RESPIRATORY INFECTIONS, IMMUNITY, AND HEMOSTASIS IN AGING

急性病毒性呼吸道感染，尤其是由 感染呼吸道合胞病毒(RSV)和流感，导致 老年人住院率过高和死亡率增加。 此外，ARTI是虚弱人群非自愿静止的常见原因。 老年人，经常引发一连串的事件，导致 严重的残疾、功能衰退和随后的丧失 独立。罗切斯特地区胡椒中心(RAPC)已经开始定义 该病的流行病学、临床特点及其对功能状态的影响 在这些常见疾病中，重点关注在 成人日托中心和长期护理机构是最脆弱的 老年人的人口数量。一种假定的急性呼吸道感染之间的联系 感染和心血管事件是由越来越多的 文学。这两个重要现象之间的共同联系可能 止血系统的改变是否与炎症性和 对病毒感染的免疫反应。更好地理解 老年人对感染的免疫反应及其与 止血系统可能导致许多特定的干预措施。 包括靶向免疫、抗凝策略或 通过改善营养来修复免疫系统的缺陷。这个 提出的干预发展研究有以下目的：1.干预发展研究。 将免疫反应的异质性定义为年龄和 定义潜在的可逆方面。2.确定是否有免疫力 生物标志物可能是更严重的ARTI的预测指标。3.评估主机 老年人对自然感染流感和RSF的反应。4. 确定与血管事件风险相关的止血参数 同样是一群体弱多病的老年人。5.调查两国之间的反应 急性病毒感染和血栓前状态。6.试行 免疫调节干预。7.评估低强度运动的作用 抗凝剂。对照临床试验已经设计完成。测试 将包括病毒诊断方法、细胞和体液的测量 免疫力、止血测定和老年功能评估。

Acute viral respiratory tract infection (ARTI), especially that caused by infection with respiratory syncytial virus (RSV) and influenza, causes excess rates of hospitalization and increased mortality in older persons. In addition, ARTI is a common cause of involuntary immobility in frail elderly, often setting into motion a cascade of events resulting in substantial disability, functional decline, and subsequent loss of independence. The Rochester AREA Pepper Center (RAPC) has begun to define the epidemiology, clinical characteristics, and impact on functional state of these common illnesses, focusing on the frail elderly in the setting of adult day centers and in long term care facilities as the most vulnerable populations of older persons. A postulated linkage between acute infection and cardiovascular events is supported by a growing body of literature. The common linkage between these two important phenomena may be alterations in the hemostatic system related to inflammatory and immunologic responses to viral infection. A better understanding of the immune response to infection in older persons, and its relationship with the hemostatic system may lead to a number of specific interventions including targeted immunization, anticoagulation strategies, or remediation of defects in the immune system by improved nutrition. The Intervention Development studies proposed have the following aims: 1. Define the heterogenicity of the immune response as a function of age and define potentially reversible aspects. 2. Determine whether immune biomarkers may be predictors of more severe ARTI. 3. Evaluate the host response of older persons to natural infection with influenza an RSF. 4. Identify hemostatic parameters associated with risk of vascular events in the same cohort of frail elderly. 5. Investigate the reaction between acute viral infection and a prothrombotic state. 6. Trial immunomodulatory interventions. 7. Evaluate the role of low intensity anticoagulation. Controlled clinical trials have been designed. Testing will include viral diagnostic methods, measures of cellular and humoral immunity, hemostatic determinations, and geriatric functional assessment.