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Overcoming immune dysfunction in the elderly: trained immunity as a novel approach.
International Immunology ( IF 4.8 ) Pub Date : 2020-08-07 , DOI: 10.1093/intimm/dxaa052
Ozlem Bulut 1, 2 , Gizem Kilic 1, 2 , Jorge Domínguez-Andrés 1, 2 , Mihai G Netea 1, 2, 3
Affiliation  

Abstract
People with advanced age have a higher susceptibility to infections and exhibit increased mortality and morbidity as the ability of the immune system to combat infections decreases with age. While innate immune cells display functional defects such as decreased phagocytosis, chemotaxis and cytokine production, adaptive immune cells exhibit reduced receptor diversity, defective antibody production and a sharp decline in naive cell populations. Successful responses to vaccination in the elderly are critical to prevent common infections such as influenza and pneumonia, but vaccine efficacy decreases in older individuals compared with young adults. Trained immunity is a newly emerging concept that showed that innate immune cells possess non-specific immunological memory established through epigenetic and metabolic reprogramming upon encountering certain pathogenic stimuli. Clinical studies suggest that trained immunity can be utilized to enhance immune responses against infections and improve the efficiency of vaccinations in adults; however, how trained immunity responses are shaped with advanced age is still an open question. In this review, we provide an overview of the age-related changes in the immune system with a focus on innate immunity, discuss current vaccination strategies for the elderly, present the concept of trained immunity and propose it as a novel approach to enhance responses against infections and vaccinations in the elderly population.


中文翻译:


克服老年人的免疫功能障碍:训练免疫力作为一种新方法。


 抽象的

高龄人群对感染的易感性更高,并且死亡率和发病率也更高,因为免疫系统对抗感染的能力随着年龄的增长而降低。先天性免疫细胞表现出功能缺陷,例如吞噬作用、趋化性和细胞因子产生减少,而适应性免疫细胞则表现出受体多样性减少、抗体产生缺陷以及初始细胞群急剧下降。老年人成功接种疫苗对于预防流感和肺炎等常见感染至关重要,但与年轻人相比,老年人的疫苗效力下降。训练免疫是一个新出现的概念,它表明先天免疫细胞具有非特异性免疫记忆,这种记忆是在遇到某些致病刺激时通过表观遗传和代谢重编程而建立的。临床研究表明,经过训练的免疫力可用于增强针对感染的免疫反应并提高成人疫苗接种的效率;然而,经过训练的免疫反应如何随着年龄的增长而形成仍然是一个悬而未决的问题。在这篇综述中,我们概述了免疫系统中与年龄相关的变化,重点关注先天免疫,讨论了当前针对老年人的疫苗接种策略,提出了训练免疫的概念,并提出将其作为一种增强针对老年人的反应的新方法。老年人口的感染和疫苗接种。
更新日期:2020-11-23
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