The document discusses ways to strengthen the immune system in the third age. It begins by explaining what the immune system is and how it functions. It then describes the changes that occur in the immune system during the third age, including it becoming less effective at distinguishing self from non-self and responding more slowly to new antigens. Finally, it outlines several approaches that can be used to boost immunity in older adults, such as specialized vaccines, drugs that alter metabolism and senolytics that target senescent cells. It also stresses the importance of an overall healthy lifestyle.

1. ‫האימונית‬ ‫המערכת‬ ‫לחיזוק‬ ‫דרכים‬
‫השלישי‬ ‫בגיל‬
‫פרופ‬
'
‫מזרחי‬ ‫אלי‬
‫הגריאטרי‬ ‫החולים‬ ‫בית‬ ‫מנהל‬
,
‫הרופא‬ ‫שמואל‬
‫תל‬ ‫באוניברסיטת‬ ‫לרפואה‬ ‫לפקולטה‬ ‫מסונף‬
-
‫אביב‬

2. ‫ידעתי‬ ‫לספר‬ ‫עצמי‬ ‫על‬ ‫רק‬

6. 
1
.
‫פועלת‬ ‫היא‬ ‫וכיצד‬ ‫אימונית‬ ‫המערכת‬ ‫מהי‬

2
.
‫המתרחשים‬ ‫שינויים‬
,
‫השלישי‬ ‫בגיל‬
,
‫האימונית‬ ‫במערכת‬

3
.
‫בגיל‬ ‫האימונית‬ ‫המערכת‬ ‫של‬ ‫התפקוד‬ ‫לחיזוק‬ ‫דרכים‬
‫השלישי‬
‫היום‬ ‫נדבר‬ ‫מה‬ ‫על‬

7. ‫היא‬ ‫וכיצד‬ ‫האימונית‬ ‫המערכת‬ ‫מהי‬
‫פועלת‬

8.  The immune system distinguishes self from nonself
and eliminates potentially harmful nonself molecules
and cells from the body.
 The immune system also has the capacity to
recognize and destroy abnormal cells that derive
from host tissues.
 Any molecule capable of being recognized by the
immune system is considered an antigen (Ag).

9. There are 2 types of immune response:
1. Innate
2. Acquired
 Acquired immunity requires prior exposure to an antigen to
be fully effective
 The system remembers past exposures and is antigen-
specific.

10. Is being composed of two arms:
 Humoral immunity: Derived from B-cell responses (B
cells develop into plasma cells, which secrete soluble
antigen-specific antibody)
 Cell-mediated immunity: Derived from certain T-cell
responses
 B cells and T cells work together to destroy invaders.
Acquired - immunity

11.  The Memory B cells are found in Bone Marrow, the
Spleen, Lymph nodes, Gingiva, Mucosal ephithelium
of tonsils, Gastro intestinal tract, Circulation
 The majority of T – cells in the human body are found
within the Lymphoid tissues (bone marrow, spleen,
tonsils, and lymph nodes), Lungs , Small and Large
Intestine and skin

13.  A type of immune cells that can kill certain cells,
Including Foreign cells, Cancer cell, and Cells infected
with virus.
 Killer T-Cells can be separated from other blood cells,
grown in the laboratory, and than given to patient to
kill cancer cells.
Killer T - Cells

15. ‫המתרחשים‬ ‫שינויים‬
,
‫השלישי‬ ‫בגיל‬
,
‫האימונית‬ ‫במערכת‬

16.  While the impact of aging on both innate and
adaptive immunity has been well documented, the
mechanistic causes are not well understood.
 The age-related changes in immune function are most
likely due to a combination of intrinsic cell aging and
the impact of the senescent/aging environment on
proliferation and differentiation in response to
antigenic stimulation.

17. As people age, the immune system becomes less
effective in the following ways:
 The immune system becomes less able to distinguish
self from nonself (that is, to identify foreign
antigens).
 As a result, autoimmune disorders become more
common

18.  Macrophages (which ingest bacteria and other
foreign cells) destroy bacteria, cancer cells, and other
antigens, more slowly.
 This slowdown may be one reason that cancer is
more common among older people.

19.  T cells (which remember antigens they have
previously encountered) respond less quickly to the
antigens
 There are fewer white blood cells capable of
responding to new antigens.
 Thus, when older people expose to a new antigen,
the body is less able to remember and defend against
it.

20.  Although the amount of antibody produced in
response to an antigen remains about the same
overall, the antibodies become less able to attach to
the antigen.
 This change may partly explain why
pneumonia, influenza, infective endocarditis,
and tetanus are more common among older people
and result in death more often.

21.  These changes may also partly explain why vaccines
are less effective in older people and thus why it is
important for older people to get booster shots
(which are available for some vaccines)
 These changes in immune function may contribute to
the greater susceptibility of older people to some
infections and cancers

23. How Age Related Changes in
Immune System
Impact Infection and Vaccination in
the Elderly Population

24.  Because of the above mentioned age-related changes
in innate and adaptive immune function, older adults
exhibit increased susceptibility to infections such as
influenza, COVID-19, and bacterial pneumonia
 Influenza is responsible for up to 500,000 deaths per
year worldwide, with two-thirds of these occurring in
adults over 65 years of age (Paget et al., 2019).

25.  Older adults are also more susceptible to COVID-19
and its complications (Nanda et al., 2020)
 In the U.S., 80% of COVID-19 deaths occur in people
>65 years of age, and mortality rates for those >80
years of age can be as high as 50% (Powell et al.,
2020).

26.  The incidence of bacterial pneumonia in adults in the
U.S. >65 years of age is more than 4 times higher than
that found in adults aged less than 65 years
 Not only are older adults more susceptible to these
infections, but they are also more susceptible to
complications during these infections, in part
because of the many co-morbidities associated with
increasing age (Keilich et al., 2019).

27.  Weakened antimicrobial immunity
 Susceptibility to respiratory infections
 Reactivation of chronic viral infections (e.g., Herpes -
Zoster)
 Impaired antivaccine responses
 Insufficient protection against malignancies
And in Summary

28.  Predisposition for unopposed tissue inflammation
1.Atherosclerotic disease
2.Osteoarthritis
3.Neurodegenerative disease
 Failing wound repair mechanisms

29. ‫המערכת‬ ‫את‬ ‫לחזק‬ ‫ניתן‬ ‫כיצד‬
‫השלישי‬ ‫בגיל‬ ‫האימונית‬

30.  Vaccinations are strongly recommended for older
adults to protect them from both influenza and
bacterial pneumonia
 but because of age related changes in immune
function, vaccine effectiveness decline with age
(Ciabattini et al., 2018).

31. Several approaches are already in use or are undergoing
testing:
 First, vaccines specifically formulated for older adults
are now available and have been shown to provide
greater protection from viral infections such as
influenza
 These vaccines have higher concentrations of antigen
or are formulated with adjuvants to boost aging
immune responses (McElhaney et al., 2020).

32.  Second, approaches that alter metabolism such as
treatment with metformin (Barzilai et al., 2016)
 or mTOR inhibitors (Mannick et al., 2018) could help
improve immunity and resistance to infectious
diseases in older adults

33. • Metformin also retards aging in model
organisms and reduces the incidence of aging-
related diseases such as neurodegenerative disease
and cancer in humans
• In spite of its widespread use, the mechanisms by
which metformin exerts favorable effects on aging
remain largely unknown

34.  TOR or the Target of Rapamycin - the purpose of the
drug Rapamycin (is an enzyme, a protein), which on
the one hand regulates metabolism, metabolism,
mitosis, division, and increased biological cell volume
 Inhibition of this enzyme, by the drug Rapamycin and
its derivatives, slows the appearance of some of the
symptoms of cell aging in middle age, and prolongs
the maximum lifespan.

35. Last, senolytics, which are a novel class of drugs that
target the destruction of senescent cells, have been
shown to alleviate age-related diseases in animal
models and could possibly also improve aged immune
function (Xu et al., 2018)

36.  For now, there are no scientifically proven direct links
between lifestyle and enhanced immune function
 But that doesn't mean the effects of lifestyle on the
immune system aren't intriguing and shouldn't be
studied

37.  Researchers are exploring the effects of diet,
exercise, age, psychological stress, and other factors
on the immune response, both in animals and in
humans.
 In the meantime, general healthy-living strategies
make sense since they likely help immune function
and they come with other proven health benefits

38. Choose a Healthy Lifesyle

39.  Following general good-health guidelines is the single
best step you can take toward naturally keeping your
immune system working properly
 Every part of your body, including your immune
system, functions better when protected from
environmental assaults

40.  Don't smoke.
 Eat a diet high in fruits and vegetables.
 Exercise regularly.
 Maintain a healthy weight.
 If you drink alcohol, drink only in moderation.

41.  Get adequate sleep.
 Take steps to avoid infection, such as washing your
hands frequently and cooking meats thoroughly.
 Try to minimize stress.
 Keep current with all recommended vaccines.
Vaccines prime your immune system to fight off
infections before they take hold in your body.

42. Thank you for listening
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