US scientists have shown in elderly mice that the immune system could be rejuvenated by eliminating blood stem cells that promote inflammation. According to details published in the journal Nature, the ability to contain viruses and respond to vaccination has been restored in these animals. “This could represent a paradigm shift in the rejuvenation therapies we have,” says Dr. Enrique Esteve, a doctor specialized in reproductive immunology and autoimmune and systemic diseases at the Parc Taulí Hospital in Sabadell.
“We are talking about directly attacking the production of cells of the immune system, the “factory defects” could be corrected and this would have many implications, both in therapies for pathologies of the bone marrow and for all types of processes that appear due to the malfunction of the immune system. these cells. It is very encouraging,” adds Dr. Esteve, who is also a researcher at the Vall d'Hebron Research Institute and who has just published Inmunes. Know and strengthen your defense system (Grijalbo). He welcomes us into his office to chat about everything related to the immune system, age and aging. When we introduce ourselves and introduce the topic, he cites immunoaging.
There is talk of immunoaging… What does it consist of?
It is a term that encompasses two major points, the aging of the immune system as such, and that of our body, secondary to the aging of the immune system. On the one hand, immunoaging can contemplate what you should monitor due to the aging action of these cells in the system, and on the other hand, the consequences that the fact that these cells age and are not performing their function correctly may have for your aging. .
To what extent does a healthy immune system influence the way we age?
A healthy immune system is capable of balancing between defense processes, but also between cell regeneration processes and avoiding phenomena known as autoimmunity, which attack yourself. Having a healthy immune system will help you not only avoid having a serious infectious problem, which impacts your health and aging, but also, by having it in proper functioning, you will regenerate tissues better, you will have less vascular risk, less risk of cognitive deterioration, dementia, less pain... In other words, it is a whole set because it will not only fight infections, but it will also be able to perform other functions. That's what immunoaging is all about.
What are the most common age-related immune system problems, that is, those that usually appear as we get older?
The most important is immunosenescence, the progressive loss of function of these cells, both because you have fewer of them (the bone marrow makes less) and also because they actually lose their function, age and are not as active. The main problems derived? Greater risk of infections, lower response to vaccines and worse control of inflammation. This inflammation is often caused by innate, automatic immunity mechanisms, which curiously do not decrease as much as acquired ones with age. We are losing a little more immune memory. We must protect immunological memory so that it is also capable of solving these problems of inflammation, which from the age of 50 or 60, will be linked to cardiovascular and bone problems (pain, osteoarthritis, fracture) and with cognitive obstacles. , such as the development of dementia.
In other words, inflammation is the cause of many age-related health problems. Is that so?
We are subjected to a hostile environment, toxins, endocrine disruptors, ultra-processed foods, microplastics, a high pace of life... What manages all this is the immune system. If we generate a tendency in our immune system towards exhaustion during our adulthood, when we reach 60 or 65 years of age, this system will weaken and will not be able to respond as it did before, this hostile environment will not be able to handle it as much. . This low-grade inflammation is learned processes that the body has incorporated to solve external problems (sleep, diet, sedentary lifestyle...). The only thing that inflammation will do is perpetuate a state of disease that can trigger more cardiovascular risk, more risk of dementia, bone pain, etc.
How do we know if we have this inflammation? What symptoms does it present?
We have to listen to ourselves from now on: the pain is signaling something, fatigue or tiredness is not normal, signs also appear in the tests, intestinal problems... We should not trivialize all this because we can detect low-grade inflammation very early on. Pain, fatigue, lack of recovery after exercise, gastrointestinal or cognitive problems... are signs. In men, beyond infertility, erectile dysfunction often also speaks of low-grade inflammation.
If we want to take care of the immune system in adulthood, starting at 60, what can we do?
In that age range because that is when a second peak in the incidence of autoimmune diseases occurs. There is a peak around age 20, when the reproductive search begins, and there is another here at 50, 55, 60, due to the drop in levels of sexual hormones. The alteration or imbalance that exists with these hormones causes us to have exaggerated peaks of estrogen for a time, which are immunoactivators. This implies that at this stage we can begin to experience symptoms of autoimmune diseases to which we have to be attentive. This will lead to chronic inflammation that will ultimately be a disease for the rest of your adulthood.
And what are the most common autoimmune diseases at this stage of life?
At this stage, systemic autoimmune diseases are more common, which can impact different organs. The most common in patients aged 65 and 70 is polymyalgia rheumatica, which affects diffusely, it is a weakness and affects the joints, the red blood cells, it can cause anemia, fever... It is like a state of generalized weakness. Also, obviously, lupus, which affects the joints, can affect the heart, kidney, and also the blood. Next, also at the level of the vertebral axis, spondyloarthropathies, typically ankylopoietic spondylitis, which is an inflammation in the sacroiliac joint. In other words, there really is a focus on blood and joints, because at this age the bone begins to suffer more chronic inflammation phenomena.
So that all this does not happen, to prevent, what are the indications for immunoaging? Are there any specific recommendations to take care of the immune system and prevent low-grade inflammation?
To patients in this age range, I talk about mindful aging: understanding how healthy aging really involves protecting your immune system from the moment you read this article, putting the regenerating and repairing tissues as a priority, which is the immune system. This involves adapting your life to your stage of life. It is difficult to articulate, but there are two or three fundamental pillars that the immune system needs to be healthy. Aging healthily requires taking care of the three pillars of the immune system.
What are those pillars?
The first is a good night's rest, adapting your life to your circadian rhythm and the small changes that will occur with age. It is better to get up at half past six in the morning if the sun has risen and your body cannot sleep than to take sleeping pills.
What happens to many older people if they get up so early is that they become sleepy during the day and doze off...
It is the second part or pillar: trying to maintain a cognitive activity continuously that provides you with some challenge, a stimulus. At a professional level you can downgrade because you are at another stage, but you need new projects because at a cognitive level we need neuronal plasticity, it is as if we were building muscle. By muscularizing the brain we reduce inflammation because we induce regeneration and repair mechanisms and then you don't fall asleep.
Rest, cognitive activity... What is the third pillar?
Adapted but continued physical exercise, and without fear incorporating strength exercise because it helps immunoregulation the most. By destroying muscle fiber and having to repair and regenerate, with strength exercise, immune tolerance phenomena occur, an inflammatory focus is created in the muscle fiber and muscle is formed there, but you also clean toxins, you clean everything with the activity of the immune system . Plus, if you get tired well, you sleep better!
Cognitive stimulation, that brain muscle that is a pillar of healthy aging, how is it worked? Sudokus are not enough...
It is much more than doing a sudoku, you need social interaction and cognitive-behavioral therapies. You don't have to be afraid to go at any given time to a psychologist, to a mental professional who adapts some therapies or some type of action beyond the specific medication for your mood. Staying active on a cognitive level, on a social level and with objectives, that implies a challenge. It is complex to make that change of vital paradigm and it is easier to accommodate, but all that impoverishment does is inflame.
We have not talked about food and the much talked about supplements for the immune system...
Good nutrition must be in the mindful eating equation. I am against fad diets, because you know what suits you when and you should not repeat mistakes that you know are not good for your body. It must be taken into account that at this age changes occur in the microbiota and in the quality of the gastric mucosa, and many drugs can alter it. Diet is a very complex topic to deal with superficially, to give a recommendation for a specific regimen, there may be diverticula or ischemic changes in the intestine and some type of diet that works well in a healthy mucosa, otherwise it may be counterproductive. The basis is to take care of the microbiota and not eat ultra-processed foods, trans fats, sugars...
And how do you take care of the microbiota, in advanced age?
Prebiotic foods should be in the weekly diet, and we must keep in mind that the abuse of many medications - some prescribed by doctors and others not - and all this can alter the microbiota. The problem at this age is that there is a tendency towards polypharmacy, the “take this, take that” that friends and neighbors say, and that in the end has a negative impact on the microbiota.
Many people of advanced age take collagen or magnesium supplements, for example, without a doctor's prescription...
I would tell readers to put all the tablets they take for their chronic pathologies on a table and next to them everything that someone has recommended they take, to visualize the number of tablets. You have to be a little more restrictive and always consult your doctor about supplements.
