Ageing is associated with a prolonged fever response in human endotoxemia

The purpose of this study was to investigate whether an age associated impa ired acute-phase response exists, Nine healthy elderly volunteers (median, 66 years; range, 61 to 69 years) and eight young controls (median, 24 years ; range, 20 to 27 years) were given an intravenous bolus of endotoxin (2 ng /kg). The rectal temperature was monitored continuously, and blood samples for cytokine measurements were obtained before endotoxin administration as well as 0.5, 1, 1.5, 2, 3, 4, 8, 12, and 24 h after the injection. The elde rly subjects showed a more prolonged fever response compared to the young c ontrols. Levels of tumor necrosis factor alpha (TNF-alpha), soluble TNF rec eptors (sTNFR-I), interleukin-6 (IL-6),IL-8, IL-10, and IL-1 receptor antag onist (IL-1) in plasma increased markedly following endotoxin administratio n in both groups. The elderly group showed larger initial increases in TNF- alpha and sTNFR-I levels and prolonged increased levels of sTNFR-I. Monocyt e concentrations decreased in both groups, with the elderly group showing a more rapid decrease and a slower subsequent increase than did the young gr oup. Furthermore, the elderly group had a more rapid increase in C-reactive protein levels than did the young group, In conclusion, ageing is associat ed with an altered acute-phase response including initial hyperreactivity, prolonged inflammatory activity, and prolonged fever response.