Editorial: C-Reactive Protein in Age-Related Disorders

Wasting syndrome and associated factors in hospitalized older people

Wasting syndrome (WS) is characterized by clinically important unintentional weight loss >5 % in six to 12 months. This syndrome is responsible for a significant portion of hospitalizations throughout the world and is an important indicator of serious diseases, especially in individuals with 60 years of age or older. The aim of the present study was to investigate WS and associated factors in hospitalized older people. An observational cross-sectional study was developed at a university hospital in Brazil with male and female patients ≥60 years of age. WS was considered in the occurrence of unintentional weight loss of 10 % in 12 months, 7.5 % in six months or >5 % in three months. Data were collected on sociodemographic, clinical, lifestyle, nutritional and biochemical characteristics. This study received approval from the local institutional review board and all participants signed a statement of informed consent. The sample was composed of 178 older people with a mean age of 70.0 ± 8.0 years. The prevalence of WS was 45.5 %. WS was associated with the following clinical variables: conservative CKD (p = 0.007), dysphagia (p = 0.035), dementia (p = 0.017), anorexia (p < 0.001), fatigue (p = 0.001), functional dependence (measured using the Barthel Index) (p = 0.001) and medications that cause malabsorption (p = 0.020); the following nutritional variables: body mass index (p < 0.001), low calf circumference (p < 0.001), low muscle strength (p = 0.001), low muscle mass (p < 0.001) and undernourishment or risk of malnutrition (evaluated using the Mini Nutritional Assessment); and the following biochemical variables: high CRP (p = 0.027), hypoalbuminemia (p = 0.005) and anemia (p < 0.001). The prevalence of WS was high among the hospitalized older people in the present sample and was associated with clinical and biochemical aspects as well as all nutritional variables analyzed. In contrast, lifestyle and sociodemographic characteristics were not associated with wasting syndrome.

Biomarkers of Senescence during Aging as Possible Warnings to Use Preventive Measures

Human life expectancy is increasing significantly over time thanks to the improved possibility for people to take care of themselves and the higher availability of food, drugs, hygiene, services, and assistance. The increase in the average age of the population worldwide is, however, becoming a real concern, since aging is associated with the rapid increase in chronic inflammatory pathologies and degenerative diseases, very frequently dependent on senescent phenomena that occur alongside with senescence. Therefore, the search for reliable biomarkers that can diagnose the possible onset or predict the risk of developing a disease associated with aging is a crucial target of current medicine. In this review, we construct a synopsis of the main addressable biomarkers to study the development of aging and the associated ailments.

Single-Arm, Multicenter Phase I/II Clinical Trial for the Treatment of Envenomings by Massive Africanized Honey Bee Stings Using the Unique Apilic Antivenom

We evaluated the safety, optimal dose, and preliminary effectiveness of a new-approach Africanized honeybee (Apis mellifera) Antivenom (AAV) in a phase I/II, multicenter, non-randomized, single-arm clinical trial involving 20 participants with multiple stings. Participants received 2 to 10 vials of AAV depending on the number of stings they suffered, or a predefined adjuvant, symptomatic, and complementary treatment. The primary safety endpoint was the occurrence of early adverse reactions within the first 24 h of treatment. Preliminary efficacy based on clinical evolution, including laboratory findings, was assessed at baseline and at various time points over the four following weeks. ELISA assays and mass spectrometry were used to estimate venom pharmacokinetics before, during, and after treatment. Twenty adult participants, i.e., 13 (65%) men and 7 (35%) women, with a median age of 44 years and a mean body surface area of 1.92 m² (median = 1.93 m²) were recruited. The number of stings ranged from 7 to > 2,000, with a median of 52.5. Symptoms of envenoming were classified as mild, moderate, or severe in 80% (16), 15% (3), and 5% (1) of patients, respectively; patients with mild, moderate, or severe envenoming received 2, 6, and 10 vials of AAV as per the protocol. None of the patients had late reactions (serum sickness) within 30 d of treatment. There was no discontinuation of the protocol due to adverse events, and there were no serious adverse events. One patient had a moderate adverse event, transient itchy skin, and erythroderma. All participants completed the intravenous antivenom infusion within 2 h, and there was no loss to follow-up after discharge. ELISA assays showed venom (melittin and PLA₂) concentrations varying between 0.25 and 1.479 ng/mL prior to treatment. Venom levels decreased in all patients during the hospitalization period. Surprisingly, in nine cases (45%), despite clinical recovery and the absence of symptoms, venom levels increased again during outpatient care 10 d after discharge. Mass spectrometry showed melittin in eight participants, 30 d after treatment. Considering the promising safety results for this investigational product in the treatment of massive Africanized honeybee attack, and its efficacy, reflected in the clinical improvements and corresponding immediate decrease in blood venom levels, the AAV has shown to be safe for human use. Clinical Trial Registration: UTN: U1111-1160-7011, identifier [RBR-3fthf8].