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Pellegrino R, Paganelli R, Di Iorio A, Bandinelli S, Moretti A, Iolascon G, Sparvieri E, Tarantino D, Tanaka T, Ferrucci L. Neutrophil, lymphocyte count, and neutrophil to lymphocyte ratio predict multimorbidity and mortality-results from the Baltimore Longitudinal Study on Aging follow-up study. GeroScience 2024; 46:3047-3059. [PMID: 38183599 PMCID: PMC11009209 DOI: 10.1007/s11357-023-01034-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/02/2023] [Indexed: 01/08/2024] Open
Abstract
Immunosenescence is the age-related changes in the immune system, namely, progressively higher levels of circulating inflammatory markers, characteristics changes of circulating immune subset cells and altered immune function. The neutrophil to lymphocyte ratio (NL ratio) has been identified as a prognostic indicator for neoplastic disease progression, in predicting chronic degenerative diseases, and as a potential indirect marker of healthy aging. This study aims to examine the longitudinal association of neutrophil, lymphocyte absolute count, and their ratio with longitudinal risk for multimorbidity and mortality. The Baltimore Longitudinal Study of Aging (BLSA) is an open observational cohort study of community-dwelling volunteers that are followed every 1-4 years depending on their age. The sample considered in the study consists of 1769 participants (5090 follow-ups) with completed data for physical examination, health history assessment, and donated a blood sample. The NL ratio increased with age and was associated with a higher risk of mortality, while a lower NL ratio was inversely correlated with multimorbidity. Neutrophils increased with aging and an increase in their absolute number predicted mortality risk. However, the absolute number of lymphocytes was associated with age only in a cross-sectional analysis. In conclusion, this study supports the importance of the NL ratio and absolute neutrophil count as markers of aging health status, and as significant predictors of all-cause mortality and multimorbidity in aging individuals. It remains to be demonstrated whether interventions contrasting these trends in circulating cells may result in improved health outcomes.
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Affiliation(s)
- Raffaello Pellegrino
- Department of Scientific Research, Off-Campus Semmelweis University, Campus Ludes, 6912, Lugano-Pazzallo, Switzerland
- Santa Chiara Institute, 73100, Lecce, Italy
| | - Roberto Paganelli
- Saint Camillus International, University of Health and Medical Sciences, Rome, Italy
| | - Angelo Di Iorio
- Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio", 66100, Chieti-Pescara, Italy.
| | | | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | | | - Domiziano Tarantino
- Department of Public Health, University of Naples Federico II, 80131, Naples, Italy
| | - Toshiko Tanaka
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute On Aging, National Institutes of Health, Baltimore, MD, 21224, USA
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute On Aging, National Institutes of Health, Baltimore, MD, 21224, USA
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Tarantino D, Mottola R, Sirico F, Corrado B, Ruosi C, Saggini R, Pellegrino R. Exploring the impact of vitamin D on tendon health: a comprehensive review. J Basic Clin Physiol Pharmacol 2024; 0:jbcpp-2024-0061. [PMID: 38776444 DOI: 10.1515/jbcpp-2024-0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024]
Abstract
Tendons are vital components of the musculoskeletal system, facilitating movement and supporting mechanical loads. Emerging evidence suggests that vitamin D, beyond its well-established role in bone health, exerts significant effects on tendon physiology. The aim of this manuscript is to review the impact of vitamin D on tendons, focusing on its mechanisms of action, clinical implications, and therapeutic applications. A comprehensive search of scientific electronic databases was conducted to identify articles on the effects of vitamin D on tendon health. Fourteen studies were included in this review. Five studies were performed in vitro, and nine studies were conducted in vivo. Despite some conflicting results, the included studies showed that vitamin D regulates collagen synthesis, inflammation, and mineralization within tendons through its interaction with vitamin D receptors. Epidemiological studies link vitamin D deficiency with tendon disorders, including tendinopathy and impaired healing. Supplementation with vitamin D shows promise in improving tendon strength and function, particularly in at-risk populations such as athletes and the elderly. Future research should address optimal supplementation strategies and explore the interplay between vitamin D and other factors influencing tendon health. Integrating vitamin D optimization into clinical practice could enhance tendon integrity and reduce the burden of tendon-related pathologies.
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Affiliation(s)
- Domiziano Tarantino
- Department of Public Health, 9307 University of Naples Federico II , Naples, Italy
| | - Rosita Mottola
- Department of Public Health, 9307 University of Naples Federico II , Naples, Italy
| | - Felice Sirico
- Department of Public Health, 9307 University of Naples Federico II , Naples, Italy
| | - Bruno Corrado
- Department of Public Health, 9307 University of Naples Federico II , Naples, Italy
| | - Carlo Ruosi
- Department of Public Health, 9307 University of Naples Federico II , Naples, Italy
| | - Raoul Saggini
- Faculty of Psychology, 471917 eCampus University , Novedrate, Italy
| | - Raffaello Pellegrino
- Department of Scientific Research, Campus Ludes, Off-Campus Semmelweis University, Lugano, Switzerland
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Pellegrino R, Paganelli R, Di Iorio A, Bandinelli S, Moretti A, Iolascon G, Sparvieri E, Tarantino D, Tanaka T, Ferrucci L. Beyond Inflammaging: The Impact of Immune System Aging on Age-Related Muscle Decline, Results From the InCHIANTI Study. J Gerontol A Biol Sci Med Sci 2024; 79:glad238. [PMID: 37795971 PMCID: PMC10799757 DOI: 10.1093/gerona/glad238] [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: 06/29/2023] [Indexed: 10/06/2023] Open
Abstract
Aging is characterized by chronic low-level inflammation and is associated with geriatric syndromes such as sarcopenia and frailty. Our aim was to evaluate the longitudinal variation of muscle area, muscle quality, and muscle strength, relative to the variation of leukocyte-derived markers, and to assess the presence of a pathway of associations among derived leukocyte ratios, and the components of muscle health. The InCHIANTI is a longitudinal cohort study of aging that began in 1998 with follow-up visits every 3 years. Out of the 1 453 participants enrolled at baseline, this study includes 1 179 participants with complete data. Muscle strength was assessed by hand grip strength test, whereas muscle density and fat area were considered as indirect markers of muscle quality, derived from peripheral quantitative computed tomography of the calf. Muscle area was associated with neutrophil-to-lymphocyte ratio (NL-ratio), age, gender, comorbidities, and body mass index (BMI). Muscle density variation over time was inversely associated with age, comorbidities, and BMI, while being positively associated with monocyte-to-lymphocyte ratio (ML-ratio) and male gender. Fat area was inversely associated with age, interleukine-6 (IL-6), male gender, and NL-ratio, while being positively associated with ML-ratio, comorbidities, and BMI. Handgrip strength decreased with age, IL-6 levels, comorbidities, and NL-ratio, but increased with ML-ratio, being male, and having a higher BMI. In a path-analysis model, ML-ratio positively correlates with muscle mass, density, and strength, while NL-ratio only correlates inversely with muscle mass and density. NL-ratio and ML-ratio are associated with aging and may be implicated in age-related mechanisms that affect body composition and muscle strength. These ratios may represent a link between aging of the immune system and decline of muscle health with aging. However, further studies are needed to identify their usefulness for early detection of sarcopenia, myosteatosis, and frailty in the older adult.
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Affiliation(s)
- Raffaello Pellegrino
- Department of Scientific Research, Campus Ludes, Off-Campus Semmelweis University, Lugano–Pazzallo, Switzerland
| | | | - Angelo Di Iorio
- Department of Innovative Technologies in Medicine & Dentistry, University “G. d’Annunzio”, Chieti-Pescara, Italy
| | | | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | | | - Domiziano Tarantino
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Toshiko Tanaka
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
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Teijeira L, Martínez M, Moreno A, de Elejoste I, Ibáñez-Beroiz B, Arrazubi V, Díaz de Corcuera I, Elejalde I, Campillo-Calatayud A, Les I. Baseline Circulating Blood Cell Counts and Ratios and Changes Therein for Predicting Immune-Related Adverse Events during Immune Checkpoint Inhibitor Therapy: A Multicenter, Prospective, Observational, Pan-Cancer Cohort Study with a Gender Perspective. Cancers (Basel) 2023; 16:151. [PMID: 38201577 PMCID: PMC10778233 DOI: 10.3390/cancers16010151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 12/21/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
Several factors have been associated with the occurrence of immune-related adverse events (irAEs) induced by immune checkpoint inhibitor (ICI) therapy. Despite their availability, the predictive value of circulating blood cell parameters remains underexplored. Our aim was to investigate whether baseline values of and early changes in absolute neutrophil count (ANC), absolute lymphocyte count (ALC), other blood cell counts, and lymphocyte-related ratios can predict irAEs and whether sex may differentially influence this potential predictive ability. Of the 145 patients included, 52 patients (35.8%) experienced at least one irAE, with a 1-year cumulative incidence of 41.6%. Using Fine and Gray competing risk models, we identified female sex (hazard ratio (HR) = 2.17, 95% confidence interval (CI) = 1.20-3.85), high ALC before ICI initiation (HR = 1.63, 95% CI = 1.09-2.45), and low ANC after ICI initiation (HR = 0.81, 95% CI = 0.69-0.96) as predictors of irAEs. However, ALC and ANC may only have an impact on the risk of irAEs in women (stratified for female sex, ALC-related HR = 2.61, 95% CI = 1.40-4.86 and ANC-related HR = 0.57, 95% CI = 0.41-0.81). Priority should be given to developing models to predict ICI-related toxicity and their validation in various settings, and such models should assess the impact of patient sex on the risk of toxicity.
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Affiliation(s)
- Lucía Teijeira
- Servicio de Oncología Médica, Hospital Universitario de Navarra, 31008 Pamplona, Spain; (L.T.); (V.A.)
| | - Mireia Martínez
- Servicio de Oncología Médica, Hospital Universitario Araba, Servicio Vasco de Salud Osakidetza, 01009 Vitoria-Gasteiz, Spain;
- Grupo de Investigación en Cáncer de Pulmón, Instituto de Investigación Sanitaria Bioaraba, 01009 Vitoria-Gasteiz, Spain
| | - Amaia Moreno
- Servicio de Oncología Médica, Hospital Universitario Galdakao, 48960 Galdácano, Spain; (A.M.); (I.D.d.C.)
| | - Ibone de Elejoste
- Servicio de Oncología Médica, Hospital Universitario Donostia, 20014 San Sebastián, Spain;
| | - Berta Ibáñez-Beroiz
- Servicio de Metodología, IdISNA, Navarrabiomed-Universidad Pública de Navarra, 31008 Pamplona, Spain;
| | - Virginia Arrazubi
- Servicio de Oncología Médica, Hospital Universitario de Navarra, 31008 Pamplona, Spain; (L.T.); (V.A.)
| | - Isabela Díaz de Corcuera
- Servicio de Oncología Médica, Hospital Universitario Galdakao, 48960 Galdácano, Spain; (A.M.); (I.D.d.C.)
| | - Iñaki Elejalde
- Servicio de Medicina Interna, Hospital Universitario de Navarra, 31008 Pamplona, Spain;
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario de Navarra, 31008 Pamplona, Spain
- Grupo de Enfermedades Inflamatorias e Inmunomediadas, IdISNA, Navarrabiomed-Universidad Pública de Navarra, 31008 Pamplona, Spain;
| | - Ana Campillo-Calatayud
- Grupo de Enfermedades Inflamatorias e Inmunomediadas, IdISNA, Navarrabiomed-Universidad Pública de Navarra, 31008 Pamplona, Spain;
| | - Iñigo Les
- Servicio de Medicina Interna, Hospital Universitario de Navarra, 31008 Pamplona, Spain;
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario de Navarra, 31008 Pamplona, Spain
- Grupo de Enfermedades Inflamatorias e Inmunomediadas, IdISNA, Navarrabiomed-Universidad Pública de Navarra, 31008 Pamplona, Spain;
- Departamento de Ciencias de la Salud, Universidad Pública de Navarra, 31008 Pamplona, Spain
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