The Aged Intestine: Performance and Rejuvenation

Aging-associated intestinal dysfunction impairs 5-heptadecylresorcinol absorption: Mechanistic insights into transporter-mediated uptake, barrier integrity and inflammatory regulation

5-heptadecylresorcinol (AR-C17), a key bioactive component of whole grain (WG) wheat and rye, has been shown to exhibit anti-aging properties. However, the intestinal absorption dynamics of AR-C17 across different intestinal segments, as well as the aging-dependent differences in absorption between young and aging mice and their underlying mechanisms, remain poorly understood. In this study, we systematically evaluated AR-C17 absorption in various intestinal regions using an Ussing chamber system and elucidated potential contributing factors. Our results revealed that the jejunum and ileum served as the principal sites for AR-C17 absorption, with total absorption rates (TAR) reaching approximately 60 % in young mice. Conversely, aging mice exhibited significantly diminished AR-C17 absorption, with TAR values reduced to 20-45 % in these segments. Aging-associated alterations in key absorption parameters-including apparent permeability coefficient, transmucosal resistance, and short-circuit current-were observed during AR-C17 absorption, ultimately leading to reduced uptake in aging mice. Histopathological analysis demonstrated aging-associated structural deterioration, characterized by villus damage with irregular crypt architecture in the jejunum and villus vacuolization in the ileum. These morphological changes were accompanied by downregulated expression of Oct1 in the jejunum and Octn2 in the ileum, which collectively contributed to impaired AR-C17 absorption in aging mice. Further mechanistic investigations indicated that the differential absorption of AR-C17 between young and aging mice was closely associated with alterations in transmembrane transporters, inflammation, and tight junction. This study provided compelling evidence that aging-associated intestinal dysfunction significantly attenuated AR-C17 absorption, providing novel insights for optimizing the bioavailability of WG-derived bioactive compounds in the elderly.

Global, regional, and national burden of disease analysis on paralytic ileus and intestinal obstruction in adults aged 65 and over from 1990 to 2021, with projections for 2030: a Global Burden of Disease Study 2021 analysis

OBJECTIVE

This study aimed to evaluate the burden and trends of paralytic ileus and bowel obstruction in individuals aged ≥ 65 years, offering insights into prevention, treatment, and healthcare policy.

METHODS

Data from the Global Burden of Disease Study 2021 were used to analyze paralytic ileus and intestinal obstruction by demographics, year, country/region, and Socio-Demographic Index (SDI). The statistical methods included Joinpoint regression, decomposition analysis, and Bayesian Age-Period-Cohort modeling.

RESULTS

In 2021, the global age-standardized incidence of paralytic ileus and intestinal obstruction among the elderly was 643.45 cases per 100,000 individuals. The corresponding prevalence was 24.05 per 100,000 individuals, with disability-adjusted life years (DALYs) of 294.01 per 100,000 person-years and a mortality rate of 20.55 per 100,000 individuals. Between 1990 and 2021, the age-standardized incidence and prevalence of paralytic ileus and intestinal obstruction in the elderly gradually increased, while age-standardized DALYs and mortality consistently declined. Despite similar trends observed across both genders, the disease burden increased with age and was more pronounced in males than in females. Furthermore, the age-standardized incidence and prevalence of these conditions increased with SDI, whereas mortality and DALYs decreased. By 2030, the incidence and prevalence are expected to continue increasing, whereas mortality and DALYs are expected to decrease.

CONCLUSIONS

Despite the consistent decrease in mortality and DALYs associated with paralytic ileus and bowel obstruction in the elderly population aged ≥ 65 years, their incidence and prevalence continue to increase annually. This underscores the importance of improving preventive measures, early screening, and treatment efforts to address this pressing public health challenge.

Dyspepsia in nonagenarian women

PURPOSE

Dyspeptic complaints are common across all age groups, but limited research explores their characteristics and underlying pathologies in nonagenarians. This pioneering study aims to investigate the clinical, laboratory, and histopathological features in women nonagenarians vs. middle-aged.

METHODS

A cross-sectional study included 93 female nonagenarians and 90 under 65 years (control), all presenting with dyspeptic complaints to general surgery, internal medicine, and gastroenterology outpatient clinics. Both groups underwent comprehensive evaluations, including laboratory parameters, upper gastric endoscopic examinations, and histopathological assessments of gastric biopsies. Statistical analysis compared the two groups' demographic, laboratory, and histopathological findings.

RESULTS

Of the patients included in the study, 49.8% were under 65 years, and 50.2% were nonagenarians. The mean age of the control group was 54.8 years, while nonagenarians had a mean age of 92.7 years. Significant differences were observed in several laboratory biomarkers such as leukocytes, neutrophils, glucose, creatinine, sodium, potassium, albumin, alanine transaminase, C-reactive protein, etc. between the groups (p < 0.05). Nonagenarians were less infected with Helicobacter pylori, whereas they had a higher frequency of intestinal metaplasia.

CONCLUSIONS

Nonagenarians group has a higher rate of intestinal metaplasia and displasia, while a lower rate of Helicobacter pylori infection in their gastric mucosal specimens. More extensive randomized controlled trials should illuminate the possible pathophysiological mechanisms for this association.

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.

The senotherapeutic potential of phytochemicals for age-related intestinal disease

During the last few decades, life expectancy has increased worldwide along with the prevalence of several age-related diseases. Among aging pathways, cellular senescence and chronic inflammation (or "inflammaging") appear to be connected to gut homeostasis and dysbiosis of the microbiome. Cellular senescence is a state of essentially irreversible cell cycle arrest that occurs in response to stress. Although senescent cells (SC) remain metabolically active, they do not proliferate and can secrete inflammatory and other factors comprising the senescence-associated secretory phenotype (SASP). Accumulation of SCs has been linked to onset of several age-related diseases, in the brain, bones, the gastrointestinal tract, and other organs and tissues. The gut microbiome undergoes substantial changes with aging and is tightly interconnected with either successful (healthy) aging or disease. Senotherapeutic drugs are compounds that can clear senescent cells or modulate the release of SASP factors and hence attenuate the impact of the senescence-associated pro-inflammatory state. Phytochemicals, phenolic compounds and terpenes, which have antioxidant and anti-inflammatory activities, could also be senotherapeutic given their ability to act upon senescence-linked cellular pathways. The aim of this review is to dissect links among the gut microbiome, cellular senescence, inflammaging, and disease, as well as to explore phytochemicals as potential senotherapeutics, focusing on their interactions with gut microbiota. Coordinated targeting of these inter-related processes might unveil new strategies for promoting healthy aging.

Agar oligosaccharides improve the intestinal health of induced-aging mice by maintaining intestinal homeostasis via balancing the ISCs proliferation and differentiation

PURPOSE

Aging is a process that accompanies a decline in the function of various tissues and organs, especially affecting intestinal health. Agarose oligosaccharide (AOS) can prolong the lifespan of organisms and protect the intestine in the previous study. It was examined to evaluate the effects of AOS on intestinal health, and the potential associations between intestinal homeostasis and health status were further validated.

METHODS

D-galactose-induced aging mice were used to investigate the role of AOS in promoting intestinal health by determining intestinal physiology, microbiota and stem cells.

RESULTS

AOS supplementation decreased the clinical frailty index of aging mice with increasing intestinal length and crypt depth; moreover, it decreased the average flatulence index and PCNA protein content in the intestine. Besides, AOS contributed to the diversity of the gut microbiota by increasing the relative abundance of Bacteroidetes and other bacteria that could produce short-chain fatty acids. Furthermore, AOS affected the expression of proinflammatory factors in aging mice, promoting the proliferative equilibrium of intestinal stem cells.

CONCLUSION

These findings confirmed that AOS could improve intestinal health in aging mice by maintaining intestinal homeostasis, which provides new insights into the potential application of AOS as a prebiotic.

Crosstalk between gut microbiota and cellular senescence: a vicious cycle leading to aging gut

Two phenomena, the accumulation of senescent cells and changes in the gut microbiota, are thought to contribute to the decline of biological functions and the development of diseases associated with aging. However, the relationship between these two phenomena and their effects on aging remains to be clarified. Recently, we have reported that gut bacteria induce cellular senescence in ileal germinal center (GC) B cells, resulting in decreased IgA production and diversity. This, in turn, leads to an imbalance in the gut microbiota. Thus, the crosstalk between the gut microbiota and cellular senescence via the host immune system may establish a vicious cycle and contribute to the disruption of gut homeostasis associated with aging.

Tissue and cellular spatiotemporal dynamics in colon aging

Tissue structure and molecular circuitry in the colon can be profoundly impacted by systemic age-related effects, but many of the underlying molecular cues remain unclear. Here, we built a cellular and spatial atlas of the colon across three anatomical regions and 11 age groups, encompassing ~1,500 mouse gut tissues profiled by spatial transcriptomics and ~400,000 single nucleus RNA-seq profiles. We developed a new computational framework, cSplotch, which learns a hierarchical Bayesian model of spatially resolved cellular expression associated with age, tissue region, and sex, by leveraging histological features to share information across tissue samples and data modalities. Using this model, we identified cellular and molecular gradients along the adult colonic tract and across the main crypt axis, and multicellular programs associated with aging in the large intestine. Our multi-modal framework for the investigation of cell and tissue organization can aid in the understanding of cellular roles in tissue-level pathology.

Fasting mimicking diet extends lifespan and improves intestinal and cognitive health

Caloric restriction is an effective means of extending a healthy lifespan. Fasting mimicking diet (FMD) is a growing pattern of caloric restriction. We found that FMD significantly prolonged the lifespan of prematurely aging mice. In naturally aging mice, FMD improved cognitive and intestinal health. Through a series of behavioral experiments, we found that FMD relieved anxiety and enhanced cognition in aged mice. In the intestine, the FMD cycles enhanced the barrier function, reduced senescence markers, and maintained T cell naïve-memory balance in the lamina propria mucosa. To further explore the causes of immune alterations, we examined changes in the stool microbiota using 16S rRNA sequencing. We found that FMD remodeled gut bacterial composition and significantly expanded the abundance of Lactobacillus johnsonii. Our research revealed that FMD has in-depth investigative value as an anti-aging intervention for extending longevity and improving cognition, intestinal function, and gut microbiota composition.

Nonlinear DNA methylation trajectories in aging male mice

Although DNA methylation data yields highly accurate age predictors, little is known about the dynamics of this quintessential epigenomic biomarker during lifespan. To narrow the gap, we investigate the methylation trajectories of male mouse colon at five different time points of aging. Our study indicates the existence of sudden hypermethylation events at specific stages of life. Precisely, we identify two epigenomic switches during early-to-midlife (3-9 months) and mid-to-late-life (15-24 months) transitions, separating the rodents' life into three stages. These nonlinear methylation dynamics predominantly affect genes associated with the nervous system and enrich in bivalently marked chromatin regions. Based on groups of nonlinearly modified loci, we construct a clock-like classifier STageR (STage of aging estimatoR) that accurately predicts murine epigenetic stage. We demonstrate the universality of our clock in an independent mouse cohort and with publicly available datasets.

The loss of antioxidant activities impairs intestinal epithelium homeostasis by altering lipid metabolism

Reactive oxygens species (ROS) are common byproducts of metabolic reactions and could be at the origin of many diseases of the elderly. Here we investigated the role of ROS in the renewal of the intestinal epithelium in mice lacking catalase (CAT) and/or nicotinamide nucleotide transhydrogenase (NNT) activities. Cat-/- mice have delayed intestinal epithelium renewal and were prone to develop necrotizing enterocolitis upon starvation. Interestingly, crypts lacking CAT showed fewer intestinal stem cells (ISC) and lower stem cell activity than wild-type. In contrast, crypts lacking NNT showed a similar number of ISCs as wild-type but increased stem cell activity, which was also impaired by the loss of CAT. No alteration in the number of Paneth cells (PCs) was observed in crypts of either Cat-/- or Nnt-/- mice, but they showed an evident decline in the amount of lysozyme. Cat deficiency caused fat accumulation in crypts, and a fall in the remarkable high amount of adipose triglyceride lipase (ATGL) in PCs. Notably, the low levels of ATGL in the intestine of Cat -/- mice increased after a treatment with the antioxidant N-acetyl-L-cysteine. Supporting a role of ATGL in the regulation of ISC activity, its inhibition halt intestinal organoid development. These data suggest that the reduction in the renewal capacity of intestine originates from fatty acid metabolic alterations caused by peroxisomal ROS.

Evidence that the loss of colonic anti-microbial peptides may promote dysbiotic Gram-negative inflammaging-associated bacteria in aging mice

Introduction: Aging studies in humans and mice have played a key role in understanding the intestinal microbiome and an increased abundance of "inflammaging" Gram-negative (Gn) bacteria. The mechanisms underlying this inflammatory profile in the aging microbiome are unknown. We tested the hypothesis that an aging-related decrease in colonic crypt epithelial cell anti-microbial peptide (AMP) gene expression could promote colonic microbiome inflammatory Gn dysbiosis and inflammaging. Methods: As a model of aging, C57BL/6J mice fecal (colonic) microbiota (16S) and isolated colonic crypt epithelial cell gene expression (RNA-seq) were assessed at 2 months (mth) (human: 18 years old; yo), 15 mth (human: 50 yo), and 25 mth (human: 84 yo). Informatics examined aging-related microbial compositions, differential colonic crypt epithelial cell gene expressions, and correlations between colonic bacteria and colonic crypt epithelial cell gene expressions. Results: Fecal microbiota exhibited significantly increased relative abundances of pro-inflammatory Gn bacteria with aging. Colonic crypt epithelial cell gene expression analysis showed significant age-related downregulation of key AMP genes that repress the growth of Gn bacteria. The aging-related decrease in AMP gene expressions is significantly correlated with an increased abundance in Gn bacteria (dysbiosis), loss of colonic barrier gene expression, and senescence- and inflammation-related gene expression. Conclusion: This study supports the proposed model that aging-related loss of colonic crypt epithelial cell AMP gene expression promotes increased relative abundances of Gn inflammaging-associated bacteria and gene expression markers of colonic inflammaging. These data may support new targets for aging-related therapies based on intestinal genes and microbiomes.

Heat-inactivated Bifidobacterium adolescentis ameliorates colon senescence through Paneth-like-cell-mediated stem cell activation

Declined numbers and weakened functions of intestinal stem cells (ISCs) impair the integrity of the intestinal epithelium during aging. However, the impact of intestinal microbiota on ISCs in this process is unclear. Here, using premature aging mice (telomerase RNA component knockout, Terc-/-), natural aging mice, and in vitro colonoid models, we explore how heat-inactivated Bifidobacterium adolescentis (B. adolescentis) affects colon senescence. We find that B. adolescentis could mitigate colonic senescence-related changes by enhancing intestinal integrity and stimulating the regeneration of Lgr5+ ISCs via Wnt/β-catenin signaling. Furthermore, we uncover the involvement of Paneth-like cells (PLCs) within the colonic stem-cell-supporting niche in the B. adolescentis-induced ISC regeneration. In addition, we identify soluble polysaccharides (SPS) as potential effective components of B. adolescentis. Overall, our findings reveal the role of heat-inactivated B. adolescentis in maintaining the ISCs regeneration and intestinal barrier, and propose a microbiota target for ameliorating colon senescence.

Pharmacokinetics of Antibacterial Agents in the Elderly: The Body of Evidence

Infections are important factors contributing to the morbidity and mortality among elderly patients. High rates of consumption of antimicrobial agents by the elderly may result in increased risk of toxic reactions, deteriorating functions of various organs and systems and leading to the prolongation of hospital stay, admission to the intensive care unit, disability, and lethal outcome. Both safety and efficacy of antibiotics are determined by the values of their plasma concentrations, widely affected by physiologic and pathologic age-related changes specific for the elderly population. Drug absorption, distribution, metabolism, and excretion are altered in different extents depending on functional and morphological changes in the cardiovascular system, gastrointestinal tract, liver, and kidneys. Water and fat content, skeletal muscle mass, nutritional status, use of concomitant drugs are other determinants of pharmacokinetics changes observed in the elderly. The choice of a proper dosing regimen is essential to provide effective and safe antibiotic therapy in terms of attainment of certain pharmacodynamic targets. The objective of this review is to perform a structure of evidence on the age-related changes contributing to the alteration of pharmacokinetic parameters in the elderly.

Benefits of neutral polysaccharide from rhizomes of Polygonatum sibiricum to intestinal function of aged mice

One purified neutral polysaccharide fraction was obtained from the rhizome of Polygonatum sibiricum by DEAE ion exchange and gel chromatography. Structure elucidation was performed by methanolysis, methylation, FT-IR, and NMR. The results indicated that PSP-NP was composed of 1,4-β-D-Gal,1, 4, 6-β-D-Gal, T-α-D-Man,1, 4-α-D-Glc, and T-α-D-Glc with a molecular weight of 43.0 kDa. We supplied this polysaccharide to aged mice and found it is of benefits to intestinal functions, as indicated by better tissue integrity and motility, improved oxidative stress and inflammation, reduced intestinal permeability and serum LPS level, as well as balanced gut microbial composition and short-chain fatty acids production. These results display a novel Polygonatum sibiricum polysaccharide to improve the intestinal function of aged mice, which provides pieces of evidence for its further development and utilization.

Ischemic stroke and intestinal flora: an insight into brain-gut axis

Stroke is a type of cerebrovascular disease that significantly endangers human health and lowers quality of life. This understandably places a heavy burden on society and families. In recent years, intestinal flora has attracted increasing attention from scholars worldwide, and its association with ischemic stroke is becoming a hot topic of research amongst researchers in field of stroke. After suffering from a stroke, intestinal microbial dysbiosis leads to increased intestinal permeability and activation of the intestinal immune system, which in turn leads to ectopic intestinal bacteria and pro-inflammatory cells that enter brain tissue through the damaged blood-brain barrier. This exacerbates ischemia-reperfusion injury. Interestingly, after a stroke, some metabolites produced by the intestinal flora attenuate ischemia-reperfusion injury by suppressing the post-stroke inflammatory response and promotes the repair of neurological function. Here we elucidate the changes in gut flora after occurrence of a stroke and highlight the immunomodulatory processes of the post-stroke gut flora.