title: Immunosenescence and inflammation characterize chronic heart failure patients with more advanced disease.
abstract: BACKGROUND
  Chronic heart failure (CHF) is characterized by an inflammatory status with high levels of cytokines such as IL-6. We hypothesized that patients with CHF may develop immunosenescence due to inflammation and that this may be associated with a worse stage of the disease.
  
  
  RESULTS
  We compared the immunological features of 58 elderly CHF patients (ECHF), 40 young CHF patients (YCHF), 60 healthy elderly controls (HEC) and 40 healthy young controls (HYC). We characterized leukocyte and lymphocyte subpopulations by flow cytometry, and IL-6 concentration by ELISA. The extent of CHF was classified according to functional and/or morphological criteria: New York Heart Association functional class, AHA/ACC heart failure stages, left ventricular ejection fraction, and left ventricular hypertrophy. CHF patients showed an increased number of leukocytes, neutrophils and monocytes, but a decreased number of lymphocytes. CHF patients had significantly lower levels of B-cells and CD4+ T-cells, increased NK-cells in YCHF, and increased CD8+ T-cells only in ECHF. CHF was associated with high differentiation in CD4+ and CD8+ T-lymphocyte subsets. Aging of T-lymphocyte subpopulations and high IL-6 levels were associated with a worse clinical status. IL-6 also correlated positively with the number of highly differentiated T-lymphocytes and with their accelerated aging.
  
  
  CONCLUSIONS
  We conclude that CHF patients show a higher degree of immunosenescence than age-matched healthy controls. T-lymphocyte differentiation and IL-6 levels are increased in patients with an advanced clinical status and may contribute to disease impairment through a compromised adaptive immune response due to accelerated aging of their immune system.
authors.affiliation: Immunology Department, Hospital Universitario Central de Asturias, 33006 Oviedo, Spain.
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Moro-García
authors.affiliation: Immunology Department, Hospital Universitario Central de Asturias, 33006 Oviedo, Spain.
authors.forename: Ainara
authors.initials: A
authors.lastname: Echeverría
authors.affiliation: Internal Medicine and Geriatrics Department, Hospital Monte Naranco, 33012 Oviedo, Spain.
authors.forename: María Concepción
authors.initials: MC
authors.lastname: Galán-Artímez
authors.affiliation: Consejería de Salud y Servicios Sanitarios del Principado de Asturias, 33006 Oviedo, Spain.
authors.forename: Francisco Manuel
authors.initials: FM
authors.lastname: Suárez-García
authors.affiliation: Internal Medicine and Geriatrics Department, Hospital Monte Naranco, 33012 Oviedo, Spain.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Solano-Jaurrieta
authors.affiliation: Servicio de Cardiología, Área del Corazón, Hospital Universitario Central de Asturias, 33006 Oviedo, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Avanzas-Fernández
authors.affiliation: Servicio de Cardiología, Área del Corazón, Hospital Universitario Central de Asturias, 33006 Oviedo, Spain.
authors.forename: Beatríz
authors.initials: B
authors.lastname: Díaz-Molina
authors.affiliation: Servicio de Cardiología, Área del Corazón, Hospital Universitario Central de Asturias, 33006 Oviedo, Spain.
authors.forename: J L
authors.initials: JL
authors.lastname: Lambert
authors.affiliation: Immunology Department, Hospital Universitario Central de Asturias, 33006 Oviedo, Spain; Fundación Renal "Iñigo Alvarez de Toledo", Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: López-Larrea
authors.affiliation: Servicio de Cardiología, Área del Corazón, Hospital Universitario Central de Asturias, 33006 Oviedo, Spain.
authors.forename: Cesar
authors.initials: C
authors.lastname: Morís de la Tassa
authors.affiliation: Immunology Department, Hospital Universitario Central de Asturias, 33006 Oviedo, Spain. Electronic address: ralonsoarias@hotmail.es.
authors.forename: Rebeca
authors.initials: R
authors.lastname: Alonso-Arias
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016922:Cellular Senescence / Q000276:immunology*; D002908:Chronic Disease; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000276:immunology*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis / Q000276:immunology; D018836:Inflammation Mediators / Q000097:blood / Q000276:immunology; D015850:Interleukin-6 / Q000097:blood* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013601:T-Lymphocytes / Q000276:immunology / Q000473:pathology
chemical_list: C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6
keywords: Aging; Immune system; Inflammation; Interleukins; Lymphocytes