1
|
Ding J, Yang G, Sun W, Li Y, Wang N, Wang J, Zhao Y. Association of interleukin-6 with sarcopenia and its components in older adults: a systematic review and meta-analysis of cross-sectional studies. Ann Med 2024; 56:2384664. [PMID: 39172549 PMCID: PMC11342818 DOI: 10.1080/07853890.2024.2384664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/29/2024] [Accepted: 05/23/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND Observational studies have documented increased serum IL-6 levels in elderly individuals afflicted with sarcopenia. Nevertheless, the relationship between serum IL-6 concentrations and sarcopenia prevalence in the aging population is yet to be defined. METHODS We executed a systematic review and meta-analysis of cross-sectional studies that scrutinized serum IL-6 levels in older adults with and without sarcopenia. Relevant studies were sourced from PubMed, Scopus, Embase, Cochrane Library, and Web of Science from inception until 10 September 2023. The standard mean differences (SMDs) in serum IL-6 levels between studies were synthesized using a random-effects model. To examine the influence of demographic and clinical factors on these outcomes, we performed subgroup analyses and meta-regression, focusing on variables such as sex, age, and body mass index (BMI). We also assessed the relationship between serum IL-6 levels and the defining components of sarcopenia: muscle mass, muscle strength, and physical performance. We used Fisher's Z transformation to standardize the interpretation of effect sizes from these relationships. The transformed values were then converted to summary correlation coefficients (r) for a clear and unified summary of the results. RESULTS We included twenty-one cross-sectional studies involving 3,902 participants. Meta-analysis revealed significantly elevated serum IL-6 levels in older adults with sarcopenia compared with those without sarcopenia (SMD = 0.31; 95% CI 0.18, 0.44). The difference was highly pronounced in the subgroups of male and those with female percentage below 50% or a mean BMI below 24 kg/m2. Serum IL-6 levels were inversely correlated with muscle mass (summary r = -0.18; 95% CI -0.30, -0.06), but not with handgrip strength (summary r = -0.10; 95%CI: -0.25, 0.05) or gait speed (summary r = -0.09; 95%CI: -0.24, 0.07). CONCLUSIONS This meta-analysis establishes a link between increased serum IL-6 levels and sarcopenia in the elderly, particularly in relation to decreased muscle mass.
Collapse
Affiliation(s)
- Jie Ding
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, P.R. China
- Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, P.R. China
| | - Guangyue Yang
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, P.R. China
- Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, P.R. China
| | - Wen Sun
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, P.R. China
- Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, P.R. China
| | - Yifei Li
- Shanghai University of Traditional Chinese Medicine, Shanghai, P.R. China
- Shanghai Seventh People’s Hospital, Shanghai, P.R. China
| | - Ning Wang
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, P.R. China
- Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, P.R. China
| | - Jiening Wang
- Shanghai Seventh People’s Hospital, Shanghai, P.R. China
| | - Yongfang Zhao
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, P.R. China
- Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, P.R. China
| |
Collapse
|
2
|
Bozzetti F. Age-related and cancer-related sarcopenia: is there a difference? Curr Opin Clin Nutr Metab Care 2024; 27:410-418. [PMID: 38488242 DOI: 10.1097/mco.0000000000001033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
PURPOSE OF REVIEW The aim of this review is the attempt to differentiating the pathophysiologic and clinical features of the aging-related sarcopenia from cancer-related sarcopenia. In fact, there is some controversy among the experts mainly regarding two points: is always sarcopenia, even that aging-related one, the expression of a generalized disease or may exist independently and without major alteration of the muscle function? Are always aging-related and cancer-related sarcopenia completely separated entities? RECENT FINDINGS Literature shows that sarcopenia, defined as simple skeletal muscle mass loss, may range from a mainly focal problem which is common in many healthy elderly people, to a component of a complex multiorgan syndrome as cancer cachexia. Disuse, malnutrition and (neuro)degenerative processes can account for most of the aging-related sarcopenias while systemic inflammation and secretion of cancer-and immune-related molecules play an additional major role in cachexia. SUMMARY A multimodal approach including physical exercise and optimized nutritional support are the key measures to offset sarcopenia with some contribution by the anti-inflammatory drugs in cancer patients. Results are more promising in elderly patients and are still pending for cancer patients where a more specific approach will only rely on the identification and contrast of the key mediators of the cachectic process.
Collapse
|
3
|
Lin CL, Chen HC, Huang MH, Huang SW, Liao CD. Comparative Efficacy of Various Exercise Therapies and Combined Treatments on Inflammatory Biomarkers and Morphological Measures of Skeletal Muscle among Older Adults with Knee Osteoarthritis: A Network Meta-Analysis. Biomedicines 2024; 12:1524. [PMID: 39062097 PMCID: PMC11275072 DOI: 10.3390/biomedicines12071524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/25/2024] [Accepted: 07/06/2024] [Indexed: 07/28/2024] Open
Abstract
Osteoarthritis is associated with high risks of sarcopenia in older populations. Exercise interventions are promising treatments for musculoskeletal impairments in knee osteoarthritis (KOA). The purpose of this study was to identify the comparative effects of exercise monotherapy and its adjunct treatments on muscle volume and serum inflammation for older individuals with KOA. A literature search in the electronic databases was comprehensively performed from this study's inception until April 2024 to identify relevant randomized controlled trials (RCTs) that reported muscle morphology and inflammation outcomes after exercise. The included RCTs were analyzed through a frequentist network meta-analysis (NMA). The standard mean difference (SMD) with a 95% confidence interval was estimated for treatment effects on muscle morphology and inflammation biomarkers. The relative effects on each main outcome among all treatment arms were compared using surface under the cumulative ranking (SUCRA) scores. The certainty of evidence (CoE) was assessed by the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) ranking system. Probable moderators of the treatment efficacy were investigated by network meta-regression analysis. This study included 52 RCTs (4255 patients) for NMA. Among the 27 identified treatment arms, isokinetic training plus physical modality as well as low-load resistance training plus blood-flow restriction yielded the most optimal treatment for inflammation reduction (-1.89; SUCRA = 0.97; CoE = high) and muscle hypertrophy (SMD = 1.28; SUCRA = 0.94; CoE = high). The patient's age (β = -0.73), the intervention time (β = -0.45), and the follow-up duration (β = -0.47) were identified as significant determinants of treatment efficacy on muscle hypertrophy. Exercise therapy in combination with noninvasive agents exert additional effects on inflammation reduction and muscle hypertrophy compared to its corresponding monotherapies for the KOA population. However, such treatment efficacy is likely moderated by the patient's age, the intervention time, and the follow-up duration.
Collapse
Affiliation(s)
- Che-Li Lin
- Department of Orthopedic Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Hung-Chou Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Mao-Hua Huang
- Department of Biochemistry, University of Washington, Seattle, WA 98015, USA
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
| | - Chun-De Liao
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- International Ph.D. Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei 110301, Taiwan
| |
Collapse
|
4
|
He S, Meng D, Wei M, Guo H, Yang G, Wang Z. Proposal and validation of a new approach in tele-rehabilitation with 3D human posture estimation: a randomized controlled trial in older individuals with sarcopenia. BMC Geriatr 2024; 24:586. [PMID: 38977995 PMCID: PMC11232209 DOI: 10.1186/s12877-024-05188-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 07/01/2024] [Indexed: 07/10/2024] Open
Abstract
OBJECTIVE Through a randomized controlled trial on older adults with sarcopenia, this study compared the training effects of an AI-based remote training group using deep learning-based 3D human pose estimation technology with those of a face-to-face traditional training group and a general remote training group. METHODS Seventy five older adults with sarcopenia aged 60-75 from community organizations in Changchun city were randomly divided into a face-to-face traditional training group (TRHG), a general remote training group (GTHG), and an AI-based remote training group (AITHG). All groups underwent a 3-month program consisting of 24-form Taichi exercises, with a frequency of 3 sessions per week and each session lasting 40 min. The participants underwent Appendicular Skeletal Muscle Mass Index (ASMI), grip strength, 6-meter walking pace, Timed Up and Go test (TUGT), and quality of life score (QoL) tests before the experiment, during the mid-term, and after the experiment. This study used SPSS26.0 software to perform one-way ANOVA and repeated measures ANOVA tests to compare the differences among the three groups. A significance level of p < 0.05 was defined as having significant difference, while p < 0.01 was defined as having a highly significant difference. RESULTS (1) The comparison between the mid-term and pre-term indicators showed that TRHG experienced significant improvements in ASMI, 6-meter walking pace, and QoL (p < 0.01), and a significant improvement in TUGT timing test (p < 0.05); GTHG experienced extremely significant improvements in 6-meter walking pace and QoL (p < 0.01); AITHG experienced extremely significant improvements in ASMI, 6-meter walking pace, and QoL (p < 0.01), and a significant improvement in TUGT timing test (p < 0.05). (2) The comparison between the post-term and pre-term indicators showed that TRHG experienced extremely significant improvements in TUGT timing test (p < 0.01); GTHG experienced significant improvements in ASMI and TUGT timing test (p < 0.05); and AITHG experienced extremely significant improvements in TUGT timing test (p < 0.01). (3) During the mid-term, there was no significant difference among the groups in all tests (p > 0.05). The same was in post-term tests (p > 0.05). CONCLUSION Compared to the pre-experiment, there was no significant difference at the post- experiment in the recovery effects on the muscle quality, physical activity ability, and life quality of patients with sarcopenia between the AI-based remote training group and the face-to-face traditional training group. 3D pose estimation is equally as effective as traditional rehabilitation methods in enhancing muscle quality, functionality and life quality in older adults with sarcopenia. TRIAL REGISTRATION The trial was registered in ClinicalTrials.gov (NCT05767710).
Collapse
Affiliation(s)
- Shichun He
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China
| | - Deyu Meng
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China
| | - Meiqi Wei
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China
| | - Hongzhi Guo
- AI Group, Intelligent Lancet LLC, Sacramento, CA, 95816, USA
- Graduate School of Human Sciences, Waseda University, Tokorozawa, 3591192, Aitama, Japan
| | - Guang Yang
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China.
| | - Ziheng Wang
- Chinese Center of Exercise Epidemiology, Northeast Normal University, Renmin Street, Changchun, 130024, Jilin, China.
- AI Group, Intelligent Lancet LLC, Sacramento, CA, 95816, USA.
- Advanced Research Center for Human Sciences, Waseda University, Tokorozawa, 3591192, Aitama, Japan.
| |
Collapse
|
5
|
da Costa Teixeira LA, Soares LA, Lima LP, Avelar NCP, de Moura JA, Leopoldino AAO, Figueiredo PHS, Parentoni AN, Mendonça VA, Lacerda ACR. Cognitive function is associated with performance in time up and go test and with leptin blood levels in community-dwelling older women. Sci Rep 2024; 14:9841. [PMID: 38684691 PMCID: PMC11058236 DOI: 10.1038/s41598-024-60274-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 04/21/2024] [Indexed: 05/02/2024] Open
Abstract
Considering the challenge that cognitive dysfunction and dementia represent to health is imperative to prioritize early diagnosis strategies and explore the pathophysiological mechanisms. There is no consensus on specific markers and physical tests that indicate cognitive decline in older. The objective of this study was to evaluate a panel of inflammatory biomarkers and physical function and investigate their association with cognitive function in community-dwelling older women. Seventy-one participants were included in this study. Cognitive function was assessed by Mini Mental State Examination, muscle strength using dynamometer, body composition using Dual X-ray absorptiometry, respiratory muscle strength using manuvacuometer, and physical function using the Short Physical Performance Battery and Time Up and Go (TUG) tests. Blood samples were collected to analyze a panel of inflammatory biomarkers. The cognitive function was associated with TUG (β = - 0.48; 95%IC = - 0.54 to - 0.21; p < 0.001), inspiratory muscle strength (β = 0.30; 95%IC = 0.005-0.03; p = 0.009), and leptin concentrations (β = 0.32; 95% IC = 0.001-0.006; 0.007). Time spent on TUG test and leptin levels accounted for 27% of variability in cognitive function independent of age. Poorer physical function with leptin plasma levels is associated with decreased cognitive function in older women. These findings contribute to comprehension of pathophysiology underlying cognitive decline and informing the development of new approaches to prevent, diagnose, monitoring and treat cognitive decline in aging.
Collapse
Affiliation(s)
- Leonardo Augusto da Costa Teixeira
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Luana Aparecida Soares
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Liliana Pereira Lima
- Programa de Pós-Graduação em Ciências Fisiológicas (PPGCF), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | | | - Julia Araújo de Moura
- Programa de Pós-Graduação em Educação Física (PPGEF-UnB), Universidade de Brasília, Brasília, DF, Brazil
| | | | - Pedro Henrique Scheidt Figueiredo
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Adriana Netto Parentoni
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Vanessa Amaral Mendonça
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil.
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil.
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil.
| |
Collapse
|
6
|
Augusto da Costa Teixeira L, Rocha-Vieira E, Aparecida Soares L, Mota de Oliveira F, Aparecida Oliveira Leopoldino A, Netto Parentoni A, Amaral Mendonça V, Cristina Rodrigues Lacerda A. The strong inverse association between plasma concentrations of soluble tumor necrosis factor receptors type 1 with adiponectin/leptin ratio in older women. Cytokine 2024; 176:156512. [PMID: 38281360 DOI: 10.1016/j.cyto.2024.156512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/27/2023] [Accepted: 01/16/2024] [Indexed: 01/30/2024]
Abstract
Complex inflammatory crosstalk between muscular and adipose organs during ageing is controlled by adipokines and myokines. The Adiponectin/Leptin ratio (A/L ratio) has proven to be a promising biomarker for identifying insulin sensitivity, cardiovascular risk and adipose tissue inflammation. Although the A/L ratio has been related to inflammatory conditions, its ability to associate with or indicate the behavior of other inflammatory mediators remains unknown. The present study aimed to verify the association between the A/L ratio and a panel of inflammatory biomarkers in community-dwelling older women. The plasmatic concentrations of adiponectin, leptin, resistin, brain-derived neurotrophic factor (BDNF), interferon-gamma (IFN-γ), interleukins 2, 4, 5, 6, 8 and 10, tumour necrosis factor (TNF) and its soluble receptors (sTNF-r) 1 and 2 were evaluated in 71 community-dwelling older women with 75 (±7) years. The A/L ratio was negative and inverse correlated with BNDF (r = -0.29; p = 0.01), IL-8 (r = -0.37; p = 0.001) and sTNFr- 1 (r = -0.98; p < 0.001) levels. A strong and inverse association, with proportional effect, between A/L ratio and sTNFr-1 concentrations was found (Adjusted R2 = 0.22; β = -0.48; p > 0.001). It suggests that the presence of sTNFr-1 causes an inflammatory effect that affect cross-talk between muscle and adipose tissue, contributing to pro-inflammatory imbalance, which may have molecular and functional consequences. In addition, we provide insights into diagnostic biomarkers for inflammation, especially related to muscle wasting and intrinsic capacity in older people.
Collapse
Affiliation(s)
- Leonardo Augusto da Costa Teixeira
- Programa de pós-graduação em ciências da saúde da UFVJM, Brazil; Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil
| | - Etel Rocha-Vieira
- Programa de pós-graduação em ciências da saúde da UFVJM, Brazil; Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil; Faculdade de Medicina do campus JK da UFVJM, Brazil
| | - Luana Aparecida Soares
- Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil; Programa de pós-graduação em Reabilitação e Desempenho Funcional da UFVJM, Brazil
| | | | | | | | - Vanessa Amaral Mendonça
- Programa de pós-graduação em ciências da saúde da UFVJM, Brazil; Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil; Faculdade de Medicina do campus JK da UFVJM, Brazil; Programa de pós-graduação em Reabilitação e Desempenho Funcional da UFVJM, Brazil; Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Programa de pós-graduação em ciências da saúde da UFVJM, Brazil; Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil; Faculdade de Medicina do campus JK da UFVJM, Brazil; Programa de pós-graduação em Reabilitação e Desempenho Funcional da UFVJM, Brazil; Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil.
| |
Collapse
|
7
|
Abbate V, Troise S, Togo G, Barone S, Bonavolontà P, Pacella D, Vaira LA, Committeri U, Tel A, Ugga L, Robiony M, Califano L, Orabona GD. Impact of Sarcopenia on Survival of Patients With Malignant Salivary Glands Tumors. Otolaryngol Head Neck Surg 2024; 170:837-844. [PMID: 38031504 DOI: 10.1002/ohn.608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/06/2023] [Accepted: 11/14/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE Malignant salivary glands tumors (MSGTs) are a quite rare and heterogeneous group of tumors. Management of these lesions remains controversial and challenging. Thus, finding new prognostic factors that can help to guide the decision-making process, appears to be paramount. The aim of this study was to evaluate the prognostic performance of preoperative sarcopenia to stratify MSGTs patients at high risk of disease progression. STUDY DESIGN Retrospective study. SETTING A single-institution analysis (Maxillo-facial Surgery Unit, University of Naples Federico II). METHODS The study consists of a retrospective analysis of 74 patients surgically treated for MSGTs. For all patients, the skeletal muscle index (SMI) was calculated and sarcopenia was defined as SMI < 41 in females and <43 in males. The correlation between sarcopenia and tumor variables was analyzed. The prognostic performance of sarcopenia was evaluated through survival Kaplan-Meier curves. RESULTS Sarcopenia resulted statistically related to age (P < .001), tumor size (P < .001), lymph node metastases (P < .001), and American Joint Committee on Cancer tumor, node, metastasis stage (P < .001). Kaplan-Meier survival curves show that 47.3% of sarcopenic patients died before their final follow-up. CONCLUSION Data obtained from our study seem to confirm the correlation between sarcopenia and other high-risk features. The early detection of sarcopenia in patients with negative prognostic factors could be used to implement the support therapeutic strategies aimed at restore the clinical conditions of the patients. Sarcopenia may be routinely investigated before surgery to suggest the implementation of precautionary therapeutic strategies to improve the standard treatment response, reducing possible complications.
Collapse
Affiliation(s)
- Vincenzo Abbate
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University of Naples Federico II, Naples, Italy
| | - Stefania Troise
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University of Naples Federico II, Naples, Italy
| | - Giulia Togo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University of Naples Federico II, Naples, Italy
| | - Simona Barone
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University of Naples Federico II, Naples, Italy
| | - Paola Bonavolontà
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University of Naples Federico II, Naples, Italy
| | - Daniela Pacella
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Luigi Angelo Vaira
- Department of Medicine, Surgery and Pharmacy, Maxillo Facial Unit, University Hospital of Sassari, Sassari, Italy
| | - Umberto Committeri
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University of Naples Federico II, Naples, Italy
| | - Alessandro Tel
- Department of Medicine, Maxillofacial Surgery Unit, University Hospital of Udine Santa Maria della Misericordia, Udine, Italy
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Massimo Robiony
- Department of Medicine, Maxillofacial Surgery Unit, University Hospital of Udine Santa Maria della Misericordia, Udine, Italy
| | - Luigi Califano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University of Naples Federico II, Naples, Italy
| | - Giovanni Dell'Aversana Orabona
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University of Naples Federico II, Naples, Italy
| |
Collapse
|
8
|
Tan LF, Chan YH, Denishkrshna A, Merchant RA. Association between different skeletal muscle mass indices, physical function, and inflammation in obese pre-frail older adults. Arch Gerontol Geriatr 2024; 118:105289. [PMID: 38043454 DOI: 10.1016/j.archger.2023.105289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/31/2023] [Accepted: 11/25/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVES There is lack of consensus on measurement of muscle mass and quality in obese older adults. We aim to evaluate the association of four muscle mass indices (appendicular skeletal muscle mass (ASM) over height2(ASMIht), ASM/weight (ASMwt), ASM/body fat percentage (ASMbfp)and ASM/body mass index (BMI) ASMIbmi) with physical function and inflammation in pre-frail obese older adults. METHODS Cross-sectional study of 407 community dwelling pre-frail older adults. Data on demographics, cognition, and physical function(gait speed, handgrip strength (HGS) and Short Physical Performance Battery (SPPB) test), body composition and inflammation biomarkers were collected. Participants were analysed based on BMI tertiles(T1 lowest,T3 highest). RESULTS The mean age was 72.67 years, mean BMI 25.42 kg/m2 and 59.5 % were females. Participants in T3 had a mean BMI of 30.75 kg/m2, younger with lower education levels, multimorbidity, polypharmacy and lower prevalence of sarcopenia. In BMI T3, ASMIbmi was significantly associated with EQ-5D index (β 0.53, 95 % CI 0.04 to 1.03, p = 0.033),HGS (β 5.28, 95 % CI 0.27 to 10.29, p = 0.039), SPPB (β 2.19, 95 % CI 0.47 to 3.91, p = 0.013) and IL-6 (β -4.13, 95 % CI -7.46 to -0.81, p = 0.017). ASMIwt was associated with EQ-5D index (β 0.17, 95 % CI 0.02 - 0.33, p = 0.047). ASMbfp was associated with HGS (β 6.97, 95 % CI 0.051 to 13.92, p = 0.049). There was significant association of HGS with all muscle mass indices in BMI T2, and ASMbfpin BMI T1. CONCLUSION ASMIbmi was significantly associated with SPPB, HGS, EQ-5D index and IL-6 in BMI T3. ASMbfp was associated with HGS in all the tertiles. Our results need further validation at population level.
Collapse
Affiliation(s)
- Li Feng Tan
- Healthy Ageing Programme, Alexandra Hospital, National University Health System, Singapore
| | - Yiong Huak Chan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - A Denishkrshna
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Reshma Aziz Merchant
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Geriatric Medicine, Department of Medicine, National University Hospital, 1E Kent Ridge Road, Singapore 119228, Singapore.
| |
Collapse
|
9
|
Rentflejsz J, Wojszel ZB. Diabetes Mellitus Should Be Considered While Analysing Sarcopenia-Related Biomarkers. J Clin Med 2024; 13:1107. [PMID: 38398421 PMCID: PMC10889814 DOI: 10.3390/jcm13041107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/02/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024] Open
Abstract
Sarcopenia is a chronic, progressive skeletal muscle disease characterised by low muscle strength and quantity or quality, leading to low physical performance. Patients with type 2 diabetes mellitus (T2DM) are more at risk of sarcopenia than euglycemic individuals. Because of several shared pathways between the two diseases, sarcopenia is also a risk factor for developing T2DM in older patients. Various biomarkers are under investigation as potentially valuable for sarcopenia diagnosis and treatment monitoring. Biomarkers related to sarcopenia can be divided into markers evaluating musculoskeletal status (biomarkers specific to muscle mass, markers of the neuromuscular junction, or myokines) and markers assuming causal factors (adipokines, hormones, and inflammatory markers). This paper reviews the current knowledge about how diabetes and T2DM complications affect potential sarcopenia biomarker concentrations. This review includes markers recently proposed by the expert group of the European Society for the Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) as those that may currently be useful in phase II and III clinical trials of sarcopenia: myostatin (MSTN); follistatin (FST); irisin; brain-derived neurotrophic factor (BDNF); procollagen type III N-terminal peptide (PIIINP; P3NP); sarcopenia index (serum creatinine to serum cystatin C ratio); adiponectin; leptin; insulin-like growth factor-1 (IGF-1); dehydroepiandrosterone sulphate (DHEAS); C-reactive protein (CRP); interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α). A better understanding of factors influencing these biomarkers' levels, including diabetes and diabetic complications, may lead to designing future studies and implementing results in clinical practice.
Collapse
Affiliation(s)
- Justyna Rentflejsz
- Doctoral School, Medical University of Bialystok, 15-089 Bialystok, Poland
- Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland;
| | - Zyta Beata Wojszel
- Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland;
| |
Collapse
|
10
|
Ko JS, Chang BY, Choi YJ, Choi JS, Kwon HY, Lee JY, Kim SY, Choung SY. Ashwagandha Ethanol Extract Attenuates Sarcopenia-Related Muscle Atrophy in Aged Mice. Nutrients 2024; 16:157. [PMID: 38201986 PMCID: PMC10781061 DOI: 10.3390/nu16010157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/23/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
The investigation focused on the impact of Withania somnifera (ashwagandha) extract (WSE) on age-related mechanisms affecting skeletal muscle sarcopenia-related muscle atrophy in aged mice. Beyond evaluating muscular aspects, the study explored chronic low-grade inflammation, muscle regeneration, and mitochondrial biogenesis. WSE administration, in comparison to the control group, demonstrated no significant differences in body weight, diet, or water intake, affirming its safety profile. Notably, WSE exhibited a propensity to reduce epidermal and abdominal fat while significantly increasing muscle mass at a dosage of 200 mg/kg. The muscle-to-fat ratio, adjusted for body weight, increased across all treatment groups. WSE administration led to a reduction in the pro-inflammatory cytokines TNF-α and IL-1β, mitigating inflammation-associated muscle atrophy. In a 12-month-old mouse model equivalent to a 50-year-old human, WSE effectively preserved muscle strength, stabilized grip strength, and increased muscle tissue weight. Positive effects were observed in running performance and endurance. Mechanistically, WSE balanced muscle protein synthesis/degradation, promoted fiber differentiation, and enhanced mitochondrial biogenesis through the IGF-1/Akt/mTOR pathway. This study provides compelling evidence for the anti-sarcopenic effects of WSE, positioning it as a promising candidate for preventing sarcopenia pending further clinical validation.
Collapse
Affiliation(s)
- Jin-Sung Ko
- Department of Biomedical Science & BK21 Four NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 31116, Chungnam, Republic of Korea; (J.-S.K.); (Y.-J.C.)
| | - Bo-Yoon Chang
- Institute of Pharmaceutical Research and Development, College of Pharmacy, Wonkwang University, Iksan 54538, Jeonbuk, Republic of Korea; (B.-Y.C.); (S.-Y.K.)
| | - Young-Ju Choi
- Department of Biomedical Science & BK21 Four NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan 31116, Chungnam, Republic of Korea; (J.-S.K.); (Y.-J.C.)
| | - Ji-Soo Choi
- R&D Center, NSTbio Co., Ltd., 32 Songdogwahak-ro, Yeonsu-gu, Incheon 21984, Republic of Korea; (J.-S.C.); (H.-Y.K.); (J.-Y.L.)
| | - Hee-Yeon Kwon
- R&D Center, NSTbio Co., Ltd., 32 Songdogwahak-ro, Yeonsu-gu, Incheon 21984, Republic of Korea; (J.-S.C.); (H.-Y.K.); (J.-Y.L.)
| | - Jae-Yeon Lee
- R&D Center, NSTbio Co., Ltd., 32 Songdogwahak-ro, Yeonsu-gu, Incheon 21984, Republic of Korea; (J.-S.C.); (H.-Y.K.); (J.-Y.L.)
| | - Sung-Yeon Kim
- Institute of Pharmaceutical Research and Development, College of Pharmacy, Wonkwang University, Iksan 54538, Jeonbuk, Republic of Korea; (B.-Y.C.); (S.-Y.K.)
| | - Se-Young Choung
- Department of Preventive Pharmacy, College of Pharmacy, Dankook University, Cheonan 31116, Chungnam, Republic of Korea
| |
Collapse
|
11
|
Granic A, Suetterlin K, Shavlakadze T, Grounds M, Sayer A. Hallmarks of ageing in human skeletal muscle and implications for understanding the pathophysiology of sarcopenia in women and men. Clin Sci (Lond) 2023; 137:1721-1751. [PMID: 37986616 PMCID: PMC10665130 DOI: 10.1042/cs20230319] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/01/2023] [Accepted: 11/14/2023] [Indexed: 11/22/2023]
Abstract
Ageing is a complex biological process associated with increased morbidity and mortality. Nine classic, interdependent hallmarks of ageing have been proposed involving genetic and biochemical pathways that collectively influence ageing trajectories and susceptibility to pathology in humans. Ageing skeletal muscle undergoes profound morphological and physiological changes associated with loss of strength, mass, and function, a condition known as sarcopenia. The aetiology of sarcopenia is complex and whilst research in this area is growing rapidly, there is a relative paucity of human studies, particularly in older women. Here, we evaluate how the nine classic hallmarks of ageing: genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communication contribute to skeletal muscle ageing and the pathophysiology of sarcopenia. We also highlight five novel hallmarks of particular significance to skeletal muscle ageing: inflammation, neural dysfunction, extracellular matrix dysfunction, reduced vascular perfusion, and ionic dyshomeostasis, and discuss how the classic and novel hallmarks are interconnected. Their clinical relevance and translational potential are also considered.
Collapse
Affiliation(s)
- Antoneta Granic
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, U.K
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, U.K
| | - Karen Suetterlin
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, U.K
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, U.K
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Centre for Life, Newcastle upon Tyne, U.K
| | - Tea Shavlakadze
- Regeneron Pharmaceuticals Inc., Tarrytown, New York, NY, U.S.A
| | - Miranda D. Grounds
- Department of Anatomy, Physiology and Human Biology, School of Human Sciences, the University of Western Australia, Perth, WA 6009, Australia
| | - Avan A. Sayer
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, U.K
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, U.K
| |
Collapse
|
12
|
Bellanti F, Lo Buglio A, Quiete S, Dobrakowski M, Kasperczyk A, Kasperczyk S, Vendemiale G. Sarcopenia Is Associated with Changes in Circulating Markers of Antioxidant/Oxidant Balance and Innate Immune Response. Antioxidants (Basel) 2023; 12:1992. [PMID: 38001845 PMCID: PMC10669556 DOI: 10.3390/antiox12111992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/04/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
(1) Background: The involvement of redox balance alterations and innate immunity is suggested to play a key role in the pathogenesis of sarcopenia. This investigation aimed to define and relate modifications in circulating markers of redox homeostasis and the innate immune response in human sarcopenia. (2) Methods: A total of 32 subjects aged >65 years old and affected by sarcopenia according to the second "European Working Group on sarcopenia in older people" guidelines were compared with 40 non-sarcopenic age-matched controls. To assess systemic redox homeostasis, reduced (GSH) and oxidized (GSSG) blood glutathione and plasma malondialdehyde (MDA)- and 4-hydroxy-2,3-nonenal (HNE)-protein adducts were measured. Immune cells and circulating interleukins were determined to compare the innate immune response between both groups. (3) Results: Impaired redox balance in sarcopenic patients, characterized by a high blood GSSG/GSH ratio and plasma MDA/HNE-protein adducts, was sustained by reduced antioxidants in peripheral blood mononuclear cells. Furthermore, sarcopenic patients showed higher neutrophil-to-lymphocyte ratios and interleukin (IL)-4, IL-6, IL-10, and tumor necrosis factor (TNF) with respect to non-sarcopenic patients. Linear regression analysis resulted in a strong association between redox balance and immune response markers in the sarcopenic group. (4) Conclusions: These results support the interplay between redox homeostasis alteration and disruption of the innate immune response in the pathogenesis of sarcopenia.
Collapse
Affiliation(s)
- Francesco Bellanti
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (A.L.B.); (S.Q.); (G.V.)
| | - Aurelio Lo Buglio
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (A.L.B.); (S.Q.); (G.V.)
| | - Stefano Quiete
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (A.L.B.); (S.Q.); (G.V.)
| | - Michał Dobrakowski
- Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-800 Katowice, Poland; (M.D.); (A.K.); (S.K.)
| | - Aleksandra Kasperczyk
- Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-800 Katowice, Poland; (M.D.); (A.K.); (S.K.)
| | - Sławomir Kasperczyk
- Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-800 Katowice, Poland; (M.D.); (A.K.); (S.K.)
| | - Gianluigi Vendemiale
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (A.L.B.); (S.Q.); (G.V.)
| |
Collapse
|
13
|
Aljawini N, Habib SS. Estimation of Sarcopenia Indices in Women from Saudi Arabia in Relation to Menopause and Obesity: Cross-Sectional Comparative Study. J Clin Med 2023; 12:6642. [PMID: 37892780 PMCID: PMC10607446 DOI: 10.3390/jcm12206642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
Sarcopenia prevalence depends on the definition, and ethnicity must be considered when setting reference values. However, there is no specific cut-off for sarcopenia in Saudi women. Accordingly, we aimed to establish a cut-off value for sarcopenia in Saudi women. We determined the prevalence of sarcopenia in terms of low handgrip strength (HGS) in postmenopausal women using the EWGSOP2 value, redefined a specific cut-off for low HGS derived from Saudi premenopausal women, re-determined the prevalence of low HGS using the new cut-off, and analyzed the proportion of low HGS in women with obesity compared to those without obesity. Following EWGSOP2 guidelines, we defined probable sarcopenia and set new HGS values. We assessed HGS and body composition in 134 pre/postmenopausal women. Probable sarcopenia prevalence was calculated using EWGSOP2's HGS of 16 kg and new cut-offs from young premenopausal women without obesity. HGS 10 and 8 kg cut-offs were calculated from premenopausal Saudi women's mean -2 SDs and mean -2.5 SDs. Using the HGS 16 kg cut-off, sarcopenia prevalence was 44% in postmenopausal and 33.89% in premenopausal women. Applying the new HGS 10 kg and 8 kg cut-offs, the prevalence was 9.33% and 4%, respectively, in postmenopausal and 5% and 3.40%, respectively, in premenopausal women. Women with obesity had a higher proportion of low HGS across all cut-offs. We suggest that EWGSOP2 cut-offs may not be adaptable for Saudi women. Considering body composition differences between Saudis and Caucasians, our proposed HGS cut-offs appear more relevant.
Collapse
Affiliation(s)
- Nouf Aljawini
- Department of Physiology, College of Medicine, King Saud University, Riyadh 11416, Saudi Arabia; (N.A.)
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia;
| | - Syed Shahid Habib
- Department of Physiology, College of Medicine, King Saud University, Riyadh 11416, Saudi Arabia; (N.A.)
| |
Collapse
|
14
|
Han X, Ashraf M, Tipparaju SM, Xuan W. Muscle-Brain crosstalk in cognitive impairment. Front Aging Neurosci 2023; 15:1221653. [PMID: 37577356 PMCID: PMC10413125 DOI: 10.3389/fnagi.2023.1221653] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/07/2023] [Indexed: 08/15/2023] Open
Abstract
Sarcopenia is an age-related, involuntary loss of skeletal muscle mass and strength. Alzheimer's disease (AD) is the most common cause of dementia in elderly adults. To date, no effective cures for sarcopenia and AD are available. Physical and cognitive impairments are two major causes of disability in the elderly population, which severely decrease their quality of life and increase their economic burden. Clinically, sarcopenia is strongly associated with AD. However, the underlying factors for this association remain unknown. Mechanistic studies on muscle-brain crosstalk during cognitive impairment might shed light on new insights and novel therapeutic approaches for combating cognitive decline and AD. In this review, we summarize the latest studies emphasizing the association between sarcopenia and cognitive impairment. The underlying mechanisms involved in muscle-brain crosstalk and the potential implications of such crosstalk are discussed. Finally, future directions for drug development to improve age-related cognitive impairment and AD-related cognitive dysfunction are also explored.
Collapse
Affiliation(s)
| | | | | | - Wanling Xuan
- Department of Pharmaceutical Sciences, USF Health Taneja College of Pharmacy, University of South Florida, Tampa, FL, United States
| |
Collapse
|