Allergic diseases in the elderly: biological characteristics and main immunological and non-immunological mechanisms.
Life expectancy and the number of elderly people are progressively increasing around the world. Together with other pathologies, allergic diseases also show an increasing incidence in geriatric age. This is partly due to the growing emphasis on a more accurate and careful diagnosis of the molecular mechanisms that do not allow to ignore the real pathogenesis of many symptoms until now unknown, and partly to the fact that the allergic people from 20 years ago represent the elderly population now. Moreover, environmental pollution predisposes to the onset of allergic asthma and dermatitis which are the result of internal pathologies more than the expression of allergic manifestations. At the same time the food contamination permits the onset of allergic diseases related to food allergy. In this review we provide the state of the art on the physiological changes in the elderly responsible for allergic diseases, their biological characteristics and the major immunological and extra immunological mechanisms. Much emphasis is given to the management of several diseases in the elderly, including anaphylactic reactions. Moreover, some new features are discussed, such as management of asthma with the support of physical activity and the use of the AIT as prevention of respiratory diseases and for the purpose of a real and long lasting benefit. The mechanisms of adverse reactions to drugs are also discussed, due to their frequency in this age, especially in polytherapy regimens. Study of the modifications of the immune system is also of great importance, as regards to the distribution of the lymphocytes and also the presence of a chronic inflammatory disease related to the production of cytokines, especially in prevision of all the possible therapies to be adopted to allow an active and healthy aging.
Interdisciplinary Department of Medicine, Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy.
Maria Teresa
MT
Ventura
DIBIMIS, University of Palermo, Palermo, Italy.
Nicola
N
Scichilone
Laboratory of Immunology and Allergy, Department of Medicine and Sciences of Aging, University of G. d'Annunzio, Chieti, Italy.
Roberto
R
Paganelli
Division and School of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy.
Paola Lucia
PL
Minciullo
Division of Allergy and Clinical Immunology, Department of Medicine, Battipaglia Hospital, Battipaglia, Salerno, Italy.|School of Allergy and Clinical Immunology, University of Naples Federico II, Naples, Italy.
Vincenzo
V
Patella
National Heart and Lung Institute (NHLI), Imperial College London & Royal Brompton Hospital, London, UK.
Matteo
M
Bonini
Allergy and Respiratory Diseases, IRCCS San Martino-IST-University of Genoa, Genoa, Italy.
Giovanni
G
Passalacqua
Departmental Unit of AllergologyClinical Immunology & Pneumology, Fondazione Poliambulanza Hospital, Brescia, Italy.
Carlo
C
Lombardi
Department of Medicine, Allergy Service, ULSS 2 Feltre, Belluno, Italy.
Livio
L
Simioni
Experimental and Clinical Medicine, University of Parma, Parma, Italy.
Erminia
E
Ridolo
Department of Medical Sciences "M. Aresu", University of Cagliari, Cagliari, Italy.
Stefano R
SR
Del Giacco
Division and School of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy.
Sebastiano
S
Gangemi
Allergy and Respiratory Diseases, IRCCS San Martino-IST-University of Genoa, Genoa, Italy.
Giorgio Walter
GW
Canonica
Aging; Allergy; Anaphylaxis; Asthma; Conjunctivitis; Drug reaction; Elderly; Food allergy; Immunotherapy; Urticaria