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CMV seropositivity and T‐cell senescence predict increased cardiovascular mortality in octogenarians: results from the Newcastle 85+ study
Authors:Ioakim Spyridopoulos  Carmen Martin‐Ruiz  Catharien Hilkens  Mohammad E. Yadegarfar  John Isaacs  Carol Jagger  Tom Kirkwood  Thomas von Zglinicki
Affiliation:1. Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK;2. Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK;3. Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK;4. Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK;5. Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK;6. Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, UK
Abstract:Although chronic infection with cytomegalovirus (CMV) is known to drive T lymphocytes toward a senescent phenotype, it remains controversial whether and how CMV can cause coronary heart disease (CHD). To explore whether CMV seropositivity or T‐cell populations associated with immunosenescence were informative for adverse cardiovascular outcome in the very old, we prospectively analyzed peripheral blood samples from 751 octogenarians (38% males) from the Newcastle 85+ study for their power to predict survival during a 65‐month follow‐up (47.3% survival rate). CMV‐seropositive participants showed a higher prevalence of CHD (37.7% vs. 26.7%, P = 0.030) compared to CMV‐seronegative participants together with lower CD4/CD8 ratio (1.7 vs. 4.1, P < 0.0001) and higher frequencies of senescence‐like CD4 memory cells (41.1% vs. 4.5%, P < 0.001) and senescence‐like CD8 memory cells (TEMRA, 28.1% vs. 6.7%, P < 0.001). CMV seropositivity was also associated with increased six‐year cardiovascular mortality (HR 1.75 [1.09–2.82], P = 0.021) or death from myocardial infarction and stroke (HR 1.89 [107–3.36], P = 0.029). Gender‐adjusted multivariate Cox regression analysis revealed that low percentages of senescence‐like CD4 T cells (HR 0.48 [0.32–0.72], P < 0.001) and near‐senescent (CD27 negative) CD8 T cells (HR 0.60 [0.41–0.88], P = 0.029) reduced the risk of cardiovascular death. For senescence‐like CD4, but not near‐senescent CD8 T cells, these associations remained robust after additional adjustment for CMV status, comorbidities, and inflammation markers. We conclude that CMV seropositivity is linked to a higher incidence of CHD in octogenarians and that senescence in both the CD4 and CD8 T‐cell compartments is a predictor of overall cardiovascular mortality as well as death from myocardial infarction and stroke.
Keywords:aging  CD4  CD8  coronary heart disease  cytomegalovirus  immunosenescence  octogenarians  survival  T lymphocytes
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