PDF(Pubmed)
Abstract：
There is consistent evidence that immune response declines with aging, with wide interindividual variability and a still unclear relationship with the development of frailty. To address this question, we assessed the role of immune resilience (capacity to restore immune functions), operationalized as the neutrophil-to-lymphocytes ratio (NL-ratio) and monocytes-to-lymphocytes ratio (ML-ratio), in the pathway that from robust status shifts to pre-frailty and frailty, and finally to death. The InCHIANTI study enrolled representative samples from the registry lists of 2 towns in Tuscany, Italy. Baseline data were collected in 1998, with follow-up visits every 3 years. The 1 453 participants enrolled were assessed and followed for lifestyle, clinical condition, physical performance, clinical, and physiological measures. For the purpose of this analysis, we used only 1 022 subjects aged 65 or older at baseline. Participants in the 3 highest deciles of distribution for NL-ratio (>2.44) were more likely to experience a transition from robust to pre-frail, and to overt frailty status. Moreover, NL-ratio (tenth decile > 3.53) and ML-ratio (tenth decile > 2.02) were both predictors of mortality. These results were independent of chronological age, sex, comorbidities, and chronic low-grade inflammation assessed by high sensitivity C-reactive protein measurement. The 2 leucocytes-derived ratios, NL-ratio and ML-ratio, represent markers of immune resilience and predict changes in physical resilience and mortality. These biomarkers are inexpensive because they are based on data routinely collected in clinical practice and can be used to assess the risk of frailty progression and mortality. Clinical Trials Registration Number: NCT01331512.
摘要：
有一致的证据表明免疫反应随着衰老而下降，具有广泛的个体间变异性，与虚弱发展的关系尚不清楚。为了解决这个问题，我们评估了免疫弹性（恢复免疫功能的能力）的作用。操作为中性粒细胞与淋巴细胞之比（NL比）和单核细胞与淋巴细胞之比（ML比），在从稳健状态转变为脆弱和脆弱之前的路径中，最后走向死亡。InCHIANTI研究从托斯卡纳两个城镇的登记名单中登记了代表性样本，意大利。基线数据收集于1998年，每三年进行一次随访。对1453名参与者进行了评估和生活方式随访，临床状况,物理性能，临床和生理措施。出于本分析的目的，我们仅使用了基线时年龄在65岁或以上的1022名受试者。NL比率分布的三个最高分位数（>2.44）的参与者更有可能经历从稳健到脆弱前的转变，明显的脆弱状态。此外，NL比率(十分之一>3.53)和ML比率(十分之一>2.02)都是死亡率的预测因子。这些结果与实际年龄无关，性别,合并症,和通过高敏C反应蛋白测量评估的慢性低度炎症。两个白细胞来源的比率，NL比率和ML比率，代表免疫弹性的标志物，并预测身体弹性和死亡率的变化。这些生物标志物是廉价的，因为基于临床实践中常规收集的数据，并可用于评估虚弱进展和死亡的风险。
