Is Chronic Obstructive Pulmonary Disease an Accelerated Aging Disease?
Is Chronic Obstructive Pulmonary Disease an Accelerated Aging Disease?
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DOI：
10.1513/annalsats.201602-124aw
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发表时间：
2016-12-01
影响因子：
8.3
通讯作者：
MacNee, William
中科院分区：
文献类型：
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作者：
MacNee, William
衰老是大多数慢性疾病最重要的危险因素之一。在世界范围内，随着预期寿命的延长，与年龄有关的疾病的流行率也在增加，这些疾病造成了很高的发病率和死亡率，给保健和资源带来了巨大的负担。衰老是组织的进行性退化，对重要器官的结构和功能产生负面影响。肺部老化，导致功能下降，对环境压力和损伤的反应能力下降。慢性阻塞性肺疾病（COPD）也存在正常衰老时肺部发生的许多变化，如肺功能下降、气体捕获增加、肺弹性后坐力丧失和远端气隙扩大。60岁以上人群的慢性阻塞性肺病患病率是年轻人群的两到三倍。事实上，慢性阻塞性肺病一直被认为是肺加速老化的一种情况。慢性阻塞性肺病患者的肺部存在几种与衰老相关的机制。肺气肿肺中存在细胞衰老，并与端粒缩短和抗衰老分子减少有关，提示COPD患者肺部衰老加速。年龄的增长导致炎症和氧化应激（炎症）的基础水平升高，并导致先天和适应性免疫反应变化相关的免疫衰老增加。这些变化与COPD中发生的变化相似，可能会增强疾病的活动性，并增加COPD患者对病情恶化的易感性。了解COPD中年龄相关变化的机制可能会为这种疾病找到新的治疗方法。
Aging is one of the most important risk factors for most chronic diseases. The worldwide increase in life expectancy has been accompanied by an increase in the prevalence of age-related diseases that result in significant morbidity and mortality and place an enormous burden on healthcare and resources. Aging is a progressive degeneration of the tissues that has a negative impact on the structure and function of vital organs. The lung ages, resulting in decreased function and reduced capacity to respond to environmental stresses and injury. Many of the changes that occur in the lungs with normal aging, such as decline in lung function, increased gas trapping, loss of lung elastic recoil, and enlargement of the distal air spaces, also are present in chronic obstructive pulmonary disease (COPD). The prevalence of COPD is two to three times higher in people over the age of 60 years than in younger age groups. Indeed, COPD has been considered a condition of accelerated lung aging. Several mechanisms associated with aging are present in the lungs of patients with COPD. Cell senescence is present in emphysematous lungs and is associated with shortened telomeres and decreased antiaging molecules, suggesting accelerated aging in the lungs of patients with COPD. Increasing age leads to elevated basal levels of inflammation and oxidative stress (inflammaging) and to increased immunosenescence associated with changes in both the innate and adaptive immune responses. These changes are similar to those that occur in COPD and may enhance the activity of the disease as well as increase susceptibility to exacerbations in patients with COPD. Understanding the mechanism of age-related changes in COPD may identify novel therapies for this condition.