The role of the three major intestinal barriers in ulcerative colitis in the elderly

IF 12.5 1区医学 Q1 CELL BIOLOGY

Ageing Research Reviews Pub Date : 2025-04-08 DOI:10.1016/j.arr.2025.102752

Min Fu , Qi-Wen Wang , Ya-Ru Liu , Shu-Jie Chen

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引用次数: 0

Abstract

With the unprecedented pace of global population aging, there has been a parallel epidemiological shift marked by increasing incidence rates of ulcerative colitis (UC) in geriatric populations, imposing a substantial disease burden on healthcare systems globally. The etiopathogenesis of UC in the elderly remains poorly delineated, while current therapeutic strategies require further optimization to accommodate the unique pathophysiological characteristics of elderly patients. This review systematically elucidates the three barrier dysfunction - encompassing the gut microbiota ecosystem, mucosal epithelial integrity, and immunoregulatory network - that collectively drives UC pathogenesis during biological senescence. We emphasize the therapeutic potential of barrier-targeted interventions, particularly highlighting emerging modalities including fecal microbiota transplantation, intestinal organoid regeneration techniques, mesenchymal stem cell-mediated immunomodulation, and precision-engineered Chimeric Antigen Receptor T-cell therapies. Through this multidimensional analysis, we propose a paradigm-shifting approach to UC management in the elderly, advocating for the development of tailored and evidence-based therapeutic interventions that address the complex interplay between age-related biological changes and intestinal barrier homeostasis in elderly patients.

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三大肠道屏障在老年人溃疡性结肠炎中的作用

随着全球人口老龄化的空前步伐，溃疡性结肠炎（UC）在老年人群中的发病率不断增加，这也出现了平行的流行病学转变，给全球卫生保健系统带来了沉重的疾病负担。老年UC的发病机制仍然不清楚，而目前的治疗策略需要进一步优化，以适应老年患者独特的病理生理特征。这篇综述系统地阐明了三种屏障功能障碍-包括肠道微生物群生态系统，粘膜上皮完整性和免疫调节网络-共同驱动UC在生物衰老过程中的发病机制。我们强调了屏障靶向干预的治疗潜力，特别强调了包括粪便微生物群移植、肠道类器官再生技术、间充质干细胞介导的免疫调节和精确工程嵌合抗原受体t细胞疗法在内的新兴模式。通过这一多维分析，我们提出了一种范式转换的方法来管理老年UC，提倡发展量身定制的循证治疗干预措施，以解决老年患者年龄相关的生物学变化与肠道屏障稳态之间复杂的相互作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ageing Research Reviews 医学-老年医学

CiteScore

19.80

自引率

2.30%

发文量

216

审稿时长

55 days

期刊介绍： With the rise in average human life expectancy, the impact of ageing and age-related diseases on our society has become increasingly significant. Ageing research is now a focal point for numerous laboratories, encompassing leaders in genetics, molecular and cellular biology, biochemistry, and behavior. Ageing Research Reviews (ARR) serves as a cornerstone in this field, addressing emerging trends. ARR aims to fill a substantial gap by providing critical reviews and viewpoints on evolving discoveries concerning the mechanisms of ageing and age-related diseases. The rapid progress in understanding the mechanisms controlling cellular proliferation, differentiation, and survival is unveiling new insights into the regulation of ageing. From telomerase to stem cells, and from energy to oxyradical metabolism, we are witnessing an exciting era in the multidisciplinary field of ageing research. The journal explores the cellular and molecular foundations of interventions that extend lifespan, such as caloric restriction. It identifies the underpinnings of manipulations that extend lifespan, shedding light on novel approaches for preventing age-related diseases. ARR publishes articles on focused topics selected from the expansive field of ageing research, with a particular emphasis on the cellular and molecular mechanisms of the aging process. This includes age-related diseases like cancer, cardiovascular disease, diabetes, and neurodegenerative disorders. The journal also covers applications of basic ageing research to lifespan extension and disease prevention, offering a comprehensive platform for advancing our understanding of this critical field.