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
Materias:	polymorbidity ageing inflammaging innate immunity adaptive immunity chronic antigen load Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/3241c226e73c4c71aa84f9ba0285893f
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spelling	oai:doaj.org-article:3241c226e73c4c71aa84f9ba0285893f2021-11-18T08:03:49ZPolymorbidity, ageing of immune system and low-grade systemic inflammation: a challenge for modern medicine1563-06252313-741X10.15789/1563-0625-PAO-2042https://doaj.org/article/3241c226e73c4c71aa84f9ba0285893f2020-08-01T00:00:00Zhttps://www.mimmun.ru/mimmun/article/view/2042https://doaj.org/toc/1563-0625https://doaj.org/toc/2313-741XThe 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.V. S. ShirinskyI. V. ShirinskySPb RAACIarticlepolymorbidityageinginflammaginginnate immunityadaptive immunitychronic antigen loadImmunologic diseases. AllergyRC581-607RUMedicinskaâ Immunologiâ, Vol 22, Iss 4, Pp 609-624 (2020)
institution	DOAJ
collection	DOAJ
language	RU
topic	polymorbidity ageing inflammaging innate immunity adaptive immunity chronic antigen load Immunologic diseases. Allergy RC581-607
spellingShingle	polymorbidity ageing inflammaging innate immunity adaptive immunity chronic antigen load Immunologic diseases. Allergy RC581-607 V. S. Shirinsky I. V. Shirinsky Polymorbidity, ageing of immune system and low-grade systemic inflammation: a challenge for modern medicine
description	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.
format	article
author	V. S. Shirinsky I. V. Shirinsky
author_facet	V. S. Shirinsky I. V. Shirinsky
author_sort	V. S. Shirinsky
title	Polymorbidity, ageing of immune system and low-grade systemic inflammation: a challenge for modern medicine
title_short	Polymorbidity, ageing of immune system and low-grade systemic inflammation: a challenge for modern medicine
title_full	Polymorbidity, ageing of immune system and low-grade systemic inflammation: a challenge for modern medicine
title_fullStr	Polymorbidity, ageing of immune system and low-grade systemic inflammation: a challenge for modern medicine
title_full_unstemmed	Polymorbidity, ageing of immune system and low-grade systemic inflammation: a challenge for modern medicine
title_sort	polymorbidity, ageing of immune system and low-grade systemic inflammation: a challenge for modern medicine
publisher	SPb RAACI
publishDate	2020
url	https://doaj.org/article/3241c226e73c4c71aa84f9ba0285893f
work_keys_str_mv	AT vsshirinsky polymorbidityageingofimmunesystemandlowgradesystemicinflammationachallengeformodernmedicine AT ivshirinsky polymorbidityageingofimmunesystemandlowgradesystemicinflammationachallengeformodernmedicine
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Polymorbidity, ageing of immune system and low-grade systemic inflammation: a challenge for modern medicine

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