An aged immune system drives senescence and ageing of solid organs

Ageing of the immune system, or immunosenescence, contributes to the morbidity and mortality of the elderly1,2. To define the contribution of immune system ageing to organism ageing, here we selectively deleted Ercc1, which encodes a crucial DNA repair protein3,4, in mouse haematopoietic cells to increase the burden of endogenous DNA damage and thereby senescence5-7 in the immune system only. We show that Vav-iCre+/-;Ercc1-/fl mice were healthy into adulthood, then displayed premature onset of immunosenescence characterized by attrition and senescence of specific immune cell populations and impaired immune function, similar to changes that occur during ageing in wild-type mice8-10. Notably, non-lymphoid organs also showed increased senescence and damage, which suggests that senescent, aged immune cells can promote systemic ageing. The transplantation of splenocytes from Vav-iCre+/-;Ercc1-/fl or aged wild-type mice into young mice induced senescence in trans, whereas the transplantation of young immune cells attenuated senescence. The treatment of Vav-iCre+/-;Ercc1-/fl mice with rapamycin reduced markers of senescence in immune cells and improved immune function11,12. These data demonstrate that an aged, senescent immune system has a causal role in driving systemic ageing and therefore represents a key therapeutic target to extend healthy ageing.

Mesenchymal stem cell-derived extracellular vesicles reduce senescence and extend health span in mouse models of aging

Aging drives progressive loss of the ability of tissues to recover from stress, partly through loss of somatic stem cell function and increased senescent burden. We demonstrate that bone marrow-derived mesenchymal stem cells (BM-MSCs) rapidly senescence and become dysfunctional in culture. Injection of BM-MSCs from young mice prolonged life span and health span, and conditioned media (CM) from young BM-MSCs rescued the function of aged stem cells and senescent fibroblasts. Extracellular vesicles (EVs) from young BM-MSC CM extended life span of Ercc1^-/- mice similarly to injection of young BM-MSCs. Finally, treatment with EVs from MSCs generated from human ES cells reduced senescence in culture and in vivo, and improved health span. Thus, MSC EVs represent an effective and safe approach for conferring the therapeutic effects of adult stem cells, avoiding the risks of tumor development and donor cell rejection. These results demonstrate that MSC-derived EVs are highly effective senotherapeutics, slowing the progression of aging, and diseases driven by cellular senescence.

Exosomes as biomarkers and therapeutic tools for type 1 diabetes mellitus

Early diagnosis of diabetes mellitus can significantly improve therapeutic strategies and overall health span. Identifying biomarkers as a tool for determining the risk of developing diabetes as well as a monitoring strategy for progression of the disease state would be useful in predicting potential complications while simultaneously improving our ability to prevent and treat diabetes. Extracellular vesicles (EV) have recently emerged as prominent mediators of intercellular communication and as a potential source for the discovery of novel biomarkers. A deeper understanding of the cargo molecules present in EVs obtained from type 1 diabetes mellitus (T1D) patients may aid in the identification of novel diagnostic and prognostic biomarkers, and can potentially lead to the discovery of new therapeutic targets.

Using an intranet for physician desk top data consolidation

Kaleida Health developed one of the first web-based information delivery systems specific to patient care. Through an Intranet or secure dial-up connection, registered practitioners and staff access patient demographics, laboratory data, radiology results, and dictated reports. Additionally, standard forms, patient educational material, and other management information are available. The development team designed and wrote interfaces to existing systems and applications, designed security systems, instituted usage policies and procedures, and developed a name and logo. Since the program's launch in February of 1997, more than 800 users have been registered both in-house and off-site.

The bedfast

Many geriatric beds are occupied by bedfast patients. Most were immobile from the time of admission and many were admitted from other hospital departments or residential care. More are discharged home than remain in hospital or are transferred to any other institution. Although a small minority of admissions become long-term bedfast inpatients this group require a disproportionate resource commitment. Reduction in the number of bedfast inpatients is more likely to be effected by changes in unit policy than by improvement in clinical practice.

Epidemiology of infection by nontuberculous mycobacteria. V. Numbers in eastern United States soils and correlation with soil characteristics

Organisms of the Mycobacterium avium, M. intracellulare, and M. scrofulaceum (MAIS) group were recovered in significant numbers from 63 soil samples collected from the floodplains of 4 major rivers in the eastern United States: Hudson (NY), James (VA), Savannah (GA, SC), and Tombigbee (AL, MS). The mean numbers of M. avium-intracellulare, M. scrofulaceum, and MAIS-intermediate biovars recovered increased significantly from the Hudson to the James to the Tombigbee and Savannah soil samples, agreeing reasonably well with previous findings on MAIS distribution in eastern U.S. waters and with the geographic distribution of naval recruits reacting to PPD-B and PPD-G, which is higher in the southeastern United States. From the Savannah and Tombigbee rivers, soils were collected throughout their lengths. The number of total MAIS and biovars recovered from the different soil sites varied widely and showed no obvious trends. However, statistical analysis revealed a highly significant correlation between high numbers of MAIS recovered and high acidity of the soils. Other soil characteristics, such as high total organic matter, high conductivity, and reduced moisture, were only weakly, if at all, correlated with high MAIS numbers. Whereas the general distribution of MAIS in these soils of the Northeast (NY), mid-Atlantic (VA), and Southeast (GA, SC, AL, and MS) might explain the geographic distribution of the naval recruits reacting to PPD-B and PPD-G, the distribution of MAIS in soils along the stretches of the 2 southeastern rivers was not correlated with the county-by-county frequency of PPD-B reactive naval recruits in Georgia, South Carolina, Alabama, and Mississippi.

Recovery and survival of nontuberculous mycobacteria under various growth and decontamination conditions

The survival of microorganisms of the Mycobacterium avium, M. intracellulare, and M. scrofulaceum (MAIS) complex was evaluated after various soil and water decontamination regimens. Survival was reduced by growing cells in natural waters compared with laboratory media and by inclusion of malachite green in media as an antifungal agent. Decontamination with benzalkonium chloride, while reducing survival significantly less than 1% NaOH, failed to eliminate many fungi. Recovery from soil was further reduced by transfer losses and by irreversible cell adsorption onto particulates.