Immunosenescence, autoimmunity, and rheumatoid arthritis

Exp Gerontol. 2003 Aug;38(8):833-41. doi: 10.1016/s0531-5565(03)00090-1.

Abstract

Current disease models of autoimmune syndromes, such as rheumatoid arthritis, propose that chronic inflammation is caused by 'forbidden T-cell clones' that recognize disease-inducing antigens and drive tissue-injurious immune reactions. Reappraisal of disease incidence data, however, emphasizes that rheumatoid arthritis is a syndrome of the elderly that occurs with highest likelihood in individuals in whom the processes of T-cell generation and T-cell repertoire formation are compromised. Thymic T-cell production declines rapidly with advancing age. Multiple mechanisms, including antigen-driven clonal expansion and homeostasis-driven autoproliferation of post-thymic T cells, impose replicative stress on T cells and induce the biological program of cellular senescence. T-cell immunosenescence is associated with profound changes in T-cell functional profile and leads to accumulation of CD4+ T cells that have lost CD28 but have gained killer immunoglobulin-like receptors and cytolytic capability and produce large amounts of interferon-gamma. In patients with rheumatoid arthritis, T-cell immunosenescence occurs prematurely, probably due to a deficiency in the ability to generate sufficient numbers of novel T cells. We propose that autoimmunity in rheumatoid arthritis is a consequence of immunodegeneration that is associated with age-inappropriate remodeling of the T-cell pool.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Adult
  • Aged
  • Aging / physiology*
  • Antigens, CD / immunology
  • Arthritis, Rheumatoid / immunology*
  • Autoimmunity / physiology*
  • CD4-Positive T-Lymphocytes / physiology
  • Cellular Senescence / physiology
  • Coronary Artery Disease / immunology
  • Humans
  • Immune System / physiology*
  • Lymphocyte Count
  • Middle Aged
  • Thymus Gland / physiology

Substances

  • Antigens, CD