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El Assar M, Rodríguez-Sánchez I, Álvarez-Bustos A, Rodríguez-Mañas L. Biomarkers of frailty. Mol Aspects Med 2024; 97:101271. [PMID: 38631189 DOI: 10.1016/j.mam.2024.101271] [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: 11/15/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/19/2024]
Abstract
Several biomarkers have been proposed to identify frailty, a multisystemic age-related syndrome. However, the complex pathophysiology and the absence of a consensus on a comprehensive and universal definition make it challenging to pinpoint a singular biomarker or set of biomarkers that conclusively characterize frailty. This review delves into the main laboratory biomarkers, placing special emphasis on those associated with various pathways closely tied to the frailty condition, such as inflammation, oxidative stress, mitochondrial dysfunction, metabolic and endocrine alterations and microRNA. Additionally, we provide a summary of different clinical biomarkers encompassing different tools that have been proposed to assess frailty. We further address various imaging biomarkers such as Dual Energy X-ray Absorptiometry, Bioelectrical Impedance analysis, Computed Tomography and Magnetic Resonance Imaging, Ultrasound and D3 Creatine dilution. Intervention to treat frailty, including non-pharmacological ones, especially those involving physical exercise and nutrition, and pharmacological interventions, that include those targeting specific mechanisms such as myostatin inhibitors, insulin sensitizer metformin and with special relevance for hormonal treatments are mentioned. We further address the levels of different biomarkers in monitoring the potential positive effects of some of these interventions. Despite the availability of numerous biomarkers, their performance and usefulness in the clinical arena are far from being satisfactory. Considering the multicausality of frailty, there is an increasing need to assess the role of sets of biomarkers and the combination between laboratory, clinical and image biomarkers, in terms of sensitivity, specificity and predictive values for the diagnosis and prognosis of the different outcomes of frailty to improve detection and monitoring of older people with frailty or at risk of developing it, being this a need in the everyday clinical practice.
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Affiliation(s)
- Mariam El Assar
- Fundación para la Investigación Biomédica del Hospital Universitario de Getafe, Madrid, Spain; Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Alejandro Álvarez-Bustos
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Leocadio Rodríguez-Mañas
- Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Geriatría, Hospital Universitario de Getafe, Madrid, Spain.
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Heitman K, Alexander MS, Faul C. Skeletal Muscle Injury in Chronic Kidney Disease-From Histologic Changes to Molecular Mechanisms and to Novel Therapies. Int J Mol Sci 2024; 25:5117. [PMID: 38791164 PMCID: PMC11121428 DOI: 10.3390/ijms25105117] [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: 04/09/2024] [Revised: 05/03/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024] Open
Abstract
Chronic kidney disease (CKD) is associated with significant reductions in lean body mass and in the mass of various tissues, including skeletal muscle, which causes fatigue and contributes to high mortality rates. In CKD, the cellular protein turnover is imbalanced, with protein degradation outweighing protein synthesis, leading to a loss of protein and cell mass, which impairs tissue function. As CKD itself, skeletal muscle wasting, or sarcopenia, can have various origins and causes, and both CKD and sarcopenia share common risk factors, such as diabetes, obesity, and age. While these pathologies together with reduced physical performance and malnutrition contribute to muscle loss, they cannot explain all features of CKD-associated sarcopenia. Metabolic acidosis, systemic inflammation, insulin resistance and the accumulation of uremic toxins have been identified as additional factors that occur in CKD and that can contribute to sarcopenia. Here, we discuss the elevation of systemic phosphate levels, also called hyperphosphatemia, and the imbalance in the endocrine regulators of phosphate metabolism as another CKD-associated pathology that can directly and indirectly harm skeletal muscle tissue. To identify causes, affected cell types, and the mechanisms of sarcopenia and thereby novel targets for therapeutic interventions, it is important to first characterize the precise pathologic changes on molecular, cellular, and histologic levels, and to do so in CKD patients as well as in animal models of CKD, which we describe here in detail. We also discuss the currently known pathomechanisms and therapeutic approaches of CKD-associated sarcopenia, as well as the effects of hyperphosphatemia and the novel drug targets it could provide to protect skeletal muscle in CKD.
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Affiliation(s)
- Kylie Heitman
- Division of Nephrology and Section of Mineral Metabolism, Department of Medicine, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Matthew S. Alexander
- Division of Neurology, Department of Pediatrics, The University of Alabama at Birmingham and Children’s of Alabama, Birmingham, AL 35294, USA
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Department of Genetics, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Civitan International Research Center, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Center for Neurodegeneration and Experimental Therapeutics, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Christian Faul
- Division of Nephrology and Section of Mineral Metabolism, Department of Medicine, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA;
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Arroyo E, Leber CA, Burney HN, Narayanan G, Moorthi R, Avin KG, Warden SJ, Moe SM, Lim K. Relationship between klotho and physical function in healthy aging. Sci Rep 2023; 13:21158. [PMID: 38036596 PMCID: PMC10689840 DOI: 10.1038/s41598-023-47791-5] [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: 03/21/2023] [Accepted: 11/18/2023] [Indexed: 12/02/2023] Open
Abstract
Epidemiological studies have reported a strong association between circulating Klotho and physical function; however, the cohorts were comprised of older adults with multiple comorbidities. Herein, we examined the relationship between Klotho and physical function in a community-based cohort of healthy adults. In this cross-sectional study, serum Klotho was measured in 80 adults who visited the Musculoskeletal Function, Imaging, and Tissue Resource Core of the Indiana Center for Musculoskeletal Health. Participants (n = 20, 10 [50%] men per group) were chosen into four age groups: 20-34, 35-49, 50-64, and ≥ 65 years, and were further grouped based on performance (low vs. high) on grip strength and chair stand tests. Klotho levels were lower in the ≥ 65 years group (703.0 [189.3] pg/mL; p = 0.022) and the 50-64 years group (722.6 [190.5] pg/mL; p = 0.045) compared to 20-34 years (916.1 [284.8] pg/mL). No differences were observed in Klotho between the low and high performers. The ≥ 65 years group walked a shorter distance during the 6-min walk test (6MWT) compared to 20-34 years (p = 0.005). Klotho was correlated with age (p < 0.001), body fat (p = 0.037), and 6MWT distance (p = 0.022). Klotho levels decline as early as the fifth decade of life, potentially before the onset of age-related impairment in exercise capacity.
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Affiliation(s)
- Eliott Arroyo
- Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Cecilia A Leber
- Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN, USA
| | - Heather N Burney
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Gayatri Narayanan
- Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ranjani Moorthi
- Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Keith G Avin
- Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Physical Therapy, Indiana University School of Health and Human Sciences, Indianapolis, IN, USA
| | - Stuart J Warden
- Department of Physical Therapy, Indiana University School of Health and Human Sciences, Indianapolis, IN, USA
| | - Sharon M Moe
- Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Kenneth Lim
- Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
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Jiang M, Tang X, Wang P, Yang L, Du R. Association between daily alcohol consumption and serum alpha klotho levels among U.S. adults over 40 years old: a cross-sectional study. BMC Public Health 2023; 23:1901. [PMID: 37784055 PMCID: PMC10544600 DOI: 10.1186/s12889-023-16830-1] [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: 01/31/2023] [Accepted: 09/25/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Klotho is a hormone considered to be an anti-aging biomarker. The relationships between daily alcohol consumption and serum klotho are mainly unknown. The purpose of this study is to assess the relationship between alcohol consumption and serum alpha klotho (α-klotho) levels in the U.S. METHODS The data came from 11,558 participants aged ≥ 40 in the 2007-2016 National Health and Nutrition Examination Survey. Adults with reliable α-klotho plasma results were the target population. The self-report method was used to assess alcohol consumption. The relationship between daily alcohol intake and serum α-klotho levels was estimated using multivariable linear regression models. We also performed a stratified analysis of clinically important variables. RESULTS The mean serum α-klotho level among the 11,558 participants was 843.82 pg/mL. After full adjustment, participants with current moderate and heavy alcohol intake had lower serum α-klotho levels than those who never alcohol intake (β = - 62.64; 95% CI: - 88.86, - 36.43; P < 0.001; β = - 81.54; 95% CI: - 111.54, - 51.54; P < 0.001, respectively). Furthermore, the stratified analysis indicated that the association was insignificant in individuals with cardiovascular disease, chronic kidney disease, or cancer. CONCLUSION Daily alcohol consumption was inversely associated with serum α-klotho levels among U.S. adults over 40 years old. However, individuals with cardiovascular disease, chronic kidney disease, or cancer found no such relationship.
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Affiliation(s)
- Meihua Jiang
- Department of Nephrology, General Hospital of Central Theater Command, No. 627, Wuluo Road, Wuhan, Hubei, 430070, China
| | - Xiaoyan Tang
- Department of Cardiology, General Hospital of Central Theater Command, No. 627, Wuluo Road, Wuhan, Hubei, 430070, China
| | - Peng Wang
- Department of Radiology, Wuhan Hospital of Traditional Chinese Medicine, No. 303, Sixin Avenue, Wuhan, Hubei, 430050, China
| | - Li Yang
- Department of Ultrasound, General Hospital of Central Theater Command, No. 627, Wuluo Road, Wuhan, Hubei, 430070, China
| | - Rui Du
- Department of Ultrasound, General Hospital of Central Theater Command, No. 627, Wuluo Road, Wuhan, Hubei, 430070, China.
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Luthra NS, Christou DD, Clow A, Corcos DM. Targeting neuroendocrine abnormalities in Parkinson's disease with exercise. Front Neurosci 2023; 17:1228444. [PMID: 37746149 PMCID: PMC10514367 DOI: 10.3389/fnins.2023.1228444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/22/2023] [Indexed: 09/26/2023] Open
Abstract
Parkinson's Disease (PD) is a prevalent and complex age-related neurodegenerative condition for which there are no disease-modifying treatments currently available. The pathophysiological process underlying PD remains incompletely understood but increasing evidence points to multiple system dysfunction. Interestingly, the past decade has produced evidence that exercise not only reduces signs and symptoms of PD but is also potentially neuroprotective. Characterizing the mechanistic pathways that are triggered by exercise and lead to positive outcomes will improve understanding of how to counter disease progression and symptomatology. In this review, we highlight how exercise regulates the neuroendocrine system, whose primary role is to respond to stress, maintain homeostasis and improve resilience to aging. We focus on a group of hormones - cortisol, melatonin, insulin, klotho, and vitamin D - that have been shown to associate with various non-motor symptoms of PD, such as mood, cognition, and sleep/circadian rhythm disorder. These hormones may represent important biomarkers to track in clinical trials evaluating effects of exercise in PD with the aim of providing evidence that patients can exert some behavioral-induced control over their disease.
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Affiliation(s)
- Nijee S. Luthra
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Demetra D. Christou
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL, United States
| | - Angela Clow
- Department of Psychology, School of Social Sciences, University of Westminster, London, United Kingdom
| | - Daniel M. Corcos
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, McCormick School of Engineering, Northwestern University, Chicago, IL, United States
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Chuang MH, Wang HW, Huang YT, Jiang MY. Association between soluble α-klotho and mortality risk in middle-aged and older adults. Front Endocrinol (Lausanne) 2023; 14:1246590. [PMID: 37693344 PMCID: PMC10484398 DOI: 10.3389/fendo.2023.1246590] [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: 06/24/2023] [Accepted: 08/11/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction Studies on association of α-klotho levels with mortality risk in general population are relatively scarce and inconclusive. Therefore, we conducted a population-based cohort study to investigate the relationship between soluble α-klotho and all-cause mortality in a nationally representative sample of middle-aged and older adults in the United States (U.S.). Methods The study population was 2007-2016 National Health and Nutrition Examination Survey (NHANES) participants, totaling 13,583 adults aged 40-79 years. Participants were divided into 7 groups by septile of α-klotho levels. We linked the NHANES data to the National Death Index to determine participants' survival status. End of follow-up was participants' death date or December 31, 2019. Results We observed that males, current smokers, older age, higher body mass index, and lower estimated glomerular filtration rate correlated to lower α-klotho levels, while hepatitis C virus infection correlated to higher α-klotho. The population mortality rate was 11.8 per 10,000 person-months (1,490 deaths); group 1 (the first septile) had higher mortality risk compared with group 2 through group 7. By weighted Cox regression with adjustment for potential confounders, we found that group 2 through group 6, but not group 7, were associated with 25% to 35% lower risk of all-cause mortality compared with group 1. When compared with group 4, we observed that both group 1 (HR: 1.46, 95% CI 1.13-1.88) and group 7 (HR: 1.38, 95% CI 1.09-1.74) were associated with higher mortality risk. Conclusion In summary, among middle-aged and older U.S. adults, we observed a non-linear association between soluble α-klotho and all-cause mortality, with individuals at the two extremes at increased risk of death.
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Affiliation(s)
- Min-Hsiang Chuang
- Renal Division, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Hung-Wei Wang
- Renal Division, Department of Internal Medicine, Chi Mei Hospital Chiali, Tainan, Taiwan
| | - Yun-Ting Huang
- Renal Division, Department of Internal Medicine, Chi Mei Hospital Chiali, Tainan, Taiwan
| | - Ming-Yan Jiang
- Renal Division, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
- Department of Pharmacy, Chia Nan University of Pharmacy & Science, Tainan, Taiwan
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Guan Z, Ma L, Wu C. Association Between Serum Klotho and Physical Frailty in Middle-Aged and Older Adults: Finding From the National Health and Nutrition Examination Survey. J Am Med Dir Assoc 2023:S1525-8610(23)00226-8. [PMID: 37001558 DOI: 10.1016/j.jamda.2023.02.103] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/10/2023] [Accepted: 02/18/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVES To date, no consensus has been reached regarding the role of klotho in the development of frailty. This study aimed to examine the relationship between serum klotho and physical frailty and to explore potential age, sex, and racial/ethnic differences, using a large, nationally representative sample of middle-aged and older adults in the United States. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS Participants were 7107 adults aged 45 years or older from the 2007-2008, 2009-2010, 2011-2012, 2013-2014, and 2015-2016 cycles of the National Health and Nutrition Examination Survey (NHANES), a large data set including a series of cross-sectional nationally representative samples in the United States. METHODS We assessed the frailty status using the Physical Frailty Phenotype (PFP) and the Frailty Index (FI). Five criteria were used in the PFP, and 34 health items were included to construct the FI as a proportion of accumulated deficits. We used multinomial and binary logistic regression models to examine the association between serum klotho and frailty, adjusted for several covariates. RESULTS Participants with a higher serum klotho level (>785.5 pg/mL) had a lower prevalence of frailty, defined by either the PFP or the FI, than those with a lower level (≤785.5 pg/mL). After adjustment for all covariates, the higher serum klotho level was associated with a 26% (95% CI 2%-45%) and 17% (95% CI 1%-30%) lower odds of frailty vs robustness when using the PFP and FI, respectively. In the PFP, the association was significantly stronger among participants aged <60 years than those aged ≥60 years (odds ratio: 0.60 vs 0.85; Pinteraction = .03). No effect modification by race/ethnicity on the association was found. CONCLUSIONS AND IMPLICATIONS Higher serum klotho level relates to lower odds of physical frailty among middle-aged and older adults. Our findings suggest that klotho might be a potential biomarker of frailty, specifically in the middle-aged population. Future research should further investigate the mechanisms underlying this association to determine if lower levels of klotho may serve as a novel risk factor for physical frailty.
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Affiliation(s)
- Zhongyang Guan
- Yancheng Municipal Center for Disease Control and Prevention, Yancheng, Jiangsu, China
| | - Lina Ma
- Department of Geriatrics, National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Chenkai Wu
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China.
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Luthra NS, Clow A, Corcos DM. The Interrelated Multifactorial Actions of Cortisol and Klotho: Potential Implications in the Pathogenesis of Parkinson's Disease. Brain Sci 2022; 12:1695. [PMID: 36552155 PMCID: PMC9775285 DOI: 10.3390/brainsci12121695] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
The pathogenesis of Parkinson's disease (PD) is complex, multilayered, and not fully understood, resulting in a lack of effective disease-modifying treatments for this prevalent neurodegenerative condition. Symptoms of PD are heterogenous, including motor impairment as well as non-motor symptoms such as depression, cognitive impairment, and circadian disruption. Aging and stress are important risk factors for PD, leading us to explore pathways that may either accelerate or protect against cellular aging and the detrimental effects of stress. Cortisol is a much-studied hormone that can disrupt mitochondrial function and increase oxidative stress and neuroinflammation, which are recognized as key underlying disease mechanisms in PD. The more recently discovered klotho protein, considered a general aging-suppressor, has a similarly wide range of actions but in the opposite direction to cortisol: promoting mitochondrial function while reducing oxidative stress and inflammation. Both hormones also converge on pathways of vitamin D metabolism and insulin resistance, also implicated to play a role in PD. Interestingly, aging, stress and PD associate with an increase in cortisol and decrease in klotho, while physical exercise and certain genetic variations lead to a decrease in cortisol response and increased klotho. Here, we review the interrelated opposite actions of cortisol and klotho in the pathogenesis of PD. Together they impact powerful and divergent mechanisms that may go on to influence PD-related symptoms. Better understanding of these hormones in PD would facilitate the design of effective interventions that can simultaneously impact the multiple systems involved in the pathogenesis of PD.
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Affiliation(s)
- Nijee S. Luthra
- Department of Neurology, University of California San Francisco, San Francisco, CA 94127, USA
| | - Angela Clow
- Department of Psychology, School of Social Sciences, University of Westminster, London W1B 2HW, UK
| | - Daniel M. Corcos
- Department of Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60208, USA
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Corrêa HDL, Raab ATO, Araújo TM, Deus LA, Reis AL, Honorato FS, Rodrigues-Silva PL, Neves RVP, Brunetta HS, Mori MADS, Franco OL, Rosa TDS. A systematic review and meta-analysis demonstrating Klotho as an emerging exerkine. Sci Rep 2022; 12:17587. [PMID: 36266389 PMCID: PMC9585050 DOI: 10.1038/s41598-022-22123-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 10/10/2022] [Indexed: 01/13/2023] Open
Abstract
Klotho is an anti-aging protein with several therapeutic roles in the pathophysiology of different organs, such as the skeletal muscle and kidneys. Available evidence suggests that exercise increases Klotho levels, regardless of the condition or intervention, shedding some light on this anti-aging protein as an emergent and promising exerkine. Development of a systematic review and meta-analysis in order to verify the role of different exercise training protocols on the levels of circulating soluble Klotho (S-Klotho) protein. A systematic search of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE through PubMed, EMBASE, CINAHL, CT.gov, and PEDro. Randomized and quasi-randomized controlled trials that investigated effects of exercise training on S-Klotho levels. We included 12 reports in the analysis, comprising 621 participants with age ranging from 30 to 65 years old. Klotho concentration increased significantly after chronic exercise training (minimum of 12 weeks) (Hedge' g [95%CI] 1.3 [0.69-1.90]; P < 0.0001). Moreover, exercise training increases S-Klotho values regardless of the health condition of the individual or the exercise intervention, with the exception of combined aerobic + resistance training. Furthermore, protocol duration and volume seem to influence S-Klotho concentration, since the effect of the meta-analysis changes when subgrouping these variables. Altogether, circulating S-Klotho protein is altered after chronic exercise training and it might be considered an exerkine. However, this effect may be influenced by different training configurations, including protocol duration, volume, and intensity.
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Affiliation(s)
- Hugo de Luca Corrêa
- Graduate Program of Physical Education, Catholic University of Brasilia (UCB), EPTC, QS07, LT1 S/N, Bloco G Sala 119, Águas Claras, Taguatinga, Brasília, Distrito Federal, CEP 72030-170, Brazil.
| | | | - Thamires Marra Araújo
- Faculty of Bio-Medicine, Catholic University of Brasilia, Brasília, Distrito Federal, Brazil
| | - Lysleine Alves Deus
- Graduate Program of Physical Education, Catholic University of Brasilia (UCB), EPTC, QS07, LT1 S/N, Bloco G Sala 119, Águas Claras, Taguatinga, Brasília, Distrito Federal, CEP 72030-170, Brazil
| | - Andrea Lucena Reis
- Graduate Program of Physical Education, Catholic University of Brasilia (UCB), EPTC, QS07, LT1 S/N, Bloco G Sala 119, Águas Claras, Taguatinga, Brasília, Distrito Federal, CEP 72030-170, Brazil
| | - Fernando Sousa Honorato
- Graduate Program of Physical Education, Catholic University of Brasilia (UCB), EPTC, QS07, LT1 S/N, Bloco G Sala 119, Águas Claras, Taguatinga, Brasília, Distrito Federal, CEP 72030-170, Brazil
| | | | - Rodrigo Vanerson Passos Neves
- Graduate Program of Physical Education, Catholic University of Brasilia (UCB), EPTC, QS07, LT1 S/N, Bloco G Sala 119, Águas Claras, Taguatinga, Brasília, Distrito Federal, CEP 72030-170, Brazil
| | | | - Marcelo Alves da Silva Mori
- Department of Biochemistry and Tissue Biology, University of Campinas, Campinas, Brazil
- Obesity and Comorbidities Research Center, University of Campinas, Campinas, Brazil
- Experimental Medicine Research Cluster, University of Campinas, Campinas, Brazil
| | - Octávio Luiz Franco
- Centro de Análises Proteômicas e Bioquímicas, Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, DF, Brazil
- S-Inova Biotech, Pós-Graduação em Biotecnologia, Universidade Católica Dom Bosco, Campo Grande, MS, Brazil
| | - Thiago Dos Santos Rosa
- Graduate Program of Physical Education, Catholic University of Brasilia (UCB), EPTC, QS07, LT1 S/N, Bloco G Sala 119, Águas Claras, Taguatinga, Brasília, Distrito Federal, CEP 72030-170, Brazil.
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Kim D, Lee S, Choi JY, Lee J, Lee HJ, Min JY, Min KB. Association of α-klotho and lead and cadmium: A cross-sectional study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 843:156938. [PMID: 35753483 DOI: 10.1016/j.scitotenv.2022.156938] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 04/17/2022] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
Epigenetic aging is associated with harmful health effects such as oxidative stress from heavy metal exposure. We considered the relationship between genes and heavy metals in association with oxidative stress and then investigated the association between serum α- klotho and lead and cadmium exposure among adults in the United States from 2007 to 2016 participating in the National Health and Nutrition Examination Survey (NHANES). Samples included 9800 adults aged 40 to 79 years with measurements of serum α-klotho, lead and cadmium, and complete covariate data. Lead and cadmium levels were measured by inductively coupled plasma mass spectrometry and serum α-klotho levels were measured using enzyme-linked immunosorbent assay (ELISA). Multivariate linear regression analysis was used to estimate the association between serum α-klotho and blood lead, blood cadmium, and urinary cadmium. A percent increase in blood lead, blood cadmium, and urinary cadmium was associated with a statistically significant 4.0 % (p < 0.001), 2.0 %, (p = 0.003) and 1.0 % (p = 0.020) decrease in serum klotho. After adjustment, a percent increase in blood lead was associated with a statistically significant 4.0 % (p < 0.001) decrease in serum klotho; blood and urinary cadmium did not show any statistically significant associations after adjustment (β (95 % CI), p-value for blood cadmium: 0.00 (-0.02-0.01), p = 0.573; urinary cadmium: -0.01 (-0.03-0.01), p = 0.210). Mean serum klotho levels showed a statistically significant decreasing trend with increasing blood lead quartiles (unadjusted and all-adjusted geometric means and 95 % confidence intervals of serum klotho (in pg/mL) for Q1, Q2, Q3, and Q4: unadjusted: 827.49 (814.20-840.92), 811.92 (794.73-829.48), 791.48 (775.11-808.19), and 772.01 (754.23-790.29); adjusted: 830.64 (805.53-856.45), 816.07 (789.18-843.87), 800.71 (773.71-828.57), and 784.31 (757.94-811.59)). Blood lead and levels were negatively associated with serum α-klotho levels in a representative population of US adults. These results suggest that blood lead levels may be associated with the serum levels of a protein associated with cognition and aging. Further research is recommended to investigate the causality behind such relationship.
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Affiliation(s)
- Donghoon Kim
- Department of Preventive Medicine, College of Medicine, Seoul National University,103 Daehak-ro, Jongno gu, Seoul 110-799, South Korea
| | - Sohyae Lee
- Department of Preventive Medicine, College of Medicine, Seoul National University,103 Daehak-ro, Jongno gu, Seoul 110-799, South Korea; Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, South Korea
| | - Ju-Young Choi
- Department of Preventive Medicine, College of Medicine, Seoul National University,103 Daehak-ro, Jongno gu, Seoul 110-799, South Korea
| | - Jaeho Lee
- Department of Preventive Medicine, College of Medicine, Seoul National University,103 Daehak-ro, Jongno gu, Seoul 110-799, South Korea; Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, South Korea
| | - Hyo-Jung Lee
- Department of Preventive Medicine, College of Medicine, Seoul National University,103 Daehak-ro, Jongno gu, Seoul 110-799, South Korea
| | - Jin-Young Min
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, South Korea.
| | - Kyoung-Bok Min
- Department of Preventive Medicine, College of Medicine, Seoul National University,103 Daehak-ro, Jongno gu, Seoul 110-799, South Korea; Institute of Health Policy and Management, Medical Research Center, Seoul National University, South Korea.
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11
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Abstract
Previous studies have reported that serum klotho and vitamin B12 levels are valuable aging-related markers. However, studies supporting the association between serum klotho and vitamin B12 levels are lacking. We investigated the association between serum klotho and vitamin B12 concentrations in adults in the United States. The analytic study sample was 2065 aged 40 to 79 who participated in the 2011 to 2014 National Health and Nutrition Examination Survey (NHANES). Serum klotho and vitamin B12 collected from adults who consented to the use of their samples in the future. The participants were divided into 2 groups based on estimated glomerular filtration rate (eGFR) levels (high: ≥90 mL/min/1.73 m2 or low: <90 mL/min/1.73 m2). Of the 2065 participants, the log-transformed klotho concentration was significantly correlated with log-transformed vitamin B12 in the high eGFR group, but not in the low eGFR group. After adjusting for all potential covariates, there was a significant association between klotho and vitamin B12 concentrations in the high eGFR groups (beta = 0.100, SE = 0.040). In contrast, there was no significant relationship between klotho and vitamin B12 concentrations in the low eGFR group (beta = 0.012, SE = 0.019). Serum klotho concentration was significantly associated with vitamin B12 increases in US adults with high kidney function. Vitamin B12 concentration may be an important marker of klotho concentration in older adults.
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Affiliation(s)
- Ju-Young Choi
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Jin-Young Min
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Kyoung-Bok Min
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Republic of Korea
- *Correspondence: Kyoung-Bok Min, Department of Preventive Medicine, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 110-799, Republic of Korea (e-mail: )
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12
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Han Y, Zhang L, Fang Y. Multidimensional Disability Evaluation and Confirmatory Analysis of Older Adults in a Home-Based Community in China. Front Public Health 2022; 10:899303. [PMID: 35801251 PMCID: PMC9253425 DOI: 10.3389/fpubh.2022.899303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/02/2022] [Indexed: 11/26/2022] Open
Abstract
A robust multi-dimensional disability assessment standard was constructed to consider physical condition, care resources, and social interaction that might lead to disability, to provide a basis for accurate identification of care needs for older people aged 60 and above in a home-based community. Based on the “Capability approach” theory, the Alkire-Foster method was applied to assess the multidimensional disability. This was followed by the confirmatory analysis of the Seemingly Unrelated Regression Estimation. Adjusted Bourguignon and Chakravarty index was also calculated to analyze the sensitivity to further support our conclusions. We constructed a multi-dimensional disability indicator system by combining physical condition, care resources, and social interaction. Findings presented that the impairment of individuals' motor ability, ability to manage disease, cognitive psychology, and communication skills and social interaction contributed to multidimensional disability the most. And older people who are female, aged over 65, with lower BMI, living in rural areas, with a lower education level, getting more formal care, and with relatively higher creatinine, tend to face a higher risk of deprivation in overall multidimensional disability. Therefore, the targeted interventions to improve health literacy, nutrition, skill of disease management, social networks, and communication skills for older people and also timely detection of the abnormal changes in potential biomarker indicators of them is necessary to delay disability and prevent its occurrence.
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Affiliation(s)
- Ying Han
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Liangwen Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- School of Economics, Xiamen University, Xiamen, China
| | - Ya Fang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- *Correspondence: Ya Fang
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13
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Tanaka SI, Fujioka Y, Tsujino T, Ishida T, Hirata KI. Association between urinary N-acetyl-β-glucosaminidase activity–urinary creatinine concentration ratio and risk of disability and all-cause mortality. PLoS One 2022; 17:e0265637. [PMID: 35333903 PMCID: PMC8956177 DOI: 10.1371/journal.pone.0265637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 03/07/2022] [Indexed: 12/03/2022] Open
Abstract
Background Recent studies have suggested that chronic kidney disease is associated with cardiovascular disease, dementia, and frailty, all of which cause disability and early death. We investigated whether increased activity of urinary N-acetyl-β-glucosaminidase (NAG), a marker of kidney injury, is associated with risk of disability or all-cause mortality in a general population. Methods Follow-up data from the Hidaka Cohort Study, a population-based cohort study of members of a Japanese rural community, were obtained via questionnaires completed by participants or their relatives. Multivariable analyses were used to investigate relations between urinary NAG activity–urinary creatinine concentration ratio and risk of disability or all-cause mortality. Results A total of 1182 participants were followed up for a median of 12.4 years. The endpoints were receipt of support under the public long-term care insurance program, and all-cause mortality. A total of 122 participants (10.3%) were reported to be receiving long-term care and 230 (19.5%) had died. After adjustment for cardiovascular risk factors along with physical activity, and using the quartile 1 results as a reference, the odds ratio (OR) for disability was 2.12 [95% confidence interval (95% confidence interval [CI]), 1.04–4.33; p = 0.038) and the hazard ratio (HR) for all-cause mortality was 1.65 (95% CI, 1.05–2.62; p = 0.031) in participants with urinary NAG/creatinine ratio in quartile 4. Similar results were obtained in participants without proteinuria: OR for disability, 2.46 (95% CI, 1.18–5.16; p = 0.017); and HR for all-cause mortality, 1.62 (95% CI, 1.00–2.63; p = 0.049). Conclusions Increased urinary NAG/creatinine ratio was associated with risk of disability or all-cause mortality in a general population.
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Affiliation(s)
- Shin-ichiro Tanaka
- Department of Internal Medicine, Toyooka Hospital Hidaka Medical Center, Toyooka, Hyogo, Japan
- * E-mail:
| | - Yoshio Fujioka
- Division of Clinical Nutrition, Faculty of Nutrition, Kobe Gakuin University, Kobe, Japan
| | - Takeshi Tsujino
- Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences, Kobe, Japan
| | - Tatsuro Ishida
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-ichi Hirata
- Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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14
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King KE, McCormick JJ, Notley SR, Fujii N, Kenny GP. Serum klotho concentrations in young and older men during prolonged exercise in temperate and hot conditions. Curr Aging Sci 2022; 15:180-185. [PMID: 35249521 DOI: 10.2174/1874609815666220304200939] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/07/2022] [Accepted: 12/14/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND The protein klotho protects cellular function during various physiological stressors, such as exercise, however it is unknown how the age-related decline in klotho production affects responses during exercise, especially in the heat. OBJECTIVE Our objective was to determine the effect of exercise in temperate and hot environmental conditions on serum klotho concentrations in young and older men. METHODS 12 young (mean ± SD: 22 ± 3 years) and 12 older (59 ± 4 years) men performed 180 minutes of moderate-intensity treadmill walking (metabolic rate: 200 W/m2) in a temperate [wet-bulb globe temperature (WBGT) 16°C, achieved with 21.9°C, 35% relative humidity (RH)] and hot (WBGT 32°C, achieved with 41.4°C, 35% RH) environment. Serum klotho was assessed before and after exercise, as well as 60-min post-exercise recovery in the respective environments. RESULTS Absolute klotho concentrations were greater in young versus older men during all measured time points in the temperate (p = 0.032), but not the hot condition (p = 0.064). In the hot condition, the change in serum klotho from baseline was significantly higher after exercise in the heat (mean ± SEM: +251 ± 73 pg/mL) than the temperate (+75 ± 57 pg/mL) environment in both groups (p = 0.026). However, this elevation was not maintained during recovery. CONCLUSION We showed that prolonged exercise in a temperate environment does not elicit a klotho response in either group. In contrast, despite lower resting klotho levels, the older men showed a similar exercise-induced increase in serum klotho response as their younger counterparts.
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Affiliation(s)
- Kelli E King
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - James J McCormick
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Sean R Notley
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Naoto Fujii
- Faculty of Health and Sport Sciences, University of Tsukuba, Japan
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada
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15
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Arroyo E, Troutman AD, Moorthi RN, Avin KG, Coggan AR, Lim K. Klotho: An Emerging Factor With Ergogenic Potential. FRONTIERS IN REHABILITATION SCIENCES 2022; 2:807123. [PMID: 36188832 PMCID: PMC9397700 DOI: 10.3389/fresc.2021.807123] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/10/2021] [Indexed: 11/13/2022]
Abstract
Sarcopenia and impaired cardiorespiratory fitness are commonly observed in older individuals and patients with chronic kidney disease (CKD). Declines in skeletal muscle function and aerobic capacity can progress into impaired physical function and inability to perform activities of daily living. Physical function is highly associated with important clinical outcomes such as hospitalization, functional independence, quality of life, and mortality. While lifestyle modifications such as exercise and dietary interventions have been shown to prevent and reverse declines in physical function, the utility of these treatment strategies is limited by poor widespread adoption and adherence due to a wide variety of both perceived and actual barriers to exercise. Therefore, identifying novel treatment targets to manage physical function decline is critically important. Klotho, a remarkable protein with powerful anti-aging properties has recently been investigated for its role in musculoskeletal health and physical function. Klotho is involved in several key processes that regulate skeletal muscle function, such as muscle regeneration, mitochondrial biogenesis, endothelial function, oxidative stress, and inflammation. This is particularly important for older adults and patients with CKD, which are known states of Klotho deficiency. Emerging data support the existence of Klotho-related benefits to exercise and for potential Klotho-based therapeutic interventions for the treatment of sarcopenia and its progression to physical disability. However, significant gaps in our understanding of Klotho must first be overcome before we can consider its potential ergogenic benefits. These advances will be critical to establish the optimal approach to future Klotho-based interventional trials and to determine if Klotho can regulate physical dysfunction.
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Affiliation(s)
- Eliott Arroyo
- Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Ashley D. Troutman
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University Purdue University, Indianapolis, IN, United States
| | - Ranjani N. Moorthi
- Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Keith G. Avin
- Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University Purdue University, Indianapolis, IN, United States
| | - Andrew R. Coggan
- Department of Kinesiology, School of Health and Human Sciences, Indiana University Purdue University Indianapolis, Indianapolis, IN, United States
| | - Kenneth Lim
- Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
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16
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Association of Klotho with physical performance and frailty in middle-aged and older adults: A systematic review. Exp Gerontol 2021; 154:111518. [PMID: 34407459 DOI: 10.1016/j.exger.2021.111518] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 01/21/2023]
Abstract
Ageing is an inevitable process of physical deterioration that impairs functional autonomy and quality of life, becoming a public health issue. Since the percentage of people over 60 years is increasing worldwide, the use of easily detectable biomarkers of ageing is a relevant tool for monitoring of the ageing process and treatment. Among them, Klotho, an ageing suppressor gene because its deficiency leads to ageing like phenotype, seems particularly promising. This systematic review includes the last 10 years clinical studies that evaluated the association between plasma Klotho and body composition, physical performance and frailty in both sedentary and active middle-aged and older adults. Sixteen studies have been found: nine regarding the association between Klotho and body composition, two the association of Klotho and frailty and finally five concerning the effects of physical activity on Klotho. The results of these studies, albeit with some exceptions, point out that Klotho is positively associated with muscle strength and negatively with osteoporosis, frailty, disability and mortality while physical activity generally increases Klotho levels. Moreover, even if there are still few clinical studies, Klotho might be positively associated with bone mineral density, muscle strength, longevity, mobility and robustness during ageing.
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17
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Müller BW, Hinney A, Scherbaum N, Weimar C, Kleinschnitz C, Peters T, Hochfeld L, Pechlivanis S, Stang A, Jokisch M, Kowall B. Klotho KL-VS haplotype does not improve cognition in a population-based sample of adults age 55-87 years. Sci Rep 2021; 11:13852. [PMID: 34226614 PMCID: PMC8257625 DOI: 10.1038/s41598-021-93211-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 06/21/2021] [Indexed: 11/18/2022] Open
Abstract
The heterozygous human Klotho KL-VS haplotype has been associated with improved cognitive performance but results are inconsistent. Here we assessed Klotho KL-VS haplotype and cognition using data from the third examination of the population-based Heinz Nixdorf Recall Study. We analyzed cognition tests (immediate and delayed word list, Trail-Making Test [TMT] part A and B, Maze test, interference condition of the Stroop color-word test, verbal fluency) and their associations with Klotho KL-VS haplotype. The Klotho KL-VS haplotype is classified by the V-allele at SNP rs9536314 (F352V) and the S-allele at SNP rs9527025 (C370S). Heterozygotes for the KL-VS haplotype were compared with non-carriers. Analyses were performed in 1812 subjects (55-87 years). We found consistent but only slightly lower performance in heterozygous carriers of the KL-VS haplotype in all tasks with Z-scores ranging between Z = - 0.042 (verbal fluency) and - 0.17 (TMT part A). Differences between carriers and non-carriers were similar for men and women for all tests but TMT part B (interaction contrast = 8.4 s (95% CI - 2.3; 19.1)). While cognition declined with age, we found an effect modification by age (55-65 years, 66-75 years, > 75 years). In the 66-75 years KL-VS heterozygous age group, lower performance was seen in memory, visual attention and motor speed. Contrary to our hypothesis, heterozygous carriers of the KL-VS haplotype did not show enhanced performance in cognitive tests in our study.
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Affiliation(s)
- Bernhard W Müller
- Department for Psychiatry and Psychotherapy, LVR-Hospital, University of Duisburg-Essen, University Hospital Essen, Essen, Germany.
- Department of Psychology, University of Wuppertal, Wuppertal, Germany.
| | - Anke Hinney
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Norbert Scherbaum
- Department for Psychiatry and Psychotherapy, LVR-Hospital, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
- Department of Addictive Behavior and Addiction Medicine, LVR-Hospital, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Christian Weimar
- BDH-Klinik Elzach gGmbH, Elzach, Germany
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany
| | - Christoph Kleinschnitz
- Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Triinu Peters
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Lara Hochfeld
- Institute of Human Genetics, University Hospital of Bonn, Bonn, Germany
| | - Sonali Pechlivanis
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany
- Institute for Asthma and Allergy Prevention, Helmholtz Zentrum München, German Research Centre for Environmental Health, Munich, Germany
| | - Andreas Stang
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany
| | - Martha Jokisch
- Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Bernd Kowall
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany
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18
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Chen Z, Xiong L, Jin H, Yu J, Li X, Fu H, Wen L, Qi H, Tong C, Saffery R, Kilby MD, Baker PN. Advanced maternal age causes premature placental senescence and malformation via dysregulated α-Klotho expression in trophoblasts. Aging Cell 2021; 20:e13417. [PMID: 34105233 PMCID: PMC8282245 DOI: 10.1111/acel.13417] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 05/20/2021] [Accepted: 05/24/2021] [Indexed: 12/20/2022] Open
Abstract
Advanced maternal age (AMA) pregnancy is associated with higher risks of adverse perinatal outcomes, which may result from premature senescence of the placenta. α-Klotho is a well-known antiaging protein; however, its expression and effect on the placenta in AMA pregnancies have not yet been fully elucidated. The expression patterns of α-Klotho in mouse and human placentas from AMA pregnancies were determined by Western blotting and immunohistochemistry (IHC) staining. α-Klotho expression in JAR cells was manipulated to investigate its role in trophoblastic senescence, and transwell assays were performed to assess trophoblast invasion. The downstream genes regulated by α-Klotho in JAR cells were first screened by mRNA sequencing in α-Klotho-knockdown and control JAR cells and then validated. α-Klotho-deficient mice were generated by injecting klotho-interfering adenovirus (Ad-Klotho) via the tail vein on GD8.5. Ablation of α-Klotho resulted in not only a senescent phenotype and loss of invasiveness in JAR cells but also a reduction in the transcription of cell adhesion molecule (CAM) genes. Overexpression of α-Klotho significantly improved invasion but did not alter the expression of senescence biomarkers. α-Klotho-deficient mice exhibited placental malformation and, consequently, lower placental and fetal weights. In conclusion, AMA results in reduced α-Klotho expression in placental trophoblasts, therefore leading to premature senescence and loss of invasion (possibly through the downregulation of CAMs), both of which ultimately result in placental malformation and adverse perinatal outcomes.
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Affiliation(s)
- Zhi Chen
- Department of ObstetricsThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing MunicipalityChongqing Medical UniversityChongqingChina
- International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of EducationChongqing Medical UniversityChongqingChina
| | - Liling Xiong
- Department of ObstetricsThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing MunicipalityChongqing Medical UniversityChongqingChina
- International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of EducationChongqing Medical UniversityChongqingChina
| | - Huili Jin
- Department of ObstetricsThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing MunicipalityChongqing Medical UniversityChongqingChina
- International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of EducationChongqing Medical UniversityChongqingChina
| | - Jiaxiao Yu
- Department of ObstetricsThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing MunicipalityChongqing Medical UniversityChongqingChina
- International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of EducationChongqing Medical UniversityChongqingChina
| | - Xin Li
- Department of ObstetricsThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing MunicipalityChongqing Medical UniversityChongqingChina
- International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of EducationChongqing Medical UniversityChongqingChina
| | - Huijia Fu
- Department of ObstetricsThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing MunicipalityChongqing Medical UniversityChongqingChina
- International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of EducationChongqing Medical UniversityChongqingChina
| | - Li Wen
- Department of ObstetricsThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing MunicipalityChongqing Medical UniversityChongqingChina
- International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of EducationChongqing Medical UniversityChongqingChina
| | - Hongbo Qi
- Department of ObstetricsThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing MunicipalityChongqing Medical UniversityChongqingChina
- International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of EducationChongqing Medical UniversityChongqingChina
| | - Chao Tong
- Department of ObstetricsThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing MunicipalityChongqing Medical UniversityChongqingChina
- International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of EducationChongqing Medical UniversityChongqingChina
| | - Richard Saffery
- International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of EducationChongqing Medical UniversityChongqingChina
- Cancer, Disease and Developmental epigenetics, Murdoch Children's Research InstituteRoyal Children's HospitalMelbourneVICAustralia
| | - Mark D. Kilby
- Centre for Women's and Newborn HealthInstitute of Metabolism and Systems ResearchUniversity of BirminghamBirminghamUK
| | - Philip N. Baker
- International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of EducationChongqing Medical UniversityChongqingChina
- College of Life SciencesUniversity of LeicesterLeicesterUK
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Sanz B, Arrieta H, Rezola-Pardo C, Fernández-Atutxa A, Garin-Balerdi J, Arizaga N, Rodriguez-Larrad A, Irazusta J. Low serum klotho concentration is associated with worse cognition, psychological components of frailty, dependence, and falls in nursing home residents. Sci Rep 2021; 11:9098. [PMID: 33907242 PMCID: PMC8079365 DOI: 10.1038/s41598-021-88455-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 04/13/2021] [Indexed: 01/13/2023] Open
Abstract
Serum alpha-klotho (s-klotho) protein has been linked with lifespan, and low concentrations of s-klotho have been associated with worse physical and cognitive outcomes. Although its significance in aging remains unclear, s-klotho has been proposed as a molecular biomarker of frailty and dependence. This study is a secondary analysis of data from a clinical trial performed in a population of 103 older individuals living in 10 nursing homes in Gipuzkoa (Spain). We aimed to elucidate associations between s-klotho (as measured by enzyme-linked immunosorbent assay) and body composition, physical fitness, and cognition, as well as frailty and dependence (determined using validated tests and scales). In addition, we investigated the association of s-klotho concentration with falls in the six months following the initial assessment. Low s-klotho levels were associated with a lower score in the psychological component of the Tilburg Frailty Indicator, a worse score in the Coding Wechsler Adult Intelligence Scale, and a greater dependence in activities of daily living. Moreover, participants with lower s-klotho concentrations suffered more falls during the 6 months after the assessment. Future translational research should aim to validate klotho's putative role as a biomarker that could identify the risk of aging-related adverse events in clinical practice.
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Affiliation(s)
- Begoña Sanz
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 489040, Leioa, Bizkaia, Spain.
| | - Haritz Arrieta
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 20014, Donostia-San Sebastián, Gipuzkoa, Spain
| | - Chloe Rezola-Pardo
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 489040, Leioa, Bizkaia, Spain
- Department of Didactics of Musical, Plastic and Corporal Expression, Faculty of Education, University of the Basque Country (UPV/EHU), 489040, Leioa, Bizkaia, Spain
| | - Ainhoa Fernández-Atutxa
- Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 489040, Leioa, Bizkaia, Spain
| | - Jon Garin-Balerdi
- Caser Residencial Anaka, Fundación Caser, 20301, Irun, Gipuzkoa, Spain
| | - Nagore Arizaga
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 489040, Leioa, Bizkaia, Spain
- Intensive Care Unit, Donostia University Hospital, 20014, Donostia, Spain
| | - Ana Rodriguez-Larrad
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 489040, Leioa, Bizkaia, Spain
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 489040, Leioa, Bizkaia, Spain
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Jovanovich A, Ginsberg C, You Z, Katz R, Ambrosius WT, Berlowitz D, Cheung AK, Cho M, Lee AK, Punzi H, Rehman S, Roumie C, Supiano MA, Wright CB, Shlipak M, Ix JH, Chonchol M. FGF23, Frailty, and Falls in SPRINT. J Am Geriatr Soc 2020; 69:467-473. [PMID: 33289072 DOI: 10.1111/jgs.16895] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND/OBJECTIVES Chronic kidney disease (CKD) is associated with frailty. Fibroblast growth factor 23 (FGF23) is elevated in CKD and associated with frailty among non-CKD older adults and individuals with human immunodeficiency virus. Whether FGF23 is associated with frailty and falls in CKD is unknown. DESIGN Cross-sectional and longitudinal observational study. SETTING Systolic Blood Pressure Intervention Trial (SPRINT), a randomized trial evaluating standard (systolic blood pressure [SBP] <140 mm Hg) versus intensive (SBP <120 mm Hg) blood pressure lowering on cardiovascular and cognitive outcomes among older adults without diabetes mellitus. PARTICIPANTS A total of 2,376 participants with CKD (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2 ). MEASUREMENTS The exposure variable was intact FGF23. We used multinomial logistic regression to determine the cross-sectional association of intact FGF23 with frailty and Cox proportional hazards analysis to determine the longitudinal association with incident falls. Models were adjusted for demographics, comorbidities, randomization group, antihypertensives, eGFR, mineral metabolism markers, and frailty. RESULTS After adjustment, the odds ratio for prevalent frailty versus non-frailty per twofold higher FGF23 was 1.34 (95% confidence interval [CI] = 1.01-1.77). FGF23 levels in the highest quartile versus the lowest quartile demonstrated more than a twofold increased fall risk (hazard ratio [HR] = 2.32; 95% CI = 1.26-4.26), and the HR per twofold higher FGF23 was 1.99 (95% CI = 1.48-2.68). CONCLUSION Among SPRINT participants with CKD, FGF23 was associated with prevalent frailty and falls.
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Affiliation(s)
- Anna Jovanovich
- VA Eastern Colorado Healthcare System, Aurora, Colorado.,University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - Zhiying You
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Ronit Katz
- University of Washington, Seattle, Washington
| | | | | | - Alfred K Cheung
- University of Utah, Salt Lake City, Utah.,Salt Lake City VA Medical Center, Salt Lake City, Utah
| | - Monique Cho
- Salt Lake City VA Medical Center, Salt Lake City, Utah
| | - Alexandra K Lee
- University of California, San Francisco, San Francisco, California
| | | | - Shakaib Rehman
- Phoenix VA Healthcare System, Phoenix, Arizona.,University of Arizona College of Medicine-Phoenix, Phoenix, Arizona
| | | | - Mark A Supiano
- University of Utah, Salt Lake City, Utah.,Salt Lake City VA Medical Center, Salt Lake City, Utah
| | - Clinton B Wright
- National Institute of Neurological Disorders and Stroke, Bethesda, Maryland
| | - Michael Shlipak
- University of California, San Francisco, San Francisco, California
| | - Joachim H Ix
- University of California San Diego, San Diego, California.,Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Michel Chonchol
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Buchanan S, Combet E, Stenvinkel P, Shiels PG. Klotho, Aging, and the Failing Kidney. Front Endocrinol (Lausanne) 2020; 11:560. [PMID: 32982966 PMCID: PMC7481361 DOI: 10.3389/fendo.2020.00560] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 07/09/2020] [Indexed: 12/11/2022] Open
Abstract
Klotho has been recognized as a gene involved in the aging process in mammals for over 30 years, where it regulates phosphate homeostasis and the activity of members of the fibroblast growth factor (FGF) family. The α-Klotho protein is the receptor for Fibroblast Growth Factor-23 (FGF23), regulating phosphate homeostasis and vitamin D metabolism. Phosphate toxicity is a hallmark of mammalian aging and correlates with diminution of Klotho levels with increasing age. As such, modulation of Klotho activity is an attractive target for therapeutic intervention in the diseasome of aging; in particular for chronic kidney disease (CKD), where Klotho has been implicated directly in the pathophysiology. A range of senotherapeutic strategies have been developed to directly or indirectly influence Klotho expression, with varying degrees of success. These include administration of exogenous Klotho, synthetic and natural Klotho agonists and indirect approaches, via modulation of the foodome and the gut microbiota. All these approaches have significant potential to mitigate loss of physiological function and resilience accompanying old age and to improve outcomes within the diseasome of aging.
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Affiliation(s)
- Sarah Buchanan
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Emilie Combet
- School of Medicine, Dentistry & Nursing, Human Nutrition, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - Peter Stenvinkel
- Division of Renal Medicine M99, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Paul G. Shiels
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
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22
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Shardell M, Drew DA, Semba RD, Harris TB, Cawthon PM, Simonsick EM, Kalyani RR, Schwartz AV, Kritchevsky SB, Newman AB. Plasma Soluble αKlotho, Serum Fibroblast Growth Factor 23, and Mobility Disability in Community-Dwelling Older Adults. J Endocr Soc 2020; 4:bvz032. [PMID: 32405607 PMCID: PMC7209777 DOI: 10.1210/jendso/bvz032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 04/20/2020] [Indexed: 12/13/2022] Open
Abstract
CONTEXT αKlotho is a hormone and co-receptor for fibroblast growth factor 23 (FGF23), a hormone that downregulates active vitamin D synthesis and promotes phosphate excretion. Low αKlotho and high FGF23 occur in chronic kidney disease (CKD). OBJECTIVE We aimed to assess the relationships of αKlotho and FGF23 with mobility disability in community-dwelling older adults. DESIGN AND SETTING We estimated associations of plasma-soluble αKlotho and serum FGF23 concentrations with mobility disability over 6 years. Additional analyses was stratified by CKD. PARTICIPANTS Participants included 2751 adults (25.0% with CKD), aged 71 to 80 years, from the 1998 to 1999 Health, Aging, and Body Composition Study visit. MAIN OUTCOME MEASURES Walking disability and stair climb disability were defined as self-reported "a lot of difficulty" or an inability to walk a quarter mile and climb 10 stairs, respectively. RESULTS Median (interquartile range [IQR]) serum FGF23 and plasma soluble αKlotho concentrations were 46.6 (36.7, 60.2) pg/mL and 630.4 (478.4, 816.0) pg/mL, respectively. After adjustment, higher αKlotho concentrations were associated with lower walking disability rates (Rate Ratio [RR] highest vs. lowest tertile = 0.74; 95% confidence interval l [CI] = 0.62, 0.89; P = 0.003). Higher FGF23 concentrations were associated with higher walking disability rates (RR highest vs. lowest tertile = 1.24; 95%CI = 1.03, 1.50; P = 0.005). Overall, higher αKlotho combined with lower FGF23 was associated with the lowest walking disability rates (P for interaction = 0.023). Stair climb disability findings were inconsistent. No interactions with CKD were statistically significant (P for interaction > 0.10). CONCLUSIONS Higher plasma soluble αKlotho and lower serum FGF23 concentrations were associated with lower walking disability rates in community-dwelling older adults, particularly those without CKD.
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Affiliation(s)
- Michelle Shardell
- Institute for Genome Sciences, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - David A Drew
- Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts
| | - Richard D Semba
- Department of Ophthalmology, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Science, National Institute on Aging Intramural Research Program, Bethesda, Maryland
| | - Peggy M Cawthon
- Research Institute, California Pacific Medical Center, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
| | - Eleanor M Simonsick
- Translational Gerontology Branch, National Institute on Aging Intramural Research Program, Baltimore, Maryland
| | - Rita R Kalyani
- Department of Endocrinology, Metabolism, and Diabetes, Johns Hopkins Medical Institutions, Baltimore Maryland
| | - Ann V Schwartz
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
| | - Stephen B Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer’s Prevention, Wake Forest University, Winston-Salem, North Carolina
| | - Anne B Newman
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
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23
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Gunawan A, Fajar JK, Tamara F, Mahendra AI, Ilmawan M, Purnamasari Y, Kartini DA, Winoto ES, Saifillah ES, Wulandari DS, Krisna PA, Mayasari ED, Dantara TWI, Wicaksono RS, Soeatmadji DW. Nitride oxide synthase 3 and klotho gene polymorphisms in the pathogenesis of chronic kidney disease and age-related cognitive impairment: a systematic review and meta-analysis. F1000Res 2020; 9:252. [PMID: 34035901 PMCID: PMC8112466 DOI: 10.12688/f1000research.22989.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2021] [Indexed: 12/25/2022] Open
Abstract
Background: While it has been known that the development of chronic kidney disease (CKD) and age-related cognitive impairment involves several mediators, the evidence in clinical practice only reveals nitride oxide synthase (NOS) and klotho. However, the evidence for this topic is conflicted. The aim of this study was to assess the role of NOS and klotho single nucleotide polymorphisms (SNPs) in the pathogenesis of CKD and age-related cognitive impairment. Methods: We performed a meta-analysis during October to December 2019. Paper collection was performed in major scientific websites, and we extracted information of interest from each paper. Data were analyzed using a Z-test with either random or fixed effect model. Results: Our initial assessment identified NOS3 G894T, NOS3 T786C, NOS3 4b/4a, klotho ( KL) G395A, and KL C1818T as the gene candidate for our meta-analysis. Our pooled calculation revealed that NOS3 G894T was associated with the risk of both age-related cognitive impairment and CKD. Increased susceptibility to age-related cognitive impairment was observed in the GG genotype, and increased risk of CKD was found in patients with a single T allele and TT genotype for NOS3 nucleotide 894. For NOS3 4b/4a, increased risk of CKD was only found in 4a4a genotype. For NOS3 T786C, we failed to show the association with both CKD and age-related cognitive impairment. Subsequently, for KL G395A, A allele and GA genotype were found to correlate with increased susceptibility to CKD, while its correlation to age-related cognitive impairment was failed to clarify. For KL C1818T, our analysis failed to find the correlation with the risk of CKD. Conclusions: Our results reveal that the NOS3 G894T gene polymorphism has a crucial role in the pathogenesis of both CKD and age-related cognitive impairment.
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Affiliation(s)
- Atma Gunawan
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Jonny Karunia Fajar
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Fredo Tamara
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Aditya Indra Mahendra
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Muhammad Ilmawan
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Yeni Purnamasari
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | | | - Eden Suryoiman Winoto
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Efriko Septananda Saifillah
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Dewi Sri Wulandari
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Pratista Adi Krisna
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Ema Dianita Mayasari
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Tri Wahyudi Iman Dantara
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Ramadi Satryo Wicaksono
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
- Department of Internal Medicine, Rumah Sakit Umum Daerah Bangil., Pasuruan, East Java, 67153, Indonesia
| | - Djoko Wahono Soeatmadji
- Division of Endocrinology and Metabolic Diseases, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
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24
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Gunawan A, Fajar JK, Tamara F, Mahendra AI, Ilmawan M, Purnamasari Y, Kartini DA, Winoto ES, Saifillah ES, Wulandari DS, Krisna PA, Mayasari ED, Dantara TWI, Wicaksono RS, Soeatmadji DW. Nitride oxide synthase 3 and klotho gene polymorphisms in the pathogenesis of chronic kidney disease and age-related cognitive impairment: a systematic review and meta-analysis. F1000Res 2020; 9:252. [PMID: 34035901 PMCID: PMC8112466 DOI: 10.12688/f1000research.22989.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/02/2020] [Indexed: 04/03/2024] Open
Abstract
Background: While it has been known that the development of chronic kidney disease (CKD) and age-related cognitive impairment involves several mediators, the evidence in clinical practice only reveals nitride oxide synthase (NOS) and klotho. However, the evidence for this topic is conflicted. The aim of this study was to assess the role of NOS and klotho single nucleotide polymorphisms (SNPs) in the pathogenesis of CKD and age-related cognitive impairment. Methods: We performed a meta-analysis during October to December 2019. Paper collection was performed in major scientific websites, and we extracted information of interest from each paper. Data were analyzed using a Z-test with either random or fixed effect model. Results: Our initial assessment identified NOS3 G894T, NOS3 T786C, NOS3 4b/4a, klotho ( KL) G395A, and KL C1818T as the gene candidate for our meta-analysis. Our pooled calculation revealed that NOS3 G894T was associated with the risk of both age-related cognitive impairment and CKD. Increased susceptibility to age-related cognitive impairment was observed in the GG genotype, and increased risk of CKD was found in patients with a single T allele and TT genotype for NOS3 nucleotide 894. For NOS3 4b/4a, increased risk of CKD was only found in 4a4a genotype. For NOS3 T786C, we failed to show the association with both CKD and age-related cognitive impairment. Subsequently, for KL G395A, A allele and GA genotype were found to correlate with increased susceptibility to CKD, while its correlation to age-related cognitive impairment was failed to clarify. For KL C1818T, our analysis failed to find the correlation with the risk of CKD. Conclusions: Our results reveal that the NOS3 G894T gene polymorphism has a crucial role in the pathogenesis of both CKD and age-related cognitive impairment.
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Affiliation(s)
- Atma Gunawan
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Jonny Karunia Fajar
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Fredo Tamara
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Aditya Indra Mahendra
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Muhammad Ilmawan
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Yeni Purnamasari
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | | | - Eden Suryoiman Winoto
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Efriko Septananda Saifillah
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Dewi Sri Wulandari
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Pratista Adi Krisna
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Ema Dianita Mayasari
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Tri Wahyudi Iman Dantara
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Ramadi Satryo Wicaksono
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
- Department of Internal Medicine, Rumah Sakit Umum Daerah Bangil., Pasuruan, East Java, 67153, Indonesia
| | - Djoko Wahono Soeatmadji
- Division of Endocrinology and Metabolic Diseases, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
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25
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Wakasugi M, Kazama JJ, Wada A, Hamano T, Masakane I, Narita I. Functional impairment attenuates the association between high serum phosphate and mortality in dialysis patients: a nationwide cohort study. Nephrol Dial Transplant 2020; 34:1207-1216. [PMID: 30124993 DOI: 10.1093/ndt/gfy253] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Both functional impairment and abnormalities in mineral and bone disorder (MBD) parameters are well-known predictors of mortality in dialysis patients. However, previous studies have not evaluated whether functional impairment modifies the association between MBD parameters and mortality. METHODS A nationwide prospective cohort study was conducted using data from the Japanese Society for Dialysis Therapy Renal Data Registry collected at the end of 2009 and 2010. The Eastern Cooperative Oncology Group performance status (PS) was used to assess functional status. Cox proportional hazards models were used to assess the associations of baseline functional status, serum phosphate, albumin-corrected calcium and intact parathyroid hormone (PTH) with 1-year all-cause mortality. RESULTS By 31 December 2010, 18 447 of 220 054 prevalent dialysis patients (8.4%) had died. Mortality significantly increased with worsening PS grade. PS grade modified the association of serum phosphate levels with mortality (Pinteraction = 0.001). Worsening PS grade attenuated the association of hyperphosphatemia (≥7.4 mg/dL) with mortality, and hyperphosphatemia was no longer significant on mortality among patients with the worst PS grade (hazard ratio = 1.1, 95% confidence interval 0.88-1.39), compared with the level between 3.5 and 4.7 mg/dL. In contrast, hypophosphatemia (<3.5 mg/dL) had a greater adjusted risk of mortality irrespective of PS grade. Serum-corrected calcium (Pinteraction = 0.26) and intact PTH (Pinteraction = 0.17) showed consistent associations with mortality irrespective of PS grade. Findings were robust in several sensitivity analyses. CONCLUSIONS Functional impairment was significantly associated with 1-year mortality and attenuated the effect of hyperphosphatemia on mortality among prevalent dialysis patients.
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Affiliation(s)
- Minako Wakasugi
- Division of Comprehensive Geriatrics in Community, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Junichiro James Kazama
- Department of Nephrology and Hypertension, Fukushima Medical University, Fukushima, Japan
| | - Atsushi Wada
- Committee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan
| | - Takayuki Hamano
- Committee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan
| | - Ikuto Masakane
- Committee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan
| | - Ichiei Narita
- Divisions of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan
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Amaro-Gahete FJ, De-la-O A, Jurado-Fasoli L, Espuch-Oliver A, de Haro T, Gutiérrez Á, Ruiz JR, Castillo MJ. Body Composition and S-Klotho Plasma Levels in Middle-Aged Adults: A Cross-Sectional Study. Rejuvenation Res 2019; 22:478-483. [DOI: 10.1089/rej.2018.2092] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Francisco J. Amaro-Gahete
- EFFECTS-262 Research Group, Department of Physiology, School of Medicine, University of Granada, Granada, Spain
- PROmoting FITness and Health Through Physical Activity Research Group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Alejandro De-la-O
- EFFECTS-262 Research Group, Department of Physiology, School of Medicine, University of Granada, Granada, Spain
| | - Lucas Jurado-Fasoli
- EFFECTS-262 Research Group, Department of Physiology, School of Medicine, University of Granada, Granada, Spain
| | - Andrea Espuch-Oliver
- Clinical Laboratory Service, “Virgen de las Nieves” University Hospital, Granada, Spain
| | - Tomás de Haro
- Clinical Laboratory Service, “San Cecilio” University Hospital, Granada, Spain
| | - Ángel Gutiérrez
- EFFECTS-262 Research Group, Department of Physiology, School of Medicine, University of Granada, Granada, Spain
| | - Jonatan R. Ruiz
- PROmoting FITness and Health Through Physical Activity Research Group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Manuel J. Castillo
- EFFECTS-262 Research Group, Department of Physiology, School of Medicine, University of Granada, Granada, Spain
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27
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The goddess who spins the thread of life: Klotho, psychiatric stress, and accelerated aging. Brain Behav Immun 2019; 80:193-203. [PMID: 30872092 PMCID: PMC6660403 DOI: 10.1016/j.bbi.2019.03.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/27/2019] [Accepted: 03/09/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Longevity gene klotho (KL) is associated with age-related phenotypes but has not been evaluated against a direct human biomarker of cellular aging. We examined KL and psychiatric stress, including posttraumatic stress disorder (PTSD), which is thought to potentiate accelerated aging, in association with biomarkers of cellular aging. METHODS The sample comprised 309 white, non-Hispanic genotyped veterans with measures of epigenetic age (DNA methylation age), telomere length (n = 252), inflammation (C-reactive protein), psychiatric symptoms, metabolic function, and white matter neural integrity (diffusion tensor imaging; n = 185). Genotyping and DNA methylation were obtained on epi/genome-wide beadchips. RESULTS In gene by environment analyses, two KL variants (rs9315202 and rs9563121) interacted with PTSD severity (peak corrected p = 0.044) and sleep disturbance (peak corrected p = 0.034) to predict advanced epigenetic age. KL variant, rs398655, interacted with self-reported pain in association with slowed epigenetic age (corrected p = 0.048). A well-studied protective variant, rs9527025, was associated with slowed epigenetic age (p = 0.046). The peak PTSD interaction term (with rs9315202) also predicted C-reactive protein (p = 0.049), and white matter microstructural integrity in two tracts (corrected ps = 0.005 - 0.035). This SNP evidenced a main effect with an index of metabolic syndrome severity (p = 0.015). Effects were generally accentuated in older subjects. CONCLUSIONS Rs9315202 predicted multiple biomarkers of cellular aging such that psychiatric stress was more strongly associated with cellular aging in those with the minor allele. KL genotype may contribute to a synchronized pathological aging response to stress and could be a therapeutic target to alter the pace of cellular aging.
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Shardell M, Semba RD, Kalyani RR, Bandinelli S, Prather AA, Chia CW, Ferrucci L. Plasma Klotho and Frailty in Older Adults: Findings From the InCHIANTI Study. J Gerontol A Biol Sci Med Sci 2019; 74:1052-1057. [PMID: 29053774 PMCID: PMC6580690 DOI: 10.1093/gerona/glx202] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 10/16/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The hormone klotho, encoded by the gene klotho, is primarily expressed in the kidney and choroid plexus of the brain. Higher klotho concentrations have been linked to better physical performance; however, it is unknown whether klotho relates to frailty status in older adults. METHODS Plasma klotho was measured in 774 participants aged ≥65 years enrolled in InCHIANTI, a prospective cohort study comprising Italian adults. Frailty status was assessed at 3 and 6 years after enrollment. Frailty was defined as presence of at least three out of five criteria of unintentional weight loss, exhaustion, sedentariness, muscle weakness, and slow walking speed; prefrailty was defined as presence of one or two criteria; and robustness was defined as zero criteria. We assessed whether plasma klotho concentrations measured at the 3-year visit related to frailty. RESULTS Each additional natural logarithm of klotho (pg/mL) was associated with lower odds of frailty versus robustness after adjustment for covariates (odds ratio [OR] 0.46; 95% confidence interval 0.21, 0.98; p-value = .045). Higher klotho was particularly associated with lower odds of exhaustion (OR 0.57; 95% CI 0.36, 0.89; p-value = .014). Participants with higher klotho also had lower estimated odds of weight loss and weakness, but these findings were not statistically significant. CONCLUSIONS Higher plasma klotho concentrations were associated with lower likelihoods of frailty and particularly exhaustion. Future studies should investigate modifiable mechanisms through which klotho may affect the frailty syndrome.
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Affiliation(s)
- Michelle Shardell
- Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland
| | - Richard D Semba
- Wilmer Eye Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Rita R Kalyani
- Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | | | - Aric A Prather
- Department of Psychiatry, University of California San Francisco, San Francisco, California
| | - Chee W Chia
- Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland
| | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland
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Physical performance, plasma S-klotho, and all-cause mortality in elderly dialysis patients: A prospective cohort study. Exp Gerontol 2019; 122:123-128. [PMID: 31077742 DOI: 10.1016/j.exger.2019.05.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/28/2019] [Accepted: 05/07/2019] [Indexed: 12/28/2022]
Abstract
The secreted protein form of the α-klotho gene, S-klotho, is gaining popularity as a predictor of overall morbimortality, and its role in dialysis patients has been recently highlighted. However, physical performance -which can be assessed through practical field-tests- might be a more practical prognostic marker. The present study aimed to analyze the relationship between physical performance, plasma S-klotho and all-cause mortality in this population. 30 male hemodialysis patients (71 ± 9 years) participated in this prospective, cohort study. Their plasma S-klotho levels and physical performance (assessed by means of the 6-minute walk test [6MWT], handgrip strength, and the sit-to-stand test [STS]) were determined at baseline, and the incidence of mortality was assessed 18-month later. Lower S-klotho levels were associated with a worse performance in all physical tests (all p < 0.05). 12 participants died during the 18 months following baseline measurements. An increased mortality risk was observed in those patients with a worse performance in the STS (RR: 3.0 [95%CI: 1.01-8.95], p < 0.05), the handgrip test (RR: 3.0 [95%CI: 1.01-8.95], p < 0.05) and the 6MWT (RR: 5.0 [95%CI: 1.31-19.07], p < 0.01), being the latter the best predictor of mortality. By contrast, this relationship was not found for plasma S-klotho (RR: 1.6 [95%CI: 0.65-1.35], p > 0.05). In summary, low plasma S-klotho levels are related to impaired physical performance in male dialysis patients. However, physical performance appears as a better and more practical predictor of mortality in this patient population.
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30
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Peripheral levels of the anti-aging hormone Klotho in patients with depression. J Neural Transm (Vienna) 2019; 126:771-776. [PMID: 31055648 DOI: 10.1007/s00702-019-02008-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 04/30/2019] [Indexed: 01/06/2023]
Abstract
Klotho is a humoral factor with pleiotropic effects. Most notably, Klotho deficiency is associated with a phenotype comprising organ manifestations accompanying aging including atherosclerosis and cognitive impairment. Research on the role of Klotho in affective disorder is scarce, which is surprising in light of the fact that depression is associated with accelerated cellular aging as well as aging-related phenotypes and comorbidity observed in Klotho deficiency. Soluble α-Klotho (sKlotho) serum levels in patients with a major depressive episode and either undergoing electroconvulsive therapy (n = 16) or a monotherapy with an antidepressant (n = 37) were investigated. We measured the sKlotho serum levels in those patients before and after treatment and compared the baseline levels with those of age-matched healthy controls (n = 39). No group differences were found between the baseline sKlotho levels of patients and controls (573.5 pg/ml vs. 563.8 pg/ml; p = 0.80) and between pre- and post-treatment in the patients with depression (563.8 pg/ml vs. 561.8 pg/ml; p = 0.15), when treated either with electroconvulsive therapy or antidepressant. The major limitation of our study might be that peripheral material such as serum might not reliably reflect processes in the central nervous system. In sum, this first study on peripheral sKlotho levels in a clinical sample cannot confirm a global Klotho dysregulation in depression as it has been already suggested by others. Nonetheless, further preclinical and clinical studies on the involvement of Klotho in affective disorders should be carried out.
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Association of physical activity and fitness with S-Klotho plasma levels in middle-aged sedentary adults: The FIT-AGEING study. Maturitas 2019; 123:25-31. [DOI: 10.1016/j.maturitas.2019.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 01/30/2019] [Accepted: 02/04/2019] [Indexed: 12/14/2022]
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Martín-González C, González-Reimers E, Quintero-Platt G, Martínez-Riera A, Santolaria-Fernández F. Soluble α-Klotho in Liver Cirrhosis and Alcoholism. Alcohol Alcohol 2019; 54:204-208. [PMID: 30860544 DOI: 10.1093/alcalc/agz019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 02/21/2019] [Indexed: 11/13/2022] Open
Abstract
AIMS AND BACKGROUND Alpha Klotho is a transmembrane protein that serves as co-receptor for FGF23. Ectodomain of membrane bound α Klotho may be shed by membrane bound proteases (activated, among other factors, by tumor necrosis factor (TNF)-α) generating the soluble form of the protein (sKl) that functions as a hormone by itself. It modulates calcium influx into cells, blunts IGF-1/Insulin signaling, promotes synthesis of antioxidants, generally slows down tumor progression, delays cell senescence, is neuroprotective and promotes oligodendrocyte maturation and myelin synthesis, and muscle rejuvenation. It may be involved in inflammation and exerts antifibrogenic effects. Some of these pathways may become altered in alcoholism or liver cirrhosis, but data are scattered and scarce and an update is required. METHOD Literature survey. RESULTS AND CONCLUSIONS Alcohol consumption in non-alcoholics is inversely related to sKl, but alcoholic cirrhotics showed higher-than-normal sKl values in association with liver function derangement. In hepatoma cells, the intensity of Klotho staining was related to faster tumor progression and a shortened life span. Among severe alcoholic cirrhotics sKl is directly related to serum TNF-α levels, and, inversely, to brain atrophy. Given the antioxidant, anti-inflammatory, and antifibrogenic effects of Klotho, perhaps the increase in cirrhosis (and in other inflammatory conditions, such as sepsis or cancer) reflects an attempt to regulate increased inflammation, but clinical and experimental research is urgently needed in this field.
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Affiliation(s)
- C Martín-González
- Servicio de Medicina Interna. Hospital Universitario de Canarias. Universidad de La Laguna. Tenerife, Canary Islands, Spain
| | - E González-Reimers
- Servicio de Medicina Interna. Hospital Universitario de Canarias. Universidad de La Laguna. Tenerife, Canary Islands, Spain
| | - G Quintero-Platt
- Servicio de Medicina Interna. Hospital Universitario de Canarias. Universidad de La Laguna. Tenerife, Canary Islands, Spain
| | - A Martínez-Riera
- Servicio de Medicina Interna. Hospital Universitario de Canarias. Universidad de La Laguna. Tenerife, Canary Islands, Spain
| | - F Santolaria-Fernández
- Servicio de Medicina Interna. Hospital Universitario de Canarias. Universidad de La Laguna. Tenerife, Canary Islands, Spain
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Maniragaba F, Nzabona A, Asiimwe JB, Bizimungu E, Mushomi J, Ntozi J, Kwagala B. Factors associated with older persons' physical health in rural Uganda. PLoS One 2019; 14:e0209262. [PMID: 30650092 PMCID: PMC6334921 DOI: 10.1371/journal.pone.0209262] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 12/03/2018] [Indexed: 12/22/2022] Open
Abstract
Introduction The proportion of older persons in developing countries is increasing with no clear evidence of improvement in physical health. The aim of this paper was to examine the factors associated with older persons’ physical health in rural Uganda. Methods This paper is based on a cross-sectional study of 912 older persons age 60 years and older across four major regions of Uganda. The study was conceptualized basing on World Health Organization quality of life BREF (WHOQOL-BREF). Analysis was done at three levels, that is, frequency distributions were generated to describe background characteristics of respondents and cross-tabulations were done to determine associations between dependent and each of the independent variables. Ordinal logistic regression was used to determine the predictors of physical health. Results The likelihood of good physical health is high among older persons (Ops) who controlled their household assets (OR = 3.64; CI = 1.81–7.30) or the household assets controlled by their spouses (OR = 4.44; CI = 1.91–10.32) relative to those whose household assets were controlled by their children. There is high likelihood of good physical health among those who engage in physical activities (OR = 2.28; CI = 1.52–3.43) compared to those who do not. Conclusion The findings have various policy implications, including creating an enabling environment and building capacities of older persons to remain in control of their household assets. Interventions focusing on deepening sensitization of older persons about importance of physical exercises could be a viable strategy for improving physical health of older persons.
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Affiliation(s)
- Fred Maniragaba
- Department of Population Studies, Makerere University, Kampala, Uganda
- * E-mail:
| | - Abel Nzabona
- Department of Population Studies, Makerere University, Kampala, Uganda
| | - John Bosco Asiimwe
- Department of Planning and Applied Statistics, Makerere University, Kampala, Uganda
| | | | - John Mushomi
- Department of Population Studies, Makerere University, Kampala, Uganda
| | - James Ntozi
- Department of Population Studies, Makerere University, Kampala, Uganda
| | - Betty Kwagala
- Department of Population Studies, Makerere University, Kampala, Uganda
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Sahu A, Mamiya H, Shinde SN, Cheikhi A, Winter LL, Vo NV, Stolz D, Roginskaya V, Tang WY, St Croix C, Sanders LH, Franti M, Van Houten B, Rando TA, Barchowsky A, Ambrosio F. Age-related declines in α-Klotho drive progenitor cell mitochondrial dysfunction and impaired muscle regeneration. Nat Commun 2018; 9:4859. [PMID: 30451844 PMCID: PMC6242898 DOI: 10.1038/s41467-018-07253-3] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 10/23/2018] [Indexed: 01/15/2023] Open
Abstract
While young muscle is capable of restoring the original architecture of damaged myofibers, aged muscle displays a markedly reduced regeneration. We show that expression of the "anti-aging" protein, α-Klotho, is up-regulated within young injured muscle as a result of transient Klotho promoter demethylation. However, epigenetic control of the Klotho promoter is lost with aging. Genetic inhibition of α-Klotho in vivo disrupted muscle progenitor cell (MPC) lineage progression and impaired myofiber regeneration, revealing a critical role for α-Klotho in the regenerative cascade. Genetic silencing of Klotho in young MPCs drove mitochondrial DNA (mtDNA) damage and decreased cellular bioenergetics. Conversely, supplementation with α-Klotho restored mtDNA integrity and bioenergetics of aged MPCs to youthful levels in vitro and enhanced functional regeneration of aged muscle in vivo in a temporally-dependent manner. These studies identify a role for α-Klotho in the regulation of MPC mitochondrial function and implicate α-Klotho declines as a driver of impaired muscle regeneration with age.
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MESH Headings
- Aging/genetics
- Aging/metabolism
- Aging/pathology
- Animals
- DNA Methylation
- DNA, Mitochondrial/genetics
- DNA, Mitochondrial/metabolism
- Epigenesis, Genetic
- Gene Expression Regulation, Developmental
- Glucuronidase
- Klotho Proteins
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Mitochondria/genetics
- Mitochondria/metabolism
- Muscle, Skeletal/metabolism
- Muscle, Skeletal/pathology
- Myoblasts/metabolism
- Myoblasts/pathology
- Promoter Regions, Genetic
- RNA, Small Interfering/genetics
- RNA, Small Interfering/metabolism
- Receptors, Cell Surface/antagonists & inhibitors
- Receptors, Cell Surface/genetics
- Receptors, Cell Surface/metabolism
- Regeneration/genetics
- Signal Transduction
- Stem Cells/metabolism
- Stem Cells/pathology
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Affiliation(s)
- A Sahu
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, 15213, PA, USA
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, 15261, PA, USA
| | - H Mamiya
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, 15213, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, 15260, PA, USA
| | - S N Shinde
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, 15213, PA, USA
| | - A Cheikhi
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, 15213, PA, USA
- Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, 15213, PA, USA
| | - L L Winter
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, 15213, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, 15260, PA, USA
| | - N V Vo
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, 15213, PA, USA
- Department of Pathology, University of Pittsburgh, Pittsburgh, 15261, PA, USA
| | - D Stolz
- Department of Cell Biology, University of Pittsburgh, Pittsburgh, 15261, PA, USA
| | - V Roginskaya
- Department of Pharmacology & Chemical Biology, University of Pittsburgh Cancer Institute, University of Pittsburgh, Pittsburgh, 15232, PA, USA
| | - W Y Tang
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, 21218-2608, MD, USA
| | - C St Croix
- Department of Cell Biology, University of Pittsburgh, Pittsburgh, 15261, PA, USA
| | - L H Sanders
- Department of Neurology, Duke University School of Medicine, Durham, 27704, NC, USA
| | - M Franti
- Research Beyond Borders: Boehringer-Ingelheim Pharmaceuticals, Ridgefield, 06877, CT, USA
| | - B Van Houten
- Department of Pharmacology & Chemical Biology, University of Pittsburgh Cancer Institute, University of Pittsburgh, Pittsburgh, 15232, PA, USA
| | - T A Rando
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA
- The Paul F. Glenn Center for the Biology of Aging, Stanford University School of Medicine, Stanford, CA, 94305, USA
- Center for Tissue Regeneration, Restoration and Repair, Veterans Affairs Hospital, Palo Alto, CA, 94036, USA
| | - A Barchowsky
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, 15261, PA, USA
- Department of Pharmacology & Chemical Biology, University of Pittsburgh Cancer Institute, University of Pittsburgh, Pittsburgh, 15232, PA, USA
| | - F Ambrosio
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, 15213, PA, USA.
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, 15261, PA, USA.
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, 15260, PA, USA.
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, 15213, PA, USA.
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, 15219, PA, USA.
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Hao Q, Wang Y, Ding X, Dong B, Yang M, Dong B, Wei Y. G-395A polymorphism in the promoter region of the KLOTHO gene associates with frailty among the oldest-old. Sci Rep 2018; 8:6735. [PMID: 29712948 PMCID: PMC5928057 DOI: 10.1038/s41598-018-25040-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 04/11/2018] [Indexed: 02/05/2023] Open
Abstract
Frailty is characterized by a decline in physiological reserve and increased vulnerability. Previous studies have shown that KLOTHO (KL) plays a protective role in several age-related diseases. We hypothesize a probable protective effect of KL on frailty in the elderly population and included a cohort of Chinese nonagenarians and centenarians for our study. This study is part of a cross-sectional study and secondary analysis of the Project of Longevity and Aging in Dujiangyan (PLAD) study, which was conducted in Southwest China. Community-dwelling Chinese residents aged 90 years or older were included in this study. Frailty was determined using the FRAIL scale as proposed by the International Association of Nutrition and Aging. On the FRAIL scale, frailty was defined by a score of ≥3. G-395A (rs1207568) genotyping of the promoter region of the KL gene was performed using TaqMan allelic discrimination assay. A total of 632 participants (68.4% females; mean age: 93.5 ± 3.2 years) were included. KL G-395A polymorphism genotype frequencies were 1.7% AA, 25.6% GA, and 72.7% GG in our sample. GG genotype frequencies for the frailty and control groups were 83.6% and 71.2%, respectively. Frailty prevalence was significantly lower in the GA+AA group when compared to the GG genotype group (6.9% vs. 13.3%, P = 0.026). In addition, subjects with a GA+AA genotype had a significantly lower risk of frailty (odds ratio (OR): 0.47, 95% confidence interval (CI) 0.23 to 0.97, P = 0.040) compared to the GG genotype after adjusting for age, gender, education level, smoking, alcohol consumption, exercise, body mass index (BMI), cognitive impairment, and other potential factors. KL-395A allele carrying genotypes (GA and AA) is associated with a lower risk of frailty relative to GG genotypes in a sample of Chinese nonagenarians and centenarians.
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Affiliation(s)
- Qiukui Hao
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuting Wang
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiang Ding
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Biao Dong
- National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,State Key Laboratory of Biotherapy and Cancer Center/Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ming Yang
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China. .,National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Birong Dong
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuquan Wei
- State Key Laboratory of Biotherapy and Cancer Center/Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Hoyer C, Sartorius A, Aksay SS, Bumb JM, Janke C, Thiel M, Haffner D, Leifheit-Nestler M, Kranaster L. Electroconvulsive therapy enhances the anti-ageing hormone Klotho in the cerebrospinal fluid of geriatric patients with major depression. Eur Neuropsychopharmacol 2018; 28:428-435. [PMID: 29274997 DOI: 10.1016/j.euroneuro.2017.12.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 10/25/2017] [Accepted: 12/06/2017] [Indexed: 02/06/2023]
Abstract
Klotho is a humoral factor with pleiotropic effects. Most notably, Klotho deficiency is associated with a phenotype comprising organ manifestations accompanying aging including atherosclerosis and cognitive impairment. Research on the role of Klotho in affective disorder is scarce, which is surprising in light of the fact that depression is associated with accelerated cellular aging as well as aging-related phenotypes and comorbidity observed in Klotho deficiency. On these grounds we investigated Klotho levels in the cerebrospinal fluid (CSF) and serum of eight geriatric patients undergoing electroconvulsive therapy (ECT) for severe depression. We hypothesize that ECT as a highly effective antidepressant treatment leads enhances Klotho levels. We found a significant difference between pre- and post-ECT CSF Klotho (792.5pg/ml vs. 991.3pg/ml, p=0.0020), but no difference in serum Klotho (602.5 vs. 594.3, p=0.32). Moreover, CSF Klotho increase positively correlated with the number of single ECT sessions that were performed in each patient (F1, 6)=7.84, p=0.031). Conjointly, the results of our exploratory study with a small sample size suggest a central nervous system-specific impact of ECT on Klotho, which may in turn partake in mediating the antidepressant effect of ECT. We suggest the modulation of neuroinflammatory processes, which have been ascribed pathophysiological relevance within the conceptual framework of the neuroinflammation hypothesis of depression, through ECT as a potential mechanism by which Klotho is enhanced in response to treatment. Further preclinical and clinical investigation should aim for a precise identification of the role of Klotho in depressive disorder.
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Affiliation(s)
- Carolin Hoyer
- Department of Neurology, University Medical Centre Mannheim, Mannheim, Germany
| | - Alexander Sartorius
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Suna Su Aksay
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jan Malte Bumb
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Christoph Janke
- Department of Anesthesiology and Critical Care Medicine, University Medical Centre Mannheim, Mannheim, Germany
| | - Manfred Thiel
- Department of Anesthesiology and Critical Care Medicine, University Medical Centre Mannheim, Mannheim, Germany
| | - Dieter Haffner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Maren Leifheit-Nestler
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Laura Kranaster
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
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37
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Saghiv MS, Sira DB, Goldhammer E, Sagiv M. The effects of aerobic and anaerobic exercises on circulating soluble-Klotho and IGF-I in young and elderly adults and in CAD patients. J Circ Biomark 2017; 6:1849454417733388. [PMID: 29081845 PMCID: PMC5644364 DOI: 10.1177/1849454417733388] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 08/09/2017] [Indexed: 12/15/2022] Open
Abstract
Different studies support the notion that chronic aerobic exercises training can influence the circulating levels of soluble-Klotho (s-Klotho) and insulin-like growth factor 1 (IGF-I). The effects of s-Klotho include improving the quality of life, alleviating the negative impact of age on the body's work capacity, and possibly increasing longevity. This review provides an overview of the latest findings in this field of research in humans. The different modes of dynamic exercise and their impact on circulating levels of s-Klotho and IGF-I in young adult athletes, untrained young adults, trained healthy older adults, untrained healthy older adults, and coronary artery disease (CAD) patients are reviewed and discussed. Together these findings suggest that long-lasting (chronic) aerobic exercise training is probably one of the antiaging factors that counteract the aging and CAD process by increasing the circulating s-Klotho and lowering the IGF-I levels. However, following anaerobic exercise training the opposite occurs. The exact metabolic and physiological pathways involved in the activity of these well-trained young and master sportsmen should be further studied and elucidated. The purpose of this review was to provide a clarification regarding the roles of s-Klotho and intensities and durations of different exercise on human health.
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Affiliation(s)
- Moran S Saghiv
- Exercise Physiology Department, University of Mary, Bismarck, ND, USA
| | - D Ben Sira
- Life Sciences Department, Wingate College, Wingate, Israel
| | - E Goldhammer
- Heart Institute Bnai-Zion Haifa Medical Center, Technion Institute, Haifa, Israel
| | - M Sagiv
- Life Sciences Department, Wingate College, Wingate, Israel
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Chalhoub D, Marques E, Meirelles O, Semba RD, Ferrucci L, Satterfield S, Nevitt M, Cauley JA, Harris T. Association of Serum Klotho with Loss of Bone Mineral Density and Fracture Risk in Older Adults. J Am Geriatr Soc 2016; 64:e304-e308. [PMID: 27910102 DOI: 10.1111/jgs.14661] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Klotho deficiency has been previously linked to aging-like phenotypes such as osteoporosis, cognitive impairment, and sarcopenia. Low serum klotho was shown to be related to grip strength and disability. Nonetheless, no previous study has explored the association between serum klotho and fractures. The purpose of this report is to examine the relationship of serum klotho with bone mineral density (BMD) loss and fractures in older adults. DESIGN The Health, Aging, and Body Composition (Health ABC) Study is a longitudinal cohort study of 3,075 community-dwelling older adults. SETTING US clinical centers. PARTICIPANTS Two thousand seven hundred and seventy six well-functioning black and white adults aged 70 to 79 years with serum klotho measurements were followed up for a median of 5 years. MEASUREMENTS Percent annualized BMD change and fracture risk were compared across klotho quartiles. A Poisson distribution was used to calculate age-adjusted fracture incidence rates, and Cox proportional hazards models for multivariable-adjusted hazard ratios. RESULTS The annualized percent changes in hip, femoral neck, and vertebral BMD were similar across klotho quartiles. Participants experienced 507 nonspine fractures, 203 hip fractures, and 135 vertebral fractures. The Incidence rate (IR) of nonspine fractures was 17 per 1,000 person-years. The most frequent site was hip (IR = 6 per 1,000 person-years) and the IR of vertebral fractures was 3 per 1,000 person-years. There was no association between the lowest quartile of plasma klotho and nonspine (hazard ratio (HR) = 1.19, 95% confidence interval (CI) = 0.86-1.65), hip (HR = 1.34, 95% CI = 0.79-2.27), or vertebral fractures (HR = 1.17, 95% CI = 0.65-2.11). CONCLUSION Although klotho gene is a susceptible gene for reduced BMD, klotho blood concentration does not appear to be a predictor of bone loss or fracture risk in well-functioning older adults.
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Affiliation(s)
- Didier Chalhoub
- Intramural Research Program, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, Maryland
| | - Elisa Marques
- Intramural Research Program, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, Maryland
| | - Osorio Meirelles
- Intramural Research Program, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, Maryland
| | - Richard D Semba
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Luigi Ferrucci
- Longitudinal Studies Section, National Institute on Aging, Baltimore, Maryland
| | - Suzanne Satterfield
- Department of Preventive Medicine, University of Tennessee, Memphis, Tennessee
| | - Michael Nevitt
- Department of Epidemiology and Biostatistics, UCSF School of Medicine, San Francisco, California
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Tamara Harris
- Intramural Research Program, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, Maryland
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Angulo J, El Assar M, Rodríguez-Mañas L. Frailty and sarcopenia as the basis for the phenotypic manifestation of chronic diseases in older adults. Mol Aspects Med 2016; 50:1-32. [PMID: 27370407 DOI: 10.1016/j.mam.2016.06.001] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 06/18/2016] [Indexed: 12/13/2022]
Abstract
Frailty is a functional status that precedes disability and is characterized by decreased functional reserve and increased vulnerability. In addition to disability, the frailty phenotype predicts falls, institutionalization, hospitalization and mortality. Frailty is the consequence of the interaction between the aging process and some chronic diseases and conditions that compromise functional systems and finally produce sarcopenia. Many of the clinical manifestations of frailty are explained by sarcopenia which is closely related to poor physical performance. Reduced regenerative capacity, malperfusion, oxidative stress, mitochondrial dysfunction and inflammation compose the sarcopenic skeletal muscle alterations associated to the frailty phenotype. Inflammation appears as a common determinant for chronic diseases, sarcopenia and frailty. The strategies to prevent the frailty phenotype include an adequate amount of physical activity and exercise as well as pharmacological interventions such as myostatin inhibitors and specific androgen receptor modulators. Cell response to stress pathways such as Nrf2, sirtuins and klotho could be considered as future therapeutic interventions for the management of frailty phenotype and aging-related chronic diseases.
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Affiliation(s)
- Javier Angulo
- Unidad de Investigación Cardiovascular (IRYCIS/UFV), Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Mariam El Assar
- Instituto de Investigación Sanitaria de Getafe, Getafe, Madrid, Spain
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Bartali B, Semba RD, Araujo AB. Klotho, FGF21 and FGF23: Novel Pathways to Musculoskeletal Health? J Frailty Aging 2016; 2:179-83. [PMID: 27070923 DOI: 10.14283/jfa.2013.26] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Bone mineral density, muscle mass and physical function reach their peak between the second and fourth decade of life and then decline steadily with aging. The crucial question is: what factors contribute to or modulate this decline? The aim of this mini-review is to propose a theoretical framework for the potential role of emerging biomarkers such as klotho, fibroblast growth factors (FGF)21 and FGF23 on musculoskeletal health, with a particular focus on decline in muscle mass and function, and calls for future research to examine this proposed link. The identification of new physiological mechanisms underlying these declines may open a potentially important avenue for the development of novel intervention strategies aimed at preventing or reducing their potentially detrimental consequences.
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Affiliation(s)
- B Bartali
- Benedetta Bartali, PhD, New England Research Institutes, 9 Galen Street Watertown, MA 02472 USA, Phone: +1(617) 972-3350, FAX: +1 (617) 673-9514,
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Rubinek T, Modan-Moses D. Klotho and the Growth Hormone/Insulin-Like Growth Factor 1 Axis: Novel Insights into Complex Interactions. VITAMINS AND HORMONES 2016; 101:85-118. [PMID: 27125739 DOI: 10.1016/bs.vh.2016.02.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The growth hormone (GH)/insulin-like growth factor (IGF)-1 axis is pivotal for many metabolic functions, including proper development and growth of bones, skeletal muscles, and adipose tissue. Defects in the axis' activity during childhood result in growth abnormalities, while increased secretion of GH from the pituitary results in acromegaly. In order to keep narrow physiologic concentration, GH and IGF-1 secretion and activity are tightly regulated by hypothalamic, pituitary, endocrine, paracrine, and autocrine factors. Klotho was first discovered as an aging-suppressor gene. Mice that do not express klotho die prematurely with multiple symptoms of aging, several of them are also characteristic of decreased GH/IGF-1 axis activity. Klotho is highly expressed in the brain, the kidney, and parathyroid and pituitary glands, but can also serve as a circulating hormone by its shedding, forming soluble klotho that can be detected in blood, cerebrospinal fluid, and urine. Several lines of evidence suggest an association between klotho levels and activity of the GH/IGF-1 axis: the GH-secreting cells in the anterior pituitary of klotho-deficient mice are hypotrophic; klotho levels are altered in subjects with pathologies of the GH/IGF-1 axis; and accumulating data indicate that klotho is a direct regulator of GH secretion. Thus, klotho seems to be a new player in the intricate regulation of the GH/IGF-1 axis.
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Affiliation(s)
- T Rubinek
- Institute of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
| | - D Modan-Moses
- The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel; Tel Aviv University, Tel Aviv, Israel
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Patel MS, Donaldson AV, Lewis A, Natanek SA, Lee JY, Andersson YM, Haji G, Jackson SG, Bolognese BJ, Foley JP, Podolin PL, Bruijnzeel PLB, Hart N, Hopkinson NS, Man WDC, Kemp PR, Polkey MI. Klotho and smoking--An interplay influencing the skeletal muscle function deficits that occur in COPD. Respir Med 2016; 113:50-6. [PMID: 27021580 DOI: 10.1016/j.rmed.2016.02.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 02/05/2016] [Accepted: 02/11/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND Klotho is an 'anti-ageing' hormone and transmembrane protein; Klotho deficient mice develop a similar ageing phenotype to smokers including emphysema and muscle wasting. The objective of this study was to evaluate skeletal muscle and circulating Klotho protein in smokers and COPD patients and to relate Klotho levels to relevant skeletal muscle parameters. We sought to validate our findings by undertaking complimentary murine studies. METHODS Fat free mass, quadriceps strength and spirometry were measured in 87 participants (61 COPD, 13 'healthy smokers' and 13 never smoking controls) in whom serum and quadriceps Klotho protein levels were also measured. Immunohistochemistry was performed to demonstrate the location of Klotho protein in human skeletal muscle and in mouse skeletal muscle in which regeneration was occurring following injury induced by electroporation. In a separate study, gastrocnemius Klotho protein was measured in mice exposed to 77 weeks of smoke or sham air. RESULTS Quadriceps Klotho levels were lower in those currently smoking (p = 0.01), irrespective of spirometry, but were not lower in patients with COPD. A regression analysis identified current smoking status as the only independent variable associated with human quadriceps Klotho levels, an observation supported by the finding that smoke exposed mice had lower gastrocnemius Klotho levels than sham exposed mice (p = 0.005). Quadriceps Klotho levels related to local oxidative stress but were paradoxically higher in patients with established muscle wasting or weakness; the unexpected relationship with low fat free mass was the only independent association. Within locomotor muscle, Klotho localized to the plasma membrane and to centralized nuclei in humans and in mice with induced muscle damage. Serum Klotho had an independent association with quadriceps strength but did not relate to quadriceps Klotho levels or to spirometric parameters. CONCLUSIONS Klotho is expressed in skeletal muscle and levels are reduced by smoking. Despite this, quadriceps Klotho protein expression in those with established disease appears complex as levels were paradoxically elevated in COPD patients with established muscle wasting. Whilst serum Klotho levels were not reduced in smokers or COPD patients and were not associated with quadriceps Klotho protein, they did relate to quadriceps strength.
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Affiliation(s)
- M S Patel
- NIHR Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust and Imperial College, UK; Imperial College London, UK
| | - A V Donaldson
- NIHR Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust and Imperial College, UK; Imperial College London, UK
| | | | - S A Natanek
- NIHR Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust and Imperial College, UK; Imperial College London, UK
| | | | | | - G Haji
- NIHR Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust and Imperial College, UK; Imperial College London, UK
| | | | - B J Bolognese
- Respiratory Therapeutic Area, GlaxoSmithKline, King of Prussia, PA, USA
| | - J P Foley
- Respiratory Therapeutic Area, GlaxoSmithKline, King of Prussia, PA, USA
| | - P L Podolin
- Respiratory Therapeutic Area, GlaxoSmithKline, King of Prussia, PA, USA
| | | | - N Hart
- NIHR Comprehensive Biomedical Research Centre, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - N S Hopkinson
- NIHR Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust and Imperial College, UK; Imperial College London, UK
| | - W D-C Man
- NIHR Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust and Imperial College, UK; Imperial College London, UK
| | | | - M I Polkey
- NIHR Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust and Imperial College, UK; Imperial College London, UK.
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Shardell M, Semba RD, Rosano C, Kalyani RR, Bandinelli S, Chia CW, Ferrucci L. Plasma Klotho and Cognitive Decline in Older Adults: Findings From the InCHIANTI Study. J Gerontol A Biol Sci Med Sci 2015; 71:677-82. [PMID: 26297657 DOI: 10.1093/gerona/glv140] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 07/20/2015] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The hormone klotho, encoded by the gene klotho, is primarily expressed in the kidney and choroid plexus of the brain. Higher klotho concentrations and certain genetic variants of klotho have been linked to better cognition; however, it is unknown whether klotho relates prospectively to slower cognitive decline in older adults. METHODS Plasma klotho was measured in 833 participants aged 55 or older without dementia enrolled in InCHIANTI, a prospective cohort study comprising Italian adults. Cognition was measured by Mini-Mental State Examination (MMSE) and Trail-Making Tests A and B (Trails A and Trails B) at enrollment and at 3 and 6 years after enrollment. We assessed whether klotho concentrations measured at the 3-year visit related to cognition and cognitive decline. RESULTS Each additional natural logarithm of klotho (pg/mL) was associated with 35% lower risk of meaningful decline in MMSE, defined as decline exceeding three points (relative risk = 0.65; 95% confidence interval 0.45, 0.95; p value = .02), and 0.75-point smaller average 3-year decline (baseline to 3-year visit) in MMSE (95% confidence interval 0.02, 1.48; p value = .04). No statistically significant associations were found between klotho and declining Trails A (relative risk = 0.99; 95% confidence interval 0.75, 1.32; p value = .97) and B (relative risk = 1.02; 95% confidence interval 0.84, 1.24; p value = .82). CONCLUSIONS Higher plasma klotho concentrations were associated with lower risk of meaningful decline and smaller average decline in MMSE. We did not observe such findings with Trails A and B, perhaps because they test executive function and motor skills, whereas MMSE measures global cognition. Future studies should investigate mechanisms through which klotho may affect domain-specific cognitive changes.
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Affiliation(s)
- Michelle Shardell
- Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland.
| | - Richard D Semba
- Wilmer Eye Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Rita R Kalyani
- Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | | | - Chee W Chia
- Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland
| | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on Aging, Baltimore, Maryland
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Prather AA, Epel ES, Arenander J, Broestl L, Garay BI, Wang D, Dubal DB. Longevity factor klotho and chronic psychological stress. Transl Psychiatry 2015; 5:e585. [PMID: 26080320 PMCID: PMC4490291 DOI: 10.1038/tp.2015.81] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 05/07/2015] [Indexed: 12/31/2022] Open
Abstract
Chronic psychological stress is associated with accelerated aging and premature morbidity and mortality; however, the biology linking chronic psychological stress and its maladaptive effects remains largely unknown. Klotho is a pleiotropic hormone that regulates the aging process and promotes better brain and body health. Whether klotho is linked to psychosocial stress or its negative impact in humans has not been investigated. To address this gap, we recruited 178 healthy women who were either chronically high-stress maternal caregivers for a child with autism spectrum disorder (n = 90) or low-stress control mothers of a typically developing child (n = 88). We found that women under high chronic stress displayed significantly lower levels of the longevity hormone klotho compared with low-stress controls (t(176) = 2.92, P = 0.004; d = 0.44), and the decrease among those under high stress was age-dependent. In addition, high-stress caregivers who reported more depressive symptoms displayed even lower klotho levels compared with low-stress participants. These findings provide the first evidence that klotho levels are sensitive to psychosocial stressors and raise the possibility that klotho may serve as a novel biological link connecting stress, depression and risk for accelerated disease development. Furthermore, these findings have important implications for understanding the plasticity of the aging process and may represent a therapeutic target for mitigating the deleterious effects of chronic psychological stress on health and well-being.
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Affiliation(s)
- A A Prather
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA,Department of Psychiatry, University of California, San Francisco, 3333 California Street, Suite 465, San Francisco, CA 94118, USA E-mail:
| | - E S Epel
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - J Arenander
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - L Broestl
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - B I Garay
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - D Wang
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - D B Dubal
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA,Department of Neurology, University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA, 94158, USA. E-mail:
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Shardell M, Semba RD, Kalyani RR, Hicks GE, Bandinelli S, Ferrucci L. Serum 25-Hydroxyvitamin D, Plasma Klotho, and Lower-Extremity Physical Performance Among Older Adults: Findings From the InCHIANTI Study. J Gerontol A Biol Sci Med Sci 2015; 70:1156-62. [PMID: 25748032 DOI: 10.1093/gerona/glv017] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 01/29/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The hormone klotho is encoded by aging-suppressor gene klotho and has multiple roles, including regulating mineral (calcium and phosphate) homeostasis. Vitamin D also regulates mineral homeostasis and upregulates klotho expression. Klotho positively relates to longevity, upper-extremity strength, and reduced disability in older adults; however, it is unknown whether circulating klotho relates to lower-extremity physical performance or whether the relation of vitamin D with physical performance is mediated by klotho. METHODS Klotho and 25-hydroxyvitamin D [25(OH)D] were measured in 860 participants aged ≥ 55 years in Invecchiare in Chianti, "Aging in Chianti" (InCHIANTI), a prospective cohort study comprising Italian adults. Lower-extremity physical performance was measured using the Short Physical Performance Battery, a summary score of balance, chair stand ability, and walking speed. Weighted estimating equations related plasma klotho and serum 25(OH)D concentrations measured at one visit to Short Physical Performance Battery measured longitudinally at multiple visits. RESULTS Each additional natural log of klotho (pg/mL) was associated with 0.47 higher average Short Physical Performance Battery scores (95% confidence interval: 0.08 to 0.86, p value = .02) after adjustment for covariates, including 25(OH)D. Each natural log of 25(OH)D (ng/mL) was associated with 0.61 higher average Short Physical Performance Battery scores (95% confidence interval: 0.35 to 0.88, p value < .001) after adjustment for covariates, a result that changed little after adjustment for klotho. CONCLUSIONS Plasma klotho and 25(OH)D both positively related to lower-extremity physical performance. However, the findings did not support the hypothesis that klotho mediates the relation of 25(OH)D with physical performance.
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Affiliation(s)
- Michelle Shardell
- National Institute on Aging, Translational Gerontology Branch, Baltimore, Maryland.
| | | | - Rita R Kalyani
- Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Gregory E Hicks
- Department of Physical Therapy, University of Delaware, Newark
| | | | - Luigi Ferrucci
- National Institute on Aging, Translational Gerontology Branch, Baltimore, Maryland
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Barker SL, Pastor J, Carranza D, Quiñones H, Griffith C, Goetz R, Mohammadi M, Ye J, Zhang J, Hu MC, Kuro-o M, Moe OW, Sidhu SS. The demonstration of αKlotho deficiency in human chronic kidney disease with a novel synthetic antibody. Nephrol Dial Transplant 2014; 30:223-33. [PMID: 25324355 DOI: 10.1093/ndt/gfu291] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND αKlotho is the prototypic member of the Klotho family and is most highly expressed in the kidney. αKlotho has pleiotropic biologic effects, and in the kidney, its actions include regulation of ion transport, cytoprotection, anti-oxidation and anti-fibrosis. In rodent models of chronic kidney disease (CKD), αKlotho deficiency has been shown to be an early biomarker as well as a pathogenic factor. The database for αKlotho in human CKD remains controversial even after years of study. METHODS We used a synthetic antibody library to identify a high-affinity human antigen-binding fragment that recognizes human, rat and mouse αKlotho primarily in its native, rather than denatured, form. RESULTS Using an immunoprecipitation-immunoblot (IP-IB) assay, we measured both serum and urinary levels of full-length soluble αKlotho in humans and established that human CKD is associated with αKlotho deficiency in serum and urine. αKlotho levels were detectably lower in early CKD preceding disturbances in other parameters of mineral metabolism and progressively declined with CKD stages. We also found that exogenously added αKlotho is inherently unstable in the CKD milieu suggesting that decreased production may not be the sole reason for αKlotho deficiency. CONCLUSION Synthetic antibody libraries harbor tremendous potential for a variety of biomedical and clinical applications. Using such a reagent, we furnish data in support of αKlotho deficiency in human CKD, and we set the foundation for the development of diagnostic and therapeutic applications of anti-αKlotho antibodies.
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Affiliation(s)
- Sarah L Barker
- Banting and Best Department of Medical Research and Department of Molecular Genetics, The Donnelly Centre, University of Toronto, Toronto, ON, Canada
| | - Johanne Pastor
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Danielle Carranza
- Banting and Best Department of Medical Research and Department of Molecular Genetics, The Donnelly Centre, University of Toronto, Toronto, ON, Canada
| | - Henry Quiñones
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Carolyn Griffith
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Regina Goetz
- Department of Biochemistry and Molecular Pharmacology, New York University School of Medicine, New York, NY, USA
| | - Moosa Mohammadi
- Department of Biochemistry and Molecular Pharmacology, New York University School of Medicine, New York, NY, USA
| | - Jianfeng Ye
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jianning Zhang
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ming Chang Hu
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Makoto Kuro-o
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Orson W Moe
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX, USA Department of Physiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sachdev S Sidhu
- Banting and Best Department of Medical Research and Department of Molecular Genetics, The Donnelly Centre, University of Toronto, Toronto, ON, Canada
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Wolf I, Shahmoon S, Ben Ami M, Levy-Shraga Y, Mazor-Aronovitch K, Pinhas-Hamiel O, Yeshayahu Y, Hemi R, Kanety H, Rubinek T, Modan-Moses D. Association between decreased klotho blood levels and organic growth hormone deficiency in children with growth impairment. PLoS One 2014; 9:e107174. [PMID: 25198618 PMCID: PMC4157849 DOI: 10.1371/journal.pone.0107174] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 08/07/2014] [Indexed: 02/05/2023] Open
Abstract
Objective Klotho is an aging-modulating protein expressed mainly in the kidneys and choroid plexus, which can also be shed, released into the circulation and act as a hormone. Klotho deficient mice are smaller compared to their wild-type counterparts and their somatotropes show marked atrophy and reduced number of secretory granules. Recent data also indicated an association between klotho levels and growth hormone (GH) levels in acromegaly. We aimed to study the association between klotho levels and GH deficiency (GHD) in children with growth impairment. Design Prospective study comprising 99 children and adolescents (aged 9.0±3.7 years, 49 male) undergoing GH stimulation tests for short stature (height-SDS = −2.1±0.6). Klotho serum levels were measured using an α-klotho ELISA kit. Results Klotho levels were significantly lower (p<0.001) among children with organic GHD (n = 11, 727±273 pg/ml) compared to both GH sufficient participants (n = 59, 1497±754 pg/ml) and those with idiopathic GHD (n = 29, 1645±778 pg/ml). The difference between GHS children and children with idiopathic GHD was not significant. Klotho levels positively correlated with IGF-1- standard deviation scores (SDS) (R = 0.45, p<0.001), but were not associated with gender, pubertal status, age or anthropometric measurements. Conclusions We have shown, for the first time, an association between low serum klotho levels and organic GHD. If validated by additional studies, serum klotho may serve as novel biomarker of organic GHD.
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Affiliation(s)
- Ido Wolf
- Institute of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shiri Shahmoon
- Institute of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Ben Ami
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Yael Levy-Shraga
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Kineret Mazor-Aronovitch
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Orit Pinhas-Hamiel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Yonatan Yeshayahu
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Rina Hemi
- Institute of Endocrinology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Hannah Kanety
- Institute of Endocrinology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Tami Rubinek
- Institute of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Dalit Modan-Moses
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
- * E-mail:
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Avin KG, Coen PM, Huang W, Stolz DB, Sowa GA, Dubé JJ, Goodpaster BH, O'Doherty RM, Ambrosio F. Skeletal muscle as a regulator of the longevity protein, Klotho. Front Physiol 2014; 5:189. [PMID: 24987372 PMCID: PMC4060456 DOI: 10.3389/fphys.2014.00189] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 04/29/2014] [Indexed: 01/06/2023] Open
Abstract
Klotho is a powerful longevity protein that has been linked to the prevention of muscle atrophy, osteopenia, and cardiovascular disease. Similar anti-aging effects have also been ascribed to exercise and physical activity. While an association between muscle function and Klotho expression has been previously suggested from longitudinal cohort studies, a direct relationship between circulating Klotho and skeletal muscle has not been investigated. In this paper, we present a review of the literature and preliminary evidence that, together, suggests Klotho expression may be modulated by skeletal muscle activity. Our pilot clinical findings performed in young and aged individuals suggest that circulating Klotho levels are upregulated in response to an acute exercise bout, but that the response may be dependent on fitness level. A similar upregulation of circulating Klotho is also observed in response to an acute exercise in young and old mice, suggesting that this may be a good model for mechanistically probing the role of physical activity on Klotho expression. Finally, we highlight overlapping signaling pathways that are modulated by both Klotho and skeletal muscle and propose potential mechanisms for cross-talk between the two. It is hoped that this review will stimulate further consideration of the relationship between skeletal muscle activity and Klotho expression, potentially leading to important insights into the well-documented systemic anti-aging effects of exercise.
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Affiliation(s)
- Keith G Avin
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh Pittsburgh, PA, USA ; Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh PA, USA
| | - Paul M Coen
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh Pittsburgh, PA, USA ; Department of Health and Physical Education, University of Pittsburgh Pittsburgh, PA, USA
| | - Wan Huang
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh Pittsburgh, PA, USA
| | - Donna B Stolz
- Department of Cell Biology and Physiology, University of Pittsburgh Pittsburgh, PA, USA
| | - Gwendolyn A Sowa
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh Pittsburgh, PA, USA
| | - John J Dubé
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh Pittsburgh, PA, USA
| | - Bret H Goodpaster
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh Pittsburgh, PA, USA
| | - Robert M O'Doherty
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh Pittsburgh, PA, USA
| | - Fabrisia Ambrosio
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh Pittsburgh, PA, USA ; McGowan Institute for Regenerative Medicine, University of Pittsburgh Pittsburgh, PA, USA
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Sze L, Neidert MC, Bernays RL, Zwimpfer C, Wiesli P, Haile SR, Brändle M, Schmid C. Gender dependence of serum soluble Klotho in acromegaly. Clin Endocrinol (Oxf) 2014; 80:869-73. [PMID: 24330426 DOI: 10.1111/cen.12385] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 09/12/2013] [Accepted: 12/08/2013] [Indexed: 01/01/2023]
Abstract
OBJECTIVES In acromegaly, disease activity is biochemically assessed by growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels. However, they are often discrepant, as several factors including gender influence their relationship. We recently found excessively high serum levels of soluble Klotho (sKl) in acromegalic patients, which depended on GH to a comparable extent as IGF-1. To further elucidate the relationship between GH and sKl, we examined the effect of gender on sKl in patients with untreated acromegaly. PATIENTS AND DESIGN We determined GH, IGF-1 and sKl in sera of 62 consecutive patients with newly diagnosed acromegaly (31 females/31 males, aged 20-85 years). RESULTS For their given GH excess at presentation with acromegaly, females had lower IGF-1 (490 ± 33 vs 604 ± 33 ng/ml, P = 0·02), but higher sKl [5171 ± 590 vs 3439 ± 431 pg/ml (mean ± SE), P = 0·02] levels than males. In multiple regression analysis, IGF-1 was closely associated with logGH (estimate 139, SE 47, P = 0·005) and BMI (estimate 14·2, SE 4·8, P = 0·005). sKl was closely associated with logGH (estimate 3088, SE 652, P = 0·0001) and gender (estimate 2034, SE 612, P = 0·002), and to a lesser extent with BMI (estimate 174, SE 66, P = 0·01). CONCLUSIONS For a given GH status, sKl concentrations are higher and IGF-1 concentrations are lower in women than in men. GH is the strongest predictor for both sKl and IGF-1, but gender needs to be considered when using these parameters for monitoring acromegalic patients.
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Affiliation(s)
- Lisa Sze
- Division of Endocrinology and Diabetes, University Hospital, Zurich, Switzerland; Division of Endocrinology and Diabetes, Kantonsspital St. Gallen, St. Gallen, Switzerland
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Abstract
Acromegaly is characterized by excessively high GH and IGF1 levels. Recent data suggest that soluble Klotho (sKlotho) is also elevated in patients with active acromegaly. sKlotho decreases towards normal following removal of the GH-producing pituitary adenoma. The Klotho gene was identified in mice following its accidental disruption by ectopic DNA. It is an ageing suppressor gene of restricted expression (mainly in kidneys, brain, and parathyroid and pituitary glands) encoding a transmembrane protein, mKlotho. mKlotho serves as a co-receptor in fibroblast growth factor 23 (FGF23) signalling. FGF23 promotes urinary phosphate excretion and inhibits the synthesis of calcitriol. The ectodomain of mKlotho is enzymatically released to result in a humoral factor, sKlotho, which exerts systemic effects (on ion channels and signalling pathways), possibly by working as an enzyme that modifies glycans of cell surface glycoproteins. GH enhances renal phosphate reabsorption and calcitriol production, i.e. exerts effects in the proximal tubule opposing those attributed to mKlotho, and attenuates calciuria in the distal tubule similar to sKlotho. sKlotho can be measured in extracellular fluids (serum, urine and cerebrospinal fluid (CSF)) by an ELISA. In line with predominant expression of Klotho in kidneys and choroid plexus, concentrations of sKlotho are particularly high in urine and CSF. Determination of sKlotho in serum and urine (both presumably reflecting GH action on the kidneys) could be used as a supplementary tool in the diagnosis and follow-up of patients with acromegaly. The question arises whether GH exerts selected actions via modifying activities of Klotho.
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Affiliation(s)
- Christoph Schmid
- Division of Endocrinology and Diabetology, University Hospital Zurich, Rämistrasse 100, CH-8091 Zurich, Switzerland Department of Neurosurgery, University Hospital Zurich, Frauenklinikstrasse 10, 8091 Zurich, Switzerland Division of Endocrinology and Diabetology, Kantonsspital St Gallen, 9007 St Gallen, Switzerland Department of Neurosurgery, Clinic Hirslanden, Witellikerstrasse 40, 8032 Zurich, Switzerland
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