Fostering healthy aging: The interdependency of infections, immunity and frailty

Vetrano, Davide Liborio; Triolo, Federico; Maggi, Stefania; Malley, Richard; Jackson, Thomas; Poscia, Andrea; Bernabei, Roberto; Ferrucci, Luigi; Fratiglioni, Laura

doi:10.1016/j.arr.2021.101351

Cited by 53 publications

(42 citation statements)

References 141 publications

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“…Indeed, fiAbs levels were decreased in frailer patients. Such a hypothesis has been proposed by Vetrano et al [ 29 ], but limited experimental support for this hypothesis exists. Thus, our study is among the first experimental evidence demonstrating that decreased generation of functional antibodies is closely linked to frailty.…”

Section: Discussionmentioning

confidence: 91%

Decreased Levels of SARS-CoV-2 Fusion-Inhibitory Antibodies in the Serum of Aged COVID-19 Patients

Malézieux-Picard¹,

Abdul

Herrmann³

et al. 2022

Diagnostics

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Background: The SARS-CoV-2 pandemic was particularly devastating for elderly people, and the underlying mechanisms of the disease are still poorly understood. In this study, we investigated fusion inhibitory antibodies (fiAbs) in elderly and younger COVID-19 patients and analyzed predictive factors for their occurrence. Methods: Data and samples were collected in two cohorts of hospitalized patients. A fusion assay of SARS-CoV-2 spike-expressing cells with ACE2-expressing cells was used to quantify fiAbs in the serum of patients. Results: A total of 108 patients (52 elderly (mean age 85 ± 7 years); 56 young (mean age 52 ± 10 years)) were studied. The concentrations of fiAbs were lower in geriatric patients, as evidenced at high serum dilutions (1/512). The association between fiAbs and anti-Spike Ig levels was weak (correlation coefficient < 0.3), but statistically significant. Variables associated with fusion were the delay between the onset of symptoms and testing (HR = −2.69; p < 0.001), clinical frailty scale (HR = 4.71; p = 0.035), and WHO severity score (HR = −6.01, p = 0.048). Conclusions: Elderly patients had lower fiAbs levels after COVID-19 infection. The decreased fiAbs levels were associated with frailty.

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Section: Discussionmentioning

confidence: 91%

Decreased Levels of SARS-CoV-2 Fusion-Inhibitory Antibodies in the Serum of Aged COVID-19 Patients

Malézieux-Picard¹,

Abdul

Herrmann³

et al. 2022

Diagnostics

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“…However, aging per se and perhaps frailty as an indicator of accelerated aging reduces the effectiveness of influenza vaccination, 13 most likely due to immunosenescence. 30 …”

Section: Discussionmentioning

confidence: 99%

Influenza infection is not associated with phenotypical frailty in older patients, a prospective cohort study

Takahashi

Ryu

et al. 2022

Health Science Reports

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Background and Aims Influenza is a challenging infectious illness for older adults. It is not completely clear whether influenza is associated with frailty or functional decline. We sought to determine the association between incident influenza infection and frailty and prefrailty in community patients over 50 years of age. We also investigated the association between influenza vaccination and frailty and prefrailty as a secondary aim. Methods This was a prospective community cohort study from October 2019 to November 2020 in participants over 50 years. The primary outcome was the development of frailty as defined by three of five frailty criteria (slow gait speed, low grip strength, 5% weight loss, low energy, and low physical functioning). The primary predictor was a positive polymerase chain reaction (PCR) for influenza infection. Influenza vaccination was based on electronic health record reviewing 1 year before enrollment. We reported the relationship between influenza and frailty by calculating odds ratios (OR) with 95% confidence intervals (CI) after adjustment for age, sex, socioeconomic status, Charlson Comorbidity Index (CCI), influenza vaccine, and previous self‐rated frailty from multinomial logistic regression model comparing frail and prefrail to nonfrail subjects. Results In 1135 participants, the median age was 67 years (interquartile range 60−74), with 41% men. Eighty‐one participants had PCR‐confirmed influenza (7.1%). Frailty was not associated with influenza, with an OR of 0.50 (95% CI 0.17−1.43) for frail participants compared to nonfrail participants. Influenza vaccination is associated with frailty, with an OR of 1.69 (95% CI 1.09−2.63) for frail compared to nonfrail. Frailty was associated with a higher CCI with an OR of 1.52 (95% CI 1.31−1.76). Conclusion We did not find a relationship between influenza infection and frailty. We found higher vaccination rates in participants with frailty compared to nonfrail participants While influenza was not associated with frailty, future work may involve longer follow‐up.

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“…Greater immunological frailty was associated with a poorer response to vaccination ( 55 ). Subsequent studies have further supported the association of frailty with poor immune responses ( 56 ), and diminished vaccination efficacy ( 56 – 58 ). In SARS-CoV-2 infection, frailty correlated with severe disease and mortality more than chronological age ( 59 – 61 ).…”

Section: Evaluating Immunity In Immunocompromised Subjectsmentioning

confidence: 94%

Cellular Immunity Is Critical for Assessing COVID-19 Vaccine Effectiveness in Immunocompromised Individuals

Paramithiotis¹,

Sugden²,

Papp³

et al. 2022

Front. Immunol.

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COVID-19 vaccine clinical development was conducted with unprecedented speed. Immunity measurements were concentrated on the antibody response which left significant gaps in our understanding how robust and long-lasting immune protection develops. Better understanding the cellular immune response will fill those gaps, especially in the elderly and immunocompromised populations which not only have the highest risk for severe infection, but also frequently have inadequate antibody responses. Although cellular immunity measurements are more logistically complex to conduct for clinical trials compared to antibody measurements, the feasibility and benefit of doing them in clinical trials has been demonstrated and so should be more widely adopted. Adding significant cellular response metrics will provide a deeper understanding of the overall immune response to COVID-19 vaccination, which will significantly inform vaccination strategies for the most vulnerable populations. Better monitoring of overall immunity will also substantially benefit other vaccine development efforts, and indeed any therapies that involve the immune system as part of the therapeutic strategy.

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Fostering healthy aging: The interdependency of infections, immunity and frailty

Cited by 53 publications

References 141 publications

Decreased Levels of SARS-CoV-2 Fusion-Inhibitory Antibodies in the Serum of Aged COVID-19 Patients

Decreased Levels of SARS-CoV-2 Fusion-Inhibitory Antibodies in the Serum of Aged COVID-19 Patients

Influenza infection is not associated with phenotypical frailty in older patients, a prospective cohort study

Cellular Immunity Is Critical for Assessing COVID-19 Vaccine Effectiveness in Immunocompromised Individuals

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