Year: 2023
Type: article
Abstract: Immunologic exposures often result in non-uniform disease severity and seemingly unpredictable clinical sequelae.Such variance was less obvious in hospital-based cohorts due to selection biases but is now strikingly illustrated in contemporary population-level analysis which account for those exposed but do not become ill.Immune function is often related to demographic factors (i.e.age, sex, and racial/ethnic background), a host of clinical features (e.g.diabetes, rheumatologic disease, medications), but also relates to a myriad of unmeasured variables such as genetics and prior exposures.Although population level studies in this electronic health era include a wealth of sociodemographic and clinical factors, the extent to which immunologic risk/resilience is captured with standard epidemiologic approaches is not clear.Heterogeneity in immune system functioning is germane to infections but also sterile insults and thus have implications for a full gamete of non-communicable diseases including cardiovascular diseases and certain malignancies as well.This potential gap in identifying subclinical immune dysfunction is relevant and especially timely on several fronts.Importantly, patients are generally curious about and display substantial self-efficacy when it comes to immune health.In the United States alone, annual consumer spending approaches $50 billion on supplements and vitamins to improve "inflammation", in spite of prevailing evidence for ineffectiveness or harm 1 .The pandemic has only accelerated this awareness and need to understand immune health.The first wave of COVID-19 led to death in nearly 6% of those infected, but was asymptomatic in others, including up to 20% of octogenarians 2 .This stark illustration of variance in host response was obvious to a global audience, and thus presents challenges and opportunities across the entire spectrum of stakeholders.Unfortunately, existing disease prevention paradigms in adults remain costly, imprecise, geographically limited, and contribute centrally to health inequities 3,4 .And while immune-based therapies have revolutionized the treatment of certain cancers and rheumatologic conditions, clinical responses are not uniform and adverse events, while rare, are unpredictable 5,6 .Meanwhile, cutting edge techniques for deep
Source: American Journal of Hematology
DOI: 10.1002/ajh.27125
Author: David A. Zidar
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4387638879