Gems David
Institute of Healthy Ageing, and Genetics, Evolution and Environment, University College London, Gower Street, London WC1E 6BT, United Kingdom.
Exp Gerontol. 2014 Oct;58:14-8. doi: 10.1016/j.exger.2014.07.003. Epub 2014 Jul 11.
Key objectives of biogerontology are to understand the biology of aging and to translate scientific insight into interventions that improve late-life health - or anti-aging treatments. In this context, when considering the problem of how to effect translational research, it is useful to have a clear, consensus view on what exactly constitutes an anti-aging treatment. This essay critically assesses the understanding of this concept common among biogerontologists, and proposes a new definition. A current conception of anti-aging treatment imagines a primary cause of aging that is causally upstream of, and the cause of, all age-related pathology. Intervening in this aging process thus protects against the totality of age-related diseases. However, this underlying aging process remains an abstraction. By contrast, what is demonstrable is that interventions in model organisms can improve late-life health and extend lifespan. Furthermore, a safe deduction is that treatments that extend lifespan do so by reducing age-related pathology, both florid and subtle. What is currently identifiable about aging (i.e. senescence) is that it is a very complex disease syndrome, likely involving a number of biological mechanisms. Treatments that substantially extend lifespan must suppress multiple pathologies that otherwise limit lifespan, but whether they suppress the entire aging process remains undemonstrated. A more pragmatic and realistic definition of anti-aging treatment is any preventative approach to reduce late-life pathology, based on the understanding that senescence is a disease syndrome. This definition would encompass preventative approaches aimed at both broad and narrow spectra of age-related pathologies. Its adoption would facilitate translation, since it would shift the emphasis to medical practice, particularly the introduction of preventative approaches. Narrow spectrum anti-aging treatments (e.g. the cardiovascular polypill) could establish a practice that eventually extends to broader spectrum anti-aging treatments (e.g. dietary restriction mimetics).
生物老年学的主要目标是了解衰老生物学,并将科学见解转化为改善晚年健康的干预措施——即抗衰老治疗。在这种背景下,在考虑如何开展转化研究的问题时,对究竟什么构成抗衰老治疗有一个清晰、共识性的观点是很有用的。本文批判性地评估了生物老年学家中常见的对这一概念的理解,并提出了一个新的定义。当前对抗衰老治疗的一种概念设想是,存在一个衰老的主要原因,它在因果关系上处于所有与年龄相关的病理学的上游,并是其原因。因此,干预这个衰老过程就能预防所有与年龄相关的疾病。然而,这个潜在的衰老过程仍然是一个抽象概念。相比之下,可证明的是,对模式生物的干预可以改善晚年健康并延长寿命。此外,可以合理推断的是,延长寿命的治疗是通过减少明显和细微的与年龄相关的病理学来实现的。目前关于衰老(即衰老)可确定的是,它是一种非常复杂的疾病综合征,可能涉及多种生物学机制。能大幅延长寿命的治疗必须抑制多种否则会限制寿命的病理学,但它们是否抑制了整个衰老过程仍未得到证实。对抗衰老治疗更务实和现实的定义是,基于衰老为一种疾病综合征的认识,任何旨在减少晚年病理学的预防方法。这个定义将涵盖针对广泛和狭义的与年龄相关病理学的预防方法。采用这个定义将有助于转化研究,因为它将重点转向医疗实践,特别是预防方法的引入。狭义的抗衰老治疗(如心血管复方制剂)可以建立一种实践,最终扩展到广义的抗衰老治疗(如饮食限制模拟物)。