Systemic immune response in young and elderly patients after traumatic brain injury

Immunity & Ageing

Research

Anna Cargnoni¹  Antonietta R Silini¹  Anna Pasotti¹  Marta Magatti¹  Elisa R Zanier²  Francesca Pischiutta²  Enrico Caruso³  Marco Locatelli⁴  Elisa Erba⁵  Daniele Prati⁵  Franco Capuzzi⁶  Marco Carbonara⁷  Fabrizio Ortolano⁷  Nino Stocchetti⁸  Tommaso Zoerle⁸  Andrea Papait⁹  Ornella Parolini^1,10  Stefano Borsa^1,11 

[1] Centro di Ricerca E. Menni, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy;Department of Acute Brain Injury, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy;Department of Acute Brain Injury, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy;Dipartimento di Anestesia-Rianimazione e Emergenza Urgenza, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy;Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy;Unit of Neurosurgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy;Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy;Dipartimento Medicina di Laboratorio, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy;Dipartimento di Anestesia-Rianimazione e Emergenza Urgenza, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy;Dipartimento di Anestesia-Rianimazione e Emergenza Urgenza, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy;Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy;Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore Facoltà di Medicina e Chirurgia, Roma, Italy;Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore Facoltà di Medicina e Chirurgia, Roma, Italy;Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Roma, Italy;Unit of Neurosurgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy;

关键词: Aging;    Immune cells;    Systemic immune cells;    Traumatic brain injury;    Elderly;    Young;   

DOI  :  10.1186/s12979-023-00369-1

 received in 2023-05-26, accepted in 2023-08-07,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundTraumatic brain injury (TBI) is a leading cause of death and long-term disability worldwide. In addition to primary brain damage, systemic immune alterations occur, with evidence for dysregulated immune responses in aggravating TBI outcome and complications. However, immune dysfunction following TBI has been only partially understood, especially in the elderly who represent a substantial proportion of TBI patients and worst outcome. Therefore, we aimed to conduct an in-depth immunological characterization of TBI patients, by evaluating both adaptive (T and B lymphocytes) and innate (NK and monocytes) immune cells of peripheral blood mononuclear cells (PBMC) collected acutely (< 48 h) after TBI in young (18–45 yo) and elderly (> 65 yo) patients, compared to age-matched controls, and also the levels of inflammatory biomarkers.ResultsOur data show that young respond differently than elderly to TBI, highlighting the immune unfavourable status of elderly compared to young patients. While in young only CD4 T lymphocytes are activated by TBI, in elderly both CD4 and CD8 T cells are affected, and are induced to differentiate into subtypes with low cytotoxic activity, such as central memory CD4 T cells and memory precursor effector CD8 T cells. Moreover, TBI enhances the frequency of subsets that have not been previously investigated in TBI, namely the double negative CD27- IgD- and CD38-CD24- B lymphocytes, and CD56dim CD16- NK cells, both in young and elderly patients. TBI reduces the production of pro-inflammatory cytokines TNF-α and IL-6, and the expression of HLA-DM, HLA-DR, CD86/B7-2 in monocytes, suggesting a compromised ability to drive a pro-inflammatory response and to efficiently act as antigen presenting cells.ConclusionsWe described the acute immunological response induced by TBI and its relation with injury severity, which could contribute to pathologic evolution and possibly outcome. The focus on age-related immunological differences could help design specific therapeutic interventions based on patients’ characteristics.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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