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Physiology & Science: Ageing > Ageing and Immunity > Flashcards

Ageing and Immunity Flashcards

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1
Q

Which infections are more common in the elderly?

A
  • Sepsis
  • Pneumonia
  • Asymptomatic bacteruria -> UTIs
  • Influenza
  • Herpes zoster -> post-herpetic neuralgia
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2
Q

What are key features of the innate immune system?

A
  • Rapid responses
  • Physical barriers - muscosal membranes + skin
  • Unchanged w/ repeated exposure
  • Phagocytosis main cellular process
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3
Q

What are key features of the adaptive immune system?

A
  • Specific reactive response
  • Memory for recurrent exposure
  • Lymphocytes - T + B
  • Speel + thymus important organs
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4
Q

Which cells are involved in innate immunity and which one of these is the main antigen-presenting cell?

A
  • Mast cell
  • Dendritic cell
  • Macrophage
  • Neutrophil
  • Eosinophil
  • Basophil
  • Complement protein
  • Natural killer cell
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5
Q

What is the role of the dendritic cell?

A

Dendritic cell performs some phagocytosis but presents new antigens to T cells - this is where adaptive immunity is initiated.

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6
Q

What happens to neutrophils during ageing?

A
  • Less recruitment to site of infection
  • Less phagocytosis
  • Less signalling
  • Less intracellular killing
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7
Q

What happens to dendritic cells during ageing?

A
  • Less phagocytosis
  • Less migration
  • Reduced antigen capture + presentation
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8
Q

What happens to macrophages during ageing?

A
  • Reduced recruitment to site of infection
  • Causes more collateral damage (to healthy cells as well)
  • Reduced phagocytosis + killing ability
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9
Q

What changes occur in B-cells in regards to ageing?

A
  • More non-specific antibodies produced
  • More antibodies against self-antigens (autoimmune)
  • Lower affinity + diversity of antibodies
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10
Q

Immunosenescence refers to the gradual deterioration of the immune system brought on by natural age advancement. Describe T-cell immunosenescence

A
  • Thymic involution
  • Reduction in naive T cells
  • Less of new T cells, but more of old T cells
  • Inability to respond to novel antigens
  • Less T helper support of B cell population
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11
Q

Many cells produce cytokines, both pro and anti-inflammatory. Ageing is accompanied by an increase in which type? What are examples?

A

Ageing accompanied by increased pro-inflammatory cytokines - mainly IL-6, TNF-alpha

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12
Q

What does increased background inflammation (inflammaging) do?

A
  • Reduces response to specific infective stressors
  • Exacerbates conditions w inflammatory aetiology
  • > autoimmune disease
  • > alzheimer’s
  • > cardiovascular disease
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13
Q

Elderly patients often don’t come to hospital presenting with typical infectious symptoms, so what do they come in with?

A
  • Delirium
  • Lethargy
  • Falls
  • Anorexia

Can be caused by anything

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14
Q

What is difficult about diagnosing elderly patients coming into hospital?

A
  • 50% present later due to blunted inflammatory response
  • Cognitive impairment makes history more difficult
  • Imaging + microbiology specimens are difficult to obtain
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15
Q

Multiple admissions mean increased drug resistant organisms, such as?

A
  • MRSA
  • ESBL
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16
Q

Which healthcare associated infections are more common in elderly patients?

A
  • Catheter Associated UTI
  • Hospital acquired pneumonia
  • C. diff
17
Q

Co-morbidity increases likelihood of organ specific septic complications, such as?

A
  • Acute kidney injury
  • Cardiac dysfunction + type 2 MI
18
Q

What do we see in regards to vaccination in elderly people?

A
  • Vaccine response is attenuated (reduced) by immune senescence
  • Response rate 30-40% in over 65s, 80% in under 65s
19
Q

What is the impact of influenza vaccination?

A
  • Benefit to older people due to high incidence + mortality
  • Reduction in mortality, morbidity + hospitalisation
20
Q

What other vaccination is often co-administered with the influenza vaccine?

A
  • Pneumococcal vaccination
  • Moderate efficacy in older people
  • Cost-effective due to low cost of co-administration with flu vaccine
21
Q

There are slight increase in autoimmune disease in the elderly. Specifically which autoantibody is more frequent?

A

Increased rheumatoid factor -> RA!

22
Q

What is the median age of cancer diagnosis?

A
  • 70
  • Cancer incidence increases with age
23
Q

In which individuals is there an increased frequency of cancer?

A
  • Immunosupressed individuals:
  • HIV
  • Solid organ transplants
  • Long term immunosupression for autoimmune conditions
24
Q

What is immunosurveillance?

A
  • If a normal cell is faulty/abnormally functioning, it will kill itself by apoptosis
  • Cancer is the upregulation of abnormal endogenous cells
  • Precursor cells of cancer in whom apoptosis has not occurred should be destroyed by a healthy immune system
  • So immunosurveillance is a important role of the immune system
25
Q

How does immune senescence (T cells) contribute to an increased likelihood of cancer?

A
  • Particularly T cells reduced identification of abnormal cells
  • Decreased cytotoxic activity
  • Allows tumour cells to escape immunosurveillance + subsequent destruction

Physiology & Science: Ageing (13 decks)

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