Linking interdisciplinary and multiscale approaches to improve healthspan-a new UK model for collaborative research networks in ageing biology and clinical translation.
Linking interdisciplinary and multiscale approaches to improve healthspan-a new UK model for collaborative research networks in ageing biology and clinical translation.
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将跨学科和多尺度方法联系起来以改善健康寿命——英国衰老生物学和临床转化合作研究网络的新模式。
DOI：
10.1016/s2666-7568(22)00095-2
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Cox LS
中科院分区：
文献类型：
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作者：
Cox LS
在过去的世纪里，医疗保健、卫生、饮食和教育的改善显著提高了预期寿命，但这并没有被健康预期寿命的相应增长所抵消。因此，增加健康寿命，即没有重大疾病或疾病的时间，是全世界的一个重要优先事项。例如，英国政府承诺到2035年将英国人口的健康预期寿命再延长5年，同时不增加不平等。实现这一目标将同时改善个人生活质量，提高生产力，增加国家财富。值得注意的是，仅仅一个额外的健康年的收益预计将为美国带来38万亿美元。然而，2021年对英国实现这一目标的国家进展的审查显示，政策制定者对通过关注技术解决方案（促进独立但不促进健康）或饮食和运动制度（由于社会经济不平等，这些通常是那些最受益的人无法达到的）可以显着提高健康预期寿命几乎没有信心。2同一次审查2表明，人们普遍缺乏对通过改善衰老过程本身来改善晚年健康的潜力的认识和审查。这种无知是令人震惊的背景下，一个安静的研究革命，在老年医学已经看到了一些关键的老化标志的识别，3证据表明，这些标志和潜在的机制独立预测出现与年龄有关的疾病在真实的患者，4和积极的结果，从临床前和早期阶段的人体临床试验的基础上针对老化机制。5，6人类正站在能够通过解决衰老的潜在生物学来预防多重疾病和与年龄相关的疾病的门槛上;与抗生素时代的相似之处似乎并不过分夸张。对这些事态发展的无知带来了令人震惊的代价，除非情况有所改变，否则老年人已经并将继续承担这种代价。例如，英国2017年的健康老龄化重大挑战特别将生物医学科学研究排除在其资助范围之外，而世卫组织（2021年）广泛的十年健康老龄化：基线报告7没有提到这些进展，甚至没有提到生物学这个词，而是关注健康的社会经济决定因素和克服年龄歧视。鉴于标志性的衰老机制会导致先天和适应性免疫的逐渐衰竭，如果国际社会在此之前持续努力针对免疫衰老和增强晚年免疫功能，那么如何应对当前的COVID-19大流行，这是一个有趣的反事实。8未来避免这类错误的必要性是专利，三重经济效益也是专利（降低医疗和社会保健成本，增加老年人的经济活动，以及投资新的产业）。也许是人们对老龄化生物学的复杂性的认识，使决策者不愿直接解决这个问题。因此，在地球仪的许多地方，关于老龄问题的学术研究是零散和孤立的，2受资助模式和奖励专门化和针对具体疾病的专业衡量标准的驱动。然而，如果要使旨在改善终身健康的综合和交叉办法真正有效，造成老化的生物机制必须成为一个中心焦点9（图）。因此，非常令人兴奋的是，整个生命过程中老龄化的多样性和复杂性现在已经在全国范围内得到了认可。
Improvements in health care, sanitation, diet, and education over the past century have markedly increased life expectancy, but this has not been paralleled by concomitant increases in healthy life expectancy. Increasing healthspan, which is the time spent free of major illness or disease, is therefore an important priority worldwide. The UK Government, for example, has pledged to increase the healthy life expectancy of the UK population by an extra 5 years by 2035 without increasing inequality. Achieving this goal would simultaneously improve individual quality of life, increase productivity, and boost national wealth. Notably, a gain of just one additional healthy year is predicted to be worth US $38 trillion to the USA. 1 However, a 2021 review of national progress in the UK towards this goal revealed that policy makers have little confidence that healthy life expectancy can be markedly improved either through focusing on technological solutions (which promote independence but not health) or on diet and exercise regimes (which are often out of reach of those who would most benefit, because of socioeconomic inequalities). 2 The same review2 revealed a general lack of awareness and scrutiny of the potential offered for improving health in later life by ameliorating the ageing process itself. This unawareness is alarming when set against the backdrop of a quiet research revolution in biogerontology that has seen the identification of some key hallmarks of ageing, 3 evidence that these hallmarks and underlying mechanisms independently predict the emergence of age-related diseases in real patients, 4 and positive outcomes from preclinical and early-stage human clinical trials based on targeting ageing mechanisms. 5, 6 Humanity stands on the threshold of being able to prevent multimorbidity and age-associated diseases by addressing the underlying biology of ageing; parallels with the era of antibiotics do not seem unduly hyperbolic. Ignorance of these developments carries appalling costs, which have been, and will continue to be, borne by older people unless the situation changes. For example, the UK’s 2017 Healthy Ageing Grand Challeng e specifically excluded biomedical science research from its funding remit, and the extensive Decade of Healthy Ageing: baseline report, 7 by WHO (2021), fails to mention these advances, or even the word biology, focussing instead on socioeconomic determinants of health and overcoming ageism. Given that hallmark ageing mechanisms cause the progressive failure of innate and adaptive immunity, it is a fascinating counterfactual to consider how the ongoing COVID-19 pandemic would have been handled had it been preceded by a sustained international effort to target immune senescence and enhance later life immune function. 8 The need to avoid such mistakes in the future is patent, as are the triple economic benefits (lower health and social care costs, greater economic activity of older adults, and investment into new industries) that will accompany efforts in this area.It is perhaps the perceived complexity of ageing biology that has dissuaded policy makers from directly tackling it. As a result, academic research on ageing in many parts of the globe is fragmented and siloed, 2 and driven by funding models and professional metrics that reward specialisation and disease-specific focus. However, the biological mechanisms that cause ageing must be a central focus if integrational and intersectional approaches aimed at improving lifelong health9 (figure) are to be truly effective. It is therefore hugely exciting that the diversity and complexity of ageing across the life course has now been recognised in a national …
DOI：
10.1038/s43587-021-00080-0
发表时间：
2021-07
期刊：
NATURE AGING
影响因子：
--
作者：
Scott, Andrew J. J.;Ellison, Martin;Sinclair, David A. A.
通讯作者：
Sinclair, David A. A.