The impracticality of biomedical rejuvenation therapies: translational and pharmacological barriers

Personalized-Inherent Variability in a Time-Dependent Immune Response: A Look into the Fifth Dimension in Biology

Introduction

Individualized response to the immune triggers influences the course of immune-mediated diseases and the response to immunotherapies. Both inter- and intra-subject variations occur in time-dependent dynamics of biological systems. The present study aimed to establish a model for inherent personalized-time-dependent variability in response to immune triggers.

Methods

Male C57BL/6 mice were administered concanavalin A (ConA) and followed every 2 h for 10 h and at 24 h for serum alanine aminotransferase (ALT) levels.

Results

A marked intragroup variability was noted for both the timing of the effect of ConA, the magnitude of the increase in ALT levels, and the time to peak. While in some mice, a peak level was achieved, whereas a continuous increase in liver damage was noted in others. Four mice died at different time points during the study irrespective of their liver damage, further supporting the individualized-based response to the trigger.

Conclusions

This feasibility study established a model for determining the personalized-inherent variability in a time-dependent response to the immune triggers. These results highlight the importance of considering both the time and the wide range of individualized variability in immune responses while designing personalized-based immunotherapies.

P4 Medicine as a model for precision periodontal care

Objectives

P4 Medicine is based on a proactive approach for clinical patient care incorporating the four “pillars” of prediction, prevention, personalization, and participation for patient management. The purpose of this review is to demonstrate how the concepts of P4 medicine can be incorporated into the management of periodontal diseases (particularly periodontitis) termed P4 periodontics.

Methods

This is a narrative review that used current literature to explore how P4 periodontics can be aligned with the 2018 Classification of Periodontal Diseases, current periodontal treatment paradigms, and periodontal regenerative technologies.

Results

The proposed model of P4 periodontics is highly aligned with the 2018 Classification of Periodontal Diseases and represents a logical extension of this classification into treatment paradigms. Each stage of periodontitis can be related to a holistic approach to clinical management. The role of “big data” in future P4 periodontics is discussed and the concepts of a treat-to-target focus for treatment outcomes are proposed as part of personalized periodontics. Personalized regenerative and rejuvenative periodontal therapies will refocus our thinking from risk management to regenerative solutions to manage the effects of disease and aging.

Conclusions

P4 Periodontics allows us to focus not only on early prevention and intervention but also allow for personalized late-stage reversal of the disease trajectory and the use of personalized regenerative procedures to reconstruct damaged tissues and restore them to health.

Clinical Significance

P4 Periodontics is a novel means of viewing a holistic, integrative, and proactive approach to periodontal treatment.

Four Principles Regarding an Effective Treatment of Aging

The question whether aging is a disease or not, has been asked by many professionals who are involved in the study of age-related degeneration. However, not only an agreement on this remains elusive, but also effective clinical treatments against human aging have not been forthcoming. In this Opinion paper I suggest that the complexity involved in aging is such that we need to remodel our thinking to involve a much more 'systems-oriented' approach. I explore four main principles which should be employed by those who are working on finding treatments against agerelated degeneration. First, I discuss the problems encountered in translating laboratory research into effective therapies for humans. Second, I propose that a 'systems-thinking' method needs to be more extensively employed, instead of relying exclusively on the current reductionist one. Third, it is submitted that we must learn from the history of life-extension research, and not blindly follow contemporary paradigms, which may lead us into yet more 'dead ends' with regards to therapies. Finally, I suggest that, we may need to employ certain universal notions and use these in order to gain insights into the mechanics of a possible therapy against age-related degeneration. Examples may be the principle of hormesis, those of degeneracy, exaptation, and others from cybernetic or systems science domains. By using this four-pronged approach we liberate our thinking from the shackles of existing common mistakes and fallacies, and we open the way for a fresh approach that may lead us towards entirely new paradigms for providing clinically effective therapies against agerelated degeneration.

Translating laboratory anti-aging biotechnology into applied clinical practice: Problems and obstacles

Although the use of biomedical technologies against ageing (rejuvenation biotechnologies) is considered by many as an effective way of controlling all age-related degeneration, in reality this belief cannot be justified. The human body is notoriously resistant to external perturbations and can respond in unpredictable or undesirable ways. Basic concepts of science, evolution and disease must also be considered. In this paper, I discuss some relevant problems associated with the application of any putative rejuvenation biotechnologies such as stem cell therapies, genetic engineering, tissue manipulation, as well as pharmacological approaches. I conclude that these and other biotechnologies will not be applicable to humans in the community. This is due to a wide spectrum of problems and obstacles, such as unpredictable therapeutic results, unrealistic expectations, lack of infrastructure, cellular network disruption, and many more. Even if some such technologies are developed, the totality of the problems, issues and side effects will prove an insurmountable final hurdle, rendering the development of such therapies, essentially and practically useless.

Evaluation of individual aging degree by standard-free, label-free LC-MS/MS quantification of formaldehyde-modified peptides

In this study, a standard-free, label-free LC-MS/MS method is proposed to evaluate aging based on the cross-linkage theory. First, an aging-biomarker screening model was set up in vitro with formaldehyde and the most abundant protein in plasma, human serum albumin (HSA), based on the Maillard reaction. The modification level of peptides cleaved from HSA was investigated using a liquid chromatography tandem mass spectrometry (LC-MS/MS) method with an (18)O-labeling technique. One formaldehyde-insensitive peptide and six formaldehyde-sensitive peptides that would be verified for being putative peptide-biomarkers were screened via the in vitro aging model. These six putative biomarkers were then preliminarily verified by plasma samples with the aldehyde-insensitive peptide serving as the internal standard. The verification results indicated that the peptides LDELRDEGK and VFDEFKPLVEEPQNLIK showed a significant quantitative difference among young/mid-aged/elderly groups of people.