Immune function and vaccine responses in healthy advanced elderly patients
Immune function and vaccine responses in healthy advanced elderly patients
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DOI：
10.1001/archinte.160.13.2017
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发表时间：
2000-07-10
影响因子：
--
通讯作者：
Janoff, EN
中科院分区：
文献类型：
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作者：
Carson, PJ;Nichol, KL;Janoff, EN
背景：免疫功能的下降已被报道可预见地伴随着年龄的增长。然而，据我们所知，很少有研究专门描述了迅速扩大的先进的老年人口或控制适当的并发疾病。目的：评估是否成功地达到先进的年龄在良好的健康与保留的免疫功能。方法：我们前瞻性地比较了体内和体外变量的免疫功能在29个健康，独立生活的老年人受试者（平均年龄，80岁;年龄范围，75-103岁）和21名健康年轻对照受试者（平均年龄，29岁，年龄范围，25-35岁）。在体内，在老年和年轻受试者中，总白色血细胞、单核细胞、淋巴细胞，淋巴细胞亚群（CD 4（+）、CD 8（+）T淋巴细胞和CD 20（+）B细胞）、血清总IgG和IgM水平相似。只有血清伊加水平在老年受试者中较高（3.0 vs 1.7 g/L; P=.001）。在功能上，两组都对蛋白质（破伤风和白喉类毒素）和多糖（23价肺炎球菌）疫苗表现出强烈的反应。虽然杠杆变化，疫苗抗原特异性IgG的倍数增加在年轻和老年受试者中没有显著差异，并且IgG对肺炎球菌多糖14和19 F的亲合力在疫苗接种前后相似。血单个核细胞对T淋巴细胞和B细胞有丝分裂原的增殖反应（美洲商陆有丝分裂原、金黄色葡萄球菌科万菌株I和金黄色葡萄球菌科万菌株I加白细胞介素2）和脂多糖诱导的肿瘤坏死因子α的产生在老年受试者与年轻受试者中相当。成功的衰老，定义为达到一个人的整体健康完好的高龄，可能与保留的免疫功能和对疫苗的充分反应有关。
Background: Decline in immune function has been reported to predictably accompany advancing age. However, to our knowledge, few studies have specifically characterized the rapidly expanding advanced elderly population or controlled adequately for concurrent diseases.Objective: To assess whether successfully reaching an advanced age in good health is associated with preserved immune function.Methods: We prospectively compared in vivo with in vitro variables of immune function in 29 healthy, independently living elderly subjects (mean age, 80 years; age range, 75-103 years) and in 21 healthy young control subjects (mean age, 29 years, age range, 25-35 years) in a Veterans Affairs Medical Center.Results: In vivo, among elderly and young subjects, numbers of total white blood cells, monocytes, lymphocytes, and lymphocyte subsets (CD4(+) and CD8(+) T lymphocytes and CD20(+) B cells) were similar, as were levels of total serum IgG and IgM. Only levels of serum IgA were higher in the elderly subjects (3.0 vs 1.7 g/L; P=.001). Functionally, both groups showed vigorous responses to protein (tetanus and diphtheria toxoids) and polysaccharide (23-valent pneumococcal) vaccines. Although levers varied, the fold increases in vaccine antigen-specific IgG were not significantly different in young and elderly subjects, and the avidities of IgG to pneumococcal polysaccharides 14 and 19F were similar before and after vaccination. In vitro, proliferative responses of blood mononuclear cells to T-lymphocyte and B-cell mitogens (pokeweed mitogen, Staphylococcus aureus Cowan strain I, and S aureus Cowan strain I plus interleukin 2), and lipopolysaccharide-induced production of tumor necrosis factor alpha, were comparable in elderly vs young subjects.Conclusion: Successful aging, defined by reaching an advanced age with one's overall health intact, may be associated with preserved immune function and adequate responses to vaccines.