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Savary-Auzeloux I, Jarzaguet M, Migné C, Kemeny JL, Novais-Gameiro L, de Azevedo M, Mathé V, Mariotti F, Langella P, Chatel JM, Dardevet D. Anti-inflammatory Streptococcus thermophilus CNRZ160 limits sarcopenia induced by low-grade inflammation in older adult rats. Front Nutr 2022; 9:986542. [PMID: 36245508 PMCID: PMC9559730 DOI: 10.3389/fnut.2022.986542] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background and aimsAging is characterized, at the systemic level, by the development of low-grade inflammation, which has been identified as determining sarcopenia by blunting postprandial muscle anabolism. The causes of this “inflammageing” is still not clearly defined. An increased intestinal permeability, a microbiota dysbiosis and subsequent generation of intestinal then generalized inflammation have been hypothesized. The objective of this study was to test in vivo during aging if (1) a chronic low-grade intestinal inflammation can lead to anabolic resistance and muscle loss and (2) if a bacterial strain presenting anti-inflammatory properties could prevent these adverse effects.MethodsYoung adult (6 m) and elderly rats (18 m) received Dextran Sodium Sulfate (DSS) for 28 days to generate low-grade intestinal inflammation, and received (PB1 or PB2 groups) or not (DSS group) one of the two S. Thermophilus strains (5 × 109 CFU/day) previously shown to present an anti-inflammatory potential in vitro. They were compared to pair fed control (PF). Muscle and colon weights and protein synthesis (using 13C Valine) were measured at slaughter. Muscle proteolysis, gut permeability and inflammatory markers were assessed only in old animals by RT-PCR or proteins quantifications (ELISA).ResultsIn both adult and old rats, DSS reduced absolute protein synthesis (ASR) in gastrocnemius muscle [−12.4% (PB1) and −9.5% (PB2) vs. PF, P < 0.05] and increased ASR in colon (+86% and +30.5%, respectively vs. PF, P < 0.05). PB1 (CNRZ160 strain) but not PB2 resulted in a higher muscle ASR as compared to DSS in adults (+18%, P < 0.05), a trend also observed for PB1 in old animals (+12%, P = 0.10). This was associated with a blunted increase in colon ASR. In old rats, PB1 also significantly decreased expression of markers of autophagy and ubiquitin-proteasome pathways vs. DSS groups and improved gut permeability (assessed by Occludin, Zonula Occludens 1 and Claudin 1 expression, P < 0.05) and alleviated systemic inflammation (A2M: −48% vs. DSS, P < 0.05).ConclusionThe loss of muscle anabolism associated with low-grade intestinal inflammation can be prevented by supplementation with anti-inflammatory CNRZ160 strain. We propose that the moderated gut inflammation by CNRZ160 may result in curtailed amino acids (AA) utilization by the gut, and subsequent restored AA systemic availability to support muscle protein accretion. Therefore, CNRZ160 could be considered as an efficient probiotic to modulate muscle mass loss and limit sarcopenia during aging.
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Affiliation(s)
- Isabelle Savary-Auzeloux
- Unité Nutrition Humaine, UMR1019, Université Clermont Auvergne, INRAE, Clermont-Ferrand, France
- *Correspondence: Isabelle Savary-Auzeloux
| | - Marianne Jarzaguet
- Unité Nutrition Humaine, UMR1019, Université Clermont Auvergne, INRAE, Clermont-Ferrand, France
| | - Carole Migné
- MetaboHUB Clermont, Plateforme d'Exploration du Métabolisme, Unité de Nutrition Humaine (UNH), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Jean-Louis Kemeny
- Centre Imagerie cellulaire et Santé – CICS - Université Clermont Auvergne, Clermont-Ferrand, France
| | - Lorraine Novais-Gameiro
- Centre Imagerie cellulaire et Santé – CICS - Université Clermont Auvergne, Clermont-Ferrand, France
| | - Marcela de Azevedo
- Université Paris Saclay, AgroParisTech, UMR1319 MICALIS, INRAE, Jouy en Josas, France
| | - Véronique Mathé
- Université Paris-Saclay, AgroParisTech, UMR PNCA, INRAE, Paris, France
| | - François Mariotti
- Université Paris-Saclay, AgroParisTech, UMR PNCA, INRAE, Paris, France
| | - Philippe Langella
- Université Paris Saclay, AgroParisTech, UMR1319 MICALIS, INRAE, Jouy en Josas, France
| | - Jean-Marc Chatel
- Université Paris Saclay, AgroParisTech, UMR1319 MICALIS, INRAE, Jouy en Josas, France
| | - Dominique Dardevet
- Unité Nutrition Humaine, UMR1019, Université Clermont Auvergne, INRAE, Clermont-Ferrand, France
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Kang J, Jeong YJ, Jang JH, Lee M. Risk Factors for Frailty in Critical Care Survivors: A secondary analysis. Intensive Crit Care Nurs 2020; 64:102981. [PMID: 33358896 DOI: 10.1016/j.iccn.2020.102981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 10/26/2020] [Accepted: 11/15/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the prevalence of frailty and its risk factors among critical care survivors who were discharged after receiving treatment in an intensive care unit. METHODS This was a secondary analysis using data from a methodological study conducted between June and August 2018. The sample included 494 adults who had been admitted to the intensive care unit for more than 48 hours within a year. Only post-intensive care frailty was evaluated using the Kihon Checklist. The sociodemographic and intensive care-related risk factors for frailty were analysed using multivariate logistic regression. RESULTS The prevalence of frailty in the sample was 65.8%. The risk factors for frailty were female sex (adjusted odds ratio [aOR] = 1.68, 95% CI: 1.02-2.78), aged 70 years or older (aOR = 4.16, 95% CI: 2.00-8.65), unemployment (aOR = 2.41, 95% CI: 1.39-4.17) and longer ICU days (aOR = 2.29, 95% CI: 1.35-3.91). Analysis of differences in risk factors according to sex revealed that risk factors for frailty were unemployment and longer ICU length of stay for male and older age for female. CONCLUSION Health care providers should be aware of frailty risk factors in female and male patients and provide patient-specific interventions for preventing frailty.
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Affiliation(s)
- Jiyeon Kang
- College of Nursing, Dong-A University, Busan, South Korea
| | - Yeon Jin Jeong
- Department of Nursing, Dongju College, Busan, South Korea
| | - Jun Hee Jang
- Department of Nursing, Dongju College, Busan, South Korea
| | - Minju Lee
- Department of Nursing, Youngsan University, Yangsan, South Korea.
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Minton C, Power T, Wilson S, Jackson D. Understanding recovery and survivorship after a prolonged critical illness. J Clin Nurs 2020; 29:665-666. [DOI: 10.1111/jocn.15018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Claire Minton
- School of Nursing College of HealthMassey University Palmerston North New Zealand
| | - Tamara Power
- Faculty of Health University of Technology Sydney Sydney Australia
| | - Stacey Wilson
- School of Nursing College of HealthMassey University Palmerston North New Zealand
| | - Debra Jackson
- Faculty of Health University of Technology Sydney Sydney Australia
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Geense W, Zegers M, Dieperink P, Vermeulen H, van der Hoeven J, van den Boogaard M. Changes in frailty among ICU survivors and associated factors: Results of a one-year prospective cohort study using the Dutch Clinical Frailty Scale. J Crit Care 2019; 55:184-193. [PMID: 31739088 DOI: 10.1016/j.jcrc.2019.10.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/24/2019] [Accepted: 10/31/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE Frailty is an important predictor for the prognosis of intensive care unit (ICU) patients. This study examined changes in frailty in the year after ICU admission, and its associated factors. MATERIALS AND METHODS Prospective cohort study including adult ICU patients admitted between July 2016-December 2017. Frailty was measured using the Clinical Frailty Scale (CFS), before ICU admission, at hospital discharge, and three and 12 months after ICU admission. Multivariable linear regression was used to explore factors associated with frailty changes. RESULTS Frailty levels changed among 1300 ICU survivors, with higher levels at hospital discharge and lower levels in the following months. After one year were 42% of the unplanned, and 27% of the planned patients more frail. For both groups were older age, longer hospital length of stay, and discharge location associated with being more frail. Male sex, higher education level and mechanical ventilation were associated with being less frail in the planned patients. CONCLUSION One year after ICU admission, 42% and 27% of the unplanned and planned ICU patients, respectively, were more frail. Insight in the associated factors will help to identify patients at risk, and may help in informing patients and their family members. REGISTRATION ClinicalTrials.gov database (NCT03246334).
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Affiliation(s)
- Wytske Geense
- Department of Intensive Care Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Marieke Zegers
- Department of Intensive Care Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Peter Dieperink
- Department of Intensive Care Medicine, University Medical Center Groningen, Groningen, the Netherlands
| | - Hester Vermeulen
- Scientific Center for Quality of Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Johannes van der Hoeven
- Department of Intensive Care Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Mark van den Boogaard
- Department of Intensive Care Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
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Abstract
Frailty is a geriatric syndrome associated with adverse outcomes such as falls, disability, and mortality. Frailty is common and contributes to rising health care costs. Early screening and timely tailored intervention may effectively prevent or delay the adverse outcomes in older adults. Studies on frailty and its specific measurement tools are increasing in number, but the debate on the screening instruments remains. Currently, self-reported screening tools can identify frailty and predict the risk of adverse outcomes in older adults. Because they are easy to use and quickly provide information, self-reported frailty screening tools have significant implication in primary care settings and clinics. We reviewed the frailty screening instruments in older adults and proposed a two-step pathway for frailty identification, and to manage declines in intrinsic capacity as well as boost resilience.
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Affiliation(s)
- L Ma
- Dr. Lina Ma, Department of Geriatrics, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing 100053, China. E-mail:
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