Immunosenescence and inflammaging in the aging process: age-related diseases or longevity?

Distinct impacts of aging on the immune responses to extracellular matrix-based versus synthetic biomaterials

All implanted materials inevitably trigger an acute inflammatory response. The long-term outcome, however, is dependent on the trajectory of this response. This study investigates the effects of aging on the immune response to two commercially available biomaterials. Extracellular matrix-based urinary bladder matrix (UBM) and synthetic polypropylene mesh (PPM) were implanted in young (4 months) and aged (18 months) C57BL/6J mice. Overall, PPM led to a sustained inflammatory response regardless of the age of the mice. In contrast, UBM induced an initial inflammatory response that matured into a pro-regenerative/remodeling response with time, though aged mice exhibited a delayed resolution of inflammation. The PPM-induced response was predominantly pro-inflammatory with consistently higher M1-like macrophage phenotype, whereas the response to UBM was characterized by an anti-inflammatory M2-like phenotype, especially in young mice. RNA sequencing revealed marked age-related differences in gene transcription. At day 7 post-implantation, the young mice with UBM showed a robust upregulation of both pro- and anti-inflammatory pathways as compared to young mice implanted with PPM, however, by day 14, the gene expression profile transitioned into an anti-inflammatory profile. Intriguingly, in aged mice, the response to UBM was distinct with consistent downregulation of inflammatory genes compared to PPM, while the response to PPM in both young and aged animals was largely consistent. Upstream analysis identified cytokines as key drivers of the host response, with IL-4 and IL-13 in young mice, and TNF-α and IL-1β driving chronic inflammation in aged mice. These findings highlight the importance of host age in biomaterial outcome, and the potential of ECM-based materials to mount a favorable response even in the presence of age-related immune dysregulation.

Associations between serum trace elements and biological age acceleration in the Chinese elderly: A community-based study investigating the mediating role of inflammatory markers and the moderating effect of physical activity

Growing evidence suggests that environmental factors play a significant role in the aging process. We established the Klemera and Doubal Method biological age acceleration (KDM-BAA) by using the KDM as a biological age predictor to assess the trace elements (ELEs) role. Generalized Linear Model (GLM) was used to assess the associations between single ELE (trace element) and KDM-BAA. Restricted cubic splines (RCS) were used to assess the nonlinear relationship between elemental levels and KDM-BAA. Quantile G-Computation (QGC) regression was employed to explore the direction and weight. Weighted Quantile Sum (WQS) Regression was used to study the weights of different groups of ELEs. Bayesian Kernel Machine Regression (BKMR) was utilized to analyze the overall effect of mixed elemental exposure. Mediation analysis was conducted to investigate the role of intermediate biomarkers and the moderating effects of physical activity (PA) was used on the pathway. The results showed serum Copper (Cu) levels positively correlated with KDM-BAA, while Zinc (Zn) and Iron (Fe) negatively correlated with it, respectively. The mixture of Zn, Cobalt (Co), Selenium (Se), and Fe exhibited a significant overall negative effect. Additionally, PA could ease the association between Cu and KDM-BAA through impacting the inflammation level. This study provides novel insights into how inflammation mediates the association between ELEs exposure and KDM-BAA, while PA acts as a potential protective factor.

Epidemiological and clinical profiles of young and senior dogs fed a standard diet

This study aimed to explore age-related differences in epidemiological and clinical parameters in dogs consuming a standardized diet, focusing on factors relevant to veterinary practitioners. A total of 106 dogs were included, comprising young (2-5 years) and senior (≥8 years) individuals. Epidemiological data were collected through questionnaires and veterinary consultations, while clinical parameters were assessed via physical examinations and blood analyses. Compared to younger dogs, senior dogs were less active, more likely to live in houses, and more frequently received regular deworming. They were also more likely to consume food purchased from pet stores or supermarkets compared to younger dogs. Clinical evaluations revealed that senior dogs had higher plasma globulin and platelets and lower albumin, consistent with chronic low-grade inflammation associated with aging. Muscle loss, poor coat quality, and reduced lymphocyte counts were also prominent in senior dogs, potentially reflecting sarcopenia, malnutrition, and immunosenescence, respectively. Notably, dogs previously fed diets lacking a source of omega-3 fatty acids exhibited elevated plasma triglycerides even after transitioning for four weeks to a premium diet containing fish oil, underscoring the lasting impact of long-term dietary habits. These findings highlight the importance of regular veterinary follow-ups for senior dogs and the role of high-quality nutrition, including sources of omega-3 fatty acids. By identifying key epidemiological and clinical differences, this study offers valuable insights to help veterinary practitioners distinguish between healthy and pathological aging.

Immunosenescence and Inflammaging in Dogs and Cats: A Narrative Review

A consistent and important feature of biological aging is the change in the types and functions of cells comprising the immune system. Across various mammalian species, this change follows consistent patterns, including diminished protective capacity, leading to increased vulnerability to infectious disease, and increased low-grade chronic inflammation, raising the risk of numerous aging-associated diseases. Although these patterns are well characterized in rodents and humans, there is less evidence available in companion animal species. The most recent review of the literature evaluating aging changes in the immune system in dogs and cats was published in 2010. The purpose of this narrative review is to summarize the currently available information concerning immune system aging in these species and to review what is known about the clinical consequences of this process and about potential strategies for mitigation.

From soil to the intestinal tract: The key role of beneficial elements and probiotics in promoting health and longevity

Although soil quality and gut probiotics have been extensively accepted as critical for human health, the combined effects of soil and fecal bacteria on public health remain underexplored. This study collected soil and human fecal samples from three towns with high, medium, and low proportion of longevous populations in a well-known longevity region in Yangtze River Delta, China. Beneficial elements were detected in all soils, including selenium (0.01-0.05 mg kg-1), germanium (1.07-1.44 mg kg-1), boron (0.42-1.49 mg kg-1), zinc (1.07-1.70 mg kg-1) and manganese (38.78-43.52 mg kg-1). These elements were more abundant in high-proportion region (HP) compared to medium (MP) and low (LP) proportion region (p < 0.05). Similar dominant bacteria were detected in all soils and feces, including Proteobacteria (29.93 %), Acidobacteriota (16.23 %), and Bacillus (2.25 %). Notably, positive correlations were detected between beneficial metal contents and soil bacterial abundance (p < 0.05), suggesting a role in promoting bacterial growth. Moreover, beneficial element metabolic genes, such as zupT (encoding high-affinity zinc transporter for active zinc ion transport) and mntA (encoding manganese ion transporter protein) were significantly enriched in HP soil and fecal bacteria (p < 0.05). Additionally, Source Tracker analysis indicated that 41.13 % of fecal bacteria in HP area originated from HP soil bacteria. Structural equation model indicated that soil beneficial elements significantly enhanced the relative abundance of probiotic associated genes in the dominant fecal bacteria (path coefficients of 0.869 and 0.905, respectively; p < 0.05). Together, soil-borne beneficial elements promote intestinal bacterial functionality, contributing to human health and longevity.

Diagnostic performance of procalcitonin for detecting anastomotic leak in older adults with colorectal cancer: A delayed type cross-sectional study

BACKGROUND

The utility of procalcitonin for detecting anastomotic leaks after colorectal surgery in older adults has not been well documented. As the immune system undergoes changes with age, procalcitonin levels may differ at baseline, and its diagnostic performance could vary when an anastomotic leak occurs after colorectal surgery in older adult patients with cancer. The aim of this study is to evaluate the diagnostic performance of procalcitonin on postoperative day 3 for detecting anastomotic leaks in older adults with colorectal cancer.

METHODS

We conducted a diagnostic test study on the basis of a delayed-type cross-sectional design in older adults (≥65 years old) with colorectal cancer. Postoperative day 3 procalcitonin levels were tested. The reference standard was anastomotic leak. We calculated the receiver operating characteristic curve and its area under the curve.

RESULTS

The incidence of anastomotic leak was 7.7%. On postoperative day 3, the receiver operating characteristic demonstrated an area under the curve of 0.68 (95% confidence interval, 0.58-0.78) for the prediction of an anastomotic leak using procalcitonin levels. The cutoff point with the greatest diagnostic performance, according to the Youden index, was 0.61 ng/mL, with a sensitivity of 0.69, specificity of 0.62, a positive likelihood ratio of 1.86, and a negative likelihood ratio of 0.48 for predicting an anastomotic leak. The area under the curve was 0.78 when ileostomies were excluded and 0.81 when evaluating grade C leaks.

CONCLUSION

Our study reveals that procalcitonin levels on postoperative day 3 are a poor diagnostic marker for identifying anastomotic leaks in older adults with colorectal cancer, with an improvement in performance for the grade C anastomotic leak subgroup.

Integrating cuproptosis and immunosenescence: A novel therapeutic strategy in cancer treatment

Recent advancements in our understanding of cell death mechanisms have progressed beyond traditional apoptosis to encompass various forms of regulated cell death, notably cuproptosis. This copper-dependent cell death occurs when copper interacts with lipoylated enzymes in the tricarboxylic acid cycle, leading to protein aggregation and subsequent cell death. Alongside this, immunosenescence the gradual decline in immune function due to aging has emerged as a significant factor in cancer progression and response to treatment. Innovative strategies that integrate cuproptosis and immunosenescence are showing considerable promise in cancer therapy. By leveraging the altered copper metabolism in cancer cells, cuproptosis can selectively induce cell death, effectively targeting and eliminating tumors. Simultaneously, addressing immunosenescence can rejuvenate the aging immune system, enhancing its capacity to identify and destroy cancer cells. This dual approach creates a synergistic effect, optimizing therapeutic efficacy by directly attacking tumor cells while revitalizing the immune response. Such integration bolsters the defense against cancer progression and recurrence and holds great potential for advancing cancer treatment modalities and improving patient outcomes. This paper delves into the interactions between cuproptosis and immunosenescence, emphasizing their implications for developing innovative cancer therapies.

Extracellular vesicles in age-related diseases: disease pathogenesis, intervention, and biomarker

Aging is a multifactorial biological process characterized by the irreversible accumulation of molecular damage, leading to an increased risk of age-related diseases. With the global prominent rise in aging populations, elucidating the mechanisms underlying the aging process and developing strategies to combat age-related diseases have become a pressing priority. Extracellular vesicles (EVs) have gained significant attention due to their role in intercellular communication. EVs are known for their ability to deliver biocargoes, such as miRNA, proteins, and lipids, implicating their involvement in disease pathogenesis and intervention. In this review article, we explore the dual role of EVs in age-related diseases: contributing to the pathogenesis of diseases by transferring deleterious molecules, while also offering therapeutic ability by transferring beneficial molecules. We also highlight the application of EVs as biomarkers for early diagnosis of age-related diseases, paving the way for early intervention and precision medicine. Additionally, we discuss how analysing the composition of EVs cargo can provide insights into disease progression. Finally, we address the challenges and future perspectives of EV-based-therapy in clinical translation, including standardization of EVs isolation methods and improving cargo specificity.

Immunosenescence Profile Is Associated With Increased Susceptibility to Severe COVID-19

In this study, we tested the hypothesis that the immunosenescence profile could account for the disproportional susceptibility of the elderly to severe forms of COVID-19. The immunological profiles of volunteers residing in endemic and non-endemic areas for chronic infectious diseases were analyzed at the early stage of SARS-CoV-2 infection. A unique signature of inflammatory plasma mediators was identified in COVID-19 volunteers when compared to individuals with other flu-like syndromes. COVID-19 severity correlated with high levels of inflammatory mediators; among them, CXCL9, a serum marker of aging. Patients who progressed to hospitalization displayed high frequencies of CD8+ and CD4+ T cells expressing exhaustion and senescence markers and showed reduced and more mature B cell repertoires, which are typical of senescence. They also had an acceleration of epigenetic age measured by DNA methylation. Therefore, severe COVID-19 correlated with phenotypic, functional, and epigenetic features of accelerated immunosenescence at the onset of infection.

Sex differences in middle-aged and old Wistar rats in response to long-term sulforaphane treatment for prevention of neuroinflammation, cognitive decline and brain senescence

The nervous system (NS) experiences morphological and functional changes during the aging process, where low-grade chronic inflammation, oxidative stress and senescence are key regulators. Sulforaphane (SFN) is an isothiocyanate that activates redox response and inhibits the inflammatory process, which could modify the pro-inflammatory components of senescent cells secretory phenotype (SASP). Here we aimed to determine if SFN long-term treatment was able to prevent age-associated damage in the NS of adult and old females and males Wistar rats. We evaluated cytokines and chemokines profile, senescent cells markers, and memory parameters of adult (15 m.o.) and old (21 m.o.) rats after three months of SFN treatment. Young rats (4 m.o.) were used as age controls. Differences between sexes were observed in the inflammatory profile. Our results showed that SFN-treatment diminished proinflammatory molecules, senescence markers and senescent cells number in brain cortex and hippocampus from males and females' adult rats, but no effects were observed in both sexes old groups compared with the same age control groups. SFN-dependent reduction in inflammatory and senescence parameters resulted in better scores in Barnes Maze Trial memory test when compared with same age non-treated group. Interestingly, adult females showed higher levels of proinflammatory cytokines and chemokines than adult males, which were prevented by SFN-treatment. No effects of SFN were observed in memory of old-treated groups.

Delirium risk associated with esketamine, sevoflurane, propofol, and dexmedetomidine: A real-world study based on the FDA adverse event reporting system

OBJECTIVE

Delirium is a serious postoperative complication, increasingly recognized for its heightened risk following the use of sedative drugs. This study aimed to assess the relationship of esketamine, sevoflurane, propofol, and dexmedetomidine with the risk of delirium.

METHODS

Data were obtained from the FDA Adverse Event Reporting System (FAERS) database covering the period from the first quarter of 2004 to the second quarter of 2024. Cases of delirium associated with these medications were identified using preferred terms (PTs) defined by the Medical Dictionary for Regulatory Activities (MedDRA 20.0). Disproportionality analyses employed reported odds ratios (ROR) and multiple gamma-Poisson shrinkage (MGPS), while logistic regression assessed the effects of age and sex on the risk of delirium.

RESULTS

A total of 21,433,114 adverse events (AEs) were recorded in the FAERS database, including 16 cases of delirium associated with esketamine, 189 with propofol, 90 with sevoflurane, and 103 with dexmedetomidine. Propofol (ROR: 5.44, EBGM05: 4.8), sevoflurane (ROR: 9.9, EBGM05: 8.26), and dexmedetomidine (ROR: 21.1, EBGM05: 17.67) were significantly associated with the delirium risk, whereas esketamine (ROR: 1.45, EBGM05: 0.96) did not show a significant association. Age was identified as a significant risk factor for delirium, particularly in patients aged 55 years and older.

CONCLUSION

The findings indicate a significant correlation between propofol, sevoflurane, and dexmedetomidine and the risk of delirium, whereas esketamine does not appear to have a significant association with delirium. Future studies should further explore drug administration and dosage effects on delirium risk to improve clinical safety.

Depression increases cancer mortality by 23-83%: a meta-analysis of 65 studies across five major cancer types

Depression is a prevalent but often underrecognized comorbidity among cancer patients. Emerging evidence suggests that psychological distress may adversely impact cancer outcomes, but the magnitude of its effect on survival remains unclear. This meta-analysis evaluates the association between depression diagnosed after cancer diagnosis and cancer-specific and all-cause mortality across major cancer types. A systematic search of PubMed, Web of Science, Google Scholar, and the Cochrane Library was conducted to identify cohort studies examining the impact of depression on cancer mortality. Studies were included if they assessed clinically diagnosed depression or depressive symptoms using validated scales and reported hazard ratios (HRs) for mortality outcomes. A random-effects meta-analysis was performed to pool HR estimates, with heterogeneity assessed via Cochran's Q and I2 statistics. Funnel plots and Egger's test were used to evaluate publication bias. A total of 65 cohort studies were included. Depression was associated with significantly increased cancer-specific mortality in colorectal cancer (HR 1.83, 95% CI 1.47-2.28), breast cancer (HR 1.23, 95% CI 1.13-1.34), lung cancer (HR 1.59, 95% CI 1.36-1.86), and prostate cancer (HR 1.74, 95% CI 1.36-2.23). When considering mixed cancer types, depression was linked to a 38% increased risk of cancer mortality (HR 1.38, 95% CI 1.20-1.60). Significant heterogeneity was observed across studies (I2 range 56-98%), suggesting variations in study populations and methodologies. Sensitivity analyses confirmed the robustness of the findings, and trial sequential analysis indicated sufficient evidence for a conclusive association. Depression after cancer diagnosis is associated with a significantly increased risk of cancer-specific mortality across multiple cancer types. These findings highlight the urgent need for integrating routine mental health screening and interventions into oncology care. Future research should focus on mechanistic pathways and targeted interventions to mitigate the negative impact of depression on cancer survival.

Host immune response to respiratory syncytial virus infection and its contribution to protection and susceptibility in adults: a systematic literature review

INTRODUCTION

Respiratory syncytial virus (RSV) is an important pathogen in infants, children, older adults, and those with comorbidities. Mechanisms involving viral proteins appear to underlie the ability of RSV to evade and modulate host immunity. We aimed to understand virus- and host-dependent factors regulating the development and severity of RSV infection, as related to the prevention and treatment of RSV-associated disease in adults, through a systematic literature review (SLR).

METHODS

An SLR was conducted to identify immune mechanisms involved in the protective response to RSV infection in adults, and responses that may contribute to the development of severe disease. Concurrent searches (MEDLINE/Embase) using embase.com identified relevant papers published between 1990 and 19 April 2023.

RESULTS

Of 1813 records identified, 113 were selected for review. Inclusion criteria were based on relevant patient populations, outcomes, and study methodologies. RSV is common, recurrent, and associated with high morbidity and mortality in older adults and people with underlying chronic diseases. Immune responses differ between younger and older adults. The approval of effective vaccines may protect older individuals from symptomatic RSV infection.

CONCLUSIONS

We established the complexities of RSV immune response, but further research is required to fully understand anti-RSV immunology.

Reshaping the immune microenvironment and reversing immunosenescence by natural products: Prospects for immunotherapy in gastric cancer

Gastric cancer (GC) represents a global health-care challenge. Recent progress in immunotherapy has elicited attracted considerable attention as a viable treatment option through modulating the host immune system and unleashing pre-existing immunity, which has profoundly revolutionized oncology, especially GC. Nonetheless, low clinical response and intrinsic and acquired resistance remain persistently challenging. The microenvironment of GC comprising multifarious stromal cell types has remarkable immunosuppressive elements that may impact the efficacy of immunotherapy. Immunosenescence is increasingly regarded as a factor that contributes to cancer development, remodels the tumor microenvironment and affects the efficacy of immunotherapy. Natural products are at the forefront of traditional medicine. Senotherapeutics is a class of drugs and natural products capable of delaying, preventing, or reversing the senescence process (i.e., senolytics) or suppressing senescence-associated secretory phenotype (i.e., senomorphics). Emerging evidence supports that natural products can improve the efficacy of existing immunotherapy and expand their indications in GC mainly based upon remodeling the immunosuppressive microenvironment and reversing immunosenescence. The review provides an integrated review of previously reported and ongoing clinical trials with immunotherapeutic regimens in GC and discusses current challenges. Next, we focus on natural compounds that exert anti-GC functions and possess immunomodulatory properties. More attention is paid to the potential of these natural compounds in modulating the immune microenvironment and immunosenescence. Lastly, we discuss the nanomedicine that can overcome the deficiencies of natural products. Altogether, our review suggests the enormous potential of natural compounds in GC immunotherapy, and provides an important direction for future research.

Age-related peculiarities of antibody-mediated humoral immune response following SARS-CoV-2 infection

Thousands of articles were published about the COVID-19 disease and hundreds about the immune response. But still little is known about the features of SARS-CoV-2-specific immunity in elderly. The aim of current research was to evaluate the age-related peculiarities of antibody mediated humoral immune response following SARS-CoV-2 infection. Our study presents an intriguing divergence from the classical concept of immunosenescence, where aging has been assumed to cause poor antibody responses, reduced or inefficient vaccination, and overall blunted immune responses in elderly people. Our findings were opposite to some of these expectations; participants aged over 60 expressed elevated titers of anti-SARS-CoV-2 antibodies in comparison to younger adults. Analyzing the data of relative neutralization and avidity of anti-SARS-Cov-2 (S) antibodies we propose that although older adults produce a higher quantity of antibodies, their functional efficiency appears relatively reduced exhibiting lower neutralizing capacity and binding strength per antibody compared to younger adults. We can assume that the immune system of the elderly may require a higher level of antibody production to obtain a comparable level of protection. Our findings highlight the intricate nature of immune responses in convalescent older adults. This has particular relevance to understanding immunity and vaccine responses in different age groups.

Lipid dysregulation and delirium in older adults: A review of the current evidence and future directions

Delirium is a complex medical condition marked by acute episodes of cognitive dysfunction and behavioral disturbances, with a multifaceted etiology and challenging management across various clinical settings. Older adults, particularly in postoperative contexts, are at increased risk of developing delirium. Despite extensive research, a single underlying pathophysiological mechanism for delirium remains elusive. However, emerging evidence suggests a correlation between lipid dysregulation and delirium development in elderly patients, especially in postoperative settings. This connection has led to proposed treatments targeting dyslipidemia and associated neuroinflammatory effects in acute-phase delirium. This review aims to synthesize current literature on the relationship between lipid dysregulation and delirium in older adults, highlighting the need for further research into specific neurolipidome constituents and age-related lipid profile changes, potentially uncovering novel therapeutic strategies for delirium.

Insulitis and aging: Immune cell dynamics in Langerhans islets

With increasing age, the risk for age-related type-2-diabetes also increases due to impaired glucose tolerance and insulin secretion. This disease process may be influenced by various factors, including immune cell triggered inflammation and fibrosis. Although immune cells are a necessary component of islets, little is known about immune cell accumulation, immune cell subtype shifts and subsequent influence on glucose metabolism in healthy aging. However, this is critical for understanding the mechanisms that influence β-cell health. Therefore, we studied young and old male C57BL/6J mice, focusing on immune cell composition, patterns of accumulation, and the presence of fibrosis within the pancreatic islets. Our findings demonstrate that insulitis occurs in healthy aged mice without immediate development of a diabetic phenotype. Aged islets exhibited an increase in leukocytes and a shift in immune cell composition. While insulitis typically involves excessive immune cell accumulation, we observed a moderate increase in macrophages and T-cells during aging, which may support β-cell proliferation via cytokine secretion. In fact, aged mice in our study showed an increase in β-cell mass as well as a partially higher insulin secretory capacity, which compensated for the loss of β-cell functionality in insulitic islets and led to improved glucose tolerance. Furthermore, fibrosis which is normally triggered by immune cells, increased with age but appears to reach a steady state, emphasizing the importance of counter-regulatory mechanisms and immune system regulation. Our results suggest, that immune cell subtypes change with age and that non-pathological accumulation of immune-cells may regulate glucose metabolism through secretion of cytokines.

Adverse childhood experiences and trajectories of chronic diseases: A population-base longitudinal study

OBJECTIVES

Adverse childhood experiences (ACEs) have far-reaching effects on health outcomes. This study aimed to evaluate the associations of ACEs with trajectories and number of chronic diseases.

STUDY DESIGN

Cohort study.

METHODS

Participants aged 45 years or older of China Health and Retirement Longitudinal Study were included. Ten kinds of ACEs encountered before 17 years old were calculated. Number of chronic diseases were assessed by 14 kinds of self-reported or proxy-reported diagnosed chronic diseases. The associations of specific types and number of ACEs with trajectories and number of chronic diseases were analyzed with latent class trajectory model, multinomial Logistic regression, and general estimating equation.

RESULTS

Four trajectories of chronic diseases were identified in 12157 participants. With the reference of low baseline and persistent growth trajectory, those encountered physical abuse, domestic violence, household mental illness, and parental death had higher risks of high baseline and transient growth trajectory, middle baseline and accelerated growth trajectory of chronic diseases (ORs = 1.18-1.65). Compared to those without ACEs, those with 1 and above kinds of ACEs had elevated risks of middle baseline and persistent growth, high baseline and transient growth trajectory, middle baseline and accelerated growth trajectory of chronic diseases (ORs = 1.15-2.71). Physical abuse, domestic violence, bullying, household mental illness, parental death, and exposure of 2 and above kinds of ACEs increased the number of chronic diseases (β = 0.09-0.62). Associations of ACEs with trajectories and number of chronic diseases were more salient in women than men.

CONCLUSIONS

Different types and number of ACEs were related to trajectories of chronic diseases, especially in women. Early, comprehensive, and joint actions should be taken to prevent chronic diseases from a life-course perspective.

Global and tissue-specific transcriptomic dysregulation in human aging: Pathways and predictive biomarkers

Aging is a universal biological process that impacts all tissues, leading to functional decline and increased susceptibility to age-related diseases, particularly cardiometabolic disorders. While aging is characterized by hallmarks such as mitochondrial dysfunction, chronic inflammation, and dysregulated metabolism, the molecular mechanisms driving these processes remain incompletely understood, particularly in a tissue-specific context. To address this gap, we conducted a comprehensive transcriptomic analysis across 40 human tissues using data from the Genotype-Tissue Expression (GTEx) project, comparing individuals younger than 40 years with those older than 65 years. We identified over 17,000 differentially expressed genes (DEGs) across tissues, with distinct patterns of up- and down-regulation. Enrichment analyses revealed that up-regulated DEGs were associated with inflammation, immune responses, and apoptosis, while down-regulated DEGs were linked to mitochondrial function, oxidative phosphorylation, and metabolic processes. Using gene co-expression network (GCN) analyses, we identified 1,099 genes as dysregulated nodes (DNs) shared across tissues, reflecting global aging-associated transcriptional shifts. Integrating machine learning approaches, we pinpointed key aging biomarkers, including GDF15 and EDA2R, which demonstrated strong predictive power for aging and were particularly relevant in cardiometabolic tissues such as the heart, liver, skeletal muscle, and adipose tissue. These genes were also validated in plasma proteomics studies and exhibited significant correlations with clinical cardiometabolic health indicators. This study provides a multi-tissue, integrative perspective on aging, uncovering both systemic and tissue-specific molecular signatures. Our findings advance understanding of the molecular underpinnings of aging and identify novel biomarkers that may serve as therapeutic targets for promoting healthy aging and mitigating age-related diseases.

Deciphering Immunosenescence From Child to Frailty: Transcriptional Changes, Inflammation Dynamics, and Adaptive Immune Alterations

Aging induces significant alterations in the immune system, with immunosenescence contributing to age-related diseases. Peripheral blood mononuclear cells (PBMCs) offer a convenient and comprehensive snapshot of the body's immune status. In this study, we performed an integrated analysis of PBMCs using both bulk-cell and single-cell RNA-seq data, spanning from children to frail elderlies, to investigate age-related changes. We observed dynamic changes in the PBMC transcriptome during healthy aging, including dramatic shifts in inflammation, myeloid cells, and lymphocyte features during early life, followed by relative stability in later stages. Conversely, frail elderly individuals exhibited notable disruptions in peripheral immune cells, including an increased senescent phenotype in monocytes with elevated inflammatory cytokine expression, heightened effector activation in regulatory T cells, and functional impairment of cytotoxic lymphocytes. Overall, this study provides valuable insights into the complex dynamics of immunosenescence, elucidating the mechanisms driving abnormal inflammation and immunosuppression in frailty.

Protein Source, Dietary Fibre Intake, and Inflammation in Older Adults: A UK Biobank Study

BACKGROUND

Chronic inflammation is linked to cardiovascular disease, cancer, and other non-communicable diseases. Dietary factors like fibre and protein may affect inflammation, but limited evidence exists exploring how they interact. This study investigated associations between dietary fibre, protein sources, and the inflammatory marker C-reactive protein (CRP) in older adults.

METHODS

This cross-sectional analysis included 128,612 UK Biobank participants aged 60+ years with CRP measurements and dietary data from multiple 24 h recalls. Fibre intake was reported as total fibre (g/day). Protein intake included total, animal, and vegetable protein (g/day). Robust regression analysis examined associations between quintiles of fibre, protein, and CRP, adjusted for demographics, lifestyle factors, and multimorbidity. Analyses were stratified by health status (with and without multimorbidity).

RESULTS

Higher fibre and vegetable protein intakes were inversely associated with CRP, while higher animal and total protein were positively associated with CRP in people with no multimorbidity. Specifically, participants in the highest quartile of dietary fibre had CRP levels that were 0.42 mg/L lower compared with the lowest quartiles. In contrast, those with the highest total protein and animal protein intakes had CRP levels that were 0.24 mg/L and 0.40 mg/L higher, respectively. In people with multimorbidity, fibre exhibited an inverted U-shaped association with the strongest association in participants in the highest quintile of intake. Vegetable protein had an inverse association with CRP. Animal and total protein had strong positive linear associations with CRP. Notably, high animal protein coupled with low dietary fibre intake resulted in CRP levels that were 0.65 mg/L higher compared with low animal protein and high dietary fibre intake.

CONCLUSIONS

Higher fibre and vegetable protein intakes were associated with lower inflammation in older adults. In promoting protein intake to maintain muscle mass and function, future studies should investigate replacing animal with vegetable protein to concomitantly reduce age-related inflammation.

PCSK9 in Vascular Aging and Age-Related Diseases

The aging process significantly contributes to human disease, and as worldwide life expectancy increases, addressing the challenges of aging and age-related cardiovascular diseases is becoming increasingly urgent. Vascular aging is a key link between aging and the development of age-related diseases. Recent studies indicate that proprotein convertase subtilisin/kexin type 9 (PCSK9), a type of protein involved in the metabolism of lipids, is crucial in modulating vascular aging by affecting the physiological functioning of vascular cells. PCSK9 is linked to lipid metabolism and chronic inflammation and is involved in regulating senescence-related activities, including migration, proliferation, apoptosis, and differentiation. These factors contribute to the aging of vascular cells and age-related vascular diseases, including atherosclerosis, hypertension, coronary artery disease, and cerebrovascular diseases. Given its involvement in these processes, this article provides a comprehensive summary of PCSK9's regulatory functions in vascular aging, highlighting potential therapeutic targets for combating age-related cardiovascular diseases.

Association between systemic immune inflammation index and serum testosterone and free testosterone in middle-aged and elderly men

BACKGROUND

Chronic inflammation is a pervasive feature of aging and may be associated with testosterone in middle-aged and older men. Systemic immune-inflammation index (SII) is a novel inflammatory biomarker. We aimed to assess the association between SII and serum testosterone and free testosterone (FT) in middle-aged and older men.

METHODS

Our study included males ≥ 40 years old in the 2011-2016 and 2021-2023 National Health and Nutrition Examination Survey. Multivariable regression analysis was used to explore the associations between SII and serum testosterone and FT in middle-aged and older men. Subgroup analysis was performed according to age.

RESULTS

About 5354 participants were included, of which 2450 contained FT data. Multivariable linear regression found that SII exhibited an inverse association with serum testosterone (β -0.05, 95% CI -0.07 to -0.03, P < 0.001) and FT (β -0.03, 95% CI -0.05 to -0.01, P = 0.032) in middle-aged and elderly men. After SII was grouped as quartiles, serum testosterone was significantly lower in SII quartile 4 than in SII quartile 1 (β -0.05, 95% CI -0.08 to -0.02, P < 0.001). However, FT was not significantly lower in SII quartile 4 than in SII quartile 1 (β -0.03, 95% CI -0.07 to 0.01, P = 0.135). In subgroup analysis, the serum testosterone results were consistent with the overall results. However, only in the ≥60 years group, SII exhibited an inverse association with FT (β -0.06, 95% CI -0.1 to -0.02, P = 0.002) and was significantly lower in SII quartile 4 than in SII quartile 1 (β -0.06, 95% CI -0.12 to -0.01, P = 0.049).

CONCLUSIONS

Our study revealed an inverse association between SII and serum testosterone and FT in middle-aged and elderly men, particularly among men ≥ 60 years.

Oxidant-Based Cytotoxic Agents During Aging: From Disturbed Energy Metabolism to Chronic Inflammation and Disease Progression

In humans, aging is an inevitable consequence of diminished growth processes after reaching maturity. The high order of biomolecules in cells and tissues is continuously disturbed by numerous physical and chemical destructive impacts. Host-derived oxidant-based cytotoxic agents (reactive species, transition free metal ions, and free heme) contribute considerably to this damage. These agents are under the control of immediately acting antagonizing principles, which are important to ensure cell and tissue homeostasis. In this review, I apply the concept of host-derived cytotoxic agents and their interplay with antagonizing principles to the aging process. During aging, energy metabolism and the supply of tissues with dioxygen and nutrients are increasingly disturbed. In addition, a chronic inflammatory state develops, a condition known as inflammaging. The balance between oxidant-based cytotoxic agents and protective mechanisms is analyzed depending on age-based physiological alterations in ATP production. Disturbances in this balance are associated with the development of age-related diseases and comorbidities. An enhanced production of reactive species from dysfunctional mitochondria, alterations in cellular redox homeostasis, and adaptations to hypoxia are highlighted. Examples of how disturbances between oxidant-based cytotoxic agents and antagonizing principles contribute to the pathogenesis of diseases in persons of advanced age are given.

Neutrophil-to-Lymphocyte Ratio as a Prognostic Biomarker for Long-Term Survival in Older Adults at a Mental Health Care Center: A Historical Cohort Analysis

Background/Objectives: Identifying reliable biomarkers for healthy aging and longevity is a fundamental challenge in aging research and medical sciences. The neutrophil-to-lymphocyte ratio (NLR) is a readily measurable indicator of immune balance that reflects the interplay between innate immune activation and adaptive immune suppression. Methods: This study examined NLR values in 204 physically healthy residents (98 men and 106 women) stratified into four lifespan categories based on death certificates. Page's test and ordinal regression (Cumulative Link Model) were used to assess trends with longevity. Results: In men, a downward trend in NLR values was observed. In women, a significant age-related decline in NLR was identified, with longer-lived individuals showing notably lower NLR values compared to their shorter-lived counterparts. The findings suggest that lower NLR is associated with longer survival, particularly in older women, reflecting superior immune regulation and reduced systemic inflammation. Conversely, elevated NLR may indicate immune dysfunction and heightened inflammatory burden. Conclusions: The results of this study complement existing findings, reinforcing the critical importance of immune balance in supporting healthy aging and longevity. These findings also underscore the potential of NLR as a robust biomarker for evaluating immune function and anticipating resilience to age-related decline, offering a practical tool for assessing immune health in the aging population.

Impact of Disease-Modifying Antirheumatic Drugs on Cognitive Function in Older Adults with Rheumatoid Arthritis

Cognitive impairment poses significant challenges for aging populations. Systemic inflammation, a hallmark of rheumatoid arthritis (RA), has been implicated in neurodegeneration through mechanisms including blood-brain barrier disruption, microglial activation, and cytokine-mediated neuronal damage. This review examines the potential impact of disease-modifying antirheumatic drugs (DMARDs) on cognitive function in RA, focusing on the inflammatory pathways linking systemic inflammation to neuroinflammation and cognitive decline. DMARDs, categorized into conventional synthetic (csDMARDs), biologic (bDMARDs), and targeted synthetic (tsDMARDs) classes, modulate immune responses through distinct mechanisms. Evidence suggests that DMARDs, particularly bDMARDs targeting proinflammatory cytokines such as TNF-α and IL-6, may mitigate neuroinflammatory processes and preserve cognitive function. However, the cognitive impact of csDMARDs such as methotrexate is complex, with conflicting reports regarding its role in vascular dementia. Emerging therapies such as Janus kinase inhibitors (JAK-i) offer promise in modulating central inflammation, though clinical evidence remains limited. While some studies highlight protective effects of DMARDs against dementia, findings are inconsistent, hindered by heterogeneity in study design, patient demographics, and cognitive assessment methods. This review underscores the need for personalized treatment strategies, integrating RA management with cognitive health considerations. Future research should prioritize robust, prospective studies with long-term follow-up, incorporating neuroimaging and biomarker analysis to elucidate the mechanisms underpinning DMARD-associated cognitive outcomes. A better understanding of the involved inflammatory pathways in RA and the potential effects of DMARDs could lead to improved therapeutic approaches, enhancing quality of life for patients with RA and potentially benefiting broader strategies in preventing or treating dementia.

Rhythms and shifts of chemokines and cytokines interplay in a decade lifespan: The longitudinal community-based Bambuí health and aging study

Aging is associated with several physiological changes, including a remarkable remodeling of the immune system. Herein, the rhythms and shifts in serum immune mediators were characterized in a decade lifespan as a longitudinal community-based prospective investigation from Bambuí Health and Aging Study. The study population included paired samples from 713 subjects survivors from the original BHAS cohort and at 10-years Follow-up, categorized into 5-years age range intervals (60-64Yrs towards 90 + Yrs). Quantification of soluble mediators were carried out by Cytometric Bead Array. The results demonstrated a rhythmic increase in serum immune mediators, especially CXCL9, CXCL10, IL-1β, IL-6 and TNF following the aging process, particularly at age intervals 70-74Yrs and 85-89Yrs. More prominent fold change magnitudes were observed for TNF (27.64×), CXCL9 (2.40×), IL-1β (2.20×), IL-6 (1.47×), and CXCL10 (1.26×). On the other hand, analysis of integrative networks showed a waning in the correlation numbers between immune mediators in a decade lifespan and a shift of connectivity from chemokines at Enrollment towards cytokines at 10-years Follow-up. Cross-correlation approaches revealed that CXCL9, CXCL10, IL-1β, IL-6, and IL-10 were placed in the innermost position, underscoring the higher contribution of these mediators along aging. Overall, these findings re-emphasize the impact of aging in the dynamic profile of serum immune mediators, highlighting the shift of selective mediators and their rhythmic signatures across chronological aging.

Neurotropic Viruses as Acute and Insidious Drivers of Aging

Aging is the result of various compounding stresses that gradually overcome the homeostatic regulation of the cell, resulting in irreversible damage. This manifests as many acute and chronic conditions, the most common of which are neurodegeneration and dementia. Epidemiological studies have shown significant, strong correlations between viral infection and neurodegenerative diseases. This review overlays the characteristics of viral pathogenesis with the hallmarks of aging to discuss how active and latent viruses contribute to aging. Through our contextualization of myriad basic science papers, we offer explanations for premature aging via viral induction of common stress response pathways. Viruses induce many stresses: dysregulated homeostasis by exogenous viral proteins and overwhelmed protein quality control mechanisms, DNA damage through direct integration and epigenetic manipulation, immune-mediated oxidative stress and immune exhaustion, and general energy theft that is amplified in an aging system. Overall, this highlights the long-term importance of vaccines and antivirals in addition to their acute benefits.

Chronic whole-body heat treatment in obese insulin-resistant C57BL/6J mice

AIM

This study examined the effects of hyperthermic therapy (HT) on mice fed normal chow or a high-fat diet (HFD) for 18 or 22 weeks, undergoing four or eight weekly HT sessions.

METHODS

Mice were housed within their thermoneutral zone (TNZ) to simulate a physiological response. HFD-induced obesity-related changes, including weight gain, visceral fat accumulation, muscle loss (indicative of obesity sarcopenia), glucose intolerance, and hepatic triglyceride buildup.

MAIN RESULTS

HT upregulated HSP70 expression in muscles, mitigated weight gain, normalised QUICK index, and reduced plasma HSP70 concentrations. It also lowered the H-index of HSP70 balance, indicating improved immunoinflammatory status, and decreased activated caspase-1 and proliferative senescence in adipose tissue, both linked to insulin resistance.

CONCLUSION

The findings suggest that even animals on a "control" diet but with insufficient physical activity and within their TNZ may experience impaired glycaemic homeostasis.

Inflamm-ageing: How cytokines and nutrition shape the trajectory of ageing

Population ageing is increasing in prevalence in most developed countries. Ageing is the decline of functional properties at the cellular, tissue, and organ level. Biochemical changes that occur in all organisms that experience biological ageing are referred to as the "Hallmarks of ageing". Inflammation is a common denominator of the hallmarks of ageing, being mechanistically involved in most age-related health consequences. Inflamm-ageing refers to age-related changes in the inflammatory and immune systems which somehow drive the ageing process towards healthy or unhealthy ageing. Current evidences, support that, reversing the age-related pro-inflammatory status of inflamm-ageing, is able to modulate most hallmarks of ageing. Inflamm-ageing is associated with increased levels of pro-inflammatory molecules (e.g. cytokines, chemokines), ultimately producing a chronic low-grade inflammatory state typically observed in older individuals. It is commonly accepted that, the balance between pro- and anti-inflammatory cytokines/chemokines is one of the factors determining whether healthy or unhealthy ageing occurs. Malnutrition and nutritional imbalances, are highly prevalent in the elderly, playing a role in driving the balance of pro- and anti-inflammatory immunoactive molecules. In particular, malnutrition is a major risk factor for sarcopenia, a phenomenon characterized by loss of muscle mass, which is often referred to as the biological basis for frailty. Given the close relationship between malnutrition and sarcopenia, there is also evidence for a link between malnutrition and frailty. Indeed, changes in cytokine/chemokine levels in elderly patients with malnutrition were demonstrated. The demonstration that specific cytokines play a role in modulating appetite and nutrient sensing and taste reception, provided further evidence for the existence of a link between inflamm-ageing, nutrition and cytokines in shaping the trajectory of ageing. The present review will overview current evidence supporting the role of specific circulating cytokines and chemokines in the relationship between ageing, inflammation, and malnutrition.

The emerging role of exercise preconditioning in preventing skeletal muscle atrophy

Skeletal muscle atrophy, characterized by the loss of muscle mass and function, can result from disuse, aging, disease, drug. Exercise preconditioning-a form of exercise training performed before these harmful threats-induces notable remodeling and extensive biochemical adaptations in skeletal muscle, creating a protective phenotype in muscle fibers, and thus serving as an effective intervention for preventing skeletal muscle atrophy. Here, we review the current understanding relating to how exercise preconditioning protects skeletal muscle from damage caused by inactivity, sarcopenia, disease, or pharmacological intervention, with an emphasis on the cellular mechanisms involved. Key mechanisms highlighted as making a significant contribution to the protective effects of exercise on skeletal muscle fibers include mitochondria; the expression of cytoprotective proteins such as HSP72, SOD2, SESN2, PGC-1α and AMPK; and the regulation of oxidative stress. These findings underscore the potential of exercise preconditioning as a non-pharmacological intervention for preserving muscle mass and function, as well as preventing muscular atrophy, ultimately improving the quality of life for at-risk populations.

Is skin thinning a natural consequence of aging or a result of sarcopenia?

It is widely known that skin thickness decreases and fragility increases with aging. However, the relationship between sarcopenia, a condition commonly associated with frailty in older adults, and skin thickness remains unclear. This study aimed to evaluate the presence of skin thinning in patients with sarcopenia and investigate the relationship between sarcopenia, age, and skin thickness. This cross-sectional study included 66 participants aged 40 to 80, comprising 20 individuals with pre-sarcopenia, 13 with sarcopenia, and 33 healthy controls. Total skin thickness (epidermal + dermal) was measured using ultrasound (US) at four anatomical regions: leg, hand, forearm, and upper arm. Leg and hand skin thicknesses were significantly lower in patients with pre-sarcopenia compared to the control group (all p < 0.05). Similarly, forearm and upper arm skin thicknesses were significantly lower in patients with sarcopenia compared to the control group (all p = 0.001). After adjusting for confounding factors such as age, sex, and BMI, Sarcopenia remained significantly associated with reduced skin thickness across all regions (all p < 0.05). A moderate-to-high positive correlation exists between HGS and leg skin thickness (all p < 0.01). However, no significant relationships were found between skin thickness and age or sex. Sarcopenia is associated with skin thinning across all examined regions, independent of age, sex, or BMI. Skin thickness measurements may serve as a diagnostic marker for sarcopenia.

Living in endemic area for infectious diseases is associated to differences in immunosenescence and inflammatory signatures

Research on aged individuals from developed countries show that lifestyle factors such as diet, physical activity, stress, smoking, and sleep quality impact aging. However, other relevant factors may influence aging in less-studied populations, such as Brazilian cohorts. This study aimed to analyze immunosenescence profile of individuals living in an endemic area for several infectious diseases in Brazil. We showed that these individuals exhibited accelerated epigenetic aging and increased production of IL-12p70, IL-17A, and IL-9. Production of inflammatory mediators IL-12p70, IL-6, IL-1β, IL-2, and IL-1ra in individuals with flu-like symptoms and those with COVID-19 was higher among residents in endemic areas than in residents from a control non-endemic area. Furthermore, residents of the endemic area had a more prominent inflammatory profile during viral infection and a different pattern of plasma mediators when compared to residents of a non-endemic area. Our data suggests that these two cohorts had specific immune signatures regardless of the presence or the type of infection at study. Therefore, we demonstrated that there were distinct patterns of immune responses and epigenetic aging depending on the environment the individuals live in. These observations add a layer of diversity to the studies of human aging by including individuals from less represented regions.

Systemic aging and aging-related diseases

Aging is a biological process along with systemic and multiple organ dysfunction. It is more and more recognized that aging is a systemic disease instead of a single-organ functional disorder. Systemic aging plays a profound role in multiple diseases including neurodegenerative diseases, cardiovascular diseases, and malignant diseases. Aged organs communicate with other organs and accelerate aging. Skeletal muscle, heart, bone marrow, skin, and liver communicate with each other through organ-organ crosstalk. The crosstalk can be mediated by metabolites including lipids, glucose, short-chain fatty acids (SCFA), inflammatory cytokines, and exosomes. Metabolic disorders including hyperglycemia, hyperinsulinemia, and hypercholesterolemia caused by chronic diseases accelerate hallmarks of aging. Systemic aging leads to the destruction of systemic hemostasis, causes the release of inflammatory cytokines, senescence-associated secretory phenotype (SASP), and the imbalance of microbiota composition. Released inflammatory factors further aggregate senescence, which promotes the aging of multiple solid organs. Targeting senescence or delaying aging is emerging as a critical health strategy for solving age-related diseases, especially in the old population. In the current review, we will delineate the mechanisms of organ crosstalk in systemic aging and age-related diseases to provide therapeutic targets for delaying aging.

Pathological and Inflammatory Consequences of Aging

Aging is a complex, progressive, and irreversible biological process that entails numerous structural and functional changes in the organism. These changes affect all bodily systems, reducing their ability to respond and adapt to the environment. Chronic inflammation is one of the key factors driving the development of age-related diseases, ultimately causing a substantial decline in the functional abilities of older individuals. This persistent inflammatory state (commonly known as "inflammaging") is characterized by elevated levels of pro-inflammatory cytokines, an increase in oxidative stress, and a perturbation of immune homeostasis. Several factors, including cellular senescence, contribute to this inflammatory milieu, thereby amplifying conditions such as cardiovascular disease, neurodegeneration, and metabolic disorders. Exploring the mechanisms of chronic inflammation in aging is essential for developing targeted interventions aimed at promoting healthy aging. This review explains the strong connection between aging and chronic inflammation, highlighting potential therapeutic approaches like pharmacological treatments, dietary strategies, and lifestyle changes.

Proinflammatory Cytokines in Chronic Respiratory Diseases and Their Management

Pulmonary homeostasis can be agitated either by external environmental insults or endogenous factors produced during respiratory/pulmonary diseases. The lungs counter these insults by initiating mechanisms of inflammation as a localized, non-specific first-line defense response. Cytokines are small signaling glycoprotein molecules that control the immune response. They are formed by numerous categories of cell types and induce the movement, growth, differentiation, and death of cells. During respiratory diseases, multiple proinflammatory cytokines play a crucial role in orchestrating chronic inflammation and structural changes in the respiratory tract by recruiting inflammatory cells and maintaining the release of growth factors to maintain inflammation. The issue aggravates when the inflammatory response is exaggerated and/or cytokine production becomes dysregulated. In such instances, unresolving and chronic inflammatory reactions and cytokine production accelerate airway remodeling and maladaptive outcomes. Pro-inflammatory cytokines generate these deleterious consequences through interactions with receptors, which in turn initiate a signal in the cell, triggering a response. The cytokine profile and inflammatory cascade seen in different pulmonary diseases vary and have become fundamental targets for advancement in new therapeutic strategies for lung diseases. There are considerable therapeutic approaches that target cytokine-mediated inflammation in pulmonary diseases; however, blocking specific cytokines may not contribute to clinical benefit. Alternatively, broad-spectrum anti-inflammatory approaches are more likely to be clinically effective. Herein, this comprehensive review of the literature identifies various cytokines (e.g., interleukins, chemokines, and growth factors) involved in pulmonary inflammation and the pathogenesis of respiratory diseases (e.g., asthma, chronic obstructive pulmonary, lung cancer, pneumonia, and pulmonary fibrosis) and investigates targeted therapeutic treatment approaches.

Sex differences in age-associated neurological diseases-A roadmap for reliable and high-yield research

Once taken into consideration, sex differences in neurological diseases emerge in abundance: (i) Stroke severity is significantly higher in females than in males, (ii) Alzheimer's disease (AD) pathology is more pronounced in females, and (iii) conspicuous links with hormonal cycles led to female-specific diagnoses, such as catamenial migraines and epilepsy. While these differences receive increasing attention in isolation, they likely link to similar processes in the brain. Hence, this review aims to present an overview of the influences of sex chromosomes, hormones, and aging on male and female brains across health and disease, with a particular focus on AD and stroke. The focus here on advancements across several fields holds promise to fuel future research and to lead to an enriched understanding of the brain and more effective personalized neurologic care for all.

FoxO1 as a Hub in Immunosenescence Induced by Hepatocellular Carcinoma and the Effect of Yangyin Fuzheng Jiedu Prescription

Purpose

Yangyin Fuzheng Jiedu Prescription (YFJP) is a traditional Chinese medicine (TCM) used for the treatment of hepatocellular carcinoma (HCC). However, the potential mechanisms remain unclear. The objective of this study is to clarify the mechanism of action of YFJP in treating HCC.

Methods

By constructing networks, the active components and molecular targets of YFJP in the treatment of HCC were explored. The TCGA database was utilized to analyze the correlation between the core target and the overall survival (OS) of patients with HCC. The regulatory effect of YFJP on T cell was evaluated by detecting samples from patients with HCC. The molecular mechanism of YFJP in treating HCC was validated through in vivo and in vitro experiments.

Results

Constructing networks and analyse indicated that the key targets of YFJP in the treatment of HCC is FoxO1. Analysis of the HCC patient cohort in the TCGA database demonstrated that FoxO1 is an independent protective factor for overall survival in patients with HCC. Pathway enrichment analysis enriched FoxO signaling pathway and Cellular senescence pathway. Prospectively collecting samples from patients with HCC suggested that YFJP treatment increased the proportion of CD8+ T cells. In vivo experiments showed that YFJP treatment ameliorated CD8+ T cell senescence in tumor-bearing mice. Western blot, flow cytometry and multi-color immunofluorescence co-staining showed that YFJP treatment increased the expression of FoxO1 in CD8+ T cells. The primary CD8+ T cells were sorted and co-cultured with an HCC cell line in vitro. Inhibiting the expression of FoxO1 in CD8+T cells confirmed that FoxO1 is a key target for YFJP to improve the senescence of CD8+ T cell.

Conclusion

FoxO1 is the key molecular target of YFJP in improving CD8+ T cell senescence in HCC. This study preliminarily clarified the mechanism of YFJP in regulating immunosenescence of HCC.

The Aging Immune System: A Critical Attack on Ischemic Stroke

Ischemic stroke caused by cerebrovascular embolism is an age-related disease with high rates of disability and mortality. Although the mechanisms of immune and inflammatory development after stroke have been of great interest, most studies have neglected the critical and unavoidable factor of age. As the global aging trend intensifies, the number of stroke patients is constantly increasing, emphasizing the urgency of finding effective measures to address the needs of elderly stroke patients. The concept of "immunosenescence" appears to explain the worse stroke outcomes in older individuals. Immune remodeling due to aging involves dynamic changes at all levels of the immune system, and the overall consequences of central (brain-resident) and peripheral (non-brain-resident) immune cells in stroke vary according to the age of the individual. Lastly, the review outlines recent strategies aimed at immunosenescence to improve stroke prognosis.

Immune surveillance of senescence: potential application to age-related diseases

Several lines of evidence suggest that the age-dependent accumulation of senescent cells leads to chronic tissue microinflammation, which in turn contributes to age-related pathologies. In general, senescent cells can be eliminated by the host's innate and adaptive immune surveillance system, including macrophages, NK cells, and T cells. Impaired immune surveillance leads to the accumulation of senescent cells and accelerates the aging process. Recently, senescent cells, like cancer cells, have been shown to express certain types of immune checkpoint proteins as well as non-classical immune-tolerant MHC variants, leading to immune escape from surveillance systems. Thus, immune checkpoint blockade (ICB) may be a promising strategy to enhance immune surveillance of senescence, leading to the amelioration of some age-related diseases and tissue dysfunction.

Does Lifelong Exercise Counteract Low-Grade Inflammation Associated with Aging? A Systematic Review and Meta-Analysis

BACKGROUND

Aging is associated with sustained low-grade inflammation, which has been linked to age-related diseases and mortality. Long-term exercise programs have been shown to be effective to for attenuating this process; however, subsequent detraining might negate some of these benefits. Master athletes, as a model of lifelong consistent exercise practice, have been suggested to present similar inflammatory profiles to untrained young adults. Nonetheless, it is unclear whether maintaining training habits throughout life can completely counteract low-grade inflammation associated with aging.

OBJECTIVES

We aimed to systematically evaluate comparisons of baseline inflammatory profiles in Master athletes, untrained middle-aged and older adults, and untrained young individuals to elucidate whether lifelong exercise can counteract low-grade inflammation associated with aging.

METHODS

A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, and a protocol was prospectively registered in PROSPERO (CRD42024521339). Studies reporting baseline systemic levels of proinflammatory and anti-inflammatory markers in Master athletes and untrained controls were eligible for inclusion. A total of six databases (PubMed [MEDLINE], Embase, Cochrane Central Register of Controlled Trials [CENTRAL], Scopus, SPORTDiscus, and Web of Science [WoS]) were searched in September 2024, and studies were independently screened by two reviewers. Risk of bias was assessed using an adapted version of the Joanna Briggs Institute Critical Appraisal tool for cross-sectional trials, and random-effect meta-analyses of standardized mean differences (SMDs) of inflammatory markers were conducted to evaluate comparisons between Master athletes and age-matched untrained middle-aged and older adults as well as Master athletes and young untrained subjects. Subgroup analyses were performed based on exercise intensity and type, and participants' sex.

RESULTS

A total of 17 studies (n = 649 participants) were included both in qualitative and quantitative synthesis. Lifelong exercise appears to attenuate increases in baseline C-reactive protein, and to elevate anti-inflammatory interleukin (IL)-10 levels compared with untrained middle-aged and older adults (C-reactive protein: SMD - 0.71, 95% confidence interval - 0.97, - 0.45, I2 0%, p = 0.78; IL-10: SMD 1.44, 95% confidence interval 0.55, 2.32, I2 87%, p < 0.00001). Statistical significance was maintained in C-reactive protein and IL-10 sub-analyses. No difference in tumor necrosis factor-α levels was observed between Master athletes and untrained middle-aged and older adults (SMD 0.40, 95% confidence interval - 0.15, 0.96, I2 72%, p = 0.0008). A trend towards decreased IL-6 levels in Master athletes was shown in pooled analyses comparing untrained middle-aged and older adults, and rendered statistically significant in sub-analyses. However, comparisons with young untrained adults indicated that Master athletes still present with elevated levels of tumor necrosis factor-α and IL-6, along with decreased IL-10.

CONCLUSIONS

Master athletes might exhibit a more anti-inflammatory profile denoted by decreased baseline circulating levels of C-reactive protein and, potentially, IL-6, along with increased IL-10 compared with healthy age-matched untrained peers. However, lifelong exercise might still be insufficient to completely counteract age-related changes in tumor necrosis factor-α, IL-6, and IL-10, as shown in comparisons with untrained young adults.

A 7T MRI Study of Fibular Bone Thickness and Density: Impact of Age, Sex and Body Weight, and Correlation with Bone Marrow Expansion and Muscle Fat Infiltration

Background: Reduced bone mass and density, hallmark features of osteopenia and osteoporosis, significantly increase the risk of fractures, falls, and loss of mobility, especially in post-menopausal women and the elderly. Methods: This quantitative 7T MRI study examines the features of fibular bone thinning and bone mineral density loss (BMD) in 107 individuals (43F/64M) across various ages, body mass indices (BMIs), and ethnicities. Results: Women had significantly lower cross-sectional bone wall thickness (BT) and bone tissue area (BA), along with greater BMD loss compared to men in those over age 50 (n = 77), but not in the younger group (n = 30). The bone g-factor, defined as the ratio of inner-to-outer bone diameters, increased with bone thinning, bone marrow expansion (BME), and muscle fat infiltration (MFI) but was independent of subcutaneous fat thickness (SFT). Bone thinning and BMD loss both tend to increase with BME and MFI. Additionally, bone density decrease correlated with bone mass loss, with a stronger association observed with BT than BA. Conclusions: These findings offer insights into the effects of aging and sex on skeletomuscular health, with implications for strategies to mitigate bone loss in osteoporosis and osteosarcopenia.

RGS10 attenuates systemic immune dysregulation induced by chronic inflammatory stress

Regulator of G-protein signaling 10 (RGS10), a key homeostatic regulator of immune cells, has been implicated in multiple diseases associated with aging and chronic inflammation including Parkinson's Disease (PD). Interestingly, subjects with idiopathic PD display reduced levels of RGS10 in subsets of peripheral immune cells. Additionally, individuals with PD have been shown to have increased activated peripheral immune cells in cerebrospinal fluid (CSF) compared to age-matched healthy controls. However, it is unknown whether peripheral immune cells in the CSF of individuals with PD also exhibit decreased levels of RGS10. Utilizing the Michael J. Fox Foundation Parkinson's Progression Markers Initiative (PPMI) study we found that RGS10 levels are decreased in the CSF of individuals with PD compared to healthy controls and prodromal individuals. As RGS10 levels are decreased in the CSF and circulating peripheral immune cells of individuals with PD, we hypothesized that RGS10 regulates peripheral immune cell responses to chronic systemic inflammation (CSI) prior to the onset of neurodegeneration. To test this, we induced CSI for 6 weeks in C57BL6/J mice and RGS10 KO mice to assess circulating and CNS-associated immune cell responses. We found that RGS10 deficiency synergizes with CSI to induce a bias for inflammatory and cytotoxic cell populations, a reduction in antigen presentation machinery in peripheral blood immune cells, as well as in and around the brain that is most notable in males. These results highlight RGS10 as an important regulator of the systemic immune response to CSI and implicate RGS10 as a potential contributor to the development of immune dysregulation in PD.

Time Allocation to Physical Activity and Sedentary Behaviour and Its Impact on Sarcopenia Risk: A Systematic Review and Meta-Analysis

AIM

To evaluate the relationship between time spent in sedentary behaviour and physical activity and sarcopenia in older adults, and to analyse the effect of reallocating time between different intensities of activities on sarcopenia.

DESIGN

Systematic review and meta-analysis.

METHODS

Following PRISMA guidelines, data were synthesised using a random-effects model, with heterogeneity assessed via Cochran's Q test and the I2 statistic. Study quality was evaluated using the Newcastle-Ottawa Scale by two independent reviewers.

DATA SOURCES

A comprehensive search was conducted in PubMed, Web of Science, Embase, CINAHL and Cochrane databases for studies published up to November 5, 2024, with no language or date restrictions. Relevant reference lists were also manually screened.

RESULTS

The present review included six studies involving 9914 older adults. Three studies suggested that older adults without sarcopenia spent more time performing light physical activities (SMD: 0.35; 95% CI: 0.24-0.45) and moderate to vigorous physical activity (SMD: 0.61; 95% CI: 0.49-0.74) and had less sedentary behaviour (SMD: -0.34; 95% CI: -0.51 to -0.16) than did older adults with sarcopenia. Replacing sedentary behaviour with an equivalent amount of moderate to vigorous physical activity (10, 30, or 60 min) each day can reduce the risk of sarcopenia, with 30 min showing the best preventive effect. However, research findings on the relationship between substituting sedentary behaviour time with light physical activities and sarcopenia are inconsistent.

IMPLICATIONS FOR THE PROFESSION

Encouraging older adults to engage in moderate to vigorous physical activity, even in short bouts of 10 min, can significantly reduce the risk of sarcopenia. Healthcare professionals should tailor activity recommendations to individual preferences and physical conditions to promote overall health and reduce sedentary behaviour.

PATIENT AND PUBLIC CONTRIBUTION

No Patient or Public Contribution.

TRIAL REGISTRATION

CRD42023416166.

The p53-miR17 family-Rankl axis bridges liver-bone communication

Our study elucidates the crucial role of the liver in bone homeostasis through the p53-miR17 family (miR17-miR20/miR20-miR106/miR93-miR106)-Rankl axis. We demonstrate the enhanced hepatocyte Rankl expression in inflammaging conditions, such as aging, ovariectomized (OVX) mice, and elderly humans. Mice with hepatocyte-specific Rankl deletion exhibit significant resistance to bone mass loss associated with aging, lipopolysaccharide (LPS)-induced inflammation, or estrogen deficiency, compared with controls. Our study highlights hepatocytes as the primary source of Rankl in the liver and serum under these conditions. We identify the p53-miR17 family axis as a crucial regulator for hepatocyte Rankl expression, with p53 inhibiting the miR17 family transcription. Through bioinformatics analysis and in vitro validation, we identify Rankl mRNA as a direct target of the miR17 family. Targeting this axis via CasRx-mediated mRNA editing or miRNA interference significantly attenuates bone mass loss in mice. Our investigation underscores the pivotal significance and therapeutic potential of modulating the p53-miR17 family-Rankl axis in the treatment of inflammaging-associated osteoporosis.

Systemic inflammatory markers in ageing, Alzheimer's disease and other dementias

Systemic inflammation with alterations in inflammatory markers is involved in ageing and Alzheimer's disease. However, few studies have investigated the longitudinal trajectories of systemic inflammatory markers during ageing and Alzheimer's disease, and specific markers contributing to Alzheimer's disease remain undetermined. In this study, a longitudinal cohort (cohort 1: n = 290; controls, 136; preclinical Alzheimer's disease, 154) and a cross-sectional cohort (cohort 2: n = 351; controls, 62; Alzheimer's disease, 63; vascular dementia, 58; Parkinson's disease dementia, 56; behavioural variant frontotemporal dementia, 57; dementia with Lewy bodies, 55) were included. Plasma levels of inflammatory markers were measured every 2 years during a 10-year follow-up in the longitudinal cohort and once in the cross-sectional cohort. The study demonstrated that the inflammatory markers significantly altered during both ageing and the development of Alzheimer's disease. However, only complement C3, interleukin-1β and interleukin-6 exhibited significant changes in participants with preclinical Alzheimer's disease, and their longitudinal changes were significantly associated with the development of Alzheimer's disease compared to controls over the 10-year follow-up. In the cross-sectional cohort, complement C3 demonstrated specificity to Alzheimer's disease, while interleukin-1β and interleukin-6 were also altered in other dementias. The study provides a new perspective on the involvement of inflammatory markers in the ageing process and the development of Alzheimer's disease, implying that regulating inflammation may have a pivotal role in promoting successful ageing and in the prevention and treatment of Alzheimer's disease.

Biological aging of different blood cell types

Biological age (BA) captures detrimental age-related changes. The best-known and most-used BA indicators include DNA methylation-based epigenetic clocks and telomere length (TL). The most common biological sample material for epidemiological aging studies, whole blood, is composed of different cell types. We aimed to compare differences in BAs between blood cell types and assessed the BA indicators' cell type-specific associations with chronological age (CA). An analysis of DNA methylation-based BA indicators, including TL, methylation level at cg16867657 in ELOVL2, as well as the Hannum, Horvath, DNAmPhenoAge, and DunedinPACE epigenetic clocks, was performed on 428 biological samples of 12 blood cell types. BA values were different in the majority of the pairwise comparisons between cell types, as well as in comparison to whole blood (p < 0.05). DNAmPhenoAge showed the largest cell type differences, up to 44.5 years and DNA methylation-based TL showed the lowest differences. T cells generally had the "youngest" BA values, with differences across subsets, whereas monocytes had the "oldest" values. All BA indicators, except DunedinPACE, strongly correlated with CA within a cell type. Some differences such as DNAmPhenoAge-difference between naïve CD4 + T cells and monocytes were constant regardless of the blood donor's CA (range 20-80 years), while for DunedinPACE they were not. In conclusion, DNA methylation-based indicators of BA exhibit cell type-specific characteristics. Our results have implications for understanding the molecular mechanisms underlying epigenetic clocks and underscore the importance of considering cell composition when utilizing them as indicators for the success of aging interventions.

Acquired hemophilia A as a disease of the elderly: A comprehensive review of epidemiology, pathogenesis, and novel therapy

Acquired hemophilia A (AHA) is a rare autoimmune bleeding disorder characterized by the development of neutralizing autoantibodies (inhibitors) against coagulation factor VIII (FVIII). This review provides an in-depth exploration of AHA, covering its epidemiology, pathogenesis, clinical presentation, diagnosis, complications, and treatment strategies, focusing on recent advancements. AHA can manifest in both men and women with no prior bleeding history. The annual incidence is estimated to be approximately 1 case per million individuals in the general population. The incidence increases significantly with age: the incidence among individuals aged 60 years or older is approximately 3 to 4 cases per million individuals per year. Typically, patients present with an acquired bleeding disorder that is characterized by an isolated, prolonged activated partial thromboplastin time stemming from FVIII deficiency. Diagnosis relies on the detection of neutralizing antibodies using the Nijmegen-modified Bethesda assay. Hemostatic control strategies involve bypassing agents like recombinant activated factor VII, activated prothrombin complex concentrate, and recombinant porcine FVIII for bleeding patients. Emicizumab, a novel bypassing agent, exhibits several potential advantages. In the realm of immunosuppressive treatment for inhibitor eradication, the CyDRi regimen emerged as a remarkable advancement, significantly enhancing the outlook for the management of AHA even in the elderly frail population.

The interplay of NAD and hypoxic stress and its relevance for ageing

Nicotinamide adenine dinucleotide (NAD) is an essential regulator of cellular metabolism and redox processes. NAD levels and the dynamics of NAD metabolism change with increasing age but can be modulated via the diet or medication. Because NAD metabolism is complex and its regulation still insufficiently understood, achieving specific outcomes without perturbing delicate balances through targeted pharmacological interventions remains challenging. NAD metabolism is also highly sensitive to environmental conditions and can be influenced behaviorally, e.g., by exercise. Changes in oxygen availability directly and indirectly affect NAD levels and may result from exposure to ambient hypoxia, increased oxygen demand during exercise, ageing or disease. Cellular responses to hypoxic stress involve rapid alterations in NAD metabolism and depend on many factors, including age, glucose status, the dose of the hypoxic stress and occurrence of reoxygenation phases, and exhibit complex time-courses. Here we summarize the known determinants of NAD-regulation by hypoxia and evaluate the role of NAD in hypoxic stress. We define the specific NAD responses to hypoxia and identify a great potential of the modulation of NAD metabolism regarding hypoxic injuries. In conclusion, NAD metabolism and cellular hypoxia responses are strongly intertwined and together mediate protective processes against hypoxic insults. Their interactions likely contribute to age-related changes and vulnerabilities. Targeting NAD homeostasis presents a promising avenue to prevent/treat hypoxic insults and - conversely - controlled hypoxia is a potential tool to regulate NAD homeostasis.