Senescent remodeling of the immune system and its contribution to the predisposition of the elderly to infections / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To review the senescent remodeling of the immune system with aging and its relevance to the increased susceptibility of the elderly to infectious diseases, along with an outlook on emerging immunological biomarkers.</p><p><b>DATA SOURCES</b>The data selected were from PubMed with relevant published articles in English or French from 1995 to the present. Searches were made using the terms "immunosenescence" and "aging" paired with the following: "innate immunity", "T-cell", "B-cell", "adaptive immunity" and "biomarkers". Articles were reviewed for additional citations and some information was gathered from web searches.</p><p><b>STUDY SELECTION</b>Articles on aging of both the innate and adaptive immunity were reviewed, with special attention to the remodeling effect on the ability of the immune system to fight infectious diseases. Articles related to biomarkers of immunosenescence were selected with the goal of identifying immunological biomarkers predisposing the elderly to infections.</p><p><b>RESULTS</b>Innate immunity is generally thought to be relatively well preserved or enhanced during aging compared with adaptive immunity which manifests more profound alterations. However, evidence, particularly in the last decade, reveals that both limbs of the immune system undergo profound remodeling with aging. Reported data on adaptive immunity is consistent and changes are well established but conflicting results about innate immunity were reported between in vivo and in vitro studies, as well as between murine and human studies. Epidemiological data suggests increased predisposition of the elderly to infections, but no compelling scientific evidence has directly linked senescent immune remodeling to this increased susceptibility. Recently, growing interest in identifying immunological biomarkers and defining "immune risk phenotypes/profiles" (IRP) has been expressed. Identification of biomarkers is in its early days and few potential biomarkers have been identified, with the Swedish having defined one IRP based on the adaptive immune response.</p><p><b>CONCLUSIONS</b>Aging does not necessarily lead to an unavoidable decline in immune functions. Instead, a complex remodeling occurs. Despite the lack of compelling scientific evidence, senescent immune remodeling surely is a significant contributing factor to the increased risk and severity of infections in the elderly. Although, no immunological biomarker has been formally linked to the increased risk of infections in the elderly, biomarkers remain a promising tool to predict the likelihood of healthy aging, the level of immune competence, and mortality risk in the elderly. Hence, more research is required to define healthy aging and identify immunological biomarkers.</p>

Influence of androgen and estrogen deprivation therapy on bone metabolism and bone mineral density in men with prostate cancer / 中华老年医学杂志

Objective To investigate the effects of castration treatment by luteinizing hormonereleasing hormone(LHRH)analog(goserelin)on bone loss and bone resorption in men with prostate cancer.Methods Serum sex hormones,bone mineral density(BMD),serum and urine concentrations of bone turnover markers were determined in men with prostate cancer(n=36) and in age-matched controls(n=13).BMD in the lumbar spine(L2-4),femoral neck,trochanter,Ward's triangle and total femoral was determined by dual energy X-ray absorptiometry(DEXA).Results After 12 months of LHTH analog therapy,the BMD of the femoral neck,total femoral and Ward's triangle decreased significantly in men with prostate cancer compared with the controls,all P＜0.05. No significant bone loss was observed in the control subjects.The concentrations of the serum markers of bone formation,i.e.bone alkaline phosphatase(BALP),and urine markers of bone resorption,i. e.DPD,Cros,Ca/Cr were significantly increased in patients treated with LHRH analog compared with control subjects,all P＜0.05,respectively.Conclusions These findings demonstrate that a significant increase of bone turnover and loss of bone mass in men with prostate cancer after receiving LHRH analog therapy were correlated with the decreased levels of serum androgen and estrogen,and suggest that measuring BMD by DEXA and assesing the bone turnover markers can early detect the bone loss and osteoporosit induced by goserelin castration treatment.

Method performance verification of the clinical chemiluminescence immunoassay / 中华检验医学杂志

Objective To establish a method performance verification project and experimental method for the clinical chemiluminescence immunoassay.Methods Referring to CLSI evaluation protocols and pertinent literature,and by combining our actual works,we designed a verification procedure and experimental method.By Using these above,the precision,accuracy,analytical sensitivity,analytical measurement range,clinical reportable range and biotic interval of AFP on the Bayer Centaur 240 chemiluminescence immunoassay system were verificated.Results would be compared with the declaration of the manufacturer or desirable specifications derived from biologic variation.Results The results showed that the between-day inaccuracy on AFP levels at 77.4 ng/ml and 168.0 ng/ml was 5.70% and 4.84% respectively,these were consistent with manufacturer's inaccuracy claimed.The relative bias between the results measured for calibrator at four levels and target value was less 5.0%,and the relative bias between the results measured for EQA control sample at five levels and target value was-3.4% to 11.9%.Lower limit of detection was 1.04 ng/ml,lower slightly manufacturer's analytical sensitivity claimed.Biologic limit of detection was 2.65 ng/ml-3.53 ng/ml,functional sensitivity was 3.53 ng/ml.Analytical measurement range was 3.53-912.00 ng/ml,within manufacturer's liner range claimed.Clinical reportable range was 3.53-182 400.00 ng/ml.Reference interval was 0.6-7.7 ng/ml,within manufacturer' s claimed.Conclusions The main performances of the detection system are accorded with the declaration of the manufacturer.The performance verification procedure and experimental method of our research ars simple and practical,which has important significations for building medical laboratory and laboratory accreditation, improving quality of the chemiluminescence immunoassay.

Using westgard's method evaluation decision chart for judging method performance of routine biochemistry items on Roche Modular PPI testing system / 中华检验医学杂志

Objective To judge method performance of routine biochemistry parameters on Roche Modular PPI testing system by using westgard's method evaluation decision chart.Methods We assessed imprecision(CV)from internal quality control and inaccuracy(bias)from external quality control evaluation.Combined estimates of imprecision and inaccuracy by plotting imprecision as the x-coordinate and inaccuracy as the y-coordinate to locate an expected operating point of every item on the chart.By comparing this operating point with allowable total errors(TEa),we can decide whether the performance is acceptable or not.Results In the 27 different parameters tested,imprecision and bias of calcium were 0.08 mmol/L and 0.06 mmol/L respectively,its performance was marginal.The imprecision of creatinine,urea,glucose, sodium,chloride and phosphorus were 3.20%,2.13%,1.52%,0.89 mmol/L,1.10% and 1.55%,the bias were 4.79%,0.96%,4.63%,0.80 mmol/L,1.74% and 4.13% respectively,their performance was good.M1 other 20 items were of excellence performance.Conclusions Routine biochemistry parameters on Roche Modular PPI testing system possessed good precision and accuracy,and their performance were acceptable.To judge method performance of biochemistry testing system by using westgard' s method evaluation decision chart was easy to do and suited for clinical laboratory.