Abstract
IntroductionThe number of aging cancer patients has increased continuously and will do so further in the future. The immune system of elderly people experiences critical changes over the time. Therefore, tumor-induced changes in the immune system are believed to differ in young and elderly cancer patients as well.MethodsThe effect of aging on the immune system was measured in peripheral blood lymphocytes (PBL) of healthy volunteers (n = 48, 21–84 yrs.) divided into three different age groups. Seventy years was set as a cut-off for defining subjects as elderly. Results were compared to two groups of adult cancer patients, which donated PBL and tumor infiltrating lymphocytes (TIL): young cancer patients (40–69 yrs.; blood: n = 13; TIL: n = 17) and elderly cancer patients (70–90 yrs.; blood: n = 20; TIL: n = 15) with head and neck squamous cell carcinoma (HNSCC). Frequencies and phenotypes of CD4+ and CD8+ T cells as well as regulatory T cells (Treg) were assessed by flow cytometry.ResultsWe observed lower frequencies of CD8+ cytotoxic T cells during aging in both groups. Frequencies of tumor infiltrating regulatory T cells were significantly higher than in the peripheral blood but showed a significant decline in older tumor patients. With increasing age, expression of immunosuppressive CD73 and CCR7 was lower and expression of PD1 elevated on peripheral T cells in healthy volunteers and tumor patients.ConclusionImmunosenescence takes place in healthy donors and cancer patients. Our results suggest that in elderly tumor patients, the immune system is impaired and the tumor-induced immune escape is less pronounced. The increased expression of PD1 implies the potential for effective immunotherapies in elderly, as treatment with checkpoint inhibitors could be more beneficial for elderly HNSCC patients.
Highlights
The number of aging cancer patients has increased continuously and will do so further in the future
The frequency of regulatory T cells (Treg) in the blood remained stable for all age groups (Fig. 1e)
In tumor patients’ blood (TB), the frequency of CD8+ T cells showed a slight decrease in elderly patients similar to our observations in healthy volunteers (p = 0.08, Fig. 1c)
Summary
The number of aging cancer patients has increased continuously and will do so further in the future. Tumor-induced changes in the immune system are believed to differ in young and elderly cancer patients as well. According to data from ‘World Population Prospects’ [1], the population aged 60 or above is growing faster than all younger age groups, globally While this population group counted 962 million people in 2017, it is estimated to rise up to 2.1 billion by 2050 and up to 3.1 billion by 2100. A growing and ageing society constitutes an immense public health burden. As it is the case for almost every malignancy, the number of older patients (2020) 17:3 people [6]. Against the background of diverse alterations in the immune system of elderly persons, our focus of interest lies in the adaptive immune system and in T lymphocytes in particular
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