Cited by 466Interstitial Lung Diseases and Idiopathic Pulmonary FibrosisChronic Obstructive Pulmonary Disease (COPD) ResearchTransplantation: Methods and Outcomes

The DOI matches its Crossref record; 152 of the 152 references it cites were found in a registry or an index; 7 of the 184 sources its claims cite were checked for support.

Aging and Lung Disease

Open access
Cho, Soo Jung, Stout-Delgado, Heather W.·2020·Annual Review of Physiology

Abstract

People worldwide are living longer, and it is estimated that by 2050, the proportion of the world's population over 60 years of age will nearly double. Natural lung aging is associated with molecular and physiological changes that cause alterations in lung function, diminished pulmonary remodeling and regenerative capacity, and increased susceptibility to acute and chronic lung diseases. As the aging population rapidly grows, it is essential to examine how alterations in cellular function and cell-to-cell interactions of pulmonary resident cells and systemic immune cells contribute to a higher risk of increased susceptibility to infection and development of chronic diseases, such as chronic obstructive pulmonary disease and interstitial pulmonary fibrosis. This review provides an overview of physiological, structural, and cellular changes in the aging lung and immune system that facilitate the development and progression of disease.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review synthesizes how normal lung aging and immunosenescence alter pulmonary structure, cellular repair, and immune responses, increasing susceptibility to COPD, IPF, ARDS, pneumonia, and asthma exacerbations. It emphasizes that senescence, oxidative stress, ECM remodeling, and innate/adaptive immune dysfunction converge to impair lung homeostasis and disease outcomes.

Key findings

  • Natural lung aging causes structural and physiologic changes: increased alveolar size and alveolar-capillary surface area, reduced elastic recoil, increased functional residual capacity, and declines in FEV1 of approximately 30 mL/year and FVC of approximately 20 mL/year, lowering the FEV1/FVC ratio; total lung capacity does not significantly change with age.
  • Cellular aging includes increased bronchoepithelial apoptosis, AEC2 senescence, mitochondrial dysfunction, impaired autophagy, decreased proliferating-to-apoptotic AEC ratio, ECM stiffening with increased collagen and decreased elastin/laminin/fibronectin, endothelial dysfunction, and altered airway smooth muscle markers.
  • Immunosenescence includes age-associated declines in alveolar macrophage phagocytosis, impaired dendritic cell antigen phagocytosis and migration, decreased neutrophil CD16 with increased superoxide and impaired phagocytosis, altered NET-mediated killing, reduced NK cell function, decreased naïve T cells with increased memory T cells, and impaired B cell development/repertoire diversity.
  • Disease links include COPD sharing aging features but with more disorganized collagen and increased collagen, fibronectin, and laminin; IPF survival of less than five years post diagnosis; severe sepsis mortality of 50–60% in elderly patients; and increased pneumonia susceptibility from impaired clearance and bacterial adhesion.

Methods

  • Design: narrative review; no primary experiments or systematic review methodology are described.
  • Data or sample: synthesis of published human, murine, and in vitro literature; no original human or animal cohort is analyzed.
  • Main analysis: thematic overview of physiologic, structural, cellular, immune, and disease-related changes in the aging lung, with 149 cited references.

Limitations

  • The paper states that more detailed mechanistic studies are needed to validate genetic determinants of disease progression, understand interactions between immune and lung cell types, clarify when lung aging begins, and link biologic hallmarks of aging to lung phenotypes and disease progression.
  • Evident from the text: as a narrative review, it does not report a systematic search strategy, inclusion criteria, quality appraisal, or primary data, and it synthesizes heterogeneous human, murine, and in vitro findings.
  • The paper notes that interpretation of healthy or normal lung function in older persons and disease diagnosis can be problematic because of heterogeneity and variable rates of lung aging; height, gender, weight, and ethnicity partly explain FEV1/FVC differences, and reference standards remain to be fully elucidated.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1146/annurev-physiol-021119-034610

Cites

152 of 152 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

90 Not checked yet · 31 Own interpretation · 5 No basis given · 4 Partly supported · 1 Supported · accuracy not yet measured

Verify all 177 references — free account

Show all 84 claims

  • It may state two separate claims as one. 40
  • Probably not a substantial claim. 8
47 of 47
  • The paper relies on this without support.

    Findings from experimental animal models of infection or injury are representative of human aging and can support conclusions about older persons.

    “Experimental models of infection or injury have demonstrated that neutrophil chemotaxis is dysregulated (123).”
    “In experimental models, DC migration into the aged lung during influenza infection is reduced (115).”
  • The paper relies on this without support.

    Findings from experimental murine studies of B cell development are representative of human B cell aging.

    “Specifically, experimental murine studies have demonstrated a decline in the number pro-B, pre-B, and immature B cell subsets present in older animals (135).”
2 of 2

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Citations

Cites

Research works printed but not linked: 8

  1. Crapo RO, 1982, Bull. Eur. Physiopathol. Respir., 18, 419
  2. Peterson DD, 1981, Am. Rev. Respir. Dis., 124, 387
  3. Crapo JD, 1982, Am. Rev. Respir. Dis., 125, 740
  4. Rose MC., 1992, Am. J. Physiol., 263, L413
  5. Greene CM, 2005, Arch. Immunol. Ther. Exp., 53, 418
  6. Walski M, 2009, J. Physiol. Pharmacol., 60, 121
  7. Nomellini V, 2012, Aging Dis, 3, 234
  8. Incalzi RA, 1989, Compr. Gerontol. A, 3, 65

Cited by

Sorted by citations

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Metadata

Authors
Cho, S. J., & Stout-Delgado, H. W.
Affiliations
Weill Cornell Medicine (US)
Venue
Annual Review of Physiology
Published
2020-02-10
Volume
82
Issue
1
Pages
433-459
ISSN
  • 0066-4278 (ISSN-L)
  • 1545-1585
OpenAlex
W2984453596
Cited by
458
References
146
Citations by year
2026: 50 · 2025: 113 · 2024: 109 · 2023: 94 · 2022: 53 · 2021: 21 · 2020: 14
FWCI
3.79
Type
journal article
Language
en
Open access
Locations
  • Annual Review of Physiology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • National Institute on Aging (R01AG056699, R01AG052530)
  • National Heart, Lung, and Blood Institute (K08HL138285)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
Keywords
lung aging, chronic obstructive pulmonary disease, interstitial pulmonary fibrosis, lung remodeling, lung infection susceptibility, immunosenescence, lung function decline
MeSH terms
Aged, Aging, Humans, Lung, Lung Diseases, Middle Aged, Cellular Senescence

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