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Hussain S, Songhua X, Aslam MU, Hussain F. Clinical predictions of COVID-19 patients using deep stacking neural networks. J Investig Med 2024; 72:112-127. [PMID: 37712431 DOI: 10.1177/10815589231201103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, which emerged in late 2019, has caused millions of infections and fatalities globally, disrupting various aspects of human society, including socioeconomic, political, and educational systems. One of the key challenges during the COVID-19 pandemic is accurately predicting the clinical development and outcome of the infected patients. In response, scientists and medical professionals globally have mobilized to develop prognostic strategies such as risk scores, biomarkers, and machine learning models to predict the clinical course and outcomes of COVID-19 patients. In this contribution, we deployed a mathematical approach called matrix factorization feature selection to select the most relevant features from the anonymized laboratory biomarkers and demographic data of COVID-19 patients. Based on these features, developed a model that leverages the deep stacking neural network (DSNN) to aid in clinical care by predicting patients' mortality risk. To gauge the performance of our suggested model, performed a comparative analysis with principal component analysis plus support vector machine, deep learning, and random forest, achieving outstanding performances. The DSNN model outperformed all the other models in terms of area under the curve (96.0%), F1-score (98.1%), recall (98.5%), accuracy (99.0%), precision (97.7%), specificity (97.0%), and maximum probability of correction decision (93.4%). Our model outperforms the clinical predictive models regarding patient mortality risk and classification in the literature. Therefore, we conclude that our robust model can help healthcare professionals to manage COVID-19 patients more effectively. We expect that early prediction of COVID-19 patients and preventive interventions can reduce the mortality risk of patients.
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Affiliation(s)
- Sajid Hussain
- School of Mathematics and Statistics XJTU, Xian, Shaanxi, China
| | - Xu Songhua
- School of Mathematics and Statistics XJTU, Xian, Shaanxi, China
| | | | - Fida Hussain
- School of Engineering and Sciences, Tecnologico de Monterrey, Monterrey, Nuevo León, Mexico
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2
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Farias LABG, Stolp ÂMV, Bandeira SP, Mesquita RF, Bessa PPDN, de Holanda PEL, Costa SF, Takeda CFV, Perdigão LV. Meningitis caused by Capnocytophaga canimorsus in a COVID-19 patient: a rare complication of dog bites. Rev Inst Med Trop Sao Paulo 2022; 64:e33. [PMID: 35544911 PMCID: PMC9084465 DOI: 10.1590/s1678-9946202264033] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/05/2022] [Indexed: 12/04/2022] Open
Abstract
Capnocytophaga canimorsus is a gram-negative rod that is part of the commensal microbiota of dogs' and cats' mouths. In this case, we report an 85-year-old man with COVID-19 who had his right arm bitten by a dog. His symptoms were impaired consciousness, agitation and aggressive behavior. Physical examination revealed neck stiffness and Brudzinski's sign. The cerebrospinal fluid culture was compatible with Capnocytophaga canimorsus. He required intensive care and received a 14-day prescription of meropenem. After 40 days of hospitalization, the patient was fully recovered and was discharged. This case highlights the importance of physician and microbiologist be awareness of this disease, mainly in patients with neurological symptoms after a dog or cat bite.
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Affiliation(s)
- Luís Arthur Brasil Gadelha Farias
- Secretaria de Saúde do Estado do Ceará, Programa de Residência Médica em Infectologia, Fortaleza, Ceará, Brazil
- Hospital São José de Doenças Infecciosas, Fortaleza, Ceará, Brazil
| | - Ângela Maria Veras Stolp
- Laboratório Central de Saúde Pública do Estado do Ceará, Setor de Microbiologia, Fortaleza, Ceará, Brazil
- Universidade de Fortaleza, Fortaleza, Ceará, Brazil
| | | | | | | | | | - Silvia Figueiredo Costa
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, Brazil
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Christianne Fernandes Valente Takeda
- Secretaria de Saúde do Estado do Ceará, Programa de Residência Médica em Infectologia, Fortaleza, Ceará, Brazil
- Hospital São José de Doenças Infecciosas, Fortaleza, Ceará, Brazil
| | - Lauro Vieira Perdigão
- Hospital São José de Doenças Infecciosas, Fortaleza, Ceará, Brazil
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, Brazil
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Getting Old Well in Sub Saharan Africa: Exploring the Social and Structural Drivers of Subjective Wellbeing among Elderly Men and Women in Uganda. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072347. [PMID: 32244270 PMCID: PMC7177324 DOI: 10.3390/ijerph17072347] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/09/2020] [Accepted: 03/17/2020] [Indexed: 01/08/2023]
Abstract
While literature attempts to explain why self-reported subjective wellbeing (SWB) generally increases with age in most high-income countries based on a social determinants of a health framework, little work attempts to explain the low levels of self-report SWB among older persons in sub-Saharan Africa. Using the 2013 Uganda Study on Global Aging and Health with 470 individuals, this research examines (i) direct and indirect effects of age on SWB through social and structural determinants, and (ii) how direct and indirect effects vary by gender. Results show a significant direct and negative effect of age on SWB (β = 0.42, p = 0.01). Six indirect paths were statistically significant and their indirect effects on wellbeing varied by gender. Providing support, education, working status, asset level, financial status and financial improvement were significantly positively associated with men’s SWB, whereas younger age, providing community support, participating in group activities, number of close friends/relatives, government assistance and all socio-economic variables were significantly positively associated with women’s SWB. Strategies to address gendered economic, social and political inequalities among and between elderly populations are urgently needed.
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Milan-Mattos JC, Anibal FF, Perseguini NM, Minatel V, Rehder-Santos P, Castro CA, Vasilceac FA, Mattiello SM, Faccioli LH, Catai AM. Effects of natural aging and gender on pro-inflammatory markers. ACTA ACUST UNITED AC 2019; 52:e8392. [PMID: 31411315 PMCID: PMC6694726 DOI: 10.1590/1414-431x20198392] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 06/25/2019] [Indexed: 12/21/2022]
Abstract
The term inflammaging is now widely used to designate the inflammatory process of natural aging. During this process, cytokine balance is altered, presumably due to the loss of homeostasis, thus contributing to a greater predisposition to disease and exacerbation of chronic diseases. The aim of the study was to analyze the relationship between pro-inflammatory markers and age in the natural aging process of healthy individuals. One hundred and ten subjects were divided into 5 groups according to age (22 subjects/group). Interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) were quantified using the ELISA method. High-sensitivity C-reactive protein (hsCRP) was analyzed by turbidimetry according to laboratory procedures. The main findings of this study were: a positive correlation between hsCRP and IL-6 as a function of age (110 subjects); women showed stronger correlations; the 51–60 age group had the highest values for hsCRP and IL-6; women presented higher values for hsCRP in the 51–60 age group and higher values for IL-6 in the 61–70 age group; and men showed higher values in the 51–60 age group for hsCRP and IL-6. In conclusion, the natural aging process increased IL-6 and hsCRP levels, which is consistent with the inflammaging theory; however, women presented stronger correlations compared to men (IL-6 and hsCRP) and the 51–60 age range seems to be a key point for these increases. These findings are important because they indicate that early preventive measures may minimize the increase in these inflammatory markers in natural human aging.
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Affiliation(s)
- J C Milan-Mattos
- Laboratório de Fisioterapia Cardiovascular, Núcleo de Pesquisas em Exercício Físico, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil.,Departamento de Morfologia e Patologia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - F F Anibal
- Departamento de Morfologia e Patologia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - N M Perseguini
- Laboratório de Fisioterapia Cardiovascular, Núcleo de Pesquisas em Exercício Físico, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - V Minatel
- Laboratório de Fisioterapia Cardiovascular, Núcleo de Pesquisas em Exercício Físico, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - P Rehder-Santos
- Laboratório de Fisioterapia Cardiovascular, Núcleo de Pesquisas em Exercício Físico, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - C A Castro
- Departamento de Morfologia e Patologia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - F A Vasilceac
- Laboratório de Função Articular, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - S M Mattiello
- Laboratório de Função Articular, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
| | - L H Faccioli
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - A M Catai
- Laboratório de Fisioterapia Cardiovascular, Núcleo de Pesquisas em Exercício Físico, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil
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Müller L, Di Benedetto S, Pawelec G. The Immune System and Its Dysregulation with Aging. Subcell Biochem 2019; 91:21-43. [PMID: 30888648 DOI: 10.1007/978-981-13-3681-2_2] [Citation(s) in RCA: 120] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Aging leads to numerous changes that affect all physiological systems of the body including the immune system, causing greater susceptibility to infectious disease and contributing to the cardiovascular, metabolic, autoimmune, and neurodegenerative diseases of aging. The immune system is itself also influenced by age-associated changes occurring in such physiological systems as the endocrine, nervous, digestive, cardio-vascular and muscle-skeletal systems. This chapter describes the multidimensional effects of aging on the most important components of the immune system. It considers the age-related changes in immune cells and molecules of innate and adaptive immunity and consequent impairments in their ability to communicate with each other and with their aged environment. The contribution of age-related dysregulation of hematopoiesis, required for continuous replenishment of immune cells throughout life, is discussed in this context, as is the developmentally-programmed phenomenon of thymic involution that limits the output of naïve T cells and markedly contributes to differences between younger and older people in the distribution of peripheral blood T-cell types. How all these changes may contribute to low-grade inflammation, sometimes dubbed "inflammaging", is considered. Due to findings implicating elevated inflammatory immuno-mediators in age-associated chronic autoimmune and neurodegenerative processes, evidence for their possible contribution to neuroinflammation is reviewed.
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Affiliation(s)
- Ludmila Müller
- Max Planck Institute for Human Development, Berlin, Germany.
| | - Svetlana Di Benedetto
- Max Planck Institute for Human Development, Berlin, Germany.,Center for Medical Research, University of Tübingen, Tübingen, Germany
| | - Graham Pawelec
- Center for Medical Research, University of Tübingen, Tübingen, Germany.,Health Sciences North Research Institute, Sudbury, ON, Canada
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Rodrigues D, de Marchi Bacellos de Dalri RDC. Eventos adversos pós-vacinação contra influenza em idosos no Brasil. Rev Salud Publica (Bogota) 2019; 21:22-28. [PMID: 33206922 DOI: 10.15446/rsap.v21n1.77308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 12/22/2018] [Indexed: 11/09/2022] Open
Abstract
Objetivo Identificar e analisar a ocorrência de eventos adversos pós vacinação contra Influenza em idosos brasileiros.Método Pesquisa descritiva, analítica, retrospectiva e quantitativa. Participaram desta pesquisa 98 idosos identificados por meio das fichas de notificação de eventos adversos pós vacinação disponibilizados pelo Sistema de Informação de Eventos Adversos Pós Vacinação de Minas Gerias - BR, entre 2014 e 2016. Os dados foram duplamente digitados e transportados para os programas Ri386 versão 3.4.3 3 IBM SPSS Statics versão 25. Realizou-se estatísticas descritivas, frequência e percentual para as variáveis qualitativas e medidas de tendência central (média e mediana) e dispersão (desvio padrão) para as variáveis numéricas. Para verificar a associação entre os tipos de eventos (não grave, grave e erro de imunização) e as manifestações sistêmicas com as variáveis de caracterização dos idosos e das vacinas, utilizou-se o teste Exato de Fisher e Qui-quadrado; o nível de significância utilizado foi p<=0,05.Resultados Dos idosos estudados, 75,5% eram do sexo feminino com predominância da raça branca (55,1%) cuja idade variou entre 60 e 97 anos; 84,7% dos eventos adversos foram descritos como Evento Adverso Não Grave, com 64,3% de manifestações locais e 27,6% de manifestações sistêmicas.Conclusão Proporcionar informações específicas aos enfermeiros no que tange os cuidados pré e pós vacinação contra Influenza é de fundamental importância para o estabelecimento de atendimento adequado livre de danos aos idosos e que não incorra em eventos adversos evitáveis.
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Affiliation(s)
- Damiana Rodrigues
- DR: Enf. Especialista em Urgência emergência e Terapia intensiva, M. Sc. Pela Escola de Enfermagem de Ribeirão Preto - Universidade de São Paulo - EERP-USP. Sao Paulo, Brasil.
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Social Context and Geographic Space: An Ecological Study about Hospitalizations of Older Persons. Value Health Reg Issues 2018; 17:8-13. [PMID: 29544112 DOI: 10.1016/j.vhri.2017.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 10/28/2017] [Accepted: 12/01/2017] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To identify the diseases that lead older persons to hospitalizations in the public health system in the state of Rio de Janeiro and, through a study of spatial distribution among hospitalization rates of the municipal districts, discuss the social contexts involved in the hospitalization of the elderly. METHODS An ecological cross-sectional study using secondary data from the Brazilian hospital information system from the period 2009 to 2015 was performed. The hospitalization rates of people 60 years and older, residing in 92 municipalities in the state of Rio de Janeiro, were calculated. The municipal districts were grouped according to the similarity of such rates using K-means nonhierarchical clustering analysis. RESULTS Diseases of the circulatory and respiratory systems, endocrine disorders, illnesses of the genitourinary system or the digestive tract, and certain infectious and parasitic diseases were the most discriminatory diseases for cluster composition. The first cluster, the municipal districts with the lowest hospitalization rates, which were more urbanized and had greater access to social and health services, was named Access and Inclusion. The second group, which had the highest hospitalization rates, was named Isolation and Vulnerability. CONCLUSIONS The primary care-sensitive conditions are the main causes of hospitalization of the elderly in the state, with greater intensity in the municipalities that are geographically rugged and remote. These outcomes reinforce the importance of valuing geographical knowledge, the guidelines of the unified health system concerning equity and regionalization, and the determinants and social determinations involved in the process of health and disease.
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Mourglia-Ettlin G, Miles S, Hernández A, Dematteis S. Ageing impairs parasite-specific antibody responses in cystic echinococcosis. Parasite Immunol 2017; 40. [DOI: 10.1111/pim.12505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 11/15/2017] [Indexed: 01/06/2023]
Affiliation(s)
- G. Mourglia-Ettlin
- Área Inmunología; Facultad de Química/Facultad de Ciencias; DEPBIO/IQB; Universidad de la República; Montevideo Uruguay
| | - S. Miles
- Área Inmunología; Facultad de Química/Facultad de Ciencias; DEPBIO/IQB; Universidad de la República; Montevideo Uruguay
| | - A. Hernández
- Área Inmunología; Facultad de Química/Facultad de Ciencias; DEPBIO/IQB; Universidad de la República; Montevideo Uruguay
| | - S. Dematteis
- Área Inmunología; Facultad de Química/Facultad de Ciencias; DEPBIO/IQB; Universidad de la República; Montevideo Uruguay
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Wennerås C, Goldblatt D, Zancolli M, Mattsson M, Wass L, Hörkkö S, Rosén A. Natural IgM antibodies in the immune defence against neoehrlichiosis. Infect Dis (Lond) 2017; 49:809-816. [PMID: 28682152 DOI: 10.1080/23744235.2017.1347815] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Neoehrlichiosis is an infectious disease caused by the tick-borne bacterium "Candidatus Neoehrlichia mikurensis". Splenectomy and rituximab therapies are risk factors for severe neoehrlichiosis. Our aim was to examine if neoehrlichiosis patients had low levels of natural IgM antibodies and/or were hypogammaglobulinemic, and if such deficiencies were associated with asplenia and vascular complications. METHODS Neoehrlichiosis patients (n = 9) and control subjects (n = 10) were investigated for serum levels of IgG, IgA, and IgM, and for levels of natural IgM antibodies to pneumococcal polysaccharides (6B, 14), and to the malondialdehyde acetaldehyde epitope of oxidized LDL. The multivariate method Projection to Latent Structures was used to analyze the data. RESULTS The levels of natural IgM antibodies of various specificities were decreased or not measurable in half of the studied patients with neoehrlichiosis. Only one patient and one control subject were hypogammaglobulinemic. An inverse relationship was noted between the levels of natural IgM antibodies and the development of deep vein thrombosis. Unexpectedly, no association was seen between having or not having a spleen and the levels of natural IgM antibody levels in the circulation. CONCLUSIONS Neither hypogammaglobulinemia nor lack of natural IgM antibodies alone predisposes for severe neoehrlichiosis. The importance of the spleen in the immune defence against Ca. N. mikurensis probably lies in its capacity to generate or maintain specific antibodies.
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Affiliation(s)
- Christine Wennerås
- a Department of Infectious Diseases and Hematology , Sahlgrenska Academy, University of Gothenburg , Göteborg , Sweden
| | - David Goldblatt
- b Immunobiology Section , Great Ormond Street Institute of Child Health, University College London , London , UK
| | - Marta Zancolli
- b Immunobiology Section , Great Ormond Street Institute of Child Health, University College London , London , UK
| | - Mattias Mattsson
- c Department of Hematology , Uppsala University Hospital , Uppsala , Sweden
| | - Linda Wass
- a Department of Infectious Diseases and Hematology , Sahlgrenska Academy, University of Gothenburg , Göteborg , Sweden
| | - Sohvi Hörkkö
- d Department of Medical Microbiology and Immunology , Medical Research Center University of Oulu, and Nordlab Oulu, Oulu University Hospital , Oulu , Finland
| | - Anders Rosén
- e Department of Clinical and Experimental Medicine , Linköping University , Linköping , Sweden
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Stanojcic M, Chen P, Xiu F, Jeschke MG. Impaired Immune Response in Elderly Burn Patients: New Insights Into the Immune-senescence Phenotype. Ann Surg 2016; 264:195-202. [PMID: 26649579 PMCID: PMC4899096 DOI: 10.1097/sla.0000000000001408] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Comparing the inflammatory and immunological trajectories in burned adults versus 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 with adults. In light of an aging 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 and 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 hyperinflammatory pattern during the later phase after burn. These findings are even more pronounced when comparing sepsis versus nonsepsis patients as well as survivors versus nonsurvivors 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 nonsurvivors had an immune exhaustion phenotype, which may represent one of the main mediators responsible for the striking mortality in elderly.
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Affiliation(s)
- Mile Stanojcic
- *Sunnybrook Research Institute, University of Toronto, Toronto, Canada†Department of Surgery, Division of Plastic Surgery, University of Toronto, Toronto, Canada‡Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
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Mantovani EP, Lucca SRD, Neri AL. Associações entre significados de velhice e bem-estar subjetivo indicado por satisfação em idosos. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2016. [DOI: 10.1590/1809-98232016019.150041] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivos: Investigar os significados atribuídos por idosos aos conceitos de velhice saudável e de ser feliz na velhice, bem como as associações entre os significados e suas avaliações sobre satisfação global e referenciada a domínios. Método: Esta investigação foi realizada a partir dos dados de um estudo multicêntrico, de corte transversal. As emissões verbais provenientes de amostras representativas de idosos comunitários (N=1.242, com 65 anos e mais), registradas no banco de dados de duas cidades brasileiras, foram submetidas à análise de conteúdo e comparadas com indicadores de satisfação, considerando-se sexo, idade e renda familiar. Resultados: Quatro temas e 14 categorias explicaram os dois conceitos: saúde física e funcionalidade (42,1% das emissões), bem-estar psicológico (25,4%), relações interpessoais (23,5%) e recursos materiais e acesso a serviços de saúde (9,0%). Exceção feita à satisfação e prazer, não foram observadas diferenças quanto às razões de prevalência entre as categorias de significado e pontuação alta em satisfação global. Conclusão: Os dois conceitos suscitaram significados comuns associados a aspectos positivos da velhice e refletiram sobre as avaliações de satisfação, evidenciando que, envelhecer de forma saudável e feliz é mais do que ter saúde, pois envolve também bem-estar psicológico e relações interpessoais.
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St-Amour I, Cicchetti F, Calon F. Immunotherapies in Alzheimer's disease: Too much, too little, too late or off-target? Acta Neuropathol 2016; 131:481-504. [PMID: 26689922 DOI: 10.1007/s00401-015-1518-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 11/12/2015] [Accepted: 12/03/2015] [Indexed: 12/19/2022]
Abstract
Years of research have highlighted the importance of the immune system in Alzheimer's disease (AD), a system that, if manipulated during strategic time windows, could potentially be tackled to treat this disorder. However, to minimize adverse effects, it is essential to first grasp which exact aspect of it may be targeted. Several clues have been collected over the years regarding specific immune players strongly modulated during different stages of AD progression. However, the inherent complexity of the immune system as well as conflicting data make it quite challenging to pinpoint a specific immune target in AD. In this review, we discuss immune-related abnormalities observed in the periphery as well as in the brain of AD patients, in relation to known risk factors of AD such as genetics, type-2 diabetes or obesity, aging, physical inactivity and hypertension. Although not investigated yet in clinical trials, C5 complement system component, CD40/CD40L interactions and the CXCR2 pathway are altered in AD patients and may represent potential therapeutic targets. Immunotherapies tested in a clinical context, those aiming to attenuate the innate immune response and those used to facilitate the removal of pathological proteins, are further discussed to try and understand the causes of the limited success reached. The prevailing eagerness to move basic research data to clinic should not overshadow the fact that a careful preclinical characterization of a drug is still required to ultimately improve the chance of clinical success. Finally, specific elements to consider prior to initiate large-scale trials are highlighted and include the replication of preclinical data, the use of small-scale human studies, the sub-typing of AD patients and the determination of pharmacokinetic and pharmacodynamics parameters such as brain bioavailability and target engagement.
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Affiliation(s)
- Isabelle St-Amour
- Axe Neurosciences, Centre de Recherche du CHU de Québec, 2705, Boulevard Laurier, Quebec, QC, G1V 4G2, Canada
- Département de Psychiatrie & Neurosciences, Faculté de médecine, Université Laval, Quebec, QC, Canada
- Faculté de pharmacie, Université Laval, Quebec, QC, Canada
| | - Francesca Cicchetti
- Axe Neurosciences, Centre de Recherche du CHU de Québec, 2705, Boulevard Laurier, Quebec, QC, G1V 4G2, Canada
- Département de Psychiatrie & Neurosciences, Faculté de médecine, Université Laval, Quebec, QC, Canada
| | - Frédéric Calon
- Axe Neurosciences, Centre de Recherche du CHU de Québec, 2705, Boulevard Laurier, Quebec, QC, G1V 4G2, Canada.
- Faculté de pharmacie, Université Laval, Quebec, QC, Canada.
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Abstract
West Nile virus (WNV) can cause severe neuroinvasive disease in humans and currently no vaccine or specific treatments are available. As aging is the most prominent risk factor for WNV, age-related immune dysregulation likely plays an essential role in host susceptibility to infection with WNV. In this review, we summarize recent findings in effects of aging on immune responses to WNV infection. In particular, we focus on the age-dependent dysregulation of innate immune cell types-neutrophils, macrophages, and dendritic cells-in response to WNV infection, as well as age-related alterations in NK cells and γδ T cells that may associate with increased WNV susceptibility in older people. We also highlight two advanced technologies, i.e., mass cytometry and microRNA profiling, which significantly contribute to systems-level study of immune dysregulation in aging and should facilitate new discoveries for therapeutic intervention against WNV.
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Affiliation(s)
- Yi Yao
- Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, New Haven, CT, 06520, USA
| | - Ruth R Montgomery
- Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, New Haven, CT, 06520, USA.
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Cárdenas D, Vélez G, Orfao A, Herrera MV, Solano J, Olaya M, Uribe AM, Saavedra C, Duarte M, Rodríguez M, López M, Fiorentino S, Quijano S. Epstein-Barr virus-specific CD8(+) T lymphocytes from diffuse large B cell lymphoma patients are functionally impaired. Clin Exp Immunol 2015; 182:173-83. [PMID: 26174440 PMCID: PMC4608507 DOI: 10.1111/cei.12682] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2015] [Indexed: 12/13/2022] Open
Abstract
Epstein-Barr virus (EBV) is a persistent virus with oncogenic capacity that has been implicated in the development of aggressive B cell lymphomas, primarily in immunosuppressed individuals, although it can be present in immunocompetent individuals. Changes in the function and clonal diversity of T lymphocytes might be implied by viral persistence and lymphoma development. The aim of the present study was to evaluate the frequency, phenotype, function and clonotypical distribution of EBV-specific T cells after peripheral blood stimulation with a virus lysate in newly diagnosed patients with diffuse large B cell lymphoma (DLBCL) aged more than 50 years without prior histories of clinical immunosuppression compared with healthy controls. Our results showed impaired EBV-specific immune responses among DLBCL patients that were associated primarily with decreased numbers of central and effector memory CD8(+) T lymphocytes. In contrast to healthy controls, only a minority of the patients showed CD4(+)/tumour necrosis factor (TNF)-α(+) T cells expressing T cell receptor (TCR)-Vβ17 and CD8(+)/TNF-α(+) T cells with TCR-Vβ5·2, Vβ9 and Vβ18 in response to EBV. Notably, the production of TNF-α was undetectable among TCR-Vβ5·3(+), Vβ11(+), Vβ12(+), Vβ16(+) and Vβ23(+) CD8(+) T cells. In addition, we observed decreased numbers of CD4(+)/TNF-α(+) and CD8(+)/TNF-α(+), CD8(+)/interleukin (IL)-2(+) and CD8(+)/TNF-α(+)/IL-2(+) T lymphocytes in the absence of T cells capable of producing TNF-α, IL-2 and IFN-γ after EBV stimulation simultaneously. Moreover, DLBCL patients displayed higher IL-10 levels both under baseline conditions and after EBV stimulation. These findings were also observed in patients with positive EBV viral loads. Prospective studies including a large number of patients are needed to confirm these findings.
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MESH Headings
- Aged
- Aged, 80 and over
- CD4-Positive T-Lymphocytes/immunology
- CD4-Positive T-Lymphocytes/metabolism
- CD8-Positive T-Lymphocytes/immunology
- CD8-Positive T-Lymphocytes/metabolism
- CD8-Positive T-Lymphocytes/virology
- Epstein-Barr Virus Infections/blood
- Epstein-Barr Virus Infections/immunology
- Epstein-Barr Virus Infections/virology
- Female
- Flow Cytometry
- Herpesvirus 4, Human/immunology
- Herpesvirus 4, Human/physiology
- Host-Pathogen Interactions/immunology
- Humans
- Interferon-gamma/immunology
- Interferon-gamma/metabolism
- Interleukin-10/immunology
- Interleukin-10/metabolism
- Interleukin-2/immunology
- Interleukin-2/metabolism
- Lymphocyte Count
- Lymphoma, Large B-Cell, Diffuse/blood
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Large B-Cell, Diffuse/virology
- Male
- Middle Aged
- Receptors, Antigen, T-Cell, alpha-beta/immunology
- Receptors, Antigen, T-Cell, alpha-beta/metabolism
- Tumor Necrosis Factor-alpha/immunology
- Tumor Necrosis Factor-alpha/metabolism
- Viral Load/immunology
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Affiliation(s)
- D Cárdenas
- Grupo De Inmunobiología Y Biología Celular Departamento De Microbiología Facultad De Ciencias Pontificia Universidad JaverianaBogotá, Colombia
| | - G Vélez
- Grupo De Inmunobiología Y Biología Celular Departamento De Microbiología Facultad De Ciencias Pontificia Universidad JaverianaBogotá, Colombia
| | - A Orfao
- Servicio General De Citometría Y Departamento De Medicina, Centro De Investigación Del Cáncer (Instituto De Biología Molecular Y Celular Del Cáncer and IBSAL; CSIC-USAL), Universidad De SalamancaSalamanca, España
| | - M V Herrera
- Servicio De Hematología Hospital Universitario San Ignacio-Centro De Oncología Javeriano
| | - J Solano
- Servicio De Hematología Hospital Universitario San Ignacio-Centro De Oncología Javeriano
| | - M Olaya
- Departamento de Patología, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio
| | - A M Uribe
- Departamento de Patología, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio
| | - C Saavedra
- Grupo De Patología Fundación Santa Fe De Bogotá
| | - M Duarte
- Servicio De Hematología Fundación Santa Fe De BogotáBogotá, Colombia
| | - M Rodríguez
- Servicio De Hematología Fundación Santa Fe De BogotáBogotá, Colombia
| | - M López
- Fundación Cardiovascular De ColombiaFloridablanca, Colombia
| | - S Fiorentino
- Grupo De Inmunobiología Y Biología Celular Departamento De Microbiología Facultad De Ciencias Pontificia Universidad JaverianaBogotá, Colombia
| | - S Quijano
- Grupo De Inmunobiología Y Biología Celular Departamento De Microbiología Facultad De Ciencias Pontificia Universidad JaverianaBogotá, Colombia
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15
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Rebhahn JA, Roumanes DR, Qi Y, Khan A, Thakar J, Rosenberg A, Lee FEH, Quataert SA, Sharma G, Mosmann TR. Competitive SWIFT cluster templates enhance detection of aging changes. Cytometry A 2015; 89:59-70. [PMID: 26441030 PMCID: PMC4737406 DOI: 10.1002/cyto.a.22740] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 04/21/2015] [Accepted: 08/05/2015] [Indexed: 12/17/2022]
Abstract
Clustering‐based algorithms for automated analysis of flow cytometry datasets have achieved more efficient and objective analysis than manual processing. Clustering organizes flow cytometry data into subpopulations with substantially homogenous characteristics but does not directly address the important problem of identifying the salient differences in subpopulations between subjects and groups. Here, we address this problem by augmenting SWIFT—a mixture model based clustering algorithm reported previously. First, we show that SWIFT clustering using a “template” mixture model, in which all subpopulations are represented, identifies small differences in cell numbers per subpopulation between samples. Second, we demonstrate that resolution of inter‐sample differences is increased by “competition” wherein a joint model is formed by combining the mixture model templates obtained from different groups. In the joint model, clusters from individual groups compete for the assignment of cells, sharpening differences between samples, particularly differences representing subpopulation shifts that are masked under clustering with a single template model. The benefit of competition was demonstrated first with a semisynthetic dataset obtained by deliberately shifting a known subpopulation within an actual flow cytometry sample. Single templates correctly identified changes in the number of cells in the subpopulation, but only the competition method detected small changes in median fluorescence. In further validation studies, competition identified a larger number of significantly altered subpopulations between young and elderly subjects. This enrichment was specific, because competition between templates from consensus male and female samples did not improve the detection of age‐related differences. Several changes between the young and elderly identified by SWIFT template competition were consistent with known alterations in the elderly, and additional altered subpopulations were also identified. Alternative algorithms detected far fewer significantly altered clusters. Thus SWIFT template competition is a powerful approach to sharpen comparisons between selected groups in flow cytometry datasets. © 2015 The Authors. Published Wiley Periodicals Inc.
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Affiliation(s)
- Jonathan A Rebhahn
- David H. Smith Center for Vaccine Biology and Immunology, University of Rochester Medical Center, Rochester, New York
| | - David R Roumanes
- David H. Smith Center for Vaccine Biology and Immunology, University of Rochester Medical Center, Rochester, New York
| | - Yilin Qi
- David H. Smith Center for Vaccine Biology and Immunology, University of Rochester Medical Center, Rochester, New York
| | - Atif Khan
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York
| | - Juilee Thakar
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York.,Department of Microbiology and Immunology, University of Rochester
| | | | - F Eun-Hyung Lee
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Sally A Quataert
- David H. Smith Center for Vaccine Biology and Immunology, University of Rochester Medical Center, Rochester, New York
| | - Gaurav Sharma
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York.,Department of Electrical and Computer Engineering, University of Rochester
| | - Tim R Mosmann
- David H. Smith Center for Vaccine Biology and Immunology, University of Rochester Medical Center, Rochester, New York.,Department of Microbiology and Immunology, University of Rochester
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16
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Statin, calcium channel blocker and Beta blocker therapy may decrease the incidence of tuberculosis infection in elderly Taiwanese patients with type 2 diabetes. Int J Mol Sci 2015; 16:11369-84. [PMID: 25993300 PMCID: PMC4463705 DOI: 10.3390/ijms160511369] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 05/11/2015] [Accepted: 05/13/2015] [Indexed: 01/23/2023] Open
Abstract
Background: It is well known that diabetes mellitus impairs immunity and therefore is an independent risk factor for tuberculosis. However, the influence of associated metabolic factors, such as hypertension, dyslipidemia and gout has yet to be confirmed. This study aimed to investigate whether the strong association between tuberculosis and diabetes mellitus is independent from the influence of hypertension and dyslipidemia, and its treatment in elderly Taiwanese patients. Methods: A total of 27,958 patients aged more than 65 years were identified from the National Health Insurance Research Database (NIHRD) in 1997 and were followed from 1998 to 2009. The demographic characteristics between the patients with and without diabetes were analyzed using the χ2 test. A total of 13,981 patients with type 2 diabetes were included in this study. Cox proportional hazard regression models were used to determine the independent effects of diabetes on the risk of tuberculosis. Results: After adjusting for age, sex, other co-morbidities and medications, calcium channel blocker, beta blocker and statin users had a lower independent association, with risk ratios of 0.76 (95% CI, 0.58–0.98), 0.72 (95% CI, 0.58–0.91) and 0.76 (95% CI, 0.60–0.97), respectively. Conclusion: Calcium channel blocker, beta blocker and statin therapy may decrease the incidence of tuberculosis infection in elderly Taiwanese patients with type 2 diabetes.
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17
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Kim S, Brooks AK, Groban L. Preoperative assessment of the older surgical patient: honing in on geriatric syndromes. Clin Interv Aging 2014; 10:13-27. [PMID: 25565783 PMCID: PMC4279607 DOI: 10.2147/cia.s75285] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Nearly 50% of Americans will have an operation after the age of 65 years. Traditional preoperative anesthesia consultations capture only some of the information needed to identify older patients (defined as ≥65 years of age) undergoing elective surgery who are at increased risk for postoperative complications, prolonged hospital stays, and delayed or hampered functional recovery. As a catalyst to this review, we compared traditional risk scores (eg, cardiac-focused) to geriatric-specific risk measures from two older female patients seen in our preoperative clinic who were scheduled for elective, robotic-assisted hysterectomies. Despite having a lower cardiac risk index and Charlson comorbidity score, the younger of the two patients presented with more subtle negative geriatric-specific risk predictors – including intermediate or pre-frail status, borderline malnutrition, and reduced functional/mobility – which may have contributed to her 1-day-longer length of stay and need for readmission. Adequate screening of physiologic and cognitive reserves in older patients scheduled for surgery could identify at-risk, vulnerable elders and enable proactive perioperative management strategies (eg, strength, balance, and mobility prehabilitation) to reduce adverse postoperative outcomes and readmissions. Here, we describe our initial two cases and review the stress response to surgery and the impact of advanced age on this response as well as preoperative geriatric assessments, including frailty, nutrition, physical function, cognition, and mood state tests that may better predict postoperative outcomes in older adults. A brief overview of the literature on anesthetic techniques that may influence geriatric-related syndromes is also presented.
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Affiliation(s)
- Sunghye Kim
- Department of Hospital Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Amber K Brooks
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Leanne Groban
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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18
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Licastro F, Carbone I, Raschi E, Porcellini E. The 21st century epidemic: infections as inductors of neuro-degeneration associated with Alzheimer's Disease. Immun Ageing 2014; 11:22. [PMID: 25516763 PMCID: PMC4266955 DOI: 10.1186/s12979-014-0022-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 11/22/2014] [Indexed: 01/18/2023]
Abstract
Alzheimer's disease (AD) is a complex disease resulting in neurodegeneration and cognitive impairment. Investigations on environmental factors implicated in AD are scarce and the etiology of the disease remains up to now obscure. The disease's pathogenesis may be multi-factorial and different etiological factors may converge during aging and induce an activation of brain microglia and macrophages. This microglia priming will result in chronic neuro-inflammation under chronic antigen activation. Infective agents may prime and drive iper-activation of microglia and be partially responsible of the induction of brain inflammation and decline of cognitive performances. Age-associated immune dis-functions induced by chronic sub-clinical infections appear to substantially contribute to the appearance of neuro-inflammation in the elderly. Individual predisposition to less efficient immune responses is another relevant factor contributing to impaired regulation of inflammatory responses and accelerated cognitive decline. Life-long virus infection may play a pivotal role in activating peripheral and central inflammatory responses and in turn contributing to increased cognitive impairment in preclinical and clinical AD.
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Affiliation(s)
- Federico Licastro
- />Department of Experimental, Diagnostic and Specialty Medicine, School of Medicine, University of Bologna, Bologna, 40100 Italy
- />Laboratory of Immunopathology and Immunogenetics, Department of Experimental, Diagnostic and Specialty Medicine, School of Medicine, University of Bologna, Via S. Giacomo 14, 40126 Bologna, Italy
| | - Ilaria Carbone
- />Department of Experimental, Diagnostic and Specialty Medicine, School of Medicine, University of Bologna, Bologna, 40100 Italy
| | - Elena Raschi
- />Department of Experimental, Diagnostic and Specialty Medicine, School of Medicine, University of Bologna, Bologna, 40100 Italy
| | - Elisa Porcellini
- />Department of Experimental, Diagnostic and Specialty Medicine, School of Medicine, University of Bologna, Bologna, 40100 Italy
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19
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Horn EE, Turkheimer E, Strachan E. Psychological Distress, Emotional Stability, and Emotion Regulation Moderate Dynamics of Herpes Simplex Virus Type 2 Recurrence. Ann Behav Med 2014; 49:187-98. [DOI: 10.1007/s12160-014-9640-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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20
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Al-Nuaimi Y, Sherratt MJ, Griffiths CEM. Skin health in older age. Maturitas 2014; 79:256-64. [PMID: 25213594 DOI: 10.1016/j.maturitas.2014.08.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 08/08/2014] [Indexed: 01/09/2023]
Abstract
As people age, their skin undergoes changes which result in reduced elasticity, increased fragility and an altered immune response; in essence it becomes frail. As life expectancy is increasing the health of older skin is becoming a progressively more important facet of overall care. In addition to the consequences of ageing for otherwise healthy skin, the relative incidence of some dermatological conditions is age-dependent. In particular, xerosis (dry skin), cutaneous malignancies and skin injuries are more common in older people. In this review we describe the functional consequences of skin ageing and discuss the current evidence on how skin health may be maintained and dermatological conditions prevented in an ageing population. The future of dermatological health-care provision in the older population relies on the development of coordinated pathways of care, which start from a young age. Better quality research coordinated by the establishment of institutions dealing with skin health and ageing would be a method of addressing these needs.
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Affiliation(s)
- Yusur Al-Nuaimi
- Manchester Academic Health Sciences Centre, The University of Manchester, Manchester M13 9PT, UK; The Dermatology Centre, Barnes Building, Salford Royal NHS Foundation Trust M6 8HD, UK.
| | - Michael J Sherratt
- Manchester Academic Health Sciences Centre, The University of Manchester, Manchester M13 9PT, UK; School of Biomedicine, The University of Manchester, Manchester M13 9PT, UK
| | - Christopher E M Griffiths
- Manchester Academic Health Sciences Centre, The University of Manchester, Manchester M13 9PT, UK; The Dermatology Centre, Barnes Building, Salford Royal NHS Foundation Trust M6 8HD, UK
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21
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HIV-1 transgenic rats display alterations in immunophenotype and cellular responses associated with aging. PLoS One 2014; 9:e105256. [PMID: 25127062 PMCID: PMC4134284 DOI: 10.1371/journal.pone.0105256] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 07/21/2014] [Indexed: 11/19/2022] Open
Abstract
Advances in anti-retroviral therapy over the last two decades have allowed life expectancy in patients infected with the human immunodeficiency virus to approach that of the general population. The process of aging in mammalian species, including rats, results in immune response changes, alterations in immunological phenotypes, and ultimately increased susceptibility to many infectious diseases. In order to investigate the immunological pathologies associated with chronic HIV-1 disease, particularly in aging individuals, the HIV-1 transgenic (HIV-1Tg) rat model was utilized. HIV-1Tg rats were challenged with lipopolysaccharide (LPS) to determine immunological alterations during the aging process. LPS is known to cause an imbalance in cytokine and chemokine release, and provides a method to identify changes in immune responses to bacterial infection in an HIV animal model. An immune profile and accompanying cellular consequences as well as changes in inflammatory cytokine and chemokine release related to age and genotype were assessed in HIV-1Tg rats. The percentage of T cells decreased with age, particularly T cytotoxic cells, whereas T helper cells increased with age. Neutrophils and monocytes increased in HIV-1Tg rats during maturation compared to age-matched F344 control rats. Aging HIV-1Tg rats displayed a significant increase in the pro-inflammatory cytokines, IL-6 and TNF-α, along with an increase in the chemokine, KC/GRO, in comparison to age-matched controls. Our data indicate that immunophenotype and immune responses can change during aging in HIV-positive individuals. This information could be important in determining the most beneficial age-dependent therapeutic treatment for HIV patients.
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22
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Shao H, Ou Y, Wang T, Shen H, Wu F, Zhang W, Tao C, Yuan Y, Bo H, Wang H, Huang S. Differences in TCR-Vβ repertoire and effector phenotype between tumor infiltrating lymphocytes and peripheral blood lymphocytes increase with age. PLoS One 2014; 9:e102327. [PMID: 25019226 PMCID: PMC4096599 DOI: 10.1371/journal.pone.0102327] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 06/16/2014] [Indexed: 12/16/2022] Open
Abstract
Tumor infiltrating lymphocytes (TIL) reflect the host's anti-tumor immune response, and can be a valuable predictor of prognosis. However, many properties of TIL are not fully understood. In the present study, TCR-Vβ repertoires of cancer patients were primarily analyzed by flow cytometry. Abnormally expressed TCR-Vβ subfamilies were generally found in both TIL and peripheral blood lymphocytes (PBL) of each patient. Of note, increased patient age was associated with increasingly biased TCR-Vβ repertoire in TIL but not in PBL, and the dispersion degree of the differences of TCR-Vβ subfamilies between TIL and PBL correlated positively with age (P = 0.007). Utilizing immunoscope analysis, we identified the age-related reduction in TCR-Vβ diversity, but polyclonal pattern was predominant in significantly expanded TCR-Vβ subfamilies. In addition, we found that older patients possessed a decreased ratio of CD8+CD62L+ non-effector cells in TIL compared to PBL, implying age-related increase of CD8+CD62L- effector cells in TIL. The colocalization analysis of CD8 and CD3, however, suggested the suppressed activity of these effector cells in tumor microenvironment. These findings further elucidate the properties of TIL, showing an increasing difference between TIL and PBL with age, which may provide insight for the development of effective immunotherapies for cancer patients of different ages.
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Affiliation(s)
- Hongwei Shao
- Guangdong Province Key Laboratory for Biotechnology Drug Candidates, Guangzhou, China
- School of Biosciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yusheng Ou
- Guangdong Province Key Laboratory for Biotechnology Drug Candidates, Guangzhou, China
- School of Biosciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Teng Wang
- Guangdong Province Key Laboratory for Biotechnology Drug Candidates, Guangzhou, China
- School of Biosciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Han Shen
- Guangdong Province Key Laboratory for Biotechnology Drug Candidates, Guangzhou, China
- School of Biosciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Fenglin Wu
- Guangdong Province Key Laboratory for Biotechnology Drug Candidates, Guangzhou, China
- School of Biosciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Wenfeng Zhang
- Guangdong Province Key Laboratory for Biotechnology Drug Candidates, Guangzhou, China
- School of Biosciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Changli Tao
- Guangdong Province Key Laboratory for Biotechnology Drug Candidates, Guangzhou, China
- School of Biosciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yin Yuan
- Guangdong Province Key Laboratory for Biotechnology Drug Candidates, Guangzhou, China
- School of Biosciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Huaben Bo
- Guangdong Province Key Laboratory for Biotechnology Drug Candidates, Guangzhou, China
- School of Biosciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Hui Wang
- Guangdong Province Key Laboratory for Biotechnology Drug Candidates, Guangzhou, China
- School of Biosciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Shulin Huang
- Guangdong Province Key Laboratory for Biotechnology Drug Candidates, Guangzhou, China
- School of Biosciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, China
- Southern Medical University, Guangzhou, China
- * E-mail:
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23
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Müller L, Pawelec G. Aging and immunity - impact of behavioral intervention. Brain Behav Immun 2014; 39:8-22. [PMID: 24315935 DOI: 10.1016/j.bbi.2013.11.015] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 11/06/2013] [Accepted: 11/21/2013] [Indexed: 12/16/2022] Open
Abstract
Immune responses to pathogens to which they were not previously exposed are commonly less effective in elderly people than in young adults, whereas those to agents previously encountered and overcome in earlier life may be amplified. This is reflected in the robust finding in many studies that the proportions and numbers of naïve B and T cells are lower and memory cells higher in the elderly. In addition to the "extrinsic" effects of pathogen exposure, "intrinsic" events such as age-associated differences in haematopoeitic stem cells and their niches in the bone marrow associated with differences in cell maturation and output to the periphery are also observed. In the case of T cells, the "intrinsic" process of thymic involution, beginning before puberty, further contributes to reducing the production of naïve T cells. Like memory T cell populations, innate immune cells may be increased in number but decreased in efficacy on a per-cell basis. Thus, superimposed on chronological age alone, remodelling of immunity as a result of interactions with the environment over the life course is instrumental in shaping immune status in later life. In addition to interactions with pathogens, host microbiome and nutrition, exercise and stress, and many other extrinsic factors are crucial modulators of this "immunosenescence" process. In this review, we briefly outline the observed immune differences between younger and older people, and discuss the possible impacts of behavioral variations thereon.
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Affiliation(s)
- Ludmila Müller
- Max Planck Institute for Human Development, Lentzeallee 94, D-14195 Berlin, Germany.
| | - Graham Pawelec
- Center for Medical Research, University of Tübingen, Waldhörnlestr. 22, D-72072 Tübingen, Germany
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24
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Cárdenas Sierra D, Vélez Colmenares G, Orfao de Matos A, Fiorentino Gómez S, Quijano Gómez SM. Age-associated Epstein-Barr virus-specific T cell responses in seropositive healthy adults. Clin Exp Immunol 2014; 177:320-32. [PMID: 24666437 PMCID: PMC4089182 DOI: 10.1111/cei.12337] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2014] [Indexed: 12/13/2022] Open
Abstract
Epstein-Barr virus (EBV) is present in 95% of the world's adult population. The immune response participates in immune vigilance and persistent infection control, and this condition is maintained by both a good quality (functionality) and quantity of specific T cells throughout life. In the present study, we evaluated EBV-specific CD4(+) and CD8(+) T lymphocyte responses in seropositive healthy individuals younger and older than 50 years of age. The assessment comprised the frequency, phenotype, functionality and clonotypic distribution of T lymphocytes. We found that in both age groups a similar EBV-specific T cell response was found, with overlapping numbers of tumour necrosis factor (TNF)-α(+) T lymphocytes (CD4(+) and CD8(+)) within the memory and effector cell compartments, in addition to monofunctional and multi-functional T cells producing interleukin (IL)-2 and/or interferon (IFN)-γ. However, individuals aged more than 50 years showed significantly higher frequencies of IL-2-producing CD4(+) T lymphocytes in association with greater production of soluble IFN-γ, TNF-α and IL-6 than subjects younger than 50 years. A polyclonal T cell receptor (TCR)-variable beta region (Vβ) repertoire exists in both age groups under basal conditions and in response to EBV; the major TCR families found in TNF-α(+) /CD4(+) T lymphocytes were Vβ1, Vβ2, Vβ17 and Vβ22 in both age groups, and the major TCR family in TNF-α(+) /CD8(+) T cells was Vβ13·1 for individuals younger than 50 years and Vβ9 for individuals aged more than 50 years. Our findings suggest that the EBV-specific T cell response (using a polyclonal stimulation model) is distributed throughout several T cell differentiation compartments in an age-independent manner and includes both monofunctional and multi-functional T lymphocytes.
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Affiliation(s)
- D Cárdenas Sierra
- Grupo de Inmunobiología y Biología Celular, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
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25
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Kline KA, Schwartz DJ, Gilbert NM, Lewis AL. Impact of host age and parity on susceptibility to severe urinary tract infection in a murine model. PLoS One 2014; 9:e97798. [PMID: 24835885 PMCID: PMC4024022 DOI: 10.1371/journal.pone.0097798] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 04/24/2014] [Indexed: 01/04/2023] Open
Abstract
The epidemiology and bacteriology of urinary tract infection (UTI) varies across the human lifespan, but the reasons for these differences are poorly understood. Using established monomicrobial and polymicrobial murine UTI models caused by uropathogenic Escherichia coli (UPEC) and/or Group B Streptococcus (GBS), we demonstrate age and parity as inter-related factors contributing to UTI susceptibility. Young nulliparous animals exhibited 10–100-fold higher bacterial titers compared to older animals. In contrast, multiparity was associated with more severe acute cystitis in older animals compared to age-matched nulliparous controls, particularly in the context of polymicrobial infection where UPEC titers were ∼1000-fold higher in the multiparous compared to the nulliparous host. Multiparity was also associated with significantly increased risk of chronic high titer UPEC cystitis and ascending pyelonephritis. Further evidence is provided that the increased UPEC load in multiparous animals required TLR4-signaling. Together, these data strongly suggest that the experience of childbearing fundamentally and permanently changes the urinary tract and its response to pathogens in a manner that increases susceptibility to severe UTI. Moreover, this murine model provides a system for dissecting these and other lifespan-associated risk factors contributing to severe UTI in at-risk groups.
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Affiliation(s)
- Kimberly A. Kline
- Singapore Centre on Environmental Life Sciences Engineering, School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
- Department of Molecular Microbiology, Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, Missouri, United States of America
- * E-mail: (KK); (AL)
| | - Drew J. Schwartz
- Department of Molecular Microbiology, Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Nicole M. Gilbert
- Department of Molecular Microbiology, Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Amanda L. Lewis
- Department of Molecular Microbiology, Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, Missouri, United States of America
- * E-mail: (KK); (AL)
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Zhao H, Roychoudhury J, Doggett TA, Apte RS, Ferguson TA. Age-dependent changes in FasL (CD95L) modulate macrophage function in a model of age-related macular degeneration. Invest Ophthalmol Vis Sci 2013; 54:5321-31. [PMID: 23821188 DOI: 10.1167/iovs.13-12122] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PURPOSE We examined the effect of aging on Fas ligand (FasL) function in a mouse model of choroidal neovascularization (CNV). METHODS Young and aged mice were laser treated to induce CNV. Bone marrow chimeras were performed between young and aged mice. FasL protein expression was examined in the eye and soluble FasL (sFasL) was measured in the blood. Young and aged mice were treated with a matrix metalloprotease (MMP) inhibitor and systemic sFasL was neutralized by antibody treatment. Macrophages from young and aged mice were tested for sFasL-mediated cytokine production and migration. RESULTS The elevated CNV response observed with aging was dependent on bone marrow-derived cells. FasL expression in the eye was increased with age, but decreased following laser treatment. Aged mice had higher levels of sFasL in the blood compared to young mice. Systemic treatment with an MMP inhibitor decreased bloodborne sFasL, and reduced CNV in young and aged mice. Systemic neutralization of sFasL reduced CNV only in aged mice. sFasL increased cytokine production in aged macrophages and proangiogenic M2 macrophages. Aged M2 macrophages had elevated Fas (CD95) expression and displayed increased migration in response to sFasL compared to M1 macrophages derived from young animals. CONCLUSIONS Age modulates FasL function where increased MMP cleavage leads to a loss of function in the eye. The released form of FasL (sFasL) preferentially induces the migration of proangiogenic M2 macrophages into the laser lesions and increases proangiogenic cytokines promoting CNV. FasL may be a viable target for therapeutic intervention in aged-related neovascular disease.
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Affiliation(s)
- Hui Zhao
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri 63110, USA
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Herpes virus in Alzheimer's disease: relation to progression of the disease. Neurobiol Aging 2013; 35:122-9. [PMID: 23916950 DOI: 10.1016/j.neurobiolaging.2013.06.024] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 06/07/2013] [Accepted: 06/30/2013] [Indexed: 01/01/2023]
Abstract
Studies regarding different viruses of the herpes family, such as cytomegalovirus (CMV), Epstein-Barr virus (EBV), or human herpes virus 6 (HHV-6) in Alzheimer's disease (AD) are scarce. DNA from peripheral blood leukocytes (PBL) and brain samples were analyzed for the presence of CMV, EBV, or HHV-6. All samples were negative for CMV. EBV positivity was 6% in AD brains, whereas 45% of PBL samples from AD patients and 31% from controls were positive for EBV (p = 0.05). HHV-6 showed a 23% positivity in PBL samples from AD and 4% from controls (p = 0.002). 17% of AD brains were HHV-6 positive. Within a group of elderly individuals, followed up for 5 years, EBV-positive or HHV-6-positive PBL increased in those who developed clinical AD. Virus serological positivity was also investigated, and IgG levels for CMV and EBV antigens were also increased in those subjects who developed AD during the follow-up. Our findings suggest that EBV and HHV-6 may be environmental risk factors for cognitive deterioration and progression to AD in elderly persons.
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28
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Biomarkers in inflammatory childhood diseases. Mediators Inflamm 2013; 2013:745493. [PMID: 23840098 PMCID: PMC3691901 DOI: 10.1155/2013/745493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 05/14/2013] [Indexed: 11/18/2022] Open
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McFadden J, Puangpet P, Basketter D, Dearman R, Kimber I. Why does allergic contact dermatitis exist? Br J Dermatol 2013; 168:692-9. [DOI: 10.1111/bjd.12145] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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30
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Santulli G, Iaccarino G. Pinpointing beta adrenergic receptor in ageing pathophysiology: victim or executioner? Evidence from crime scenes. IMMUNITY & AGEING 2013; 10:10. [PMID: 23497413 PMCID: PMC3763845 DOI: 10.1186/1742-4933-10-10] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 03/10/2013] [Indexed: 02/07/2023]
Abstract
G protein-coupled receptors (GPCRs) play a key role in cellular communication, allowing human cells to sense external cues or to talk each other through hormones or neurotransmitters. Research in this field has been recently awarded with the Nobel Prize in chemistry to Robert J. Lefkowitz and Brian K. Kobilka, for their pioneering work on beta adrenergic receptors (βARs), a prototype GPCR. Such receptors, and β2AR in particular, which is extensively distributed throughout the body, are involved in a number of pathophysiological processes. Moreover, a large amount of studies has demonstrated their participation in ageing process. Reciprocally, age-related changes in regulation of receptor responses have been observed in numerous tissues and include modifications of βAR responses. Impaired sympathetic nervous system function has been indeed evoked as at least a partial explanation for several modifications that occur with ageing. This article represents an updated presentation of the current knowledge in the field, summarizing in a systematic way the major findings of research on ageing in several organs and tissues (crime scenes) expressing βARs: heart, vessels, skeletal muscle, respiratory system, brain, immune system, pancreatic islets, liver, kidney and bone.
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Affiliation(s)
- Gaetano Santulli
- Departments of Translational Medical Sciences and Advanced Biomedical Sciences, "Federico II" University, Naples, Italy.
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Ahmadi O, McCall JL, Stringer MD. Does senescence affect lymph node number and morphology? A systematic review. ANZ J Surg 2013; 83:612-8. [PMID: 23347421 DOI: 10.1111/ans.12067] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Immunosenescence may contribute to an observed increase in infections and specific cancers in the elderly. Lymph nodes play a key role in the body's immune system. A systematic review was undertaken to investigate the effects of senescence on lymph node number and morphology. METHODS Electronic databases Ovid MEDLINE, Embase and Google Scholar were searched for relevant articles examining normal lymph node number and morphology with senescence. Data on lymph node number, gross anatomy and histo-architecture were collated and analysed. RESULTS A total of 20 articles (15 human and 5 animal studies) were eligible for inclusion; many were limited by poorly standardized methods and relatively small sample sizes. However, there is evidence to suggest both a decrease in lymph node number and histological lymph node degeneration with senescence, at least in some lymph node basins. Degenerative changes include loss of lymphoid tissue from both the cortex and the medulla of lymph nodes, a reduction in the number and size of germinal centres, and changes such as hyalinization, fibrosis, fat deposition, a decrease in high endothelial venules and 'transparency'. CONCLUSION In this first systematic review to examine changes in lymph nodes with senescence, evidence was accrued to suggest a decline in lymph node number and morphological degeneration in older age groups. These changes might adversely affect immune function and the prognosis of infections and selected cancers in the elderly. Further research is required to confirm these morphological changes and to explore their potential immunological and functional effects.
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Affiliation(s)
- Omid Ahmadi
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Abou El Azm AR, Abou-Ali L, Kobtan AR, Mansour N, Tawfik S. Can brucellosis influence the course of chronic hepatitis C in dual infection? Arch Virol 2012; 158:543-7. [PMID: 23124842 DOI: 10.1007/s00705-012-1524-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Accepted: 09/23/2012] [Indexed: 01/18/2023]
Abstract
Hepatitis C and brucellosis are infectious diseases that occur worldwide, and both are endemic in Egypt. Co-infection with both agents is possible, and this can involve the liver in various ways. In this study, we investigated serum tissue inhibitor metalloproteinase-1 (TIMP-1), viral load, and liver functions in patients co-infected with hepatitis C virus (HCV) before and after brucellosis treatment. Over 3 years, 241 consecutive HCV patients (before interferon therapy was received) with recurrent fever who had occupational contact with animals were tested for brucellosis co-infection by a standard tube agglutination test. In patients with dual infection, viraemia (RT-PCR), TIMP-1 measured by ELISA, and liver functions were assessed and re-evaluated 2 months after brucellosis treatment. The number of patients with HCV/brucellosis co-infection was 32 out of 241 (13.3%). TIMP-1, viraemia, AST, ALT and bilirubin showed significant decrease (improvement) after brucellosis treatment (p < 0.001) but an insignificant difference (p > 0.05) with regard to serum albumin and prothrombin concentration. The study revealed that brucellosis is an important infection in HCV-infected patients and can aggravate the course of disease, suggesting that early treatment and prevention are important.
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Affiliation(s)
- Abdel Raouf Abou El Azm
- Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta 31527, Egypt.
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