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Previous issue date: 2012-08-30 / Introduction: The immune risk phenotype (IRP), as shown by increased CD8+ and low CD4+ T cell counts, and cognitive impairment have been associated with increased morbidity and mortality in very old subjects. Recent evidence suggests that persistent viral infections of the herpesviridae family such as cytomegalovirus (CMV) are likely to be involved with these specific T cell changes. This study aims to identify the IRP and investigate possible associations with viral infections, cognitive and functional states of elderly in Brazil. Material and Methods: 360 elders aged between 60-103 years were recruited from the public health care system in Porto Alegre, Brazil. Peripheral blood was collected and lymphocyte subsets (CD4+, CD8+, NK, NK T, B and CD8+CD28-) assessed by multi-color flow cytometry. CMV and Epstein-Barr virus (EBV) serologies were determined by ELISAs. Cognitive function was evaluated by the word list memory and constructional praxis from the standard neuropsychological battery of Consortium to Establish a Registry for Alzheimer s Disease and Mini Mental Status Examination (MMSE) inventory. PFEFFER Functional Activities Questionnaire was used to determine activities of daily living. Results: 59 individuals were defined with IRP (CD4/CD8 ratio < 1). Increased IgG titers to CMV (p<0.01) but not to EBV were found in the IRP+ group as compared to non-IRP. The IRP+ elders had a greater late-memory deficit (p<0.05) and more functional disability and dependency (p=0.01) when compared with the non-IRP group. Subjects with both IRP and cognitive impairment did not show synergist effects upon lymphocytes or viral serologies. Conclusions: The IRP was identified in 16% of the Brazilian community dwellers. Our data further indicate the association of CMV with IRP and both cognitive and functional disability/dependency during aging. / Introdu??o: O fen?tipo risco imunol?gico (IRP) tem sido demonstrado pelo aumento de c?lulas T CD8+ e baixa contagem de T CD4+, e o comprometimento cognitivo t?m sido associado com aumento da morbidade e mortalidade em idiv?duos muito velhos. Evid?ncias recentes sugerem que infec??es virais persistentes da fam?lia Herpesviridae como o citomegalov?rus (CMV) s?o mais propensos a desenvolverem estas altera??es nas c?lulas T espec?ficas. Este estudo visa identificar o IRP e investigar poss?veis associa??es com infec??es virais, e com o estado cognitivo e funcional em idosos do Brasil. Material e M?todos: 360 idosos com idades entre 60-103 anos foram recrutados a partir do sistema p?blico de sa?de em Porto Alegre, Brasil. O sangue perif?rico foi recolhido e os subconjuntos de linf?citos (c?lulas T CD4 +, CD8 +, c?lulas NK, NK T, B e CD8+CD28-) foram avaliados por citometria de fluxo. A sorologias para CMV e para o v?rus de Epstein-Barr (EBV) foram determinadas por ELISA. A fun??o cognitiva foi avaliada atrav?s da lista de palavras e praxia construtiva do Consortium to Establish a Registry for Alzheimer s Disease (CERAD), do teste de mem?ria verbal e l?gica de Wechesler, e do Mini Exame de Estado Mental (MEEM). O question?rio de Atividade Funcionais PFEFFER foi utilizado para determinar as atividades da vida di?ria. Resultados: 59 indiv?duos foram definidos com IRP. T?tulos aumentados de IgG para CMV (p <0,01), mas n?o para o EBV foram encontrados no grupo IRP+ grupo quando comparados ao grupo Non-IRP. Idosos com IRP+ apresentaram um maior d?ficit de mem?ria tardia (p <0,05) e maior depend?ncia e incapacidade funcional (p = 0,01) em rela??o ao grupo Non-IRP. Indiv?duos com IRP e com d?ficit cognitivo n?o demonstraram efeitos sin?rgicos sobre as popula??es de linf?citos ou sorologias virais. Conclus?es: O IRP foi identificado em 16% dos moradores de comunidades brasileira. Nossos dados ainda indicam uma importante associa??o do CMV com IRP e ambos com o estado cognitivo e funcional defici?ncia/depend?ncia durante o envelhecimento.
Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/2684 |
Date | 30 August 2012 |
Creators | Correa, Bruna Luz |
Contributors | Bauer, Mois?s Evandro |
Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Gerontologia Biom?dica, PUCRS, BR, Instituto de Geriatria e Gerontologia |
Source Sets | IBICT Brazilian ETDs |
Language | Portuguese |
Detected Language | English |
Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
Format | application/pdf |
Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
Rights | info:eu-repo/semantics/openAccess |
Relation | 4438661476953179033, 500, 600, 2296420844541114010 |
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