Daniela Cataneo-Piña, Leslie Chávez-Galán, Ranferi Ocaña-Guzmán, José Alberto Ávila-Funes, Tamas Fulop, Ivette Buendia-Roldan
{"title":"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","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":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","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":"{\"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\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"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}","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}
Th1/Th2 immune regulation and functional resilience in older adults following severe COVID-19: a prospective cohort study.
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.
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.
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