Scoring of Immunological Vigor: Trial Assessment of Immunological Status as a Whole for Elderly People and Cancer Patients

Abstract

The three leading causes of death in industrialized countries are cancer, stroke and ischemic heart disease, whereas infections are more prevalent in developing countries. Nonetheless, infections such as pneumonia and urinary tract infection rank 4th and 5th even in Japan. These data are mainly based on death certificates from medical doctors without autopsy. However, infection is found to be a major cause of death in the elderly where autopsy is performed. Also in cancer patients, autopsy reveals that the proximal cause of death is commonly infection. These findings indicate that an immune deficient state is likely to contribute to morbidity and mortality in many elderly people and cancer patients. Thus, developing methods to properly assess immune function as a whole on an individual subject basis is urgently required. The assessment of immune functions should be then followed by immunological restoration, if necessary. This chapter presents one possible method for the proper assessment of global immunological function using comprehensive assessment of various immunological indices, mainly of T-cells. This algorithm is designation “scoring of immunological vigor” (SIV); its usefulness is presented for cancer patients in the first instance in humans. We have also conducted several trials of different immunological interventions in aging animal models. The most recent effective intervention is infusion of activated T-cells from syngeneic young or old mice into old mice. The infusion of autologous activated T-cells has already been applied clinically in humans, mainly for the treatment of cancer and is feasible also in old people. Thus, this approach could be useful for immunological restoration in the elderly, in analogy to the mouse models.