Department of Molecular Medicine, University of Pavia, Pavia, Italy.
Neurogenetics Research Centre, IRCCS Mondino Foundation, Pavia, Italy.
Transl Psychiatry. 2024 Jul 9;14(1):281. doi: 10.1038/s41398-024-02991-z.
Frailty is a common age-related clinical syndrome characterized by a decline in the function of multiple organ systems, increased vulnerability to stressors, and a huge socio-economic burden. Despite recent research efforts, the physiopathological mechanisms underlying frailty remain elusive and biomarkers able to predate its occurrence in the early stages are still lacking. Beyond its physical component, cognitive decline represents a critical domain of frailty associated with higher risk of adverse health outcomes. We measured by High-Performance Liquid Chromatography (HPLC) a pool of serum amino acids including L-glutamate, L-aspartate, glycine, and D-serine, as well as their precursors L-glutamine, L-asparagine, and L-serine in a cohort of elderly subjects encompassing the entire continuum from fitness to frailty. These amino acids are known to orchestrate excitatory and inhibitory neurotransmission, and in turn, to play a key role as intermediates of energy homeostasis and in liver, kidney, muscle, and immune system metabolism. To comprehensively assess frailty, we employed both the Edmonton Frail Scale (EFS), as a practical tool to capture the multidimensionality of frailty, and the frailty phenotype, as a measure of physical function. We found that D-serine and D-/Total serine ratio were independent predictors of EFS but not of physical frailty. Furthermore, higher levels of glycine, glycine/L-serine and D-/Total serine were associated with worse cognition and depressive symptoms in the frail group. These findings suggest that changes in peripheral glycine and serine enantiomers homeostasis may represent a novel biochemical correlate of frailty.
衰弱是一种常见的与年龄相关的临床综合征,其特征是多器官系统功能下降、对压力源的易感性增加以及巨大的社会经济负担。尽管最近进行了研究,但衰弱的病理生理机制仍然难以捉摸,并且缺乏能够在早期预测其发生的生物标志物。除了身体成分外,认知能力下降是衰弱的一个关键领域,与不良健康结果的风险增加有关。我们通过高效液相色谱法(HPLC)测量了包括 L-谷氨酸、L-天冬氨酸、甘氨酸和 D-丝氨酸在内的一组血清氨基酸,以及它们的前体 L-谷氨酰胺、L-天冬酰胺和 L-丝氨酸,这些氨基酸在一个涵盖从健康到衰弱的整个连续体的老年人群体中进行了测量。这些氨基酸已知可以协调兴奋性和抑制性神经递质传递,进而作为能量稳态的中间物以及在肝脏、肾脏、肌肉和免疫系统代谢中发挥关键作用。为了全面评估衰弱,我们既使用了埃德蒙顿衰弱量表(EFS),作为一种实用工具来捕捉衰弱的多维性,又使用了衰弱表型,作为身体功能的衡量标准。我们发现 D-丝氨酸和 D-/总丝氨酸比值是 EFS 的独立预测因子,但不是身体衰弱的预测因子。此外,甘氨酸、甘氨酸/L-丝氨酸和 D-/总丝氨酸水平较高与虚弱组认知能力下降和抑郁症状有关。这些发现表明,外周甘氨酸和丝氨酸对映异构体稳态的变化可能是衰弱的一种新的生化相关性。
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