Troen Bruce R
Department of Geriatrics and Adult Development, Bronx Veterans Administration Medical Center, Bronx, NY, USA.
Mt Sinai J Med. 2003 Jan;70(1):3-22.
In humans, aging is inexorable. The progressive decrease in physiological capacity and the reduced ability to respond to environmental stresses lead to increased susceptibility and vulnerability to disease. Consequently, mortality due to all causes increases exponentially with aging. Attempts at understanding the causes of aging are limited by the complexity of the problem. Aging changes are manifest from the molecular to the organismic level; environmental factors affect experimental observations; secondary effects complicate elucidation of primary mechanisms; and precisely defined, easily measurable biomarkers are lacking. No one unifying theory may exist, since the mechanisms of aging could be quite distinct in different organisms, tissues, and cells. Evolutionary pressures have selected for successful reproduction, making it likely that the post-reproductive physiology of an organism (i.e., aging) is an epigenetic and pleiotropic manifestation of the optimization for early fitness. Indeed, antagonistic pleiotropy, wherein genes that enhance early survival and function but are disadvantageous later in life, may play an overriding role in aging. Theories of aging can be divided into two general categories: stochastic and developmental-genetic. These are not mutually exclusive, particularly when considering the free radical/mitochondrial DNA theory of aging. Increasing evidence suggests that cellular senescence and organismic aging are antagonistically pleiotropic manifestations of evolutionary pressures to prevent malignant transformation. In other words, aging may be the price we pay to avoid cancer. The beneficial paradox may be that the maximum lifespan potential of humans may have been achieved, in part, due to our ability to grow old.
在人类中,衰老不可避免。生理能力的逐渐下降以及对环境压力反应能力的降低,导致对疾病的易感性和脆弱性增加。因此,各种原因导致的死亡率会随着衰老呈指数级上升。理解衰老原因的尝试受到该问题复杂性的限制。衰老变化在从分子到机体的各个层面都有体现;环境因素会影响实验观察结果;次要效应使主要机制的阐释变得复杂;而且缺乏精确界定、易于测量的生物标志物。可能不存在一个统一的理论,因为衰老机制在不同的生物体、组织和细胞中可能截然不同。进化压力选择了成功繁殖,这使得生物体的生殖后生理状态(即衰老)很可能是对早期适应性优化的一种表观遗传和多效性表现。事实上,拮抗性多效性,即那些增强早期生存和功能但在生命后期不利的基因,可能在衰老过程中起主导作用。衰老理论可大致分为两类:随机理论和发育 - 遗传理论。这两类理论并非相互排斥,尤其是在考虑衰老的自由基/线粒体DNA理论时。越来越多的证据表明,细胞衰老和机体衰老都是防止恶性转化的进化压力的拮抗性多效性表现。换句话说,衰老可能是我们为避免患癌而付出的代价。这个有益的悖论可能是,人类的最大寿命潜力在一定程度上可能正是由于我们有变老的能力才得以实现。