Characteristic Changes in the Immune Landscape of Aging Liver: From Basic Mechanism to Clinical Transformation

The global population is aging at an unprecedented rate, significantly increasing the burden of age-related liver diseases. While the mechanisms of liver aging remain incompletely understood, immune senescence within the hepatic microenvironment has emerged as a pivotal, yet underexplored, contributing factor. With advancing age, the liver undergoes profound remodeling of its immune landscape, encompassing dysfunction in both innate and adaptive immunity. This immunosenescence heightens susceptibility to infectious liver diseases, accelerates the progression of metabolic liver conditions, increases the risk of drug-induced liver injury (DILI), and promotes hepatocellular carcinoma (HCC) through compromised immune surveillance. In conclusion, aging-driven reorganization of the hepatic immune microenvironment elevates disease risk and undermines treatment efficacy. Targeting these age-related immune alterations therefore represents a promising therapeutic strategy for improving liver health in the elderly.