T cell immune senescence is associated with frailty and sarcopenia in lung transplant candidates
Backgound: Older lung transplant recipients experience increased rates of adverse clinical outcomes, including infection compared with younger patients, potentially related to impaired cell-mediated immunity, frailty, and sarcopenia. Methods: Patients over age 55 years undergoing evaluation for lung...
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| Language: | English |
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Elsevier
2025-02-01
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| Series: | JHLT Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950133424001496 |
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| author | Joanna M. Schaenman, MD, PhD Harry Pickering, PhD Elaine F. Reed, PhD Maura Rossetti, PhD Benjamin Seligman, MD S. Samuel Weigt, MD Michael Shino, MD David Sayah, MD, PhD John Belperio, MD Ashley Hu, MD Ashley Prosper, MD Kathleen Ruchalski, MD Abbas Ardehali, MD Reshma Biniwale, MD |
| author_facet | Joanna M. Schaenman, MD, PhD Harry Pickering, PhD Elaine F. Reed, PhD Maura Rossetti, PhD Benjamin Seligman, MD S. Samuel Weigt, MD Michael Shino, MD David Sayah, MD, PhD John Belperio, MD Ashley Hu, MD Ashley Prosper, MD Kathleen Ruchalski, MD Abbas Ardehali, MD Reshma Biniwale, MD |
| author_sort | Joanna M. Schaenman, MD, PhD |
| collection | DOAJ |
| description | Backgound: Older lung transplant recipients experience increased rates of adverse clinical outcomes, including infection compared with younger patients, potentially related to impaired cell-mediated immunity, frailty, and sarcopenia. Methods: Patients over age 55 years undergoing evaluation for lung transplantation were evaluated for sarcopenia by cross-sectional area and average attenuation of the pectoralis major muscle on chest computed tomography. Frailty was measured using the Fried Frailty Phenotype. Immune phenotyping was performed using multichannel flow cytometry of peripheral blood mononuclear cells (PBMC) in a total of 26 lung transplant candidates. Results: The median patient age was 65, primarily with restrictive lung disease (76.9%). Hospital readmission was associated with lower frequency of naïve CD4 (p = 0.004) and CD8 T cells (p = 0.026). Senescent CD4 (KLRG1+/CD28−) and CD8 T cells were also associated with readmission (p = 0.014 and p = 0.013, respectively), and senescent CD4 T cells were predictive of total hospital time (p = 0.003). TEMRA CD4 T cells were significantly associated with frailty (p = 0.015) and sarcopenia (p = 0.011). Senescent CD4 and CD8 T cells were significantly associated with sarcopenia (p = 0.009 and p = 0.006, respectively). Conclusions: These findings suggest that impaired cell-mediated immunity may underlie the associations between frailty and sarcopenia and poor clinical outcomes. A multifaceted approach to evaluation of older patients has the potential to improve risk stratification and inform management of immunosuppression. |
| format | Article |
| id | doaj-art-39ec6862abc3455ba6bbddb851cfaafb |
| institution | Kabale University |
| issn | 2950-1334 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JHLT Open |
| spelling | doaj-art-39ec6862abc3455ba6bbddb851cfaafb2025-02-09T05:02:00ZengElsevierJHLT Open2950-13342025-02-017100199T cell immune senescence is associated with frailty and sarcopenia in lung transplant candidatesJoanna M. Schaenman, MD, PhD0Harry Pickering, PhD1Elaine F. Reed, PhD2Maura Rossetti, PhD3Benjamin Seligman, MD4S. Samuel Weigt, MD5Michael Shino, MD6David Sayah, MD, PhD7John Belperio, MD8Ashley Hu, MD9Ashley Prosper, MD10Kathleen Ruchalski, MD11Abbas Ardehali, MD12Reshma Biniwale, MD13Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine, Los Angeles, California; Corresponding author: Joanna M. Schaenman, MD, PhD, Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine, Los Angeles, CA.Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, Los Angeles, CaliforniaDepartment of Pathology and Laboratory Medicine, David Geffen School of Medicine, Los Angeles, CaliforniaDepartment of Pathology and Laboratory Medicine, David Geffen School of Medicine, Los Angeles, CaliforniaDepartment of Medicine, Division of Geriatrics, David Geffen School of Medicine, Los Angeles, CaliforniaDepartment of Medicine, Division of Pulmonary Medicine, David Geffen School of Medicine, Los Angeles, CaliforniaDepartment of Medicine, Division of Pulmonary Medicine, David Geffen School of Medicine, Los Angeles, CaliforniaDepartment of Medicine, Division of Pulmonary Medicine, David Geffen School of Medicine, Los Angeles, CaliforniaDepartment of Medicine, Division of Pulmonary Medicine, David Geffen School of Medicine, Los Angeles, CaliforniaDepartment of Radiology, David Geffen School of Medicine, Los Angeles, CaliforniaDepartment of Radiology, David Geffen School of Medicine, Los Angeles, CaliforniaDepartment of Radiology, David Geffen School of Medicine, Los Angeles, CaliforniaDepartment of Cardiothoracic Surgery, David Geffen School of Medicine, Los Angeles, CaliforniaDepartment of Cardiothoracic Surgery, David Geffen School of Medicine, Los Angeles, CaliforniaBackgound: Older lung transplant recipients experience increased rates of adverse clinical outcomes, including infection compared with younger patients, potentially related to impaired cell-mediated immunity, frailty, and sarcopenia. Methods: Patients over age 55 years undergoing evaluation for lung transplantation were evaluated for sarcopenia by cross-sectional area and average attenuation of the pectoralis major muscle on chest computed tomography. Frailty was measured using the Fried Frailty Phenotype. Immune phenotyping was performed using multichannel flow cytometry of peripheral blood mononuclear cells (PBMC) in a total of 26 lung transplant candidates. Results: The median patient age was 65, primarily with restrictive lung disease (76.9%). Hospital readmission was associated with lower frequency of naïve CD4 (p = 0.004) and CD8 T cells (p = 0.026). Senescent CD4 (KLRG1+/CD28−) and CD8 T cells were also associated with readmission (p = 0.014 and p = 0.013, respectively), and senescent CD4 T cells were predictive of total hospital time (p = 0.003). TEMRA CD4 T cells were significantly associated with frailty (p = 0.015) and sarcopenia (p = 0.011). Senescent CD4 and CD8 T cells were significantly associated with sarcopenia (p = 0.009 and p = 0.006, respectively). Conclusions: These findings suggest that impaired cell-mediated immunity may underlie the associations between frailty and sarcopenia and poor clinical outcomes. A multifaceted approach to evaluation of older patients has the potential to improve risk stratification and inform management of immunosuppression.http://www.sciencedirect.com/science/article/pii/S2950133424001496T cellimmune senescencefrailtysarcopenialung transplantationoutcomes |
| spellingShingle | Joanna M. Schaenman, MD, PhD Harry Pickering, PhD Elaine F. Reed, PhD Maura Rossetti, PhD Benjamin Seligman, MD S. Samuel Weigt, MD Michael Shino, MD David Sayah, MD, PhD John Belperio, MD Ashley Hu, MD Ashley Prosper, MD Kathleen Ruchalski, MD Abbas Ardehali, MD Reshma Biniwale, MD T cell immune senescence is associated with frailty and sarcopenia in lung transplant candidates JHLT Open T cell immune senescence frailty sarcopenia lung transplantation outcomes |
| title | T cell immune senescence is associated with frailty and sarcopenia in lung transplant candidates |
| title_full | T cell immune senescence is associated with frailty and sarcopenia in lung transplant candidates |
| title_fullStr | T cell immune senescence is associated with frailty and sarcopenia in lung transplant candidates |
| title_full_unstemmed | T cell immune senescence is associated with frailty and sarcopenia in lung transplant candidates |
| title_short | T cell immune senescence is associated with frailty and sarcopenia in lung transplant candidates |
| title_sort | t cell immune senescence is associated with frailty and sarcopenia in lung transplant candidates |
| topic | T cell immune senescence frailty sarcopenia lung transplantation outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2950133424001496 |
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