title: An unopposed proinflammatory response is beneficial for survival in the oldest old. Results of the Leiden 85-plus Study.
abstract: The capacity to generate an efficient innate immune response is pivotal for survival. The objective of this study was to investigate innate immune function in relation to long-term survival in the oldest old. We measured ex vivo lipopolysaccharide-induced proinflammatory and antiinflammatory cytokine responses in 562 participants aged 85 years of the general population who were followed for mortality during 10 years. Compared with participants with a high proinflammatory and antiinflammatory response profile, 85 year olds with an overall low proinflammatory and antiinflammatory response had a significant higher mortality risk (hazard ratio: 1.79, 95% confidence interval: 1.29-2.50), whereas participants with a high proinflammatory and low antiinflammatory response had a survival benefit (hazard ratio: 0.74, 95% confidence interval: 0.57-0.97). This benefit was even more pronounced in survivors past 90 years of age (hazard ratio: 0.50, 95% confidence interval: 0.26-0.96). In old age, the capacity to generate an unopposed proinflammatory innate immune response is predictive of long-term survival.
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
authors.forename: Carolien A
authors.initials: CA
authors.lastname: Wijsman
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Maier
authors.forename: Anton J M
authors.initials: AJ
authors.lastname: de Craen
authors.forename: Anita H J
authors.initials: AH
authors.lastname: van den Biggelaar
authors.forename: Rudi G J
authors.initials: RG
authors.lastname: Westendorp
mesh_terms: D000369:Aged, 80 and over; D016207:Cytokines / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007113:Immunity, Innate; D008070:Lipopolysaccharides / Q000276:immunology; D008136:Longevity / Q000276:immunology*; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies
chemical_list: D016207:Cytokines; D008070:Lipopolysaccharides