Allergic Disorders at a Venerable Age: A Mini-Review

Abstract

This review focuses on 3 allergic disorders of persons coming up against venerable age: asthma, allergic rhinitis, and atopic dermatitis. The prevalence of allergic diseases in the elderly ranges from 5 to 10% and appears to be rising. A gradual decline in immune function, termed immunosenescence, and age-related changes in tissue structure influence the development of these disorders. Common complications are comorbidities, polypharmacy, and adverse effects of drugs. The elderly have difficulty mounting protective immune responses against newly encountered antigens. The integrity of epithelial barriers is compromised, leading to a chronic, subclinical inflammatory state and an enhanced Th2 (allergic) immune response. Undiagnosed asthma is frequent in elderly persons (about 8%) and still more commonplace in those with respiratory symptoms. Poorly controlled asthma in the elderly undermines their functional status and leads to a loss of autonomy and social isolation that may delay seeking medical services. Aggravation of allergic rhinitis coincides with exacerbation of asthma, whereas treatment of nasal inflammation improves control of the asthma. Atopic dermatitis is a chronically relapsing inflammatory skin disease often associated with respiratory allergy.

Analysis of inhalant allergen sensitivity by age groups in patients from Istanbul

“…In accordance with the literature [15], our data clearly demonstrated that the frequency of sensitization to the common inhalant allergens decreased with age. A significant decline in the frequency of sensitization to the inhalant allergens was observed in patients aged between 45 and 64 y and those aged>65 y.…”

“…Proliferative T-lymphocyte response was reported to be reduced [16]. Moreover, although the activity and number of B-lymphocytes are observed to decline in elderly patients, serum autoantibody levels are found to increase [15]. These changes are termed "immunosenescence," which is thought to be a result of natural genetic aging, environmental factors, and unhealthy lifestyle or habits.…”

“…A previous study also suggests that these changes do not limit the prevalence of sensitization to allergens among elderly patients. In general, immunosenescence is expected to be observed in patients aged>75 y [15].…”

Efficiency of antifungal sublingual allergen-specific immunotherapy in patients under and over 50 years old with mild persistent and moderate bronchial asthma

“…Это согласуется с данными других авторов относительно возрастных особенностей астмы, связанных с уменьше-нием с возрастом легочных объемов [6] и утяжелением течения заболевания [7]. При этом повышенная кожная чувствительность к фунгальным микст-аллергенам у боль-ных обеих групп изначально была идентич-ной и сопровождалась повышенной кож-ной чувствительностью к гистамину.…”

“…При этом эффекты «иммунологического ста-рения»: скомпроментированность эпителиальных барьеров, усиление Т-хелперных реакций 2, 17 типа [6], -а также коморбидная патология и связанная с ними лекарственная терапия [7] обуславливают до-полнительные трудности в курации пожилых боль-ных с астмой и необходимость поиска новых методов терапии.…”