Minerva Gastroenterology 2021 Jul 19

DOI: 10.23736/S2724-5985.21.02934-X

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Immune system and gut microbiota senescence in elderly IBD patients

Massimo C. FANTINI ¹ ✉, Sara ONALI ¹, Antonio GASBARRINI ², Loris R. LOPETUSO ^{2, 3, 4}

¹ Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy; ² CEMAD Digestive Disease Center, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy; ³ Department of Medicine and Ageing Sciences, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy; ⁴ Center for Advanced Studies and Technology (CAST), G. d'Annunzio University of Chieti-
Pescara, Chieti, Italy

In inflammatory bowel disease (IBD), the loss of immune tolerance against gut microbiota causes chronic inflammation and the progressive accumulation of organ damage in genetically susceptible individuals. In the elderly, IBD is often characterized by a different disease behaviour when compared with paediatric and young adult disease. Besides disease behaviour, another aspect of the multifaceted impact of age on elderly IBD course is increased susceptibility to infections. In this context, age-of-onset-dependent IBD behaviour and clinical course are two major contributors to immune system senescence and change of gut microbiota in older subjects. Here, we review the available literature linking immunosenescence and age-dependent changes in the gut microbiota composition to IBD pathogenesis speculating on their possible implications in disease expression in this age class.

KEY WORDS: Mucosal immunology; Aging; Inflammatory bowel disease