Immune senescence has emerged as one of the principal biological mechanisms linking aging with the development and progression of autoimmune rheumatic diseases. Rather than representing a simple decline in immune function, aging induces profound remodeling of both innate and adaptive immunity, characterized by chronic low-grade inflammation, loss of immune tolerance, impaired cellular regeneration, mitochondrial dysfunction, telomere shortening, epigenetic alterations, and expansion of senescent immune-cell populations. The objective of this review was to analyze current evidence regarding the mechanisms through which immune senescence reshapes autoimmune rheumatic diseases and to examine its clinical implications, biomarkers, and emerging therapeutic strategies. A narrative literature review was conducted using the scientific method and included publications retrieved from PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, SpringerLink, Nature, Frontiers, and Wiley. The evidence consistently demonstrated that inflammaging, adaptive immune remodeling, and cellular senescence contribute to disease progression, increased susceptibility to infections, reduced vaccine responsiveness, cardiovascular complications, frailty, osteoporosis, sarcopenia, and diminished functional capacity. Conventional inflammatory biomarkers remain widely used; however, increasing attention has been directed toward multi-omics technologies, epigenetic clocks, mitochondrial biomarkers, proteomics, metabolomics, and immune-cell phenotyping for more accurate assessment of biological immune aging. Current therapeutic approaches continue to rely on disease-modifying antirheumatic drugs and biologic agents, while emerging interventions—including JAK inhibitors, mTOR modulation, senolytic therapies, microbiome-targeted strategies, and precision medicine—offer promising opportunities for future individualized management. Overall, immune senescence should be recognized as a fundamental component of autoimmune rheumatic diseases, providing important opportunities for improving diagnosis, risk stratification, therapeutic decision-making, and long-term clinical outcomes in aging populations.
Stroke remains a major cause of long-term neurological disability worldwide, creating a growing need for rehabilitation strategies capable of promoting functional recovery through intensive, repetitive, task-oriented, and personalized interventions. Digital neurorehabilitation has emerged as a multidisciplinary approach that integrates neuroscience, physical and rehabilitation medicine, neurology, and biomedical engineering through technologies such as virtual reality, robot-assisted rehabilitation, brain-computer interfaces, wearable sensors, artificial intelligence, and telerehabilitation. This review analyzed international scientific evidence regarding the application of these technologies after stroke, with particular attention to their relationship with experience-dependent neuroplasticity, functional outcomes, implementation challenges, and applicability across different healthcare environments, including Latin America. Scientific evidence was identified and critically synthesized from internationally recognized databases, prioritizing randomized controlled trials, systematic reviews, meta-analyses, clinical guidelines, and relevant contemporary studies. The reviewed literature showed that virtual reality and robot-assisted rehabilitation constitute the most extensively investigated technological approaches, with favorable findings particularly in upper-limb motor function, balance, gait, functional mobility, and activities of daily living. Telerehabilitation and wearable technologies provide additional opportunities for extending therapeutic continuity and objective monitoring beyond specialized rehabilitation facilities, while brain-computer interfaces and artificial intelligence represent emerging approaches for neural feedback and personalized rehabilitation. Despite these advances, considerable heterogeneity remains regarding intervention protocols, technological platforms, therapeutic intensity, outcome measures, and patient characteristics. Furthermore, acquisition costs, infrastructure requirements, professional training, accessibility, connectivity, and digital literacy continue to influence implementation, particularly in resource-constrained healthcare systems. Current evidence supports digital technologies as complementary components of multidisciplinary stroke rehabilitation rather than substitutes for conventional therapy. Future research should prioritize standardized protocols, multicenter studies, long-term functional outcomes, cost-effectiveness, equitable accessibility, and greater representation of Latin American populations to advance toward evidence-based precision neurorehabilitation.
Benitez Barrios Sosimo Isaac, Melany Patricia Bolagay Apráez, Dr. Robinson Alexander Morey Contreras et al.· IECCMEXICO· 0 citations
