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The immune risk phenotype is associated with IL-6 in the terminal decline stage: Findings from the Swedish NONA immune longitudinal study of very late life functioning

2006; Elsevier BV; Volume: 127; Issue: 8 Linguagem: Inglês

10.1016/j.mad.2006.04.003

1872-6216

Anders Wikby, Bengt‐Olof Nilsson, Rosalyn Forsey, Julie Thompson, Jan Strindhall, Sture Löfgren, Jan Ernerudh, Graham Pawelec, Frederick G. Ferguson, Boo Johansson,

IL-33, ST2, and ILC Pathways

In the present NONA immune longitudinal study, we further examine the previously identified T cell immune risk phenotype (IRP), relative inflammatory activity, morbidity and 2-year mortality in very old individuals >90 years. T-cell subsets as well as the inflammatory markers IL-6, IL-10, C-reactive protein, transthyretin and albumin were evaluated. IRP and low-grade inflammation predicted 57% of observed deaths and 97% of survival over 2 years, and was not significantly affected by individuals' health status, suggesting that the physiological ageing processes of T-cell immunosenescence and low-grade inflammation are of primary importance in late life survival. IRP non-survivors showed only a minor inflammatory activity at baseline, but had in contrast to survivors developed increased activity at follow-up. The results suggest a sequence of stages for IRP individuals that begin with acquisition of CMV infection in earlier life, followed by generation of CD8+CD28− cells to control persistent CMV infection and eventually the development of an IRP. Intriguingly, we also found that rare individuals moved out of the IRP category by a process of immune suppression, including increases in IL-6 and IL-10 and decreases in the number of CD3+CD8+CD28− cells. The further characterisation of these exceptional individuals may allow insight into remedial approaches for those who remain in the IRP category until death.