Tinjauan Imunologi Pneumonia pada Pasien Geriatri

Pneumonia menjadi salah satu masalah kesehatan utama pada geriatri. Karakteristik pneumonia pada pasien geriatri adalah presentasi klinisnya yang khas. Perubahan status imunologi akibat proses penuaan memberi konsekuensi penting terhadap cadangan fungsional paru, kemampuan untuk mengatasi penurunan komplians paru dan peningkatan resistensi saluran napas terhadap infeksi. Saat timus mengalami involusi karena pengaruh usia, terjadi penurunan produksi sel T naif, perubahan fungsi sel T memori, pergeseran profil sitokin dari Th1 ke Th2. Pada imunitas humoral terjadi penurunan jumlah sel B dan reseptornya, penurunan formasi germinal center, disfungsi generasi dari limfosit B primer, gangguan produksi sel B memori, peningkatan autoantibodi. Manajemen penting pada pasien geriatri meliputi terapi antibiotik dan pertimbangan perawatan di ICU, serta pencegahan episode ulangan. Pneumonia becomes one of the major health problems in the elderly. A characteristic of pneumonia in geriatric patients is its typical clinical presentation. Immunological status changes due to the aging process to give an important consequence of the pulmonary functional reserve, ability to cope with decreased lung compliance and increased airway resistance to infection. Thymus involution due to aging decreases naive T cells production, changes memory T cell function, shifts the cytokine profile from Th1 to Th2. In humoral immunity, there are decrease of B cells and its receptors, decrease of germinal center formation, dysfunctional generation of primary B lymphocytes, impaired memory B cell production, and increase of autoantibodies. Management includes antibiotic therapy and considerations for ICU treatment, and prevention of further infection.