Pathophysiology of Inflammation and Immunosuppression in the Elderly After Sepsis

  • Shigeaki Inoue
  • Nobuo Watanabe
  • Sadaki Inokuchi
Living reference work entry


Prognoses among elderly individuals with sepsis are generally poor, and the pathophysiology and disease mechanism is not well understood. Immunosenescence refers to a decline in acquired immune function that occurs with age by affecting the part of the immune system that is primarily responsible for antigen-specific responses.

In our study, patients with sepsis who are older than 65 years old showed “T-cell exhaustion,” that is, impairment of IL-2 production, activation, and proliferation, in comparison to patients with sepsis who are younger than 65. We also showed a significant elevation in serum IL-6 values in elderly patients with sepsis as compared with non-elderly adult patients within the first 6 days of admission (p < 0.01). In addition, elderly patients with sepsis showed significant increases in positive bacterial cultures 2–4 weeks after admission into the ICU and an increase in positive sputum cultures for Acinetobacter and Stenotrophomonas maltophilia.

Infection and inflammation tend to be more protracted and severe in elderly patients with sepsis because of a greatly weakened immune system; therefore, the development of rapid and accurate diagnostic methods and multidisciplinary treatments for sepsis are essential.


Sepsis Elderly patient Immunosenescence T-cell exhaustion 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Shigeaki Inoue
    • 1
    • 2
  • Nobuo Watanabe
    • 1
  • Sadaki Inokuchi
    • 1
  1. 1.Department of Emergency and Critical Care MedicineTokai University School of MedicineIseharaJapan
  2. 2.Medical Science DivisionTokai University Institute of Innovative Science and TechnologyIseharaJapan

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