Category: Ageing

Categories : Ageing Cardiovascular Disease ExerciseTags :

Tailored Heart Failure Rehabilitation Improves Outcomes

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An innovative early cardiac rehabilitation intervention customised for the individual improved physical function, frailty, quality of life, and depression in hospitalised heart failure patients. 

Photo from Olivier Collett on Unsplash

These findings were published  in the New England Journal of Medicine and also presented at the American College of Cardiology’s 70th Annual Scientific Session.  

“Designing earlier and more personalised individual-specific approaches to heart failure rehab shows great promise for improving outcomes for this common but complex condition that is one of the leading causes of hospitalisation for older adults,” said National Institute on Aging (NIA) Director Richard J Hodes, MD. “These results mark encouraging progress on a path to better overall quality of life and physical function for the millions of older Americans who develop heart failure each year.”

The study team was led by Dalane W Kitzman, MD, professor of cardiovascular medicine and geriatrics/gerontology at Wake Forest School of Medicine, Winston-Salem, North Carolina, and they followed 349 clinical trial participants with heart failure enrolled in “A Trial of Rehabilitation Therapy in Older Acute Heart Failure Patients” (REHAB-HF). On average, participants had five comorbidities that reduced of function — diabetes, obesity, high blood pressure, lung disease or kidney disease.

In an earlier pilot study, Kitzman and colleagues found striking deficits in strength, mobility and balance, along with the expected loss of endurance in older patients with acute heart failure, who were mostly fail or pre-fail. The team decided to focus on improving patients’ physical function, weakened already by chronic heart failure and age, and which was worsened by the traditional cardiac hospital experience involving lots of bedrest and resulting in loss of functions often persisting after discharge.

To address this. The REHAB-HF team designed earlier and more customised exercise programs focusing on improving balance, strength, mobility and endurance. They also began REHAB-HF during a patient’s hospital stay when possible rather than the usual six weeks post-discharge. After discharge, participants shifted to outpatient sessions three times per week for three months.

Compared to a control group getting usual cardiac rehab care, REHAB-HF participants showed significant gains in measures of physical functioning and overall quality of life, including tests for lower extremity function and mobility, and a six-minute walk test. Self-perception of their health status and depression improved in surveys compared to pre-trial baselines. Over 80% of REHAB-HF participants reported they were still doing their exercises six months after study completion.

“These findings will inform choices of heart failure rehabilitation strategies that could lead to better physical and emotional outcomes,” said Evan Hadley, M.D., director of NIA’s Division of Geriatrics and Clinical Gerontology. “Tailored interventions like REHAB-HF that target heart failure’s related decline in physical abilities can result in real overall benefits for patients.”

The study did not show significant differences in related clinical events including rates of hospital readmission for any reason or for heart-failure related rehospitalizations. The research team plans to further explore that and other issues through future expansions of REHAB-HF into larger and longer-term trials with broader participant subgroups.

Source: National Institute on Aging

Journal information: Kitzman et al. Rehabilitation Intervention in Older Patients with Acute Heart Failure with Preserved versus Reduced Ejection Fraction. New England Journal of Medicine. 2021 May 16 doi: 10.1056/NEJMoa2026141.

Categories : Ageing Diet and Nutrition Neurodegenerative DiseasesTags :

A Mediterranean Diet Keeps Dementia at Bay

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A dish full of vegetables which could be in a Mediterranean diet.

Researchers have reported that a Mediterranean diet may reduce the risk of developing dementia and cognitive loss, helping preserve memory functions as people age.

Specifically, the diet appears to lower the level of amyloid and tau proteins that are linked with dementia. People following the Mediterranean diet, already noted for its numerous health benefits, scored better on memory tests than those who were not following the diet.

The first of these proteins, amyloid protein, forms plaques in the brain, whereas the second, tau protein, forms tangles. Both are present in the brains of people with Alzheimer’s, though they are not uncommon in the brains of healthy older people, too.

“These results add to the body of evidence that shows what you eat may influence your memory skills later on,” said study author Tommaso Ballarini, PhD, of the German Center for Neurodegenerative Diseases in Bonn, Germany. He adds:

Studies have linked good health with the foods that people living in Greece, Spain, and Italy ate before the 1960s. This diet consists primarily of vegetables and fruits, nuts and seeds, legumes, potatoes, whole grain foods, seafood, extra virgin olive oil, and wine in moderation. Poultry, eggs and dairy products are present to a limited extent, while red meat, added sugar, refined grains and oils, and processed foods are typically lacking in a Mediterranean diet.

Kristin Kirkpatrick, a dietitian at Cleveland Clinic told Medical News Today that the contents of a Mediterranean diet offers beneficial “omega-3 fatty acids, polyphenols, specific minerals, fiber, and protein” that “may support the brain’s health and protection throughout the years.”

However, Kirkpatrick cautioned that, “A diet, even one with strong clinical data on its benefit, is only as healthy as the individuals who choose its structure.”

Sensible portion sizes are important, she noted and warned against the “consumption of processed foods that are marketed as heart-healthy or contain the components seen in a traditional Mediterranean approach.”

The investigators recruited 512 individuals from the German Centre for Neurodegenerative Diseases’ Longitudinal Cognitive Impairment and Dementia StudyTrusted Source. Participant  assessments showed that 343 were at a higher risk of developing Alzheimer’s disease while the other 169 people were “cognitively normal.”

Participants filled in questionnaires regarding the food they ate the previous month and the investigators asked them to record their intake of 148 specific food items. Participants were scored on their diet’s similarity to a Mediterranean diet, the most similar receiving a 9 and the least similar a 1. Since this was a self-reported study on eating habits, errors or misrepresentations are possible.

Individuals also took cognitive tests designed to detect the progression of Alzheimer’s disease. The tests assessed five areas: memory, working memory, language, executive functions, and visuospatial abilities. MRI brain scans determined each individual’s brain volume.

Finally, the researchers analyzed spinal fluid from a subsample of 226 participants who gave their consent, assessing the presence and amounts of the two biomarker proteins: amyloid and tau.

After adjusting for sex, age, and education, the scientists identified several clear links between better cognitive health and a Mediterranean diet.

The investigators  reported that:

  • Every dietary score point lower than 9 was linked to almost 1 year of the brain ageing that occurs in Alzheimer’s disease progression.
  • Participants who most closely followed the Mediterranean diet had fewer amyloid and tau protein biomarkers in their spinal fluid than those who had lower dietary scores.
  • People on the Mediterranean diet scored better on memory tests than people who were not.

Dr Ballarani concluded that, “More research is needed to show the mechanism by which a Mediterranean diet protects the brain from protein buildup and loss of brain function, but findings suggest that people may reduce their risk for developing Alzheimer’s by incorporating more elements of the Mediterranean diet into their daily diets.”

Source: Medical News Today

Categories : AgeingTags :

Older People That Feel Younger Live Longer

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A smiling elderly woman. Photo by Loren Joseph on Unsplash

A new study has found that older people who feel younger are generally more healthy. Such people have greater sense of well-being, better cognitive functioning, less inflammation, lower risk of hospitalisation and even live longer than their older-feeling peers. 

As Francis Bacon once said, “I will never be an old man. To me, old age is always 15 years older than I am.” Studies have shown that feeling younger than one’s chronological age has been known to have some health benefits. A twin study in Denmark showed that perceived age, correlated significantly with physical and cognitive functioning as well as with leucocyte telomere length — which prevents cells from becoming unable to divide.

Researchers from the German Centre of Gerontology analysed three years of data from 5039 participants in the German Ageing Survey, a longitudinal survey of German residents of age 40 and older. The survey had questions about the amount of perceived stress in peoples’ lives and their functional health—how well they could conduct daily activities such as dressing and walking. Participants also indicated their subjective age by answering the question, “How old do you feel?”

Participants with more reported stress tended to have a more rapid decline in functional health over three years, and that association between stress and functional health decline was stronger for chronologically older participants.

Among people who felt younger than their chronological age, there was a weaker association between stress and functional health decline. This protective effect was strongest among the oldest participants.

“Generally, we know that functional health declines with advancing age, but we also know that these age-related functional health trajectories are remarkably varied. As a result, some individuals enter old age and very old age with quite good and intact health resources, whereas others experience a pronounced decline in functional health, which might even result in need for long-term care,” said lead author Markus Wettstein, PhD, who is now at University of Heidelberg. “Our findings support the role of stress as a risk factor for functional health decline, particularly among older individuals, as well as the health-supporting and stress-buffering role of a younger subjective age.”

The researchers said their findings suggest that helping older people feel younger could mitigate the negative effects stress and improving health—though further study is needed to help determine what kind of interventions would work best. Dr Wettstein gave examples of such efforts, such as messaging campaigns to counteract ageism and negative age stereotypes and to promote ageing in a positive light could help people feel younger. More general stress-reduction interventions and stress management training could also prevent functional health loss among older adults.

Dr Wettstein said that there needs to be further studies to find the ideal gap between subjective and chronological age, as previous research has suggested that, up to a point, it’s helpful to feel younger, but those benefits decrease as the gap between subjective and chronological age increases. “Feeling younger to some extent might be adaptive for functional health outcomes, whereas ‘feeling too young’ might be less adaptive or even maladaptive,” he said.

Source: Medical Xpress

Journal information: Markus Wettstein et al, Feeling younger as a stress buffer: Subjective age moderates the effect of perceived stress on change in functional health., Psychology and Aging (2021). DOI: 10.1037/pag0000608

Categories : AgeingTags :

Bacteria in the Mouth Linked to Arthritis

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A dentists shows her patient some dental X-rays. Photo by Tima Miroshnichenko from Pexels

Researchers found similar oral bacterial compositions among patients with early rheumatoid arthritis and those at risk of developing the disease, compared with healthy individuals who were not at risk.

The oral cavity is host to approximately 800 identified species of bacteria. The periodontum, ie the tissue surrounding the tooth, can become inflamed because of a complex interaction of bacterial infection and the body’s response, modified by behavioural factors such as smoking, result in periodontal disease. Periodontal disease has been shown to be caused by certain diseases and medical conditions, and may also cause them. Periodontitis is prevalent among rheumatoid arthritis patients. 

The researchers recruited three groups of 50 participants each: early rheumatoid arthritis patients, at‐risk individuals, and healthy controls. They were given periodontal examinations and assessed for bleeding on probing, pocket probing depth, and periodontal inflamed surface area. The microbial composition of subgingival dental plaque, saliva, and tongue coating was assessed using 16S rDNA amplicon sequencing, and compared between groups.

They found that patients and at-risk individuals had an increased relative abundance of potentially pro- inflammatory bacteria in the mouth, suggestive of a possible relationship between oral microbes and rheumatoid arthritis.

“Prevotella and Veillonella–both gram-negative anaerobes–were at higher relative abundance in saliva, and Veillonella was also at higher relative abundance in tongue coating, of both early rheumatoid arthritis patients and at-risk individuals compared to healthy controls,” the authors wrote.

The findings were published in Arthritis & Rheumatology.  

Source: News-Medical.Net

Journal information: Kroese, J. M., et al. (2021) The oral microbiome in early rheumatoid arthritis patients and individuals at risk differs from healthy controls. Arthritis & Rheumatology. doi.org/10.1002/art.41780.

Categories : Ageing Cardiovascular Disease Neurodegenerative DiseasesTags :

Mitochondria Dump DNA into Cells, Triggering Inflammation

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Researchers have discovered that when building blocks for DNA in cells are in short supply, mitochondria— the powerhouses of cells — release their own DNA, triggering an inflammatory response. Targeting this process can now open up new avenues of treatment into ageing-related diseases.

Mitochondria, the producers of energy for cells, , have their own genetic material: mitochondrial DNA. In certain situations, however, mitochondria are known to release their DNA into the interior of the cell, provoking a reaction from the cell’s own immune system. Some cardiac and neurodegenerative diseases as well as the ageing process are associated with the mitochondrial genome.

To find out when mitochondria release their DNA, the researchers have focused on the mitochondrial protein YME1L. “In cells lacking YME1L, we observed the release of mitochondrial DNA into the cell interior and a related immune response in the cells,” explained Thomas MacVicar, one of the study’s two first authors.  
“If the cells lack YME1L, there is a deficiency of DNA building blocks inside the cell,” he continued. “This deficiency triggers the release of mitochondrial DNA, which in turn causes an inflammatory response in the cell: the cell stimulates similar inflammatory reactions as it does during a bacterial or viral infection. If we add DNA building blocks to the cells from the outside, that also stops the inflammation.”

This newly discovered link between cellular inflammatory response and the metabolism of DNA building blocks could have far-reaching consequences, MacVicar explained. “Some viral inhibitors stop the production of certain DNA building blocks, thereby triggering an inflammatory response. The release of mitochondrial DNA could be a crucial factor in this, contributing to the effect of these inhibitors,” he said. 
Mitochondrial DNA is associated with a number of ageing-associated inflammatory diseases, including cardiac and neurodegenerative diseases, as well as obesity and cancer. The authors hope that new therapeutic opportunities in such diseases can be created by modulating the metabolism of DNA building blocks.

Source: Medical Xpress

Journal information: Hans-Georg Sprenger et al, Cellular pyrimidine imbalance triggers mitochondrial DNA–dependent innate immunity, Nature Metabolism (2021). DOI: 10.1038/s42255-021-00385-9

Categories : Ageing Cancer Mental HealthTags :

Loneliness in Middle-aged Men Tied to Cancer Risk

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Older man sitting alone on beach. Photo by Engin Akyurt from Pexels

A recent study by the University of Eastern Finland shows that loneliness among middle-aged men is associated with an increased risk of cancer.

Cancer is the second leading cause of death around the world, and in high-income countries it has become the main cause. Recent scientific evidence demonstrates that stress plays a positive role in cancer initiation, progression and cancer metastasis, as well as a negative role for anti-tumor immune function and therapy response.

“It has been estimated, on the basis of studies carried out in recent years, that loneliness could be as significant a health risk as smoking or overweight. Our findings support the idea that attention should be paid to this issue,” said project researcher Siiri-Liisi Kraav from the University of Eastern Finland.

The study was launched in the 1980s with middle-aged men from eastern Finland participating. To avoid reverse causality, individuals who already had a cancer diagnosis or received a cancer diagnosis within two years after the baseline data collection were excluded from the analysis. The  2570 eligible participants had their health and mortality monitored on the basis of register data through to the present. Follow-up lasted an average of 20.44 years, and the average age of cancer diagnosis was 69.96 years.
Factors accounted for included age, socio-economic status, lifestyle, sleep quality, depression symptoms, body mass index, heart disease and other risk factors.

During the follow-up, 649 men (25% of participants) developed cancer, and 283 men (11%) died of cancer. Loneliness was associated with a roughlt 10% increased cancer risk. In addition, cancer mortality was higher in cancer patients who were unmarried, widowed or divorced at baseline.
Based on these results, the researchers recommended that consideration of loneliness and social relationships should be an important part of comprehensive health care and disease prevention. The findings were published in Psychiatry Research.

“Awareness of the health effects of loneliness is constantly increasing. Therefore, it is important to examine, in more detail, the mechanisms by which loneliness causes adverse health effects. This information would enable us to better alleviate loneliness and the harm caused by it, as well as to find optimal ways to target preventive measures,” concluded Kraav.

Source: University of Eastern Finland

Journal information: Kraav, S., Lehto, S.M., Kauhanen, J., Hantunen, S., Tolmunen, T., 2021. Loneliness and social isolation increase cancer incidence in a cohort of Finnish middle-aged men. A longitudinal study. Psychiatry Research: https://doi.org/10.1016/j.psychres.2021.113868

Categories : Ageing Pain ManagementTags :

Cannabis Use Screening in Older People Urged

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Cannabis plants. Photo by Harrison Haines from Pexels

Older people who use cannabis to relieve or treat health conditions generally don’t discuss their substance use with doctors, according to a new study. 

In this study of over 17 000 people aged 50 and over in the US, some use cannabis daily and others have mental health problems. The findings were published in peer-reviewed The American Journal of Drug and Alcohol Abuse.

The research is the first to identify where older users obtain cannabis, with the majority saying obtaining it was easy. Those who use cannabis for health reasons are more likely than non-medical (recreational) users to buy it at a medical dispensary (20% vs 5%) and less likely to get it for free (25% vs 46%) or from other sources such as parties (49% vs 56%).

According to the authors, the findings have significant clinical and policy implications especially as more US states are legalising cannabis, which is leading to a rapid rise in uptake among older people. This has implications for other countries such as South Africa, which has recently decriminalised it for personal use.

They urge that doctors should be routinely screening older people for cannabis and other substance use, as well as checking cannabis users for mental health problems, and recommending treatment when necessary. They add that education on the risks of obtaining cannabis and cannabis products from unregulated sources is also vital for this group.

“Cannabis is readily available and accessible to older cannabis users for medical or non-medical purposes,” said Namkee G Choi from University of Texas.

“The findings suggest that some medical users may be self-treating without healthcare professional consultation.

“All older people who take cannabis should consult healthcare professionals about their use. As part of routine care, healthcare professionals should screen for cannabis and other substance use, and for mental health problems.

“They should also recommend services or treatment when indicated. Given the increase in THC (tetrahydrocannabinol) potency, healthcare professionals should educate older cannabis users, especially high-frequency users, on potential safety issues and adverse effects.”

THC content has increased significantly over the past decades. Since 1995, the potency of illicit cannabis plant material seized in the US has consistently increased over time, from approximately 4% in 1995 to approximately 12% in 2014. Among older US adults, cannabis has more than doubled between 2008 and 2019. Reasons include pain relief and treating health issues. However, not much is known about where they obtain cannabis and how much they discuss their use with doctors.

Data for the research was drawn responses from the 2018 and 2019 National Survey on Drug Use and Health (NSDUH), with 17 685 men and women aged 50 and older. This annual national survey measures substance use and misuse and mental illness across the US.

The researchers analysed responses including those on frequency of cannabis use, reasons for taking it, where it was obtained, and how much they utilised healthcare services.

The study found that, overall, 9% used cannabis over the past year and of these, 19% used cannabis for a medical purpose to some extent, eg, to treat chronic pain, depression or diseases like arthritis, while the rest (81%) were recreational (non-medical) users.

The authors also found that people who reported cannabis use as being for medical reasons were over four times as likely than non-medical users to discuss their use with a healthcare professional. Nevertheless, only a minority of medical users did so, which implies that some are self-treating without consulting a doctor.

Medical users were also more likely than non-medical users to more frequently take cannabis, with 40% using it between 200 and 365 days a year.

A higher proportion of older cannabis users had mental illness, alcohol use disorder, and nicotine dependence compared with non-users of the same age, although medical users were less likely to have alcohol problems compared to recreational users.

As well as calling on doctors to do more, the study authors say the NSDUH needs updating to “reflect changing cannabis product commercialization”, such as including products available to older people like cannabidiols, topical solutions and edibles.

Limitations of the study included the relatively small number of medical users and the fact some respondents may have under-reported their cannabis and other substance use.

Source: Medical Xpress

Journal information: The American Journal of Drug and Alcohol Abuse, www.tandfonline.com/doi/full/1 … 0952990.2021.1908318

Categories : AgeingTags :

Dermal Fillers Can Provide Minor Facelifts

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A new study using 3D imaging shows that dermal fillers can also provide some ‘lifting’ effects, as well as their normal ‘volumising’ effects in facial rejuvenation therapy. 

Dermal fillers are ranked second of the top five non-surgical cosmetic procedures, behind botulinum toxin injections. While dermal fillers have been increasing in popularity, plastic surgeons are trying to work out the best application for facial rejuvenation without surgery. Most studies have used subjective rating systems with little generalisability as a result.

The results of a recent study showed that in addition to ‘volumising’ effects, dermal fillers may also have variable ‘lifting’ effects. Sebastian Cotofana, MD, PhD, of the Mayo Clinic,and colleagues came up with a study to measure the true lifting effect of soft tissue fillers.

In this experimental study, the researchers performed standardised dermal filler injections in facial cadaver specimens, in the areas commonly targeted for facial rejuvenation: the forehead and temple; the midface region, including both the medial (central) and the lateral (sides) areas; and around the mouth and jawline.

Dr Cotofana and colleagues performed before-and-after 3D scans of the facial surface to measure the effects of the injections. 

Dermal filler injections showed significant increases in local soft tissue volume in central areas of the face, consistent with the well-established clinical effects of ‘injectable’ treatment in the forehead, midface, and mouth and chin areas.

Local lifting effects were also seen from central facial injections, with up to one millimetre of vertical ‘lift’ in the forehead area, but this was not seen in the other facial areas.

Injections in lateral facial areas such as the jawline also resulted in local volumising and lifting effects. These lateral facial injections also created ‘additional regional lifting effects’ in neighbouring facial areas. Temple injections resulted in a small but significant lifting effect on the lateral midface and jawline, for example.

Combined injection techniques provided even greater benefits. Added to deep filler injection, a superficial temple injection technique produced an additional 17.5% increase in the lifting effect of the temple, plus a 100% increase in the jawline lifting effect.

“These results indicate that lateral face injections co-influence adjacent lateral facial regions and can thus induce regional lifting effects,” wrote Dr Cotofana and coauthors. The results are consistent with previous knowledge of the in-depth anatomy of the face: filler injections may lead to a change in tension of the connective tissue (fascia) under the skin, resulting in “re-positioning” of the upper skin layers.

In this way, filler injections can provide a small but significant lifting effect in a minimally invasive, repeatable procedure, although they are not as effective as plastic surgery. Besides providing confirmation on previous findings on the lifting effects of facial injectables, the study also “broadens their applicability to the total lateral face…to achieve local and regional lifting effects.”

Source: News-Medical.Net
Journal information: Haidar, R., et al. (2021) Quantitative Analysis of the Lifting Effect of Facial Soft-Tissue Filler Injections. Plastic and Reconstructive Surgery. doi.org/10.1097/PRS.0000000000007857.

Categories : AgeingTags :

Leg Motion Can Protect Against Leg Swelling in the Elderly

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A study from Kanazawa University in Japan has shown that leg swelling can be reduced in the elderly as the muscle pumping action of the leg is as effective in people of all ages.

Chronic lower-limb oedema (CLO) — the permanent accumulation of fluid in the leg — often occurs in elderly people. The condition leads to various physical and mental problems, including difficulty in walking or moving, fatigue and anxiety. Lack of physical activity, associated with a decrease in muscle pump action is one of the causes of CLO.

Leg muscles can act as a blood pump: when contracted, the muscle squeezes veins together, forcing blood to flow. But it was not known whether muscle pump action changes as people age had not been thoroughly investigated. Now, Junko Sugama from Kanazawa University and colleagues have addressed this issue. In addition, they studied the effect of leg posture on the muscle pump action.

For their study, the researchers recruited 76 healthy volunteers, categorised into young, middle-aged and old, with average ages of 24, 47 and 72 years, respectively. To investigate blood flow and visualise the morphology of muscles and veins at a given position along the leg, the researchers used MRI cross-section images at 21 positions in the calf region.

To assess the effect of leg motion, subjects were asked to perform plantar flexion (pointing the foot downwards) every 2 seconds for a minute, and MRI images were taken before and after the exercise. This procedure was repeated over three different body positions: supine, sitting and standing.

The scientists found that for all postures, blood flow increased after the exercise, implying that the latter promotes muscle pump action. The blood flow velocity was observed to increase most for the standing posture (90-135%), followed by the supine (55-90%) and sitting (30-40%) postures. No age difference was seen in the flow changes, however the elderly patients had exercise habits, the researchers pointed out.

The researchers suggested that nurse measurement of muscle pump action is useful for deciding whether intervention exercise is necessary to prevent CLO but an easier measurement tool than MRI is needed.

Additional studies are needed, such as adapting the measurement equipment so that it can be applied to elderly people with reduced mobility. The scientists nevertheless concluded that for their set of subjects, “no difference was found in the changes in muscle pump action with age”, and that “elderly people may be able to maintain their muscle pump action when they have exercise habits”.

Source: News-Medical.Net

Journal reference: Fujii, T., et al. (2021) Gravity magnetic resonance imaging measurement of muscle pump change accompanied by aging and posture. Japan Journal of Nursing Science. doi.org/10.1111/jjns.12407.

Categories : Ageing Immune SystemTags :

Study Shows That Viral Infections Affect Immune System like Ageing

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A study from the Buck Institute and Stanford University suggests that chronic viral infections leave an impact on the human immune system, similar to those seen during ageing.

Using systems immunology and artificial intelligence, researchers profiled and compared immune responses in a cohort of aging individuals, people with HIV on long-term antiretroviral therapy, and people infected with hepatitis C (HCV) before and after the virus was treated with sofosbuvir, a drug with a 97% cure rate. Shared immune system alterations include T cell memory inflation, upregulation of intracellular signaling pathways of inflammation, and diminished sensitivity to cytokines in lymphocytes and myeloid cells.

“Chronic inflammation stemming from immune system dysfunction is associated with many of the diseases of ageing,” said senior author David Furman, PhD, Buck Institute associate professor. “Whether chronic viral infection contributes to age-associated immune dysfunction is still an open question, but studies of this type provide a way to start getting answers. At this point it’s clear that both ageing and chronic viral infections leave profound and indelible marks on immunity.”

The body is normally able to clean out acute viral infections, such as the common cold. But some viruses besides just HIV and HCV can remain alive, setting up ‘host-parasite housekeeping’ in the body, without people’s awareness. Dr Furman said that, depending on geographic location, 70 to 90% of the population is infected with cytomegalovirus. In healthy people, this is harmless and problematic only for pregnant women or those with compromised immune systems. Various herpes viruses can also lead to chronic infections.

“Each of us has our own virome; it’s the collection of the viral infections you have during your lifespan,” Furman said. “You probably have been infected by 12 or 15, or even more viruses that you never knew you had. Fortunately technology now exists that allows us to profile these infections in the human population; it is helping us move these types of inquiries forward.” Dr He said this study is the first to fully incorporate the concept of systems immunology, holistically analysing the immune system with the same technological platforms across different cohorts of patients.

The study demonstrated that in patients with HIV, immune system dysregulations were evident despite having been on antiretrovirals for over ten years. However, clearing the HCV virus partially restored cellular sensitivity to interferon-a, which inhibits viral replication. “This plasticity means there is room for intervention in both chronic viral infections and in ageing,” said Dr Furman. “It’s just a matter of identifying and understanding the molecular pathways and networks involved.” The study also identified changes in STAT1, the primary transcription factor activated by interferons. STAT1 plays a major role in normal immune responses, particularly to viral, mycobacterial and fungal pathogens.

As for COVID, Dr Furman said that we are in the midst of an ongoing “living” experiment. Future studies are needed to determine whether the functional imprinting of the immune system is hardwired to only involve the chronic nature of specific infections, or whether short but vigorous ones such as COVID also leave a lasting mark on the immune system. “Has the immune system of those infected with the coronavirus taken a big hit? That’s a theory, but we don’t know what will happen,” says Furman, who is collaborating with Stanford University and the University of California, San Francisco on projects involving COVID-19 and immunity.

Source: Medical Xpress

Journal information: Cesar J. Lopez Angel et al., “Signatures of immune dysfunction in HIV and HCV infection share features with chronic inflammation in aging and persist after viral reduction or elimination,” PNAS (2021). www.pnas.org/cgi/doi/10.1073/pnas.2022928118