Translational Gerontology Branch, National Institute on Aging, NIH, Baltimore, MD, USA.
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Nat Rev Cardiol. 2018 Sep;15(9):505-522. doi: 10.1038/s41569-018-0064-2.
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.
大多数老年人都会出现炎症衰老现象，其特征是血液炎症标志物水平升高，易患慢性疾病、残疾、虚弱和早逝。炎症衰老的潜在机制包括遗传易感性、中心性肥胖、肠道通透性增加、微生物群落组成变化、细胞衰老、NLRP3 炎性体激活、功能失调的线粒体引起的氧化应激、免疫细胞失调和慢性感染。炎症衰老与心血管疾病 (CVD) 相关，临床试验表明这种关联具有因果关系。炎症衰老也是慢性肾病、糖尿病、癌症、抑郁症、痴呆症和肌肉减少症的危险因素，但调节炎症是否对非 CVD 健康问题的临床病程有益仍存在争议。这种不确定性是一个重要的问题，因为患有 CVD 的老年患者通常受到多种疾病和虚弱的影响，这些疾病和虚弱会影响临床表现、预后和治疗反应，并且与 CVD 类似的机制有关。炎症通过抑制生长因子、增加分解代谢和干扰体内平衡信号来影响 CVD、多种疾病和虚弱的假说得到了机制研究的支持，但仍需要在人类中得到证实。在临床试验中应该测试早期调节炎症衰老是否可以预防或延迟心血管虚弱的发生。
