Compromised interferon gamma (IFN-gamma) production in the elderly to both acute and latent viral antigen stimulation: contribution to the immune risk phenotype?

The elderly suffer from an increased incidence of infectious disease, accompanied by increased morbidity and mortality. Interferon-gamma plays an important role in defense against intracellular pathogens such as mycobacteria and viruses. A reduced capacity to produce this cytokine in the elderly, as demonstrated by our findings of significant decreases in IFN-gamma production in vitro on stimulation with bacterial products (LPS) or viral antigens (influenza vaccine), might therefore contribute to disease susceptibility. Moreover, accumulating data suggest that persistent infection with EBV and particularly CMV impacts upon the immune system in aging and may contribute to the immune risk phenotype (IRP), which predicts remaining longevity in the very elderly. Using tetramer technology and IFN-gamma ELISPOT assays, we found that the commonly-observed clonal expansions of CD8+ T-cells in the elderly were for the most part poorly-functional CMV- and EBV-specific cells, expressing little CD28. The resulting accumulation of dysfunctional cells may lead to a reduction of the repertoire of functional T-cells available for responses to novel antigens. Further longitudinal studies are needed to demonstrate whether cytokines such as IFN-g are also part of the IRP. Improving the definition of the IRP will help to understand and thus prevent or reverse age-associated immune dysfunction.