1
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Poisson J, El-Sissy C, Serret-Larmande A, Smith N, Lebraud M, Augy JL, Conti C, Gonnin C, Planquette B, Arlet JB, Hermann B, Charbit B, Pastre J, Devaux F, Ladavière C, Lim L, Ober P, Cannovas J, Biard L, Gulczynski MC, Blumenthal N, Péré H, Knosp C, Gey A, Benhamouda N, Murris J, Veyer D, Tartour E, Diehl JL, Duffy D, Paillaud E, Granier C. Increased levels of GM-CSF and CXCL10 and low CD8 + memory stem T Cell count are markers of immunosenescence and severe COVID-19 in older people. Immun Ageing 2024; 21:28. [PMID: 38715114 PMCID: PMC11075216 DOI: 10.1186/s12979-024-00430-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/18/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Ageing leads to altered immune responses, resulting in higher susceptibility to certain infections in the elderly. Immune ageing is a heterogeneous process also associated with inflammaging, a low-grade chronic inflammation. Altered cytotoxic T cell responses and cytokine storm have previously been described in severe COVID-19 cases, however the parameters responsible for such immune response failures are not well known. The aim of our study was to characterize CD8+ T cells and cytokines associated with ageing, in a cohort of patients aged over 70 years stratified by COVID-19 severity. RESULTS One hundred and four patients were included in the study. We found that, in older people, COVID-19 severity was associated with (i) higher level of GM-CSF, CXCL10 (IP-10), VEGF, IL-1β, CCL2 (MCP-1) and the neutrophil to lymphocyte ratio (NLR), (ii) increased terminally differentiated CD8+T cells, and (ii) decreased early precursors CD8+ T stem cell-like memory cells (TSCM) and CD27+CD28+. The cytokines mentioned above were found at higher concentrations in the COVID-19+ older cohort compared to a younger cohort in which they were not associated with disease severity. CONCLUSIONS Our results highlight the particular importance of the myeloid lineage in COVID-19 severity among older people. As GM-CSF and CXCL10 were not associated with COVID-19 severity in younger patients, they may represent disease severity specific markers of ageing and should be considered in older people care.
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Affiliation(s)
- Johanne Poisson
- Université Paris Cité, Paris, France
- Department of Geriatric Medicine, Hôpital Europeen Georges Pompidou, AP-HP, Paris, France
- Inserm U1149, Center for Research on Inflammation, Paris, France
| | - Carine El-Sissy
- INSERM, Laboratory of Integrative Cancer Immunology, Paris, France
- Cordeliers Research Center, Sorbonne University, University Paris Cité, Paris, France
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Arnaud Serret-Larmande
- ECSTRRA Team, UMR-1153, Université Paris Cité, INSERM, AP-HP, Saint Louis Hospital, Paris, France
| | - Nikaïa Smith
- Translational Immunology Unit, Institut Pasteur, Université Paris Cité, Paris, France
| | - Morgane Lebraud
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Jean-Loup Augy
- Medical intensive care unit, Hopital Delafontaine, 2 rue du Dr Delafontaine, Saint-Denis, 93200, France
| | - Catherine Conti
- Université Paris Cité, Paris, France
- Department of Geriatric Medicine, Hôpital Europeen Georges Pompidou, AP-HP, Paris, France
| | - Cécile Gonnin
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
- Université Paris Cité, INSERM, PARCC, Paris, France
| | - Benjamin Planquette
- Service de Pneumologie Et Soins Intensifs, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Jean-Benoît Arlet
- Internal Medicine Department, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Faculty of Medicine, Université Paris Cité, Paris, 75006, France
| | - Bertrand Hermann
- Medical Intensive Care Unit, AP-HP. Centre Université Paris Cité, Georges Pompidou European Hospital, Paris, 75015, France
- INSERM UMR 1266, Institut de Psychiatrie Et Neurosciences de Paris (IPNP), Université Paris Cité, Paris, France
| | - Bruno Charbit
- Institute of Ophthalmology, University College London (UCL), London, UK
| | - Jean Pastre
- Service de Pneumologie Et Soins Intensifs, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Floriane Devaux
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Cyrielle Ladavière
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Lydie Lim
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Pauline Ober
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Johanna Cannovas
- Department of Geriatric Medicine, Hôpital Europeen Georges Pompidou, AP-HP, Paris, France
| | - Lucie Biard
- ECSTRRA Team, UMR-1153, Université Paris Cité, INSERM, AP-HP, Saint Louis Hospital, Paris, France
| | - Marie-Christelle Gulczynski
- Gérontologie 1, GHU AP-HP. Centre Université Paris Cité, Corentin Celton Hospital, Issy-Les-Moulineaux, 92130, France
| | - Noémie Blumenthal
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Hélène Péré
- Virology Laboratory, Hôpital Européen Georges-Pompidou, APHP.Centre - Université Paris Cité, Paris, France
- Centre de Recherche Des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Functional Genomics of Solid Tumors Laboratory, Équipe Labellisée Ligue Nationale Contre Le Cancer, Labex OncoImmunology, Paris, France
- Université Paris Cité, Faculté de Santé, UFR de Médecine, Paris, France
| | | | - Alain Gey
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Nadine Benhamouda
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Juliette Murris
- HeKA, Inria Paris, Inserm, Université Paris Cité, Paris, France
| | - David Veyer
- Virology Laboratory, Hôpital Européen Georges-Pompidou, APHP.Centre - Université Paris Cité, Paris, France
- Centre de Recherche Des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Functional Genomics of Solid Tumors Laboratory, Équipe Labellisée Ligue Nationale Contre Le Cancer, Labex OncoImmunology, Paris, France
| | - Eric Tartour
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Jean-Luc Diehl
- Medical Intensive Care Unit, AP-HP. Centre Université Paris Cité, Georges Pompidou European Hospital, Paris, 75015, France
- University Paris Cité, Innovative Therapies in Hemostasis, INSERM, Paris, 75006, France
| | - Darragh Duffy
- Translational Immunology Unit, Institut Pasteur, Université Paris Cité, Paris, France
| | - Elena Paillaud
- Université Paris Cité, Paris, France.
- Department of Geriatric Medicine, Hôpital Europeen Georges Pompidou, AP-HP, Paris, France.
- Univ. Paris Est Créteil, Inserm U955, IMRB, Créteil, France.
| | - Clémence Granier
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France.
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2
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Wu S, Liu W, Zhang M, Wang K, Liu J, Hu Y, She Q, Li M, Shen S, Chen B, Wu J. Preventive measures significantly reduced the risk of nosocomial infection in elderly inpatients during the COVID‑19 pandemic. Exp Ther Med 2022; 24:562. [PMID: 35978917 PMCID: PMC9366284 DOI: 10.3892/etm.2022.11499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/25/2022] [Indexed: 12/15/2022] Open
Affiliation(s)
- Shuangshuang Wu
- Jiangsu Provincial Key Laboratory of Geriatrics, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Wen Liu
- Jiangsu Provincial Key Laboratory of Geriatrics, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Mingjiong Zhang
- Jiangsu Provincial Key Laboratory of Geriatrics, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Kai Wang
- Jiangsu Provincial Key Laboratory of Geriatrics, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Jin Liu
- Clinical Research Institute, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Yujia Hu
- Department of Business Analytics, Management School, Lancaster University, Lancaster, LA1 4YW, UK
| | - Quan She
- Jiangsu Provincial Key Laboratory of Geriatrics, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Min Li
- Jiangsu Provincial Key Laboratory of Geriatrics, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Shaoran Shen
- Jiangsu Provincial Key Laboratory of Geriatrics, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Bo Chen
- Jiangsu Provincial Key Laboratory of Geriatrics, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Jianqing Wu
- Jiangsu Provincial Key Laboratory of Geriatrics, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
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Serum Leptin Levels, Nutritional Status, and the Risk of Healthcare-Associated Infections in Hospitalized Older Adults. Nutrients 2022; 14:nu14010226. [PMID: 35011102 PMCID: PMC8747117 DOI: 10.3390/nu14010226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/30/2021] [Accepted: 12/31/2021] [Indexed: 02/07/2023] Open
Abstract
We aimed to determine whether serum leptin levels are predictive of the occurrence of healthcare-associated infections (HAIs) in hospitalized older patients. In a prospective cohort, 232 patients had available data for leptin and were monitored for HAIs for 3 months. Admission data included comorbidities, invasive procedures, the Mini Nutritional Assessment (MNA), BMI, leptin, albumin and C-reactive protein levels, and CD4 and CD8 T-cell counts. Multivariate logistic regression modelling was used to identify predictors of HAIs. Of the 232 patients (median age: 84.8; females: 72.4%), 89 (38.4%) experienced HAIs. The leptin level was associated with the BMI (p < 0.0001) and MNA (p < 0.0001) categories. Women who experienced HAIs had significantly lower leptin levels than those who did not (5.9 μg/L (2.6–17.7) and 11.8 (4.6–26.3), respectively; p = 0.01; odds ratio (OR) (95% confidence interval): 0.67 (0.49–0.90)); no such association was observed for men. In a multivariate analysis of the women, a lower leptin level was significantly associated with HAIs (OR = 0.70 (0.49–0.97)), independently of comorbidities, invasive medical procedures, and immune status. However, leptin was not significantly associated with HAIs after adjustments for malnutrition (p = 0.26) or albuminemia (p = 0.15)—suggesting that in older women, the association between serum leptin levels and subsequent HAIs is mediated by nutritional status.
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Yeo GEC, Ng MH, Nordin FB, Law JX. Potential of Mesenchymal Stem Cells in the Rejuvenation of the Aging Immune System. Int J Mol Sci 2021; 22:5749. [PMID: 34072224 PMCID: PMC8198707 DOI: 10.3390/ijms22115749] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 12/14/2022] Open
Abstract
Rapid growth of the geriatric population has been made possible with advancements in pharmaceutical and health sciences. Hence, age-associated diseases are becoming more common. Aging encompasses deterioration of the immune system, known as immunosenescence. Dysregulation of the immune cell production, differentiation, and functioning lead to a chronic subclinical inflammatory state termed inflammaging. The hallmarks of the aging immune system are decreased naïve cells, increased memory cells, and increased serum levels of pro-inflammatory cytokines. Mesenchymal stem cell (MSC) transplantation is a promising solution to halt immunosenescence as the cells have excellent immunomodulatory functions and low immunogenicity. This review compiles the present knowledge of the causes and changes of the aging immune system and the potential of MSC transplantation as a regenerative therapy for immunosenescence.
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Affiliation(s)
| | | | | | - Jia Xian Law
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras 56000, Malaysia; (G.E.C.Y.); (M.H.N.); (F.B.N.)
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5
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Abdoli A, Ardakani HM. Helminth infections and immunosenescence: The friend of my enemy. Exp Gerontol 2020; 133:110852. [PMID: 32007545 DOI: 10.1016/j.exger.2020.110852] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 12/13/2019] [Accepted: 01/21/2020] [Indexed: 12/14/2022]
Abstract
Age-associated alterations of the immune system, which known as "immunosenescence", is characterized by a decline in innate and adaptive immunity, which leading to increased susceptibility to age-associated diseases, such as infectious diseases, rheumatic disease and malignancies. On the other hand, helminth infections are among the most prevalent infections in older individuals, especially in the nursing homes. Most of helminth infections have minor clinical symptoms and usually causing chronic infections without treatment. Nevertheless, chronic helminthiasis alters immune responses somewhat similar to the immunosenescence. Some similarities also exist between helminth infections and immunosenescence: 1) both of them led to declining the immune responses; 2) undernutrition is a consequence of immunosenescence and helminthiasis; 3) vaccine efficacy declines in aging and individuals with helminth infections; 4) increase incidence and prevalence of infectious diseases in the elder individuals and patients with helminth infections; and 5) both of them promote tumorigenesis. Hence, it is probable that helminth infections in the elderly population can intensify the immunosenescence outcomes due to the synergistic immunoregulatory effects of each of them. It would be suggested that, diagnosis, treatment and prevention of helminth infections should be more considered in older individuals. Also, it would be suggested that helminths or their antigens can be used for investigation of immunosenescence because both of them possess some similarities in immune alterations. Taken together, this review offers new insights into the immunology of aging and helminth infections.
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Affiliation(s)
- Amir Abdoli
- Department of Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran; Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran; Research Center for Noncommunicable Diseases, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
| | - Hoda Mirzaian Ardakani
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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6
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Paillaud E, Bastuji-Garin S, Plonquet A, Foucat E, Fournier B, Boutin E, Le Thuaut A, Levy Y, Hue S. Combined Plasma Elevation of CRP, Intestinal-Type Fatty Acid-Binding Protein (I-FABP), and sCD14 Identify Older Patients at High Risk for Health Care-Associated Infections. J Gerontol A Biol Sci Med Sci 2019; 73:211-217. [PMID: 28582475 DOI: 10.1093/gerona/glx106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 05/31/2017] [Indexed: 02/04/2023] Open
Abstract
Background We hypothesized that low-grade inflammation was driven by microbial translocation and associated with an increased risk of health care-associated infections (HAIs). Methods We included 121 patients aged 75 years or over in this prospective cohort study. High-sensitivity C-reactive protein (hs-CRP), I-FABP, and sCD14-as markers for low-grade inflammation, intestinal epithelial barrier integrity, and monocyte activation, respectively-were measured at admission. Results HAIs occurred during hospitalization in 62 (51%) patients. Elevated hs-CRP (≥6.02 mg/L, ie, the median) was associated with a significantly higher HAI risk when I-FABP was in the highest quartile (odds ratio [OR], 4; 95% confidence interval [95% CI], 1.39-11.49; p = .010). In patients with hs-CRP elevation and highest-quartile I-FABP, sCD14 elevation (≥0.65 µg/mL, ie, the median) was associated with an 11-fold higher HAI risk (OR, 10.8; 95% CI, 2.28-51.1; p = .003). Multivariate analyses adjusted for invasive procedures and comorbidities did not change the associations linking the three markers to the HAI risk. Conclusion Increased levels of hs-CRP, I-FABP, and sCD14 may reflect loss of intestinal epithelial barrier integrity with microbial translocation leading to monocyte activation and low-grade inflammation. In our cohort, these markers identified patients at high risk for HAIs.
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Affiliation(s)
- Elena Paillaud
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Henri-Mondor, Département de médecine interne et gériatrie, Creteil, France.,Université Paris Est (UPEC), DHU A-TVB, IMRB, CEpiA (Clinical Epidemiology and Ageing) Unit EA, Creteil, France
| | - Sylvie Bastuji-Garin
- Université Paris Est (UPEC), DHU A-TVB, IMRB, CEpiA (Clinical Epidemiology and Ageing) Unit EA, Creteil, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Service de Santé Publique, Creteil, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Unité de Recherche Clinique (URC Mondor), Creteil, France
| | - Anne Plonquet
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Service d'immunologie biologique, Creteil, France
| | - Emile Foucat
- INSERM U955, team 16, IMRB Créteil, France.,Vaccine Research Institute (VRI), Université Paris Est Créteil, Faculté de Médecine, France
| | - Bénédicte Fournier
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Service de biochimie, Creteil, France
| | - Emmanuelle Boutin
- Université Paris Est (UPEC), DHU A-TVB, IMRB, CEpiA (Clinical Epidemiology and Ageing) Unit EA, Creteil, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Unité de Recherche Clinique (URC Mondor), Creteil, France
| | - Aurélie Le Thuaut
- Université Paris Est (UPEC), DHU A-TVB, IMRB, CEpiA (Clinical Epidemiology and Ageing) Unit EA, Creteil, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Unité de Recherche Clinique (URC Mondor), Creteil, France
| | - Yves Levy
- INSERM U955, team 16, IMRB Créteil, France.,Vaccine Research Institute (VRI), Université Paris Est Créteil, Faculté de Médecine, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Service d'immunologie clinique, Creteil, France
| | - Sophie Hue
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Henri-Mondor, Service d'immunologie biologique, Creteil, France.,INSERM U955, team 16, IMRB Créteil, France.,Vaccine Research Institute (VRI), Université Paris Est Créteil, Faculté de Médecine, France
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7
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Pawelec G. Immune signatures associated with mortality differ in elderly populations from different birth cohorts and countries even within northern Europe. Mech Ageing Dev 2018; 177:182-185. [PMID: 29654793 DOI: 10.1016/j.mad.2018.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 04/04/2018] [Accepted: 04/05/2018] [Indexed: 01/07/2023]
Abstract
Since associations between lifespan and certain simple immune parameters such as T cell proliferative responses to mitogens were reported in the 1970´s, efforts to dissect out immune parameters correlating with morbidity and mortality have sought to define factors predicting individual longevity. Such "immune signatures" associating with defined clinical outcomes would represent biomarkers of "immunosenescence" that might also provide mechanistic insights into the ageing process. Because appropriate immune function is necessary for a healthy old age, a better understanding of immunosenescence contributing to frailty and death might allow interventions to improve personal and public health. Here, we discuss data from our studies in several different European countries and document significant differences between overtly similar populations. These findings draw attention to the marked variation even between presumably quite homogeneous populations, which may be due to the different birth cohorts studied in addition to numerous other variables. Thus, immunological parameters, and presumably many other factors, are sensitive to context-dependent variation, making it currently difficult to extrapolate biomarkers of longevity from any one human population to another.
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Affiliation(s)
- Graham Pawelec
- Second Department of Internal Medicine, University of Tübingen, Tübingen, Germany; Health Sciences North Research Institute of Canada, Sudbury, ON, Canada.
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8
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Pawelec G. Immune parameters associated with mortality in the elderly are context-dependent: lessons from Sweden, Holland and Belgium. Biogerontology 2017; 19:537-545. [PMID: 29185165 DOI: 10.1007/s10522-017-9739-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 11/23/2017] [Indexed: 01/10/2023]
Abstract
The pioneering Swedish OCTO/NONA-Immune longitudinal studies led by Anders Wikby in Jönköping in the 1990s established a cluster of simple baseline immune parameters associated with excess mortality in 85 year-old non-institutionalized individuals over 2, 4 and 6-year follow-up. We dubbed this cluster the "Immune Risk Profile" (IRP) consisting of poor proliferative responses of peripheral blood mononuclear cells to T cell mitogens, accumulations of CD8+ CD28- T-cells resulting in an inverted CD4:8 ratio, decreased amounts of B-cells, and seropositivity for Cytomegalovirus (CMV). The concept of the IRP has since been applied by others to many different populations in different circumstances and at different ages, but in general without specifically establishing whether the same risk factors were relevant in the tested subjects. However, our own later studies showed that risk factors in aged populations from The Netherlands and Belgium were markedly different, indicating that the IRP cannot simply be transferred between populations. Moreover, there was a striking sex difference in the Belgian study, which was the only one large enough to include sufficient numbers of old men. The reasons for these marked differences between populations which one might have assumed a priori to be quite similar to one another are not clear, and many candidates can be speculated upon, but the important lesson is that there is a marked context-dependency of immune biomarkers of ageing, suggesting that IRPs cannot be assumed to be identical in different populations.
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Affiliation(s)
- Graham Pawelec
- Second Department of Internal Medicine, University of Tübingen, Tübingen, Germany.
- Health Sciences North Research Institute of Canada, Sudbury, ON, Canada.
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9
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CXCL12 prolongs naive CD4 + T lymphocytes survival via activation of PKA, CREB and Bcl2 and BclXl up-regulation. Int J Cardiol 2016; 224:206-212. [DOI: 10.1016/j.ijcard.2016.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 08/24/2016] [Accepted: 09/08/2016] [Indexed: 01/09/2023]
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10
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Crepin T, Gaiffe E, Courivaud C, Roubiou C, Laheurte C, Moulin B, Frimat L, Rieu P, Mousson C, Durrbach A, Heng AE, Saas P, Bamoulid J, Ducloux D. Pre-transplant end-stage renal disease-related immune risk profile in kidney transplant recipients predicts post-transplant infections. Transpl Infect Dis 2016; 18:415-22. [PMID: 27027787 DOI: 10.1111/tid.12534] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 11/26/2015] [Accepted: 01/31/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND End-stage renal disease (ESRD) is associated with premature aging of the T-cell system. Nevertheless, the clinical significance of pre-transplant ESRD-related immune senescence is unknown. METHODS We studied whether immune risk phenotype (IRP), a typical feature of immune senescence, may affect post-transplant infectious complications. A total of 486 patients were prospectively studied during the first year post transplant. IRP was defined as positive cytomegalovirus serology with at least 1 of the following criteria: CD4/CD8 ratio <1 and/or CD8 T-cell count >90th percentile. RESULTS We found that 47 patients (9.7%) had pre-transplant IRP. IRP+ patients did not differ from IRP- patients for any clinical characteristics, but exhibited more pronounced immune senescence. Both opportunistic infections (43% vs. 6%, P < 0.001) and severe bacterial infection (SBI) (40% vs. 25%, P = 0.028) were more frequent in IRP(+) patients. In multivariate analysis, IRP was predictive of both opportunistic infection (hazard ratio [HR] 2.97 [95% confidence interval {CI} 1.53-5.76], P = 0.001), and SBI (HR 2.33 [95% CI 1.34-3.92], P = 0.008). Acute rejection rates were numerically much lower in IRP+ patients. A total of 418 patients (86%) had biological evaluation 1 year post transplant. Among 41 IRP+ patients, 35 (85%) remained IRP+ 1 year post transplant. CONCLUSION Pre-transplant IRP is associated with an increased risk of post-transplant infection.
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Affiliation(s)
- T Crepin
- INSERM, UMR1098, Federation Hospitalo-Universitaire INCREASE, Besançon, France.,Faculté de Médecine et de Pharmacie, Université de Franche-Comté, Besançon, France.,Structure Fédérative de Recherche, SFR FED4234, Besançon, France.,Department of Nephrology, Dialysis, and Renal Transplantation, CHU Besançon, Besançon, France
| | - E Gaiffe
- Department of Nephrology, Dialysis, and Renal Transplantation, CHU Besançon, Besançon, France.,CIC Biothérapie, INSERM CIC1431, CHU Besançon, Besançon, France
| | - C Courivaud
- INSERM, UMR1098, Federation Hospitalo-Universitaire INCREASE, Besançon, France.,Faculté de Médecine et de Pharmacie, Université de Franche-Comté, Besançon, France.,Structure Fédérative de Recherche, SFR FED4234, Besançon, France.,Department of Nephrology, Dialysis, and Renal Transplantation, CHU Besançon, Besançon, France
| | - C Roubiou
- Faculté de Médecine et de Pharmacie, Université de Franche-Comté, Besançon, France.,Structure Fédérative de Recherche, SFR FED4234, Besançon, France.,Department of Nephrology, Dialysis, and Renal Transplantation, CHU Besançon, Besançon, France
| | - C Laheurte
- INSERM, UMR1098, Federation Hospitalo-Universitaire INCREASE, Besançon, France.,Plateforme de Biomonitoring, EFS Bourgogne Franche-Comté, CIC 1431/UMR1098, Besançon, France
| | - B Moulin
- Department of Nephrology, Dialysis, and Renal Transplantation, CHU Strasbourg, Strasbourg, France
| | - L Frimat
- Department of Nephrology, Dialysis, and Renal Transplantation, CHU Nancy, Nancy, France
| | - P Rieu
- Department of Nephrology, Dialysis, and Renal Transplantation, CHU Reims, Reims, France
| | - C Mousson
- Department of Nephrology, Dialysis, and Renal Transplantation, CHU Dijon, Dijon, France
| | - A Durrbach
- Department of Nephrology, Dialysis, and Renal Transplantation, CHU Kremlin-Bicêtre, Le Kremlin-Bicêtre, France
| | - A-E Heng
- Department of Nephrology, Dialysis, and Renal Transplantation, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - P Saas
- INSERM, UMR1098, Federation Hospitalo-Universitaire INCREASE, Besançon, France.,Faculté de Médecine et de Pharmacie, Université de Franche-Comté, Besançon, France.,Structure Fédérative de Recherche, SFR FED4234, Besançon, France.,CIC Biothérapie, INSERM CIC1431, CHU Besançon, Besançon, France.,Plateforme de Biomonitoring, EFS Bourgogne Franche-Comté, CIC 1431/UMR1098, Besançon, France
| | - J Bamoulid
- INSERM, UMR1098, Federation Hospitalo-Universitaire INCREASE, Besançon, France.,Faculté de Médecine et de Pharmacie, Université de Franche-Comté, Besançon, France.,Structure Fédérative de Recherche, SFR FED4234, Besançon, France.,Department of Nephrology, Dialysis, and Renal Transplantation, CHU Besançon, Besançon, France
| | - D Ducloux
- INSERM, UMR1098, Federation Hospitalo-Universitaire INCREASE, Besançon, France.,Faculté de Médecine et de Pharmacie, Université de Franche-Comté, Besançon, France.,Structure Fédérative de Recherche, SFR FED4234, Besançon, France.,Department of Nephrology, Dialysis, and Renal Transplantation, CHU Besançon, Besançon, France.,CIC Biothérapie, INSERM CIC1431, CHU Besançon, Besançon, France
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11
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Ndumbi P, Gilbert L, Tsoukas CM. Comprehensive evaluation of the immune risk phenotype in successfully treated HIV-infected individuals. PLoS One 2015; 10:e0117039. [PMID: 25647167 PMCID: PMC4315523 DOI: 10.1371/journal.pone.0117039] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 12/18/2014] [Indexed: 01/09/2023] Open
Abstract
Background Despite successful treatment and CD4+ T-cell recovery, HIV-infected individuals often experience a profound immune dysregulation characterized by a persistently low CD4:CD8 T-cell ratio. This residual immune dysregulation is reminiscent of the Immune Risk Phenotype (IRP) previously associated with morbidity and mortality in the uninfected elderly (>85 years). The IRP consists of laboratory markers that include: a low CD4:CD8 T-cell ratio, an expansion of CD8+CD28- T-cells and cytomegalovirus (CMV) seropositivity. Despite the significant overlap in immunological phenotypes between normal aging and HIV infection, the IRP has never been evaluated in HIV-infected individuals. In this pilot study we characterized immune changes associated with the IRP in a sample of successfully treated HIV-infected subjects. Methods 18 virologically suppressed HIV-infected subjects were categorized into 2 groups based on their IRP status; HIV+IRP+, (n = 8) and HIV+IRP-, (n = 10) and compared to 15 age-matched HIV uninfected IRP negative controls. All individuals were assessed for functional and phenotypic immune characteristics including: pro-inflammatory cytokine production, antigen-specific proliferation capacity, replicative senescence, T-cell differentiation and lymphocyte telomere length. Results Compared to HIV-infected subjects without an IRP, HIV+IRP+ subjects exhibited a higher frequency of TNF-α-producing CD8+ T-cells (p = 0.05) and a reduced proportion of CD8+ naïve T-cells (p = 0.007). The IRP status was also associated with a marked up-regulation of the replicative senescence markers CD57 and KLGR1, on the surface of CD8+T-cells (p = 0.004). Finally, HIV+IRP+ individuals had a significantly shorter mean lymphocyte telomere length than their non-IRP counterparts (p = 0.03). Conclusions Our findings suggest that, despite similar levels of treatment-mediated viral suppression, the phenotypic and functional immune characteristics of HIV+IRP+ individuals are distinct from those observed in non-IRP individuals. The IRP appears to identify a subset of treated HIV-infected individuals with a higher degree of immune senescence.
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Affiliation(s)
- Patricia Ndumbi
- Immune Deficiency Treatment Centre, McGill University Health Centre, Montreal, QC, Canada
- * E-mail: (PN); (CMT)
| | - Louise Gilbert
- Immune Deficiency Treatment Centre, McGill University Health Centre, Montreal, QC, Canada
| | - Christos M. Tsoukas
- Immune Deficiency Treatment Centre, McGill University Health Centre, Montreal, QC, Canada
- * E-mail: (PN); (CMT)
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12
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Laurent M, Bastuji-Garin S, Plonquet A, Bories P, Le Thuaut A, Audureau E, Lang P, Nakib S, Liuu E, Canoui-Poitrine F, Paillaud E. Interrelations of immunological parameters, nutrition, and healthcare-associated infections: Prospective study in elderly in-patients. Clin Nutr 2015; 34:79-85. [DOI: 10.1016/j.clnu.2014.01.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 01/05/2014] [Accepted: 01/16/2014] [Indexed: 01/15/2023]
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13
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Vester H, Huber-Lang MS, Kida Q, Scola A, van Griensven M, Gebhard F, Nüssler AK, Perl M. The immune response after fracture trauma is different in old compared to young patients. Immun Ageing 2014; 11:20. [PMID: 25620994 PMCID: PMC4305233 DOI: 10.1186/s12979-014-0020-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 11/16/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND Despite significant medical progress and improved treatment, surgical procedures of proximal femur fractures in older patients are still associated with a high postoperative complication and mortality rate. Recently, several authors investigated the phenomenon of immunoageing, indicating differences in the ageing immune system. The aim of the present multi-center prospective clinical trial was to analyze differences in the posttraumatic immune response of old patients compared to young patients. METHODS Blood was collected from young patients (<50 y, n = 20) with long bone fractures (YF), old patients (>70 y, n = 21) with proximal femur fractures (OF) upon clinical admission and within 6 hours after surgery, and two healthy age matched control groups (YH & OH). Serum TRAIL- and cytokine concentrations were analyzed via cytometric bead array, Fas-Ligand and TNF-Receptor-I via ELISA. CD15(+) magnetic bead-isolated neutrophils (PMN) were TUNEL stained. RESULTS IL-6 was significantly increased only in OF after trauma and surgery whereas YF patient exhibited a marked decrease of TNF after trauma. Interestingly, a significant increase of GM-CSF serum levels was observed in YF only, whereas OF exhibited a decrease of systemic IFN-γ concentrations after trauma and after surgery. The healthy controls, old and young, had more or less similar inflammation levels. Moreover, TRAIL serum levels were diminished in OF after trauma and even further after surgery whereas in YF this was only observed after the surgical procedure. Fas-L concentrations were reduced only in YF after surgery or trauma. PMN apoptosis was significantly reduced only in YF, indicating activation of the innate immune system. DISCUSSION In summary, our data suggest that the posttraumatic immune response is differently regulated in old and young trauma patients. The operative procedure further impacts these differences after trauma. Whether the decreased activation of PMNs and phagocytes along with the observed dysregulation of the posttraumatic inflammatory response contributes to the high perioperative mortality rate of the elderly suffering from a proximal femoral fracture requires further investigation.
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Affiliation(s)
- Helen Vester
- />Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Markus S Huber-Lang
- />Department of Orthopedic Trauma, Hand-, Plastic-, and Reconstructive Surgery, University Hospital Ulm, Ulm, Germany
| | - Qerim Kida
- />Department of Orthopedic Trauma, Hand-, Plastic-, and Reconstructive Surgery, University Hospital Ulm, Ulm, Germany
| | - Alexander Scola
- />Department of Orthopedic Trauma, Hand-, Plastic-, and Reconstructive Surgery, University Hospital Ulm, Ulm, Germany
| | - Martijn van Griensven
- />Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Florian Gebhard
- />Department of Orthopedic Trauma, Hand-, Plastic-, and Reconstructive Surgery, University Hospital Ulm, Ulm, Germany
| | - Andreas K Nüssler
- />Siegfried Weller Institute for Trauma Research, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Mario Perl
- />Department of Orthopedic Trauma, Hand-, Plastic-, and Reconstructive Surgery, University Hospital Ulm, Ulm, Germany
- />BG-Trauma Center Murnau, Prof.-Küntscher-Str. 8, 82418 Murnau, Germany
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14
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Bories PN, Laurent M, Liuu E, Denjean L, Popovici T, Paillaud E. Interleukin-10 promoter (-1082) polymorphism in association with repeated hospital-acquired infections in elderly patients. Aging Clin Exp Res 2013; 26:25-31. [PMID: 24307577 DOI: 10.1007/s40520-013-0177-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 09/25/2013] [Indexed: 12/31/2022]
Abstract
BACKGROUND Infections are frequent complications of hospitalization, particularly in the elderly. Pro- and anti-inflammatory cytokines are essential components of the host response to pathogens and polymorphisms in their genes may contribute to inter-individual variations of the inflammatory response. The aim of this study was to investigate whether cytokine polymorphisms, separately or in combination, could be determining factors in the development of repeated nosocomial infections in elderly hospitalized patients. METHODS Tumor necrosis factor-α (-308) and (-238), interleukin-6 (-174) and (-6331), interleukin-10 (-1082) and (-592) polymorphisms were genotyped by PCR and hybridization with fluorescent-labeled probes in 245 hospitalized elderly patients (mean age 85.2 years; SD 6) and compared with those in 145 healthy adults. RESULTS The distribution of genotypes did not differ between elderly patients and control subjects. The presence of the interleukin-10 A(592) or A(1082) allele was more frequent individually and after adjustment for multiple comparisons in patients who suffered from several infections (p = 0.012, odds ratio = 5.3; 95 % confidence interval = 1.2-23.1). CONCLUSION Our data support a determinant role for interleukin-10 (-1082) polymorphism in the development of nosocomial infections.
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Affiliation(s)
- Phuong-Nhi Bories
- Service de Biochimie, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Cochin, 27 rue du Faubourg Saint-Jacques, Paris, 75679 Paris cedex 04, France,
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15
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Fülöp T, Larbi A, Pawelec G. Human T cell aging and the impact of persistent viral infections. Front Immunol 2013; 4:271. [PMID: 24062739 PMCID: PMC3772506 DOI: 10.3389/fimmu.2013.00271] [Citation(s) in RCA: 226] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 08/27/2013] [Indexed: 12/30/2022] Open
Abstract
Aging is associated with a dysregulation of the immune response, loosely termed “immunosenescence.” Each part of the immune system is influenced to some extent by the aging process. However, adaptive immunity seems more extensively affected and among all participating cells it is the T cells that are most altered. There is a large body of experimental work devoted to the investigation of age-associated differences in T cell phenotypes and functions in young and old individuals, but few longitudinal studies in humans actually delineating changes at the level of the individual. In most studies, the number and proportion of late-differentiated T cells, especially CD8+ T cells, is reported to be higher in the elderly than in the young. Limited longitudinal studies suggest that accumulation of these cells is a dynamic process and does indeed represent an age-associated change. Accumulations of such late-stage cells may contribute to the enhanced systemic pro-inflammatory milieu commonly seen in older people. We do not know exactly what causes these observed changes, but an understanding of the possible causes is now beginning to emerge. A favored hypothesis is that these events are at least partly due to the effects of the maintenance of essential immune surveillance against persistent viral infections, notably Cytomegalovirus (CMV), which may exhaust the immune system over time. It is still a matter of debate as to whether these changes are compensatory and beneficial or pathological and detrimental to the proper functioning of the immune system and whether they impact longevity. Here, we will review present knowledge of T cell changes with aging and their relation to chronic viral and possibly other persistent infections.
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Affiliation(s)
- T Fülöp
- Geriatrics Division, Department of Medicine, Research Center on Aging, University of Sherbrooke , Sherbrooke, QC , Canada
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16
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Pirrone V, Libon DJ, Sell C, Lerner CA, Nonnemacher MR, Wigdahl B. Impact of age on markers of HIV-1 disease. Future Virol 2013; 8:81-101. [PMID: 23596462 PMCID: PMC3625689 DOI: 10.2217/fvl.12.127] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Aging is a complicated process characterized by a progressive loss of homeostasis, which results in an increased vulnerability to multiple diseases. HIV-1-infected patients demonstrate a premature aging phenotype and develop certain age-related diseases earlier in their lifespan than what is seen in the general population. Age-related comorbidities may include the development of bone disease, metabolic disorders, neurologic impairment and immunosenescence. Age also appears to have an effect on traditional markers of HIV-1 disease progression, including CD4+ T-cell count and viral load. These effects are not only a consequence of HIV-1 infection, but in many cases, are also linked to antiretroviral therapy. This review summarizes the complex interplay between HIV-1 infection and aging, and the impact that aging has on markers of HIV-1 disease.
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Affiliation(s)
- Vanessa Pirrone
- Department of Microbiology & Immunology, Drexel University College of Medicine, 245 N 15th Street, New College Building, Philadelphia, PA 19102, USA
- Drexel University College of Medicine, 245 N 15th Street, New College Building, Philadelphia, PA 19102, USA
| | - David J Libon
- Department of Neurology, Drexel University College of Medicine, Philadelphia, PA 19129, USA
| | - Christian Sell
- Department of Pathology, Drexel University College of Medicine, Philadelphia, PA 19129, USA
| | - Chad A Lerner
- Department of Pathology, Drexel University College of Medicine, Philadelphia, PA 19129, USA
| | - Michael R Nonnemacher
- Department of Microbiology & Immunology, Drexel University College of Medicine, 245 N 15th Street, New College Building, Philadelphia, PA 19102, USA
- Drexel University College of Medicine, 245 N 15th Street, New College Building, Philadelphia, PA 19102, USA
| | - Brian Wigdahl
- Department of Microbiology & Immunology, Drexel University College of Medicine, 245 N 15th Street, New College Building, Philadelphia, PA 19102, USA
- Drexel University College of Medicine, 245 N 15th Street, New College Building, Philadelphia, PA 19102, USA
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Laurent M, Bories PN, Le Thuaut A, Liuu E, Ledudal K, Bastuji-Garin S, Paillaud E. Impact of Comorbidities on Hospital-Acquired Infections in a Geriatric Rehabilitation Unit: Prospective Study of 252 Patients. J Am Med Dir Assoc 2012; 13:760.e7-12. [DOI: 10.1016/j.jamda.2012.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Revised: 07/01/2012] [Accepted: 07/02/2012] [Indexed: 11/29/2022]
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