Casa Di Cura Prof. Nobili (Gruppo Garofalo (GHC)), Castiglione Dei Pepoli, Bologna, Italy.
Department of Geriatrics, Shanghai Institute of Geriatrics, Huadong Hospital, Fudan University, Shanghai, China.
Geroscience. 2024 Feb;46(1):113-127. doi: 10.1007/s11357-023-00947-7. Epub 2023 Oct 11.
Inflammaging refers to the age-related low grade, sterile, chronic, systemic, and long-lasting subclinical, proinflammatory status, currently recognized as the main risk factor for development and progression of the most common age-related diseases (ARDs). Extensive investigations were focused on a plethora of proinflammatory stimuli that can fuel inflammaging, underestimating and partly neglecting important endogenous anti-inflammaging mechanisms that could play a crucial role in such age-related proinflammatory state. Studies on autonomic nervous system (ANS) functions during aging highlighted an imbalance toward an overactive sympathetic nervous system (SNS) tone, promoting proinflammatory conditions, and a diminished parasympathetic nervous system (PNS) activity, playing anti-inflammatory effects mediated by the so called cholinergic anti-inflammatory pathway (CAP). At the molecular level, CAP is characterized by signals communicated via the vagus nerve (with the possible involvement of the splenic nerves) through acetylcholine release to downregulate the inflammatory actions of macrophages, key players of inflammaging. Notably, decreased vagal function and increased burden of activated/senescent macrophages (macrophaging) probably precede the development of several age-related risk factors and diseases, while increased vagal function and reduced macrophaging could be associated with relevant reduction of risk profiles. Hypothalamic-pituitary-adrenal axis (HPA axis) is another pathway related to ANS promoting some anti-inflammatory response mainly through increased cortisol levels. In this perspective review, we highlighted that CAP and HPA, representing broadly "anti-inflammaging" mechanisms, have a reduced efficacy and lose effectiveness in aged people, a phenomenon that could contribute to fuel inflammaging. In this framework, strategies aimed to re-balance PNS/SNS activities could be explored to modulate systemic inflammaging especially at an early subclinical stage, thus increasing the chances to reach the extreme limit of human lifespan in healthy status.
炎症衰老指的是与年龄相关的低度、非感染性、慢性、全身性和长期亚临床、促炎状态,目前被认为是大多数与年龄相关疾病(ARDs)发展和进展的主要危险因素。大量研究集中在大量促炎刺激物上,这些刺激物可以引发炎症衰老,而低估和部分忽视了重要的内源性抗炎衰老机制,这些机制可能在这种与年龄相关的炎症状态中发挥关键作用。对自主神经系统(ANS)在衰老过程中的功能的研究强调了向过度活跃的交感神经系统(SNS)紧张度的不平衡,促进了促炎状态,以及副交感神经系统(PNS)活性的降低,发挥了抗炎作用,这是由所谓的胆碱能抗炎途径(CAP)介导的。在分子水平上,CAP 的特征是通过迷走神经传递信号(可能涉及脾神经),通过释放乙酰胆碱来下调巨噬细胞的炎症作用,巨噬细胞是炎症衰老的关键参与者。值得注意的是,迷走神经功能下降和激活/衰老的巨噬细胞(巨噬细胞)负担增加可能先于几种与年龄相关的危险因素和疾病的发展,而迷走神经功能增加和巨噬细胞减少可能与相关的风险状况降低有关。下丘脑-垂体-肾上腺轴(HPA 轴)是另一条与 ANS 相关的促进一些抗炎反应的途径,主要通过增加皮质醇水平。在这篇综述中,我们强调了 CAP 和 HPA,它们代表了广泛的“抗炎衰老”机制,在老年人中其功效降低且失去效果,这种现象可能有助于引发炎症衰老。在这一框架内,探索旨在重新平衡 PNS/SNS 活动的策略可能有助于调节全身炎症衰老,特别是在早期亚临床阶段,从而增加在健康状态下达到人类寿命极限的机会。
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