Inmunosenescencia: el rol de la edad en la esclerosis múltiple / Immunosenescence: the role of age in multiple sclerosis

Introducción: Junto con el envejecimiento de la población general, la prevalencia de ancianos con esclerosis múltiple (EM) se encuentra en aumento. El sistema inmunológico sufre profundos cambios a lo largo de la vida, por lo que parece imprescindible conocer qué diferencias presentan respecto a pacientes más jóvenes. Desarrollo: La inmunosenescencia, definida como la alteración del sistema inmunológico en relación con el envejecimiento natural, juega un papel esencial en la tolerancia, efectos adversos y respuesta a los tratamientos modificadores de la enfermedad. Entre las principales características de este fenómeno, la involución que sufre el timo es la más destacable. Este hecho genera una reducción en la producción de células T vírgenes. Además, se observa una ratio de linfocitos CD4 + /CD8 + invertido, alteraciones severas en el funcionamiento de las células NK o una disminución en la capacidad de reparación tisular cerebral. Conclusiones: El número de personas de edad avanzada con EM se encuentra en aumento en coincidencia con el envejecimiento de la población general y gracias al avance en los tratamientos modificadores de la enfermedad, así como a la mejora en la asistencia sociosanitaria de estos pacientes. El envejecimiento del sistema inmunitario conlleva un mayor riesgo de infecciones, tumores y enfermedades autoinmunes en los ancianos. En la EM, además, tiene lugar una aceleración en la neurodegeneración por la pérdida de capacidad de remielinización del sistema nervioso. Conocer los cambios que tienen lugar en el sistema inmunológico de la población de edad avanzada es esencial para mejorar la atención de este grupo de pacientes cada vez más prevalente.(AU)

Introduction: The number of elderly people with multiple sclerosis (MS) has increased in line with population ageing. As the immune system presents profound changes over an individual's lifetime, it is important to understand the differences between these patients and younger patients. Development: Immunosenescence, defined as age-related alterations naturally occurring in the immune system, particularly influences tolerance, response, and adverse effects of disease-modifying treatments for MS. Thymic involution is the most noteworthy characteristic of this phenomenon. This process leads to a reduction in the number of virgin T cells. Other effects include an inverted CD4 + /CD8 + cell ratio, severe alterations in NK cell functioning, and reduced tissue repair capacity in the brain. Conclusions: The number of older people with MS is increasing due to population ageing, advances in disease-modifying treatments, and improved health and social care of these patients. Ageing of the immune system increases the risk of infections, tumours, and autoimmune diseases in elderly individuals. Furthermore, neurodegeneration is accelerated in patients with MS due to the nervous system's loss of remyelination capacity. Understanding of the changes affecting the immune system in the elderly population is essential to improving the care provided to this ever-growing patient group.(AU)

Immunosenescence: the role of age in multiple sclerosis.

INTRODUCTION: The number of elderly people with multiple sclerosis (MS) has increased in line with population ageing. As the immune system presents profound changes over an individual's lifetime, it is important to understand the differences between these patients and younger patients. DEVELOPMENT: Immunosenescence, defined as age-related alterations naturally occurring in the immune system, particularly influences tolerance, response, and adverse effects of disease-modifying treatments for MS. Thymic involution is the most noteworthy characteristic of this phenomenon. This process leads to a reduction in the number of virgin T cells. Other effects include an inverted CD4+/CD8+ cell ratio, severe alterations in NK cell functioning, and reduced tissue repair capacity in the brain. CONCLUSIONS: The number of older people with MS is increasing due to population ageing, advances in disease-modifying treatments, and improved health and social care of these patients. Ageing of the immune system increases the risk of infections, tumours, and autoimmune diseases in elderly individuals. Furthermore, neurodegeneration is accelerated in patients with MS due to the nervous system's loss of remyelination capacity. Understanding of the changes affecting the immune system in the elderly population is essential to improving the care provided to this ever-growing patient group.

Immunosenescence: the role of age in multiple sclerosis. / Inmunosenescencia: el rol de la edad en la esclerosis múltiple.

INTRODUCTION: The number of elderly people with multiple sclerosis (MS) has increased in line with population ageing. As the immune system presents profound changes over an individual's lifetime, it is important to understand the differences between these patients and younger patients. DEVELOPMENT: Immunosenescence, defined as age-related alterations naturally occurring in the immune system, particularly influences tolerance, response, and adverse effects of disease-modifying treatments for MS. Thymic involution is the most noteworthy characteristic of this phenomenon. This process leads to a reduction in the number of virgin T cells. Other effects include an inverted CD4 + /CD8 + cell ratio, severe alterations in NK cell functioning, and reduced tissue repair capacity in the brain. CONCLUSIONS: The number of older people with MS is increasing due to population ageing, advances in disease-modifying treatments, and improved health and social care of these patients. Ageing of the immune system increases the risk of infections, tumours, and autoimmune diseases in elderly individuals. Furthermore, neurodegeneration is accelerated in patients with MS due to the nervous system's loss of remyelination capacity. Understanding of the changes affecting the immune system in the elderly population is essential to improving the care provided to this ever-growing patient group.