Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty

被引:2275
作者
Ferrucci, Luigi [1 ]
Fabbri, Elisa [2 ]
机构
[1] NIA, Translat Gerontol Branch, NIH, Baltimore, MD 21224 USA
[2] Univ Bologna, Dept Med & Surg Sci, Bologna, Italy
关键词
C-REACTIVE PROTEIN; TUMOR-NECROSIS-FACTOR; CORONARY-HEART-DISEASE; LOW-GRADE INFLAMMATION; GROWTH-FACTOR-I; HUMAN-IMMUNODEFICIENCY-VIRUS; RANDOMIZED CONTROLLED-TRIAL; AGE-RELATED INFLAMMATION; PLASMA IL-6 LEVELS; CD8(+) T-CELLS;
D O I
10.1038/s41569-018-0064-2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Most older individuals develop inflammageing, a condition characterized by elevated levels of blood inflammatory markers that carries high susceptibility to chronic morbidity, disability, frailty, and premature death. Potential mechanisms of inflammageing include genetic susceptibility, central obesity, increased gut permeability, changes to microbiota composition, cellular senescence, NLRP3 inflammasome activation, oxidative stress caused by dysfunctional mitochondria, immune cell dysregulation, and chronic infections. Inflammageing is a risk factor for cardiovascular diseases (CVDs), and clinical trials suggest that this association is causal. Inflammageing is also a risk factor for chronic kidney disease, diabetes mellitus, cancer, depression, dementia, and sarcopenia, but whether modulating inflammation beneficially affects the clinical course of non-CVD health problems is controversial. This uncertainty is an important issue to address because older patients with CVD are often affected by multimorbidity and frailty -which affect clinical manifestations, prognosis, and response to treatment - and are associated with inflammation by mechanisms similar to those in CVD. The hypothesis that inflammation affects CVD, multimorbidity, and frailty by inhibiting growth factors, increasing catabolism, and interfering with homeostatic signalling is supported by mechanistic studies but requires confirmation in humans. Whether early modulation of inflammageing prevents or delays the onset of cardiovascular frailty should be tested in clinical trials.
引用
收藏
页码:505 / 522
页数:18
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