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J Gerontol A Biol Sci Med Sci. 2015 Feb;70(2):143-54. doi: 10.1093/gerona/glu018. Epub 2014 Feb 25.

CD4:8 ratio >5 is associated with a dominant naive T-cell phenotype and impaired physical functioning in CMV-seropositive very elderly people: results from the BELFRAIL study.

Author information

1
Department of General Practice, Katholieke Universiteit Leuven (KUL), Belgium. Institute of Health and Society, Université Catholique de Louvain (UCL), Brussels, Belgium. wim.adriaensen@med.kuleuven.be.
2
Department of Internal Medicine II, Centre for Medical Research, University of Tübingen, Germany.
3
Department of General Practice, Katholieke Universiteit Leuven (KUL), Belgium. Institute of Health and Society, Université Catholique de Louvain (UCL), Brussels, Belgium.
4
Institute of Medical Virology and Epidemiology of Viral Disease, University Hospital, Eberhard-Karls University, Tübingen, Germany.
5
Vaccine and Infectious Disease Institute, University of Antwerp, Belgium.

Abstract

A subset of older people is at increased risk of hospitalization and dependency. Emerging evidence suggests that immunosenescence reflected by an inverted CD4:8 ratio and cytomegalovirus (CMV) seropositivity plays an important role in the pathophysiology of functional decline. Nevertheless, the relation between CD4:8 ratio and functional outcome has rarely been investigated. Here, CD4:8 ratio and T-cell phenotypes of 235 community-dwelling persons aged ≥81.5 years in the BELFRAIL study and 25 younger persons (mean age 28.5 years) were analyzed using polychromatic flow cytometry. In the elderly persons, 7.2% had an inverted CD4:8 ratio, which was associated with CMV seropositivity, less naive, and more late-differentiated CD4+ and CD8+ T cells. However, 32.8% had a CD4:8 ratio >5, a phenotype associated with a higher proportion of naive T cells and absent in young donors. In CMV seropositives, this subgroup had lower proportions of late-differentiated CD4+ and CD8+ T cells and weaker anti-CMV immunoglobulin G reactivity. This novel naive T-cell-dominated phenotype was counterintuitively associated with a higher proportion of those with impaired physical functioning in the very elderly people infected with CMV. This underscores the notion that in very elderly people, not merely CMV infection but also the state of its accompanying immune dysregulation is of crucial importance with regard to physical impairment.

KEYWORDS:

CD4:8 ratio; Cytomegalovirus.; Physical functioning; T-cell subsets; Very elderly people

PMID:
24568932
DOI:
10.1093/gerona/glu018
[Indexed for MEDLINE]
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