Th1/Th2 immune regulation and functional resilience in older adults following severe COVID-19: a prospective cohort study.

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

European Geriatric Medicine Pub Date : 2025-08-31 DOI:10.1007/s41999-025-01293-x

Daniela Cataneo-Piña, Leslie Chávez-Galán, Ranferi Ocaña-Guzmán, José Alberto Ávila-Funes, Tamas Fulop, Ivette Buendia-Roldan

{"title":"Th1/Th2 immune regulation and functional resilience in older adults following severe COVID-19: a prospective cohort study.","authors":"Daniela Cataneo-Piña, Leslie Chávez-Galán, Ranferi Ocaña-Guzmán, José Alberto Ávila-Funes, Tamas Fulop, Ivette Buendia-Roldan","doi":"10.1007/s41999-025-01293-x","DOIUrl":null,"url":null,"abstract":"Background: Older adults recovering from severe COVID-19 exhibit heterogeneous trajectories, ranging from persistent frailty to full functional recovery. The biological mechanisms underpinning resilience in this population remain poorly defined. This study aimed to investigate the association between Th1/Th2 immune regulation and functional resilience, defined as improvement in frailty status, among older survivors of severe COVID-19.Methods: We conducted a prospective study at a tertiary respiratory center in Mexico. Twenty-four patients aged 65 or older with a history of severe COVID-19 were assessed at 4 and 12 months post-discharge. Frailty was evaluated using a validated phenotype adapted for the Mexican population. Peripheral blood mononuclear cells (PBMCs) were analyzed by flow cytometry to quantify CD4+ T cell subsets, cytokine production (IFN-γ, TNF, and IL-10), and the expression of T-bet, GATA-3, and TIM-3.Results: Thirteen participants showed improved frailty status over 12 months. Resilient patients exhibited a higher Th1/Th2 (T-bet/GATA-3) ratio at 4 months post-discharge and increased IFN-γ and TNF production at 12 months. TIM-3 expression on CD4+ cells and circulating levels were also elevated in the resilient group.Conclusions: A Th1-skewed immune profile early after recovery and sustained proinflammatory cytokine activity are associated with resilience in older adults following severe COVID-19. These findings offer insight into immune mechanisms that may support functional recovery in aging populations.","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Geriatric Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s41999-025-01293-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Older adults recovering from severe COVID-19 exhibit heterogeneous trajectories, ranging from persistent frailty to full functional recovery. The biological mechanisms underpinning resilience in this population remain poorly defined. This study aimed to investigate the association between Th1/Th2 immune regulation and functional resilience, defined as improvement in frailty status, among older survivors of severe COVID-19.

Methods: We conducted a prospective study at a tertiary respiratory center in Mexico. Twenty-four patients aged 65 or older with a history of severe COVID-19 were assessed at 4 and 12 months post-discharge. Frailty was evaluated using a validated phenotype adapted for the Mexican population. Peripheral blood mononuclear cells (PBMCs) were analyzed by flow cytometry to quantify CD4+ T cell subsets, cytokine production (IFN-γ, TNF, and IL-10), and the expression of T-bet, GATA-3, and TIM-3.

Results: Thirteen participants showed improved frailty status over 12 months. Resilient patients exhibited a higher Th1/Th2 (T-bet/GATA-3) ratio at 4 months post-discharge and increased IFN-γ and TNF production at 12 months. TIM-3 expression on CD4+ cells and circulating levels were also elevated in the resilient group.

Conclusions: A Th1-skewed immune profile early after recovery and sustained proinflammatory cytokine activity are associated with resilience in older adults following severe COVID-19. These findings offer insight into immune mechanisms that may support functional recovery in aging populations.

查看原文本刊更多论文

重症COVID-19后老年人Th1/Th2免疫调节和功能恢复能力：一项前瞻性队列研究

背景：从严重COVID-19中恢复的老年人表现出不同的轨迹，从持续虚弱到完全功能恢复。支撑这一群体恢复力的生物学机制仍不明确。本研究旨在调查重症COVID-19老年幸存者中Th1/Th2免疫调节与功能恢复力之间的关系，功能恢复力被定义为虚弱状态的改善。方法：我们在墨西哥的一家三级呼吸中心进行了一项前瞻性研究。24例65岁及以上且有严重COVID-19病史的患者在出院后4个月和12个月进行评估。使用适用于墨西哥人群的经过验证的表型来评估脆弱性。采用流式细胞术分析外周血单个核细胞（PBMCs），定量CD4+ T细胞亚群、细胞因子（IFN-γ、TNF和IL-10）的产生以及T-bet、GATA-3和TIM-3的表达。结果：13名参与者在12个月内表现出虚弱状态的改善。弹性患者在出院后4个月表现出更高的Th1/Th2 （T-bet/GATA-3）比率，并在12个月时增加IFN-γ和TNF的产生。弹性组CD4+细胞上的TIM-3表达和循环水平也升高。结论：恢复后早期th1倾斜的免疫谱和持续的促炎细胞因子活性与严重COVID-19后老年人的恢复力有关。这些发现提供了对免疫机制的见解，可能支持老年人的功能恢复。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Geriatric Medicine GERIATRICS & GERONTOLOGY-

CiteScore

6.70

自引率

2.60%

发文量

114

审稿时长

6-12 weeks

期刊介绍： European Geriatric Medicine is the official journal of the European Geriatric Medicine Society (EUGMS). Launched in 2010, this journal aims to publish the highest quality material, both scientific and clinical, on all aspects of Geriatric Medicine. The EUGMS is interested in the promotion of Geriatric Medicine in any setting (acute or subacute care, rehabilitation, nursing homes, primary care, fall clinics, ambulatory assessment, dementia clinics..), and also in functionality in old age, comprehensive geriatric assessment, geriatric syndromes, geriatric education, old age psychiatry, models of geriatric care in health services, and quality assurance.