Autoimmunity and geriatrics: clinical significance of autoimmune manifestations in the elderly

Abstract

The immune system undergoes continuousmorphologic and functionalchanges throughoutthe years, and it is now believed that the immune response has its peak function in puberty and gradually decreases with age (immunosenescence). Recent studies in healthy octogenarian patients suggest that the immune system, instead of suffering a generalized deterioration, undergoes a remodelling/readjustment of its major functions. Increase in two contrasting phenomena coexist in immunosenescence: on the one hand, a decrease in the capacity of the immune response and, on the other hand autoantibodyproduction.The possibleconsequencesof this progressive‘ageing’ of the immune system are the increasein autoimmune phenomena, incidenceof neoplasiaand predisposition to infections. The study of autoimmune manifestations in elderly populations should be considered a priority for future medical research because of increasing life expectancy, especially in developed countries. This review analyses the main immune disorders associated with immunosenescence, the prevalence and clinical significance of autoantibodiesin the elderly and the clinical expression of the main autoimmune diseases in older patients.