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

Mech Ageing Dev. 2006 Aug;127(8):695-704. doi: 10.1016/j.mad.2006.04.003. Epub 2006 Jun 5.

Abstract

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

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Aging / immunology*
  • Albumins / immunology
  • Body Weight
  • C-Reactive Protein / analysis
  • CD4-CD8 Ratio
  • Female
  • Humans
  • Infections
  • Inflammation*
  • Interleukin-6 / blood*
  • Longitudinal Studies
  • Male
  • Prealbumin / analysis
  • T-Lymphocytes / cytology
  • T-Lymphocytes / immunology*

Substances

  • Albumins
  • Interleukin-6
  • Prealbumin
  • C-Reactive Protein