HEMATOLOGY AND IMMUNOLOGICAL AGING THEORY

Hematopoietic stem cells (HSCs) differentiate into lymphoid proin the bone marrow
that give rise to T cells (which develop in the thymus) and B cells, and myeloid progenitors
that differentiate to monocytes, dendritic cells, neutrophils, basophils, eosinophils, as well as
erythroid and megakaryocytic lineages.

Hemopoesis adalah pembentukan sel darah, yang terbagi menjadi 3 bagian yakni,
eritropoesis (pembentukan sel darah merah), myelopoesis (pembentuk granulosit dan
monosit) dan trombopoesis (pembentukan trombosit). Eritropoesis diatur oleh eritropoetin
yang 90 % terdapat di ginjal dan 10 % di hati.
Hemopoesis pada janin dimulai di usia 0-2 bulan di dalam yolk sac, 2-7 bulan di hati
dan limpa, 7-9 bulan di sumsum tulang. Setelah lahir, hemopoesis bayi terjadi di sumsum
tulang belakang, ketika bayi tumbuh menjadi anak-anak hemopoesis terjadi di tuberositas
tibia dan sternum. Sedangkan pada dewasa hemopoesis terjadi di vertebrae, iga, sternum,
sacrum, tengkorak, pelvis dan ujung proksimal tibia.
Namun seiring berjalannya waktu dan bertambahnya usia, mineral pada tulang
berkurang bahkan menghilang, sel darah merah pada sumsum tulang berganti dengan lemak
 hemopoesis menjadi terhambat atau berkurang. Sehingga pada lansia sering terjadi
anemia.
 Adaptive immunity consists of humoral and cell-mediated immune responses. The
primary cells in adaptive immunity are B and T lymphocytes. B lymphocytes, which are
principal mediators of humoral responses, originate in bone marrow and mature in the liver
during fetal development, and subsequently in gut-associated mucosal lymphoid tissue. The
antigen receptor on the B cell membrane is the immunoglobulin (Ig) molecule, which confers
both specificity and diversity to humoral responses. During a humoral immune response, B
cells differentiate into plasma cells, which secrete antibodies specific for the invading
pathogen. T lymphocytes are responsible for the cell-mediated response. T cells originate in
bone marrow and mature in the thymus. Upon exiting from the thymus, T cells will have
differentiated into two subpopulations: helper (CD4+) T cells and cytotoxic (CD8+) T cells.
These two populations facilitate cell-mediated immunity in two ways: CD4+ T cells produce
cytokines (they are soluble factors that are released from cells after contact with specific
antigens), enhance innate immunity, and induce antibody responses, while CD8+ T cells
directly kill tumors or virus-infected cells.
4 major characteristics of geriatric immunology :
1. Antigen specificity is mediated by receptors on immune cells that recognize defined
peptides called antigens.
2. Large array of receptors, each having its own specificity for a particular antigen, is the
basis for the diversity of the adapative immune response.
3. Immunologic memory enables immune cells to "remember" a previous encounter with a
pathogen so that a more rapid response of higher magnitude can be produced after re-
exposure to that same peptide.
4. An absolutely critical feature of adaptive immunity is that immune cells must distinguish
self from nonself. This recognition phase not only ensures that a specific immune
response against only the invading pathogen is produced, but also prevents nonspecific
responses against cells of the body that would result in autoimmunity.

After all, our immune system may be affected by lifestyle, stress level, cognitive
deterioration, disease and age.

References :
1. Hazzard’s Geriatric Medicine and Gerontology. 7th Edition. 2017. Chapter 103: Aging
of the Hematopoietic System. William Tse; Maxwell M. Krem; Jino Park; Nathan A.
Berger; Scot C. Remick.
2. http://www.jimmunol.org/content/jimmunol/193/6/2622/F1.medium.gif
3. http://medicine.jrank.org/pages/891/Immunology-Human.html
4. http://www.mdpi.com/journal/ijms/special_issues/Immunology_aging