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Age-related changes in immune function: Effect on airway inflammation - 07/08/11

Doi : 10.1016/j.jaci.2010.08.011 
Paula J. Busse, MD a, , Sameer K. Mathur, MD, PhD b
a Division of Clinical Immunology, Department of Medicine, Mount Sinai School of Medicine, New York, NY 
b Department of Medicine, Section of Allergy, Pulmonary and Critical Care, University of Wisconsin School of Medicine and Public Health, William S. Middleton VA Hospital, Madison, Wis 

Reprint requests: Paula J. Busse, MD, Division of Clinical Immunology, Department of Medicine, Mount Sinai School of Medicine, 1425 Madison Avenue, Room 11-20, New York, NY 10029.

Abstract

Immunosenescence is defined as changes in the innate and adaptive immune response associated with increased age. The clinical consequences of immunosenescence include increased susceptibility to infection, malignancy and autoimmunity, decreased response to vaccination, and impaired wound healing. However, there are several immune alterations that might facilitate persistence of asthma into late adulthood or development of asthma after the age of 50 to 60 years. Asthma in older patients is not uncommon, and this is a growing population as the average lifespan increases. Specific innate changes that might affect severity of asthma in older patients or be involved in the development of late-onset asthma include impaired mucociliary clearance and changes in airway neutrophil, eosinophil, and mast cell numbers and function. Additionally, age-related altered antigen presentation and decreased specific antibody responses might increase the risk of respiratory tract infections. Respiratory tract infections exacerbate asthma in older patients and possibly play a role in the pathogenesis of late-onset asthma. Furthermore, cytokine profiles might be modified with aging, with some investigators suggesting a trend toward TH2 cytokine expression. This review examines specific innate and adaptive immune responses affected by aging that might affect the inflammatory response in older adults with asthma.

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Key words : Asthma, atopy, aging, elderly, immune function, immunosenescence

Abbreviations used : AM, BALF, Foxp3, mDC, NK, ROS, TCR, TLR, Treg


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 Series editors: Joshua A. Boyce, MD, Fred Finkelman, MD, William T. Shearer, MD, PhD, and Donna Vercelli, MD
 Disclosure of potential conflict of interest: P. J. Busse has received research support from the National Institutes of Health and the American Academy of Allergy, Asthma & Immunology. S. K. Mathur has received research support from the American Academy of Allergy, Asthma & Immunology/T. Franklin Williams Scholars Program and the John A. Hartford Foundation and is vice chair of the American Academy of Allergy, Asthma & Immunology’s Asthma and Allergic Diseases in the Elderly Committee.
 Terms in boldface and italics are defined in the glossary on page 691.


© 2010  American Academy of Allergy, Asthma & Immunology. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 126 - N° 4

P. 690-699 - octobre 2010 Regresar al número
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