The DOI matches its Crossref record; 265 of the 270 references it cites were found in a registry or an index.
The Impact of Immune System Aging on Infectious Diseases
Open accessAbstract
Immune system aging is becoming a field of increasing public health interest because of prolonged life expectancy, which is not paralleled by an increase in health expectancy. As age progresses, innate and adaptive immune systems undergo changes, which are defined, respectively, as inflammaging and immune senescence. A wealth of available data demonstrates that these two conditions are closely linked, leading to a greater vulnerability of elderly subjects to viral, bacterial, and opportunistic infections as well as lower post-vaccination protection. To face this novel scenario, an in-depth assessment of the immune players involved in this changing epidemiology is demanded regarding the individual and concerted involvement of immune cells and mediators within endogenous and exogenous factors and co-morbidities. This review provides an overall updated description of the changes affecting the aging immune system, which may be of help in understanding the underlying mechanisms associated with the main age-associated infectious diseases.
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“The elderly also face heightened vulnerability, since physiological aging, immunological decline, and cumulative environmental exposures compromise skin barrier function, leading to increased incidence and severity of inflammatory skin diseases, infections, and malignancies, especially during periods of poor air quality or extreme weather events [88,89,90].”
From The Environmental Determinants of Skin Health: Linking Climate Change, Air Pollution, and the Dermatologic Disease Burden (2025) · cites this paper as [88]
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López-Otín, C., Blasco, M. A., Partridge, L., Serrano, M., & Kroemer, G. (2013) · Cell · doi:10.1016/j.cell.2013.05.039 · Cited by 14,982 · cited 1×
“…to encompass nine common features, including genomic instability, telomere shortening attrition, epigenetic alteration, deregulation of nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, alteration of intercellular communication, and loss of proteostasis [5].”
Yang, X., Yu, Y., Xu, J., Shu, H., Xia, J., Liu, H., Wu, Y., Zhang, L., Yu, Z., Fang, M., et al. (2020) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(20)30079-5 · Cited by 10,066 · cited 1×
“This was especially poignant in the wake of the COVID-19 pandemic, when the mortality rate was disproportionately high among the elderly [238].”
Rudd, K. E., Johnson, S. C., Agesa, K. M., Shackelford, K. A., Tsoi, D., Kievlan, D. R., Colombara, D. V., Ikuta, K. S., Kissoon, N., Finfer, S., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(19)32989-7 · Cited by 7,971 · cited 1×
“Severe infections in the elderly can evolve into sepsis, a life-threatening event caused by host response failure, resulting in multiorgan collapse [215].”
Hallmarks of aging: An expanding universe
López-Otín, C., Blasco, M. A., Partridge, L., Serrano, M., & Kroemer, G. (2023) · Cell · doi:10.1016/j.cell.2022.11.001 · Cited by 6,549 · cited 1×
“In addition, three other distinctive derangements, such as alteration of metabolic pathways, adaptation to stress, and, more importantly, chronic inflammation, have been added to the list [7].”
Inflamm‐aging: An Evolutionary Perspective on Immunosenescence
FRANCESCHI, C., BONAFÈ, M., VALENSIN, S., OLIVIERI, F., DE LUCA, M., OTTAVIANI, E., & DE BENEDICTIS, G. (2000) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2000.tb06651.x · Cited by 5,358 · cited 1×
“It has also been considered a negative process because it leads to a type of inflammation called “inflammaging”, which defines a reduction in the capability to cope with a variety of stressors and a progressive increase in the pro-inflammatory status [16].”
Dendritic cells, monocytes and macrophages: a unified nomenclature based on ontogeny
Guilliams, M., Ginhoux, F., Jakubzick, C., Naik, S. H., Onai, N., Schraml, B. U., Segura, É., Tussiwand, R., & Yona, S. (2014) · Nature reviews. Immunology · doi:10.1038/nri3712 · Cited by 1,923 · cited 1×
“Although information regarding the numbers and performance of dendritic cells (DCs) is relatively scarce, the number of circulating conventional and plasmacytoid DCs appears to be reduced in frail, healthy elderly [35].”
Changes in thymic function with age and during the treatment of HIV infection
Douek, D. C., McFarland, R. D., Keiser, P. H., Gage, E. A., Massey, J. M., Haynes, B. F., Polis, M. A., Haase, A. T., Feinberg, M. B., Sullivan#, J. L., et al. (1998) · Nature · doi:10.1038/25374 · Cited by 1,893 · cited 4×
“…of highly active antiretroviral therapy, which has prolonged the survival of these patients despite a persistent inflammation, fueled by high levels of IL-6 and TNF-α , interferon (IFN)- α , reduced production of IL-2 [116–118], as well as by a variable decrease in the number of TRECs [37,119,120].”
InfluentialKirkwood, T. B. L., & Austad, S. N. (2000) · Nature · doi:10.1038/35041682 · Cited by 1,774
Senescence surveillance of pre-malignant hepatocytes limits liver cancer development
Kang, T.-W., Yevsa, T., Woller, N., Hoenicke, L., Wuestefeld, T., Dauch, D., Hohmeyer, A., Gereke, M., Rudalska, R., Potapova, A., et al. (2011) · Nature · doi:10.1038/nature10599 · Cited by 1,621 · cited 1×
“Infected patients likely produce an increased number of intrahepatic senescent, not functional T cells [156,157], which may promote the development of hepatocellular cancer as these T cells would be unable to eliminate premalignant senescent hepatocytes [158].”
Emerging concepts in the science of vaccine adjuvants
Pulendran, B., Arunachalam, P. S., & O’Hagan, D. T. (2021) · Nature Reviews Drug Discovery · doi:10.1038/s41573-021-00163-y · Cited by 1,446 · cited 1×
“These advances, which incorporate immunobiography information with clinical, immunological and omics data, could allow stratifying subgroups of subjects and to identify those markers that could lead to the rational development of vaccines specifically designed for older adults [253,254].”
Flagged first, then by citations
5 of the 270 references couldn’t be matched to a known paper.
Research works printed but not linked: 4
- Rose, M.R. (1991). Oxford University Press.
- Fulop, T., Franceschi, C., Hirokawa, K., and Pawelec, G. (2018). Handbook of Immunosenescence: Basic Understanding and Clinical Implications, Springer Nature. · DOI
- Sivick, 2010, The innate immune response to uropathogenic Escherichia coli involves IL-17A in a murine model of urinary tract infection, J. Immunol., 184, 2065, 10.4049/jimmunol.0902386 · DOI
- Dukowicz, 2007, Small intestinal bacterial overgrowth: A comprehensive review, Gastroenterol. Hepatol., 3, 112
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“The disease continues to pose a significant threat to vulnerable groups such as the elderly, those with comorbidities, and those with weakened immune systems [9–11].”
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Hamedi, E., Kheirkhah, B., & Rokhbakhsh‐Zamin, F. (2025) · Jundishapur Journal of Microbiology · doi:10.5812/jjm-157311
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Metadata
- Authors
- Quiros-Roldan, E., Sottini, A., Natali, P. G., & Imberti, L.
- Affiliations
- Department of Infectious and Tropical Diseases, ASST- Spedali Civili and DSCS- University of Brescia, 25123 Brescia, Italy
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- Mediterranean Task Force for Cancer Control (MTCC), Via Pizzo Bernina, 14, 00141 Rome, Italy
- University of Brescia (IT)
- Corresponding author
- Imberti, Luisa
- Venue
- Microorganisms
- Publisher
- MDPI AG
- Published
- 2024-04-11
- Volume
- 12
- Issue
- 4
- Pages
- 775
- ISSN
- 2076-2607 (ISSN-L)
- PMC
- PMC11051847
- OpenAlex
- W4394716887
- Cited by
- 133
- References
- 270
- Citations by year
- 2026: 56 · 2025: 63 · 2024: 14
- FWCI
- 5.87
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Microorganisms (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
- Funders
- 2nd bando Sanità; PNRR-Salute; Ministero della Salute, Italia
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Immune responses and vaccinations
- Life Sciences › Immunology and Microbiology › Immunology › Immune Response and Inflammation
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Aging › Genetics, Aging, and Longevity in Model Organisms
- Keywords
- immunosenescence, inflammaging, opportunistic infections, viral infection, bacterial infection, vaccine response in the elderly, innate immunity, adaptive immunity, comorbidities
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