Persistent cutaneous cellular immune responsiveness in a nursing home population

Area of Science:

• Immunology
• Gerontology

Background:

• Cellular immunity assessment is crucial for elderly populations.
• Nursing home residents may exhibit altered immune responses.

Purpose of the Study:

• To evaluate the cellular immune response in elderly nursing home residents using Mantoux-type skin tests.
• To determine the optimal number of antigens and reading time for detecting immune responses in this demographic.

Main Methods:

• Twenty-nine elderly residents underwent Mantoux-type skin tests with eight different antigens.
• Reactions were measured at 6, 24, 48, and 72 hours.
• Purified protein derivative of tuberculin skin test was re-administered to assess booster responses.

Main Results:

• Nearly all residents (28/29) showed a positive skin test response (≥3 mm) at 48 or 72 hours.
• The mean reaction size was greatest at 48 hours, but more responders and total reactions were observed at 72 hours.
• Five antigens (PPD-Avian, coccidioidin, histoplasmin, streptokinase-streptodornase, and trychophytin) were sufficient to identify all responsive subjects.

Conclusions:

• Elderly nursing home residents generally possess significant cellular immunity detectable by skin testing.
• A 72-hour reading provides a more comprehensive assessment of immune responses than a 48-hour reading.
• Five specific antigens can effectively identify immune responsiveness in this population.