Breëns, M.; De Man, K.; Heylen, Y.; Ha, M. K.; Kuznetsova, M.; Besbassi, H.; Affaticati, F.; Berghe, W. V.; Ogunjimi, B.; Meysman, P.

Human aging is the process through which numerous biological changes occur during life, affecting various processes. In some elderly individuals, this functional decline becomes more pronounced, leading to frailty, a condition characterised by reduced physiological reserves and increased vulnerability to stress. With the global rise of life expectancy, identification of biomarkers for healthspan and frailty are becoming more important. In this study, we directly compare two molecular readouts, namely the T cell receptor (TCR) repertoire and epigenetic clocks, on their ability to discern healthy aging. On blood samples from sixteen individuals, across age-matched healthy elderly and frail individuals, both TCR sequencing and epigenetic profiling were performed. A significantly higher TCR repertoire diversity in the CD4+ T cells differentiated the healthy elderly individuals from the frailty ones. Epigenetic clock signatures of biological relative to chronological ageing rate, did not show a clear difference between both groups. However, when taking into account the CMV-serostatus, a significant increase in epigenetic aging could be observed in the CMV-seropositive individuals. Our results support a clear hypothesis on the role of CMV infection in the healthy aging of the immune system. In healthy elderly, CMV is typically controlled by CD4+ T cells, however, in the frail elderly, the burden of managing the infection shifts to the CD8+ T cells. This change is marked by two key changes: a decrease in TCR diversity for seropositive individuals compared to seronegative individuals, as well as an increase in the fraction of CMV-associated TCRs within the CD8+ T cells. These findings contribute to our understanding of aging and provide insight into how CMV-infection may affect healthy aging and frailty. They also underline the crucial role of the immune system in healthy aging and the value of further investigating ageing-related health/disease patterns in the TCR repertoire to determine healthspan/lifespan.