免疫在老年肺部呼吸道感染易感性中的作用

Keith C Meyer
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引用次数: 135

摘要

呼吸道感染,特别是肺炎,是发达国家和发展中国家65岁以上老人死亡的主要原因。由于免疫力的许多属性随着年龄的增长而减弱,老年人可能更容易受到呼吸道感染,即使他们看起来很健康。淋巴组织对特定微生物(如流感病毒或肺炎链球菌)产生抗原特异性反应(适应性免疫)的能力下降被认为是随着年龄增长呼吸道感染易感性增加的一个重要因素。然而,先天免疫的异常也可能导致呼吸道感染的易感性增加,并且在老年人中特征不明显。尽管与年轻人相比,在健康老年人的呼吸道分泌物中观察到免疫参数(如T细胞亚群和免疫球蛋白浓度)的变化,但这些变化对肺部保护性免疫的意义尚不清楚。肺炎的发病率可以通过优化合并症的治疗、优化营养和解决吞咽障碍等措施来减少。使用针对流感病毒和肺炎链球菌的疫苗似乎对社区获得性肺炎的发病率和死亡率以及发病率产生了影响。然而,需要用改进的疫苗更好地刺激特异性免疫反应,并更广泛地使用这些疫苗来保护老年人。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The role of immunity in susceptibility to respiratory infection in the aging lung

Respiratory tract infections, particularly pneumonia, are a leading cause of death in persons 65 years or older in both developed and developing countries. Because many attributes of immunity wane with advancing age, the elderly may be more susceptible to respiratory infections, even if they appear to be in good health. A decline in the ability of lymphoid tissues to mount an antigen-specific response (adaptive immunity) to specific microorganisms such as influenza virus or Streptococcus pneumoniae is thought to be an important factor in increasing susceptibility to respiratory tract infection with advancing age. However, abnormalities in innate immunity may also contribute to increased susceptibility to respiratory infections and have been poorly characterized in the elderly. Although changes in immune parameters such as T cell subsets and immunoglobulin concentrations have been observed in respiratory secretions from older healthy individuals compared to younger subjects, the significance of these changes for protective immunity in the lung is unknown. The incidence of pneumonia may be lessened by measures such as optimizing treatment of comorbid conditions, optimizing nutrition, and addressing swallowing disorders. The use of vaccines directed against the influenza virus and S. pneumoniae appears to have made an impact on the degree of morbidity and mortality, and perhaps, the incidence, of community-acquired pneumonia. However, better stimulation of specific immune responses with improved vaccines and more widespread use of these vaccines for protection of elderly individuals are needed.

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