The aging bone marrow and its impact on immune responses in old age

Pritz, Theresa; Weinberger, Birgit; Grubeck‐Loebenstein, Beatrix

doi:10.1016/j.imlet.2014.06.016

Cited by 63 publications

(46 citation statements)

References 83 publications

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“…38 Thus, in attempt to produce a potent immune response, theoretically, each individual white blood cell of the elderly’s immune system would have to function at a greater-than-normal capacity in order to achieve an immune output comparable to adults (due to the differential leukocyte count). This overload on the elderly leukocytes, despite the delayed production of effector molecules (as shown by the surge of cytokines in the later stages of the pathophysiology from our data) bankrupts the elderly’s immune potential consequently making them susceptible to future insults, rendering them to an “immune exhausted” state.…”

Section: Discussionmentioning

confidence: 99%

Impaired Immune Response in Elderly Burn Patients

et al. 2016

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Objective Comparing inflammatory and immunological trajectories in burned adults vs. burned elderly patients to gain novel insights and better understanding why elderly have poor outcomes. Summary Background Data Despite receiving the same treatment and clinical consideration as all other burn patients, elderly patients continue to have substantially poorer outcomes compared to adults. In light of an ageing population, gaining a better understanding of their susceptibility to complications and creating new treatment strategies is imperative. Methods We included 130 burn patients (94 adults: <65 years-old & 36 elderly: ≥65 years-old) and 10 healthy controls in this study. Immune activity and expression was assessed using bioplex at various time points. Clinical outcomes such as infection, sepsis and mortality were prospectively collected. Results Elderly burn patients had significantly lower burn size but significantly higher Baux scores. Morbidity and mortality was significantly increased in the elderly cohort. Immune biomarkers indicated that elderly are immune compromised and unable to respond with the expected inflammatory response during the early phase after injury. This trajectory changes to a hyper-inflammatory pattern during the later phase after burn. These findings are even more pronounced when comparing sepsis vs. non-sepsis patients as well as survivors vs. non-survivors in the elderly. Conclusions Elderly burned patients mount a delayed immune and dampened inflammatory response early after burn injury that changes to an augmented response at later time points. Late-onset sepsis and non-survivors had an immune exhaustion phenotype, which may represent one of the main mediators responsible for the striking mortality in elderly.

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Section: Discussionmentioning

confidence: 99%

Impaired Immune Response in Elderly Burn Patients

et al. 2016

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“…Overall decrease in T cell counts is a marker for immunosenescence 9 . Thymal involution occurs as the older adult ages which not only leads to decreased thymal mass, but also decreased output of naïve T cells 9,10 .…”

Section: Geriatric Specific Factorsmentioning

confidence: 99%

“…Thymal involution occurs as the older adult ages which not only leads to decreased thymal mass, but also decreased output of naïve T cells 9,10 . These factors decrease the number of T cells which cause a decrease in interleukin-2 (IL-2) activation, secretion and proliferation effects to activate lymphocytes 10 .…”

Section: Geriatric Specific Factorsmentioning

confidence: 99%

Challenges with Diagnosing and Managing Sepsis in Older Adults

Clifford

Dy-Boarman

Haase

et al. 2016

Expert Review of Anti-infective Therapy

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Sepsis in older adults has many challenges that affect rate of septic diagnosis, treatment, and monitoring parameters. Numerous age-related changes and comorbidities contribute to increased risk of infections in older adults, but also atypical symptomatology that delays diagnosis. Due to various pharmacokinetic/pharmacodynamic changes in the older adult, medications are absorbed, metabolized, and eliminated at different rates as compared to younger adults, which increases risk of adverse drug reactions due to use of drug therapy needed for sepsis management. This review provides information to aid in diagnosis as well as offers recommendations for monitoring and treating sepsis in the older adult population.

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“…11–13 With advanced age, hematopoietic stem cells lose their full proliferative capacity, and their microenvironment is gradually replaced by fat. 14 Total myeloid cell output is maintained throughout the aging process, whereas lymphocyte production decreases over time. 15, 16 These phenomena may be inconsequential for donated blood that is subjected to pre-storage leukoreduction, which removes nearly all white blood cells, minimizing their physiologic impact and immunosuppressive potential.…”

Section: Introductionmentioning

confidence: 99%

The effects of red cell transfusion donor age on nosocomial infection among trauma patients

Loftus

Thomas

Murphy

et al. 2017

The American Journal of Surgery

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Background We hypothesized that packed red blood cell (PRBC) transfusions from older donors would be associated with fewer nosocomial infections among trauma patients. Methods We performed a four-year retrospective analysis of 264 consecutive adult trauma patients who received ≥1 PRBC transfusion during admission. The capacity of donor age to predict nosocomial infection was assessed by logistic regression. Results Thirty-three percent of all patients developed a nosocomial infection. Donor age was significantly higher among patients with nosocomial infection (40.3 vs. 37.6 years, p = 0.035), and the incidence of infection was directly proportional to donor age. The association between donor age and infection was strongest among recipients age ≥60 years, and was significant on multivariate regression for this cohort (OR 1.07 (95% CI 1.01–1.13), p = 0.024). Conclusions Among trauma patients receiving PRBC transfusions, blood from older donors may be associated with increased risk for nosocomial infection.

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The aging bone marrow and its impact on immune responses in old age

Cited by 63 publications

References 83 publications

Impaired Immune Response in Elderly Burn Patients

Impaired Immune Response in Elderly Burn Patients

Challenges with Diagnosing and Managing Sepsis in Older Adults

The effects of red cell transfusion donor age on nosocomial infection among trauma patients

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