Anemia and adverse outcomes in the elderly: a detrimental inflammatory loop?

Girelli, Domenico; Busti, Fabiana

doi:10.3324/haematol.2018.208066

Cited by 15 publications

(7 citation statements)

References 21 publications

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“… 112 , 113 This should be further investigated, as well as the reciprocal influences between CHIP and inflammaging, which can elicit a detrimental loop. 114 This would be of particular interest considering the results of a recent proof-of-concept analysis on the beneficial effects of anticytokine agents on AE. 115 …”

Section: Anemia In the Elderlymentioning

confidence: 99%

The EHA Research Roadmap: Anemias

et al. 2021

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Section: Anemia In the Elderlymentioning

confidence: 99%

The EHA Research Roadmap: Anemias

et al. 2021

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“…In a recent study, 13.8% of people aged ≥65 years who participated in a Korean national survey had anemia [ 25 ]. Aging is a proinflammatory condition that may cause altered iron handling or the suppression of erythroid progenitors [ 26 ]. Anemia in the elderly is related to various adverse outcomes, including hospitalization, morbidity, and mortality [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical features and outcomes of elderly patients with antineutrophil cytoplasmic antibody-positive vasculitis: a single-center retrospective study

Kim

Song

Seong

2022

Kidney Res Clin Pract

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BackgroundWe aimed to investigate the clinical characteristics and outcomes of patients aged ≥65 years with antineutrophil cytoplasmic autoantibody (ANCA)-positive ANCA-associated vasculitis (AAV) in Korea.MethodsSeventy patients diagnosed with ANCA-positive AAV from 2006 to 2019 at a single center were analyzed and categorized into younger (aged <65 years) or elderly (aged ≥65 years) groups. Initial induction treatments were investigated according to age group. All-cause mortality and kidney outcomes were evaluated.ResultsAfter categorization by age, 34 (48.6%) and 36 patients (51.4%) were in the younger and elderly groups, respectively. In the elderly group, more patients were treated with oral cyclophosphamide (CYC) (30.6%) than with intravenous CYC (19.4%). During a median follow-up of 14.6 months (range, 3.0-53.1 months), 13 patients died (elderly group: 11 patients, 84.6%). In the elderly group, older age (hazard ratio [HR], 1.44; 95% confidence interval [CI], 1.09-1.90; p = 0.01), lower hemoglobin (HR, 0.21; 95% CI, 0.08-0.60; p = 0.003), and higher serum creatinine level (HR 14.17; 95% CI, 1.29-155.84; p = 0.03) were significant risk factors for all-cause mortality after adjustment. Oral CYC + steroid treatment was associated with decreased all-cause mortality compared to untreated induction immunosuppressants (HR, 0.01; 95% CI, 0.0003-0.47; p = 0.02). Kidney failure or renal recovery outcomes were not significantly different between the younger and elderly groups.ConclusionPatients aged ≥65 years had higher mortality rates than younger patients, and mortality was associated with older age, lower hemoglobin, higher serum creatinine level, and nontreatment compared to oral CYC + steroids.

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“…Anaemia can be caused by nutritional factors, blood loss, chronic kidney disease, chronic inflammation, or clonal haematopoiesis [ 221 , 222 ]. The latter two factors are directly related to aging processes in the hematopoietic system [ 223 , 224 ]. The exact mechanisms of clonal haematopoiesis-related anaemia are unknown.…”

Section: Hscs Senility and Immune Aging As A Risk Factor For Pathologiesmentioning

confidence: 99%

Hematopoietic Stem Cells and the Immune System in Development and Aging

Shevyrev

Tereshchenko

Berezina

et al. 2023

IJMS

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Hematopoietic stem cells (HSCs) support haematopoiesis throughout life and give rise to the whole variety of cells of the immune system. Developing in the early embryo, passing through the precursor stage, and maturing into the first HSCs, they undergo a fairly large number of divisions while maintaining a high regenerative potential due to high repair activity. This potential is greatly reduced in adult HSCs. They go into a state of dormancy and anaerobic metabolism to maintain their stemness throughout life. However, with age, changes occur in the pool of HSCs that negatively affect haematopoiesis and the effectiveness of immunity. Niche aging and accumulation of mutations with age reduces the ability of HSCs to self-renew and changes their differentiation potential. This is accompanied by a decrease in clonal diversity and a disturbance of lymphopoiesis (decrease in the formation of naive T- and B-cells) and the predominance of myeloid haematopoiesis. Aging also affects mature cells, regardless of HSC, therefore, phagocytic activity and the intensity of the oxidative burst decrease, and the efficiency of processing and presentation of antigens by myeloid cells is impaired. Aging cells of innate and adaptive immunity produce factors that form a chronic inflammatory background. All these processes have a serious negative impact on the protective properties of the immune system, increasing inflammation, the risk of developing autoimmune, oncological, and cardiovascular diseases with age. Understanding the mechanisms of reducing the regenerative potential in a comparative analysis of embryonic and aging HSCs, the features of inflammatory aging will allow us to get closer to deciphering the programs for the development, aging, regeneration and rejuvenation of HSCs and the immune system.

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Anemia and adverse outcomes in the elderly: a detrimental inflammatory loop?

Cited by 15 publications

References 21 publications

The EHA Research Roadmap: Anemias

The EHA Research Roadmap: Anemias

Clinical features and outcomes of elderly patients with antineutrophil cytoplasmic antibody-positive vasculitis: a single-center retrospective study

Hematopoietic Stem Cells and the Immune System in Development and Aging

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