RESPIRATORY INFECTIONS, IMMUNITY, AND HEMOSTASIS IN AGING

急性病毒性呼吸道感染（阿尔蒂），尤其是由 呼吸道合胞病毒（RSV）和流感感染， 住院率过高，老年人死亡率上升。 此外，阿尔蒂是体弱多病患者非自愿不动的常见原因。 老年人，经常引发一连串的事件， 严重残疾，功能下降，随后丧失 独立 罗切斯特地区胡椒中心（RAPC）已经开始定义 流行病学、临床特征和对功能状态的影响 这些常见的疾病，重点放在体弱的老年人在设置 成人日托中心和长期护理机构是最脆弱的 老年人口。 一种假定的急性 感染和心血管事件是由越来越多的支持， 文学 这两个重要现象之间的共同联系可能 与炎症相关的止血系统改变， 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艾滋病的关系 止血系统可以导致许多特定的干预 包括靶向免疫、抗凝策略，或 通过改善营养来弥补免疫系统的缺陷。 的 提出的干预发展研究有以下目的：1。 将免疫应答的异质性定义为年龄的函数， 定义潜在的可逆方面。 2. 确定是否免疫 生物标志物可能是更严重阿尔蒂的预测因子。 3.评估主机 老年人对自然感染流感的反应。4. 确定与血管事件风险相关的止血参数， 同一批体弱的老年人。 5. 调查一下 急性病毒感染和血栓前状态。 6. 审判 免疫调节干预。 7. 评价低强度的作用 抗凝 设计了对照临床试验。 测试 将包括病毒诊断方法，细胞和体液的措施， 免疫、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.