Aging is associated with increased inflammatory activity reflected by increased circulating levels of TNF-α, IL-6, cytokine antagonists and acute phase proteins in vivo. Epidemiologic studies suggest that chronic low-grade inflammation in aging promotes an atherogenic profile and is related to age-associated disorders (eg, Alzheimer disease, atherosclerosis, type 2 diabetes, etc.) and enhanced mortality risk. Accordingly, a dysregulated production of inflammatory cytokines has an important role in the process of aging. Studies of age-related differences in the production of proinflammatory cytokines in response to acute stimulations in vitro have yielded inconsistent results. However, in vivo infectious models show delayed termination of inflammatory activity and a prolonged fever response in elderly humans, suggesting that the acute phase response is altered in aging. However, a causal relation between the acute phase response and the increased mortality because of bacterial infections in older patients remains to be demonstrated.
Department of Infectious Diseases, H:S, Rigshospitalet, University of Copenhagen, Denmark.
Correspondence to Helle Bruunsgaard, MD, PhD, Department of Infectious Diseases M7641, Rigshospitalet Tagensvej 20, 2200 Copenhagen N, Denmark