Polymorbidity, ageing of immune system and low-grade systemic inflammation: a challenge for modern medicine

The  review  article  considers the  data  from  literature that  concern polymorbidity aspects,  its interrelations with ageing of immune system and lo-grade immune ageing, mechanisms of genesis, approaches to its prevention and treatment. Evolution of “comorbidity” and “polymorbidity” terms is tra...

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Autores principales: V. S. Shirinsky, I. V. Shirinsky
Formato: article
Lenguaje:RU
Publicado: SPb RAACI 2020
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Acceso en línea:https://doaj.org/article/3241c226e73c4c71aa84f9ba0285893f
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Sumario:The  review  article  considers the  data  from  literature that  concern polymorbidity aspects,  its interrelations with ageing of immune system and lo-grade immune ageing, mechanisms of genesis, approaches to its prevention and treatment. Evolution of “comorbidity” and “polymorbidity” terms is traced, an updated definition of polymorbidity is proposed. The  world-wide incidence of polymorbidity is increased and  now it reaches  23-25%  in general  population, and up to 98%, in elderly people  (> 65 years old).  The risk factors  of polymorbidity are considered, like as its social burden due to high costs for healthcare, high mortality rates, excessive treatment provided by multidisciplinary specialists.  We present  evidence  for common molecular and cellular  mechanisms involved  in ageing and polymorbidity, being unified  by the term  “inflammaging” which represents a low-grade chronic systemic  inflammation associated with  ageing.  The  data  are  presented that concern the “inflammaging” development with involvement of ageing cells from innate and adaptive immunity systems,  different   pro and  anti-inflammatory mediators, lifelong  antigenic load.  The  data  are  analyzed concerning functional and  structural changes  in the  inborn and  adaptive  immune system  in ageing,  role of these changes  in “inflammaging” persistence and development of polymorbid conditions. There  are complex interactions shown between  the bodily senescence and immune ageing, with similar underlying mechanisms in some cases, however, being quite different  in other  instances. With age, upon  existing risk factors,  the changed adaptive  immunity in most people  is not able to full-scale  coping  with chronic antigenic load,  thus increasing the risk of diseases. Moreover, in many elderly people these changes are compensated by steady activation of the innate immunity cells. It is noted  that the aging events and development of disease (polymorbidity) cannot be considered distinct entities, since they can interact, being, however, basically different in their nature. In future, one should concentrate our efforts on elucidation of molecular and cellular mechanisms of these interactions, solution of the  tasks  oriented for development of such  interventions that  could  be able  to  reduce  harmful consequences of ageing and to use useful effects for health  maintenance and reaching maximal longevity.