health of older people has been linked with elevated levels of inflammatory markers, including IL‐6 23, 30, 31, which are often already increased in patients with B‐CLL and may therefore confound any impact of HCMV on further health outcomes 32, 33. It may also suggest that any negative effect of HCMV infection in the elderly is outweighed by a diagnosis of B‐CLL.…”

Section: Discussionmentioning

confidence: 99%

Cytomegalovirus infection does not impact on survival or time to first treatment in patients with chronic lymphocytic leukemia

et al. 2016

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Human cytomegalovirus (HCMV) is a widely prevalent herpes virus which establishes a state of chronic infection. The establishment of CMV‐specific immunity controls viral reactivation and leads to the accumulation of very large numbers of virus‐specific T cells which come to dominate the immune repertoire. There is concern that this may reduce the immune response to heterologous infections and HCMV infection has been associated with reduced survival in elderly people. Patients with chronic lymphocytic leukemia (B‐CLL) suffer from a state of immune suppression but have a paradoxical increase in the magnitude of the CMV‐specific T cell and humoral immune response. As such, there is now considerable interest in how CMV infection impacts on the clinical outcome of patients with B‐CLL. Utilizing a large prospective cohort of patients with B‐CLL (n = 347) we evaluated the relationship between HCMV seropositivity and patient outcome. HCMV seropositive patients had significantly worse overall survival than HCMV negative patients in univariate analysis (HR = 2.28, 95% CI: 1.34–3.88; P = 0.002). However, CMV seropositive patients were 4 years older than seronegative donors and this survival difference was lost in multivariate modeling adjusted for age and other validated prognostic markers (P = 0.34). No significant difference was found in multivariate modeling between HCMV positive and negative patients in relation to the time to first treatment (HR = 1.12, 95% CI: 0.68–1.84; P = 0.65). These findings in a second independent cohort of 236 B‐CLL patients were validated. In conclusion no evidence that HCMV impacts on the clinical outcome of patients with B‐CLL was found. Am. J. Hematol. 91:776–781, 2016. © 2016 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Cytomegalovirus infection does not impact on survival or time to first treatment in patients with chronic lymphocytic leukemia

et al. 2016

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“…11 The term immunosenescence refers to age-related changes in both the innate and adaptive immune systems associated to morbidity and mortality and reduction in vaccines responses. 7,14,15 In older adults, these changes seem to be linked to pro-inflammatory pathway (Inflamm-Aging), even if the mechanism is not completely understood (cellular damage? endogenous activators?…”

Section: Immunology Of Aging In Hiv-infected Patientsmentioning

confidence: 99%

“…hormonal changes?). Main data of immunosenescence associated to increased mortality in elderly derive from OCTO/NONA cohorts 15 (2 longitudinal studies in Swedish octogenarians or nonagenarians). In these studies the inversion of the CD4/ CD8 ratio (less than 1) and the expansion of terminally differentiated cytotoxic T cells, associated to raised levels of pro-inflammatory cytokines and to seropositivity to cytomegalovirus (CMV), 15 were linked to higher morbidity and mortality in healthy elderly individuals.…”

Section: Immunology Of Aging In Hiv-infected Patientsmentioning

confidence: 99%

Immunosenescence and hurdles in the clinical management of older HIV-patients

2017

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People living with HIV (PLWH) who are treated with effective highly active antiretroviral therapy (HAART) have a similar life expectancy to the general population. Moreover, an increasing proportion of new HIV diagnoses are made in people older than 50 y. The number of older HIVinfected patients is thus constantly growing and it is expected that by 2030 around 70% of PLWH will be more than 50 y old. On the other hand, HIV infection itself is responsible for accelerated immunosenescence, a progressive decline of immune system function in both the adaptive and the innate arm, which impairs the ability of an individual to respond to infections and to give rise to long-term immunity; furthermore, older patients tend to have a worse immunological response to HAART.In this review we focus on the pathogenesis of HIV-induced immunosenescence and on the clinical management of older HIV-infected patients.

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“…52). In the NONA immune study, the IRP was also examined in the context of lowgrade inflammation (124). The IRP and low-grade inflammation were found to be major independent predictors of survival, an outcome that was not significantly affected by the individuals' health status.…”

Section: T Cells At the Population Levelmentioning

confidence: 99%

“…23,41,96,97,116). Within this scenario, the age-related changes in body composition (loss of muscle/bone mass and increase of fat mass) (84), insulin growth factor 1/insulin pathway (36), as well as inflammatory phenomena occurring in the central nervous system are also emerging as critical influences on the development of frailty and major age-related diseases (59,121,124).…”

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confidence: 99%