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Poisson J, El-Sissy C, Serret-Larmande A, Smith N, Lebraud M, Augy JL, Conti C, Gonnin C, Planquette B, Arlet JB, Hermann B, Charbit B, Pastre J, Devaux F, Ladavière C, Lim L, Ober P, Cannovas J, Biard L, Gulczynski MC, Blumenthal N, Péré H, Knosp C, Gey A, Benhamouda N, Murris J, Veyer D, Tartour E, Diehl JL, Duffy D, Paillaud E, Granier C. Increased levels of GM-CSF and CXCL10 and low CD8 + memory stem T Cell count are markers of immunosenescence and severe COVID-19 in older people. Immun Ageing 2024; 21:28. [PMID: 38715114 PMCID: PMC11075216 DOI: 10.1186/s12979-024-00430-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/18/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Ageing leads to altered immune responses, resulting in higher susceptibility to certain infections in the elderly. Immune ageing is a heterogeneous process also associated with inflammaging, a low-grade chronic inflammation. Altered cytotoxic T cell responses and cytokine storm have previously been described in severe COVID-19 cases, however the parameters responsible for such immune response failures are not well known. The aim of our study was to characterize CD8+ T cells and cytokines associated with ageing, in a cohort of patients aged over 70 years stratified by COVID-19 severity. RESULTS One hundred and four patients were included in the study. We found that, in older people, COVID-19 severity was associated with (i) higher level of GM-CSF, CXCL10 (IP-10), VEGF, IL-1β, CCL2 (MCP-1) and the neutrophil to lymphocyte ratio (NLR), (ii) increased terminally differentiated CD8+T cells, and (ii) decreased early precursors CD8+ T stem cell-like memory cells (TSCM) and CD27+CD28+. The cytokines mentioned above were found at higher concentrations in the COVID-19+ older cohort compared to a younger cohort in which they were not associated with disease severity. CONCLUSIONS Our results highlight the particular importance of the myeloid lineage in COVID-19 severity among older people. As GM-CSF and CXCL10 were not associated with COVID-19 severity in younger patients, they may represent disease severity specific markers of ageing and should be considered in older people care.
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Affiliation(s)
- Johanne Poisson
- Université Paris Cité, Paris, France
- Department of Geriatric Medicine, Hôpital Europeen Georges Pompidou, AP-HP, Paris, France
- Inserm U1149, Center for Research on Inflammation, Paris, France
| | - Carine El-Sissy
- INSERM, Laboratory of Integrative Cancer Immunology, Paris, France
- Cordeliers Research Center, Sorbonne University, University Paris Cité, Paris, France
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Arnaud Serret-Larmande
- ECSTRRA Team, UMR-1153, Université Paris Cité, INSERM, AP-HP, Saint Louis Hospital, Paris, France
| | - Nikaïa Smith
- Translational Immunology Unit, Institut Pasteur, Université Paris Cité, Paris, France
| | - Morgane Lebraud
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Jean-Loup Augy
- Medical intensive care unit, Hopital Delafontaine, 2 rue du Dr Delafontaine, Saint-Denis, 93200, France
| | - Catherine Conti
- Université Paris Cité, Paris, France
- Department of Geriatric Medicine, Hôpital Europeen Georges Pompidou, AP-HP, Paris, France
| | - Cécile Gonnin
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
- Université Paris Cité, INSERM, PARCC, Paris, France
| | - Benjamin Planquette
- Service de Pneumologie Et Soins Intensifs, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Jean-Benoît Arlet
- Internal Medicine Department, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Faculty of Medicine, Université Paris Cité, Paris, 75006, France
| | - Bertrand Hermann
- Medical Intensive Care Unit, AP-HP. Centre Université Paris Cité, Georges Pompidou European Hospital, Paris, 75015, France
- INSERM UMR 1266, Institut de Psychiatrie Et Neurosciences de Paris (IPNP), Université Paris Cité, Paris, France
| | - Bruno Charbit
- Institute of Ophthalmology, University College London (UCL), London, UK
| | - Jean Pastre
- Service de Pneumologie Et Soins Intensifs, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Floriane Devaux
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Cyrielle Ladavière
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Lydie Lim
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Pauline Ober
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Johanna Cannovas
- Department of Geriatric Medicine, Hôpital Europeen Georges Pompidou, AP-HP, Paris, France
| | - Lucie Biard
- ECSTRRA Team, UMR-1153, Université Paris Cité, INSERM, AP-HP, Saint Louis Hospital, Paris, France
| | - Marie-Christelle Gulczynski
- Gérontologie 1, GHU AP-HP. Centre Université Paris Cité, Corentin Celton Hospital, Issy-Les-Moulineaux, 92130, France
| | - Noémie Blumenthal
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Hélène Péré
- Virology Laboratory, Hôpital Européen Georges-Pompidou, APHP.Centre - Université Paris Cité, Paris, France
- Centre de Recherche Des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Functional Genomics of Solid Tumors Laboratory, Équipe Labellisée Ligue Nationale Contre Le Cancer, Labex OncoImmunology, Paris, France
- Université Paris Cité, Faculté de Santé, UFR de Médecine, Paris, France
| | | | - Alain Gey
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Nadine Benhamouda
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Juliette Murris
- HeKA, Inria Paris, Inserm, Université Paris Cité, Paris, France
| | - David Veyer
- Virology Laboratory, Hôpital Européen Georges-Pompidou, APHP.Centre - Université Paris Cité, Paris, France
- Centre de Recherche Des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Functional Genomics of Solid Tumors Laboratory, Équipe Labellisée Ligue Nationale Contre Le Cancer, Labex OncoImmunology, Paris, France
| | - Eric Tartour
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Jean-Luc Diehl
- Medical Intensive Care Unit, AP-HP. Centre Université Paris Cité, Georges Pompidou European Hospital, Paris, 75015, France
- University Paris Cité, Innovative Therapies in Hemostasis, INSERM, Paris, 75006, France
| | - Darragh Duffy
- Translational Immunology Unit, Institut Pasteur, Université Paris Cité, Paris, France
| | - Elena Paillaud
- Université Paris Cité, Paris, France.
- Department of Geriatric Medicine, Hôpital Europeen Georges Pompidou, AP-HP, Paris, France.
- Univ. Paris Est Créteil, Inserm U955, IMRB, Créteil, France.
| | - Clémence Granier
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France.
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2
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Pan Y, Ma L. Inflammatory markers and physical frailty: towards clinical application. Immun Ageing 2024; 21:4. [PMID: 38184585 PMCID: PMC10770917 DOI: 10.1186/s12979-023-00410-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/27/2023] [Indexed: 01/08/2024]
Abstract
Global population aging poses a tremendous burden on the health care system worldwide. Frailty is associated with decreased physical reserve and is considered an important indicator of adverse events in the older population. Therefore, there is growing interest in the early diagnosis and intervention of frailty, but the cellular mechanisms responsible for frailty are still not completely understood. Chronic inflammation is related to decreased physical function and increased disease risk. Additionally, multiple human and animal studies suggest that inflammation probably plays the largest role in contributing to frailty. Some inflammatory markers have been proposed to predict physical frailty. However, there are still large gaps in knowledge related to the clinical application of these markers in frail patients. Therefore, understanding the biological processes and identifying recognized and reliable markers are urgent and pivotal tasks for geriatricians. In the present review, we broadly summarize the inflammatory markers that may have potential diagnostic and therapeutic use, thereby translating them into health care for older people with frailty in the near future.
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Affiliation(s)
- Yiming Pan
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Research Center for Geriatric Medicine, Beijing, 100053, China
| | - Lina Ma
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Research Center for Geriatric Medicine, Beijing, 100053, China.
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3
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Gillespie D, Wootton M, Ray R, Calder PC, Mandy Lau TM, Owen-Jones E, Lowe R, Davies L, Richards J, Hood K, Castro-Herrera V, Davies J, Francis NA, Hobbs FDR, Lown M, Moore M, Shepherd V, Butler CC. Gut microbiology of UK care home residents: a cross-sectional analysis from a randomised controlled trial. Clin Microbiol Infect 2023; 29:1437-1442. [PMID: 37595801 DOI: 10.1016/j.cmi.2023.08.001] [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] [Received: 03/28/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVE To describe the prevalence of potentially clinically relevant gut pathogens and associations with the carriage of resistant organisms in UK care home residents. METHODS Stool samples were collected pre-randomisation from care home residents participating in a randomised placebo-controlled trial. Cultivable clinically relevant bacteria were analysed. Antimicrobial susceptibility testing was performed by agar dilution (amoxicillin, co-amoxiclav, gentamicin, trimethoprim, nitrofurantoin, and ciprofloxacin). We also aimed to detect resistance to third-generation cephalosporins, carbapenems, and vancomycin. RESULTS Stool samples were available for 159/310 residents participating in the trial (51%) from 23 care homes between 2016 and 2018. In total, 402 bacterial isolates were cultured from 158 stool samples and 29 different species were cultured. The five most common species were Escherichia coli (155/158, 98%), Pseudomonas aeruginosa (40/158, 25%), Enterococcus faecalis (35/158, 22%), Enterococcus faecium (30/158, 19%), and Proteus mirabilis (25/158, 16%). Enterobacterales isolates were cultured from 157 samples (99%), and resistance to at least one of the tested antimicrobials was found in 119 of these (76%). There were high levels of variation in outcomes by care home. DISCUSSION We demonstrated that care home residents harbour significant levels of antimicrobial-resistant organisms in their stool. This work emphasises the importance of both enhanced infection control practices and antimicrobial stewardship programmes to support the appropriate use of antimicrobials in this setting.
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Affiliation(s)
- David Gillespie
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom; Centre for Trials Research, School of Medicine, College of Biomedical & Life Sciences, Cardiff University, Cardiff, United Kingdom.
| | - Mandy Wootton
- Specialist Antimicrobial Chemotherapy Unit, Public Health Wales Microbiology Cardiff, Cardiff, United Kingdom
| | - Ruby Ray
- Centre for Trials Research, School of Medicine, College of Biomedical & Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Philip C Calder
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Tin Man Mandy Lau
- Centre for Trials Research, School of Medicine, College of Biomedical & Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Eleri Owen-Jones
- Centre for Trials Research, School of Medicine, College of Biomedical & Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Rachel Lowe
- Centre for Trials Research, School of Medicine, College of Biomedical & Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Leanne Davies
- Specialist Antimicrobial Chemotherapy Unit, Public Health Wales Microbiology Cardiff, Cardiff, United Kingdom
| | - Jennifer Richards
- Specialist Antimicrobial Chemotherapy Unit, Public Health Wales Microbiology Cardiff, Cardiff, United Kingdom
| | - Kerenza Hood
- Centre for Trials Research, School of Medicine, College of Biomedical & Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Vivian Castro-Herrera
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Jane Davies
- Centre for Trials Research, School of Medicine, College of Biomedical & Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Nick A Francis
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - F D Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Mark Lown
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Michael Moore
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Victoria Shepherd
- Centre for Trials Research, School of Medicine, College of Biomedical & Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Christopher C Butler
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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Stirrup O, Shrotri M, Adams NL, Krutikov M, Nacer-Laidi H, Azmi B, Palmer T, Fuller C, Irwin-Singer A, Baynton V, Tut G, Moss P, Hayward A, Copas A, Shallcross L. Clinical Effectiveness of SARS-CoV-2 Booster Vaccine Against Omicron Infection in Residents and Staff of Long-term Care Facilities: A Prospective Cohort Study (VIVALDI). Open Forum Infect Dis 2022; 10:ofac694. [PMID: 36713473 PMCID: PMC9874026 DOI: 10.1093/ofid/ofac694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/28/2022] [Indexed: 12/30/2022] Open
Abstract
Background Successive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants have caused severe disease in long-term care facility (LTCF) residents. Primary vaccination provides strong short-term protection, but data are limited on duration of protection following booster vaccines, particularly against the Omicron variant. We investigated the effectiveness of booster vaccination against infections, hospitalizations, and deaths among LTCF residents and staff in England. Methods We included residents and staff of LTCFs within the VIVALDI study (ISRCTN 14447421) who underwent routine, asymptomatic testing (December 12, 2021-March 31, 2022). Cox regression was used to estimate relative hazards of SARS-CoV-2 infection, and associated hospitalization and death at 0-13, 14-48, 49-83, 84-111, 112-139, and 140+ days after dose 3 of SARS-CoV-2 vaccination compared with 2 doses (after 84+ days), stratified by previous SARS-CoV-2 infection and adjusting for age, sex, LTCF capacity, and local SARS-CoV-2 incidence. Results A total of 14 175 residents and 19 793 staff were included. In residents without prior SARS-CoV-2 infection, infection risk was reduced 0-111 days after the first booster, but no protection was apparent after 112 days. Additional protection following booster vaccination waned but was still present at 140+ days for COVID-associated hospitalization (adjusted hazard ratio [aHR], 0.20; 95% CI, 0.06-0.63) and death (aHR, 0.50; 95% CI, 0.20-1.27). Most residents (64.4%) had received primary course vaccine of AstraZeneca, but this did not impact pre- or postbooster risk. Staff showed a similar pattern of waning booster effectiveness against infection, with few hospitalizations and no deaths. Conclusions Our findings suggest that booster vaccination provided sustained protection against severe outcomes following infection with the Omicron variant, but no protection against infection from 4 months onwards. Ongoing surveillance for SARS-CoV-2 in LTCFs is crucial.
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Affiliation(s)
- Oliver Stirrup
- Correspondence: Oliver Stirrup, PhD, UCL Institute for Global Health, 222 Euston Road, London NW1 2DA, UK ()
| | | | | | - Maria Krutikov
- UCL Institute of Health Informatics, London, United Kingdom
| | | | - Borscha Azmi
- UCL Institute of Health Informatics, London, United Kingdom
| | - Tom Palmer
- Institute for Global Health, University College London, London, United Kingdom
| | | | | | - Verity Baynton
- Department of Health and Social Care, London, United Kingdom
| | - Gokhan Tut
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
| | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
| | - Andrew Hayward
- UCL Institute of Epidemiology & Healthcare, London, United Kingdom,Health Data Research UK, London, United Kingdom
| | - Andrew Copas
- Institute for Global Health, University College London, London, United Kingdom
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5
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Shrotri M, Krutikov M, Nacer-Laidi H, Azmi B, Palmer T, Giddings R, Fuller C, Irwin-Singer A, Baynton V, Tut G, Moss P, Hayward A, Copas A, Shallcross L. Duration of vaccine effectiveness against SARS-CoV-2 infection, hospitalisation, and death in residents and staff of long-term care facilities in England (VIVALDI): a prospective cohort study. THE LANCET. HEALTHY LONGEVITY 2022; 3:e470-e480. [PMID: 35813279 PMCID: PMC9252508 DOI: 10.1016/s2666-7568(22)00147-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background Residents and staff in long-term care facilities have been prioritised for vaccination against SARS-CoV-2, but data on potential waning of vaccine effectiveness and the effect of booster doses in this vulnerable population are scarce. We aimed to evaluate effectiveness of one, two, and three vaccine doses against infection and severe clinical outcomes in staff and residents of long-term care facilities in England over the first year following vaccine roll-out. Methods The VIVALDI study is a prospective cohort study done in 331 long-term care facilities in England. Residents aged 65 years or older and staff aged 18 years or older were eligible for participation. Participants had routine PCR testing throughout the study period between Dec 8, 2020, and Dec 11, 2021. We retrieved all PCR results and cycle threshold values for PCR-positive samples from routine testing in long-term care facilities, and positive PCR results from clinical testing in hospitals through the UK's COVID-19 Datastore. PCR results were linked to participants using pseudo-identifiers based on individuals' unique UK National Health Service (NHS) numbers, which were also used to retrieve vaccination records from the National Immunisation Management Service, hospitalisation records from NHS England, and deaths data from the Office for National Statistics through the COVID-19 Datastore. In a Cox proportional hazards regression, we estimated vaccine effectiveness against SARS-CoV-2 infection, COVID-19-related hospitalisation, and COVID-19-related death after one, two, and three vaccine doses, separately by previous SARS-CoV-2 exposure. This study is registered with the ISRCTN Registry, ISRCTN 14447421. Findings 80 186 residents and staff of long-term care facilities had records available for the study period, of whom 15 518 eligible residents and 19 515 eligible staff were included in the analysis. For residents without evidence of previous SARS-CoV-2 exposure, vaccine effectiveness decreased from 61·7% (95% CI 35·1 to 77·4) to 22·0% (-14·9 to 47·0) against infection; from 89·0% (70·6 to 95·9) to 56·3% (30·1 to 72·6) against hospitalisation; and from 96·4% (84·3 to 99·2) to 64·4% (36·1 to 80·1) against death, when comparing 14-83 days after dose two and 84 days or more after dose two. For staff without evidence of previous exposure, vaccine effectiveness against infection decreased slightly from 57·9% (43·1 to 68·9) at 14-83 days after dose two to 42·1% (29·9 to 52·2) at 84 days or more after dose two. There were no hospitalisations or deaths among unexposed staff at 14-83 days, but seven hospitalisations (vaccine effectiveness 91·0% [95% CI 74·3 to 96·8]) and one death were observed at 84 days or more after dose two. High vaccine effectiveness was restored following a third vaccine dose, with vaccine effectiveness in unexposed residents of 72·7% (55·8 to 83·1) against infection, 90·1% (80·6 to 95·0) against hospitalisation, and 97·5% (88·1 to 99·5) against death; and vaccine effectiveness in unexposed staff of 78·2% (70·0 to 84·1) against infection and 95·8% (49·9 to 99·6) against hospitalisation. There were no COVID-19-related deaths among unexposed staff after the third vaccine dose. Interpretation Our findings showed substantial waning of SARS-CoV-2 vaccine effectiveness against all outcomes in residents of long-term care facilities from 12 weeks after a primary course of ChAdOx1-S or mRNA vaccines. Boosters restored protection, and maximised immunity across all outcomes. These findings show the importance of boosting and the need for ongoing surveillance in this vulnerable cohort. Funding UK Government Department of Health and Social Care.
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Affiliation(s)
| | | | | | | | - Tom Palmer
- UCL Institute for Global Health, London, UK
| | | | | | | | | | - Gokhan Tut
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Andrew Hayward
- UCL Institute of Epidemiology and Healthcare, London, UK
- Health Data Research UK, London, UK
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Sepúlveda M, Arauna D, García F, Albala C, Palomo I, Fuentes E. Frailty in Aging and the Search for the Optimal Biomarker: A Review. Biomedicines 2022; 10:1426. [PMID: 35740447 PMCID: PMC9219911 DOI: 10.3390/biomedicines10061426] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/07/2022] [Accepted: 06/07/2022] [Indexed: 01/09/2023] Open
Abstract
In the context of accelerated aging of the population worldwide, frailty has emerged as one of the main risk factors that can lead to loss of self-sufficiency in older people. This syndrome is defined as a reduced state of physiological reserve and functional capacity. The main diagnostic tools for frailty are based on scales that show deficits compared to their clinical application, such as the Fried frailty phenotype, among others. In this context, it is important to have one or more biomarkers with clinical applicability that can objectively and precisely determine the degree or risk of frailty in older people. The objective of this review was to analyze the biomarkers associated with frailty, classified according to the pathophysiological components of this syndrome (inflammation, coagulation, antioxidants, and liver function, among others). The evidence demonstrates that biomarkers associated with inflammation, oxidative stress, skeletal/cardiac muscle function, and platelet function represent the most promising markers of frailty due to their pathophysiological association with this syndrome. To a lesser extent but with the possibility of greater innovation, biomarkers associated with growth factors, vitamins, amino acids, and miRNAs represent alternatives as markers of this geriatric syndrome. Likewise, the incorporation of artificial intelligence represents an interesting approach to strengthening the diagnosis of frailty by biomarkers.
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Affiliation(s)
- Magdalena Sepúlveda
- Thrombosis Research Center, Medical Technology School, Faculty of Health Sciences, Interuniversity Center for Healthy Aging, Universidad de Talca, Talca 3480094, Chile; (M.S.); (D.A.)
| | - Diego Arauna
- Thrombosis Research Center, Medical Technology School, Faculty of Health Sciences, Interuniversity Center for Healthy Aging, Universidad de Talca, Talca 3480094, Chile; (M.S.); (D.A.)
| | - Francisco García
- Department of Geriatric Medicine, Complejo Hospitalario de Toledo, 45007 Toledo, Spain;
| | - Cecilia Albala
- Unidad de Nutrición Pública, Instituto de Nutrición y Tecnología de los Alimentos, Interuniversity Center for Healthy Aging, Universidad de Chile, Santiago 8320000, Chile;
| | - Iván Palomo
- Thrombosis Research Center, Medical Technology School, Faculty of Health Sciences, Interuniversity Center for Healthy Aging, Universidad de Talca, Talca 3480094, Chile; (M.S.); (D.A.)
| | - Eduardo Fuentes
- Thrombosis Research Center, Medical Technology School, Faculty of Health Sciences, Interuniversity Center for Healthy Aging, Universidad de Talca, Talca 3480094, Chile; (M.S.); (D.A.)
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7
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Stirrup O, Krutikov M, Tut G, Palmer T, Bone D, Bruton R, Fuller C, Azmi B, Lancaster T, Sylla P, Kaur N, Spalkova E, Bentley C, Amin U, Jadir A, Hulme S, Giddings R, Nacer-Laidi H, Baynton V, Irwin-Singer A, Hayward A, Moss P, Copas A, Shallcross L. Severe Acute Respiratory Syndrome Coronavirus 2 Anti-Spike Antibody Levels Following Second Dose of ChAdOx1 nCov-19 or BNT162b2 Vaccine in Residents of Long-term Care Facilities in England (VIVALDI). J Infect Dis 2022; 226:1877-1881. [PMID: 35429382 PMCID: PMC9047242 DOI: 10.1093/infdis/jiac146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/14/2022] [Indexed: 12/31/2022] Open
Abstract
General population studies have shown strong humoral response following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination with subsequent waning of anti-spike antibody levels. Vaccine-induced immune responses are often attenuated in frail and older populations, but published data are scarce. We measured SARS-CoV-2 anti-spike antibody levels in long-term care facility residents and staff following a second vaccination dose with Oxford-AstraZeneca or Pfizer-BioNTech. Vaccination elicited robust antibody responses in older residents, suggesting comparable levels of vaccine-induced immunity to that in the general population. Antibody levels are higher after Pfizer-BioNTech vaccination but fall more rapidly compared to Oxford-AstraZeneca recipients and are enhanced by prior infection in both groups.
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Affiliation(s)
| | - Maria Krutikov
- Correspondence: Maria Krutikov MRCP MBChB MSc, UCL Institute of Health Informatics, 222 Euston Rd, London NW1 2DA, UK ()
| | | | - Tom Palmer
- Institute for Global Health, University College London, United Kingdom
| | - David Bone
- Institute of Immunology and Immunotherapy, University of Birmingham, United Kingdom
| | - Rachel Bruton
- Institute of Immunology and Immunotherapy, University of Birmingham, United Kingdom
| | - Chris Fuller
- Institute of Health Informatics, University College London, United Kingdom
| | - Borscha Azmi
- Institute of Health Informatics, University College London, United Kingdom
| | - Tara Lancaster
- Institute of Immunology and Immunotherapy, University of Birmingham, United Kingdom
| | - Panagiota Sylla
- Institute of Immunology and Immunotherapy, University of Birmingham, United Kingdom
| | - Nayandeep Kaur
- Institute of Immunology and Immunotherapy, University of Birmingham, United Kingdom
| | - Eliska Spalkova
- Institute of Immunology and Immunotherapy, University of Birmingham, United Kingdom
| | - Christopher Bentley
- Institute of Immunology and Immunotherapy, University of Birmingham, United Kingdom
| | - Umayr Amin
- Institute of Immunology and Immunotherapy, University of Birmingham, United Kingdom
| | - Azar Jadir
- Institute of Immunology and Immunotherapy, University of Birmingham, United Kingdom
| | - Samuel Hulme
- Institute of Immunology and Immunotherapy, University of Birmingham, United Kingdom
| | - Rebecca Giddings
- Institute of Health Informatics, University College London, United Kingdom
| | - Hadjer Nacer-Laidi
- Institute of Health Informatics, University College London, United Kingdom
| | - Verity Baynton
- Department of Health and Social Care, London, United Kingdom
| | | | - Andrew Hayward
- Institute of Epidemiology and Health Care, University College London, United Kingdom,Health Data Research UK, London, United Kingdom
| | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, United Kingdom
| | - Andrew Copas
- Institute for Global Health, University College London, United Kingdom
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Muzyka M, Tagliafico L, Serafini G, Baiardini I, Braido F, Nencioni A, Monacelli F. Neuropsychiatric Disorders and Frailty in Older Adults over the Spectrum of Cancer: A Narrative Review. Cancers (Basel) 2022; 14:258. [PMID: 35008421 PMCID: PMC8796027 DOI: 10.3390/cancers14010258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/26/2021] [Accepted: 12/02/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The interplay between different neuropsychiatric conditions, beyond dementia, in the presence of a diagnosis of cancer in older adults may mediate patients' fitness and cancer-related outcomes. Here, we aimed to investigate the presence of depression, sleep disturbances, anxiety, attitude, motivation, and support in older adults receiving a diagnosis of cancer and the dimension of frailty in order to understand the magnitude of the problem. METHODS This review provides an update of the state of the art based on references from searches of PubMed between 2000 and June 2021. RESULTS The evidence obtained underscored the tight association between frailty and unfavorable clinical outcomes in older adults with cancer. Given the intrinsic correlation of neuropsychiatric disorders with frailty in the realm of cancer survivorship, the evidence showed they might have a correlation with unfavorable clinical outcomes, late-life geriatric syndromes and higher degree of frailty. CONCLUSIONS The identification of common vulnerabilities among neuropsychiatric disorders, frailty, and cancer may hold promise to unmask similar shared pathways, potentially intercepting targeted new interventions over the spectrum of cancer with the delivery of better pathways of care for older adults with cancer.
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Affiliation(s)
- Mariya Muzyka
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.M.); (L.T.); (G.S.); (I.B.); (F.B.); (A.N.)
- Department of Internal Medicine and Medical Specialties (DIMI), Section of Geriatrics, 16132 Genoa, Italy
| | - Luca Tagliafico
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.M.); (L.T.); (G.S.); (I.B.); (F.B.); (A.N.)
- Department of Internal Medicine and Medical Specialties (DIMI), Section of Geriatrics, 16132 Genoa, Italy
| | - Gianluca Serafini
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.M.); (L.T.); (G.S.); (I.B.); (F.B.); (A.N.)
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
| | - Ilaria Baiardini
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.M.); (L.T.); (G.S.); (I.B.); (F.B.); (A.N.)
| | - Fulvio Braido
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.M.); (L.T.); (G.S.); (I.B.); (F.B.); (A.N.)
- Department of Internal Medicine and Medical Specialties (DIMI), Section of Geriatrics, 16132 Genoa, Italy
| | - Alessio Nencioni
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.M.); (L.T.); (G.S.); (I.B.); (F.B.); (A.N.)
- Department of Internal Medicine and Medical Specialties (DIMI), Section of Geriatrics, 16132 Genoa, Italy
| | - Fiammetta Monacelli
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.M.); (L.T.); (G.S.); (I.B.); (F.B.); (A.N.)
- Department of Internal Medicine and Medical Specialties (DIMI), Section of Geriatrics, 16132 Genoa, Italy
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