Identifying and targeting modifiable inflammatory factors underlying higher risk of frailty in individuals experiencing deprivation

识别和针对导致遭受剥夺的个体虚弱风险较高的可改变炎症因子

• 批准号: MR/Y010175/1
• 负责人: Ana Valdes
• 金额: $ 41.94万
• 依托单位: University of Nottingham
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2023
• 资助国家: 英国
• 起止时间: 2023 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FY010175%2F1
• 关键词: Identifying; targeting; modifiable; inflammatory; factors

Frailty is a big problem for public health, and it is especially common in poor communities. The Consensus on Healthy Ageing from Public Health England says that people who live in poverty have 20 fewer years of good health and are more likely to become weak as they age. People who are homeless, addicted to drugs or alcohol, have learning challenges, need mental health care, or are vulnerable migrants are more likely to become frail before they should.The NIHR Innovations in Clinical Trials Design and Delivery for the Underserved (INCLUDE) project has been trying to find ways to include under-served groups in health and care studies (https://tinyurl.com/y6k4y9vd). Older people have been pointed out as a group that doesn't get enough help nor their views are always adequately represented in research about ageing.This research proposal is in line with the advice recently given by experts in Geriatric medicine. The goal of that advice is to improve the inclusion of underserved groups in research, to reduce inequalities, and to learn more about the morbidity and mortality of diseases that affect these populations so that effective, real-world interventions can be developed.The his project will address this need by identifying and characterising the specific inflammatory pathways involved in premature frailty which are modifiable by targeting gut microbes, to then develop interventions to reduce premature frailtyin deprived populations. The study aims to develop effective interventions that consider the social and environmental factors that contribute to frailty and ageing, identifying first on common inflammatory mechanisms between aging and social deprivation, focusing then on those that are linked to the gut microbes carried by a person. This means that such mechanisms may be targeted by diet or exercise which modify the gut microbiome. The team will then use advance statistical techniques and data from hundreds of thousands of people in UK Biobank to ascertain a causal role of the inflammatory features identified on premature ageing and on frailty. Using microbiome and inflammation data from already completed dietary and exercise clinical interventions, it will be possible to determine which interventions or combinations of interventions are most likely to specifically tackle the inflammatory/microbiome pathways involved in premature ageing cause deprivation. The feasibility and acceptability of interventions through qualitative research. The views from deprived individuals, from frail people in care homes, from carers and charities working with these groups will all be incorporated to design a prototype intervention. This holistic approach recognises that there are multiple factors that can impact health outcomes and aims to develop interventions that are tailored to the needs of deprived populations.The interdisciplinary team comprising of experts from various fields such as clinical experts (geriatricians, orthopaedic surgeons), social scientists, bioinformaticians, omics experts, and trialists can be highly beneficial in designing interventions to target the gut microbiome and reduce premature frailty in deprived populations. Such a team brings together a diverse range of expertise and skills to assess, plan, and manage care jointly, enabling a holistic approach to care and to addressing health inequalities with regards to premature ageing.

虚弱是公共卫生的一个大问题，在贫困社区尤其常见。英国公共卫生部门《健康老龄化共识》称，生活在贫困中的人的健康年限要少 20 年，而且随着年龄的增长，更容易变得虚弱。无家可归、吸毒或酗酒、有学习困难、需要心理健康护理或弱势移民的人更有可能变得虚弱。NIHR 服务不足群体临床试验设计和实施创新 (INCLUDE) 项目一直在努力寻找将服务不足群体纳入健康和护理研究的方法 (https://tinyurl.com/y6k4y9vd)。老年人被指出是一个没有得到足够帮助的群体，他们的观点也总是在有关老龄化的研究中得到充分体现。这项研究提案符合老年医学专家最近给出的建议。该建议的目标是提高服务水平低下群体参与研究的程度，减少不平等，并更多地了解影响这些人群的疾病的发病率和死亡率，以便制定有效的、现实的干预措施。他的项目将通过识别和描述与过早衰弱相关的特定炎症途径来满足这一需求，这些途径可通过针对肠道微生物进行修改，然后开发干预措施来减少过早衰弱 贫困人口。该研究旨在制定有效的干预措施，考虑导致虚弱和衰老的社会和环境因素，首先确定衰老和社会剥夺之间的常见炎症机制，然后重点关注与人携带的肠道微生物有关的那些机制。这意味着改变肠道微生物群的饮食或运动可能会针对此类机制。然后，该团队将使用先进的统计技术和来自英国生物银行数十万人的数据来确定炎症特征与过早衰老和虚弱的因果作用。利用已经完成的饮食和运动临床干预措施中的微生物组和炎症数据，将有可能确定哪些干预措施或干预措施组合最有可能专门解决与过早衰老导致剥夺相关的炎症/微生物组途径。通过定性研究干预措施的可行性和可接受性。来自贫困个体、疗养院中的体弱者、与这些群体合作的护理人员和慈善机构的观点都将被纳入设计原型干预措施。这种整体方法认识到影响健康结果的因素有多种，旨在制定适合贫困人群需求的干预措施。由临床专家（老年科医生、整形外科医生）、社会科学家、生物信息学家、组学专家和试验人员等各个领域的专家组成的跨学科团队在设计针对肠道微生物组的干预措施时非常有帮助 并减少贫困人口的过早衰弱。这样的团队汇集了各种专业知识和技能，共同评估、规划和管理护理，从而实现整体护理方法并解决早衰方面的健康不平等问题。