Aging Medicine最新文献

{"title":"Impact of Immunosenescence on Immune-Related Adverse Events in Elderly Patients With Cancer","authors":"Jiayi Gao,&nbsp;Yue Yuan,&nbsp;Xue Wang,&nbsp;Liuer He,&nbsp;Lin Li","doi":"10.1002/agm2.70000","DOIUrl":"https://doi.org/10.1002/agm2.70000","url":null,"abstract":"<p>Immune checkpoint inhibitors (ICI), have transformed the management of several types of cancers; however, immune-related adverse events (irAEs) may cause treatment interruptions, chronic toxic effects, and death. Elderly patients are at high risk of cancer. Compared with traditional chemotherapy, immunotherapy has become a better alternative choice for elderly patients with cancer due to its high efficiency and low toxicity. However, the emergence of immunosenescence accompanied by advancing age raises safety concerns for ICI. Therefore, we summarize the characteristics of irAEs occurred in elderly patients with cancer and the physiological characteristics of immunosenescence, which will lay a theoretical foundation for the safety management of immunotherapy in elderly patients with cancer.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends of the Dementia Burden in South Asia: An Analysis of 2021 Global Burden of Disease Study","authors":"Shubham Chauhan,&nbsp;Diptismita Jena,&nbsp;Shilpa Gaidhane,&nbsp;Navneet Dev,&nbsp;Ganesh Bushi,&nbsp;G. Padma Priya,&nbsp;Pawan Sharma,&nbsp;Mahakshit Bhat,&nbsp;Shilpa Sharma,&nbsp;M. Ravi Kumar,&nbsp;Aashna Sinha,&nbsp;Quazi Syed Zahiruddin,&nbsp;Muhammed Shabil,&nbsp;Sanjit Sah,&nbsp;Rukshar Syed,&nbsp;Kamal Kundra,&nbsp;Alisha Dash,&nbsp;Hashem Abu Serhan","doi":"10.1002/agm2.70002","DOIUrl":"https://doi.org/10.1002/agm2.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aims to analyze the trends in the burden of Alzheimer's Disease and Other Dementias (ADoD) in South Asia from 1990 to 2021, focusing on incidence, prevalence, mortality, and Disability-Adjusted Life Years (DALYs). The objective is to identify key risk factors, such as metabolic and behavioral health risks, and assess regional variations in the burden of ADoD across five South Asian countries India, Pakistan, Bangladesh, Nepal, and Bhutan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the Global Burden of Disease (GBD) 2021 report were analyzed using descriptive statistics and join point regression analysis. The analysis evaluated trends in ADoD incidence, prevalence, mortality, and DALYs across five South Asian countries, focusing on health risk factors, including high body mass index, behavioral and metabolic risks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A slight decrease in incidence rates from 80.57 to 79 per 100,000 was observed, alongside a significant increase in mortality rates from 14.11 to 17.2 per 100,000. While prevalence rates experienced a minor decline, Disability-Adjusted Life Years (DALYs) rose from 272.02 to 308.27 per 100,000, reflecting an increasing burden of the disease. Notably, Nepal significantly reduced its incidence rates, while Pakistan saw an increase in mortality rates. In South Asia, the highest-ranking risk factor is metabolic risks, followed by high fasting plasma glucose (FPG).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The growing burden of ADoD in South Asia necessitates targeted public health strategies addressing key risk factors, with metabolic health risks being a primary contributor. Public health interventions should focus on the most affected populations, particularly the elderly and females, to mitigate the increasing impact of dementia across the region.</p>\u0000 </section>\u0000 </div>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin Autoimmune Syndrome: A Chinese Expert Consensus Statement","authors":"Huabing Zhang,&nbsp;Ming Xia Yuan,&nbsp;Qi Pan","doi":"10.1002/agm2.70007","DOIUrl":"https://doi.org/10.1002/agm2.70007","url":null,"abstract":"<p>Insulin autoimmune syndrome (IAS) is a rare autoimmune disorder characterized by spontaneous hypoglycemia. The incidence of IAS is higher in East Asian populations compared to other populations. Delayed diagnosis and treatment can lead to recurrent hypoglycemia, significant glucose fluctuations, and adverse clinical outcomes, including life-threatening situations. Currently, no standardized guidelines exist for the diagnosis and treatment of IAS. This consensus aims to provide a systematic summary of the epidemiology, triggers, pathogenesis, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of IAS, with the objective of standardizing its clinical management.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.70007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interaction Effect of Estimated Pulse Wave Velocity and Serum Klotho Level on Chronic Kidney Disease","authors":"Peilin Zou,&nbsp;Jiajun Li,&nbsp;Liangkai Chen,&nbsp;Man Liu,&nbsp;Hao Nie,&nbsp;Jinhua Yan,&nbsp;Le Zhang,&nbsp;Hongyu Gao,&nbsp;Cuntai Zhang,&nbsp;Yucong Zhang","doi":"10.1002/agm2.70005","DOIUrl":"https://doi.org/10.1002/agm2.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Older individuals usually have greater arterial stiffness, lower serum Klotho levels and a greater incidence of chronic kidney disease (CKD). The current study aimed to evaluate the interaction effect of estimated pulse wave velocity (ePWV) and serum Klotho levels on CKD in Americans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the National Health and Nutrition Examination Survey database from 2007 to 2016 were used. Participants with data for the assessment of ePWV and serum Klotho and for the assessment of CKD were enrolled. The associations between ePWV and serum Klotho levels were analyzed via restricted cubic spline analysis and a linear regression model. The associations between exposure factors and CKD prevalence were assessed via a logistic regression model. Subgroup analysis was performed for each confounding factor to assess the robustness of the results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study enrolled 13,273 participants, 3859 of whom were CKD patients. CKD patients had higher ePWV (9.66 ± 1.75 m/s vs. 8.48 ± 1.64 m/s, <i>p</i> &lt; 0.001) and lower levels of serum Klotho (816.35 ± 290.47 pg/mL vs. 869.87 ± 315.87 pg/mL, <i>p</i> &lt; 0.001). A significant negative linear association was found between ePWV and serum Klotho. According to the fully adjusted model, a significant interaction effect between ePWV and serum Klotho was observed on the risk of CKD (<i>p</i> &lt; 0.001). Compared with individuals with a lower ePWV and higher serum Klotho, individuals with an increased ePWV and lower serum Klotho had a significantly elevated risk of CKD (OR: 1.847, 95% confidence interval: 1.467–2.325; <i>p</i> &lt; 0.001). The subgroup analysis revealed that the results were robust.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study demonstrated significant interaction effect of ePWV and serum Klotho on the prevalence of CKD. Individuals with increased ePWV and decreased serum Klotho levels had the highest risk of CKD. The assessment of the combination of ePWV and serum Klotho for CKD management should be considered routine in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.70005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Steroids on the Progression of Alzheimer's Dementia: A Retrospective Chart Review","authors":"Julijana Zoran Conic,&nbsp;Alexandra Chetty,&nbsp;Lily Chen,&nbsp;Audrey Marsh,&nbsp;Sean Barry,&nbsp;Rodney Pattabhi,&nbsp;Thomas Reske,&nbsp;Erwin Aguilar,&nbsp;Lobna Ali","doi":"10.1002/agm2.70004","DOIUrl":"https://doi.org/10.1002/agm2.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Alzheimer's disease (AD) is a prevalent age-related neurodegenerative disease that affects millions of individuals in the United States. Neuroinflammation is a driver of the neurodegenerative changes that characterize AD, prompting interest in how inflammation can be modulated for treatment and prevention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>ICD-10 codes were quarried from electronic medical records to identify patients diagnosed with AD from 2012 to 2020. The patients were then divided into those who used systemic steroids and those who did not before the progression of their disease. Data on medication prescribed was used to measure the disease's progression. Clinical findings and laboratory results were collected to build a propensity score. Patients were followed until disease progression, death, or the last available visit. Kaplan–Meier curves and hazard ratios adjusted for the propensity score were used to compare the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 459 patients identified, 77 were included in the study, and 13 used steroids. Of the 77 patients included in the study, 59 had progression of their disease, and of those, five used steroids. The median time to progression was 408.00 (191.00, 979.00) days for the overall sample. The hazard ratio (HR) comparing the group using steroids to those not using steroids was 0.26 with a 95% CI of (0.1013, 0.673) and a <i>p</i> value of 0.00064.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In our study, steroid use delayed the progression of dementia. Further study is needed to outline how steroids and anti-inflammatory medications can be used in the treatment and prevention of AD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Multidisciplinary Approach to Polypharmacy Management in Community-Dwelling Older Adults: Insights From a Specialized Outpatient Clinic","authors":"Victoria Roncal-Belzunce,&nbsp;Marta Gutiérrez-Valencia,&nbsp;Bernardo Abel Cedeño-Veloz,&nbsp;Ramón San Miguel,&nbsp;Itxaso Marín-Epelde,&nbsp;Arkaitz Galbete,&nbsp;Javier Preciado Goldaracena,&nbsp;María Irache Ezpeleta,&nbsp;Karmele Garaioa-Aramburu,&nbsp;Nicolás Martínez-Velilla","doi":"10.1002/agm2.70001","DOIUrl":"https://doi.org/10.1002/agm2.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The increase in polypharmacy among older adults increases the risk of drug-related problems, making multidisciplinary interventions essential. This study evaluated the impact of a multidisciplinary polypharmacy consultation on medication management and outcomes in older outpatients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective observational study at a Spanish teaching hospital involved geriatricians, clinical pharmacists, and nurses. Older adults (≥ 75 years) with polypharmacy underwent medication review at baseline and at 3 and 6 months. Data on medication use, adherence to Screening Tool of Older Person's Prescriptions (STOOP) criteria, and anticholinergic burden were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 104 older adults (mean age 86.2 years; 66% female). An average of 3.6 recommendations per participant was made (63.8% acceptance rate). Common drug-related problems were adverse effects (20%), non-adherence (18.1%), and incorrect dose/regimen (14.4%). Interventions led to an average reduction of 1.7 medications per patient, with 1.3 dosage or regimen changes and 1.1 new prescriptions. The mean number of medications decreased from 9.6 at baseline to 8.9 at 3 months (<i>p</i> &lt; 0.001) and remained below baseline at 6 months. STOPP criteria violations per patient dropped from 1.2 to 1.0 (<i>p</i> = 0.036). Of the 126 medications flagged by STOPP criteria, 68.3% were addressed, 24.6% discontinued, mainly psychotropics, and 89.3% of these discontinuations were maintained. The anticholinergic burden decreased from 1.3 to 1.1 at 3 months (<i>p</i> = 0.036) and remained below baseline at 6 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A multidisciplinary clinic effectively managed polypharmacy in older adults by reducing medication load and improving appropriateness per STOPP criteria, highlighting the importance of proactive medication management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov: NCT05408598 (March 1, 2022)</p>\u0000 </section>\u0000 </div>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.70001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Gut Microbiota and Diabetic Nephropathy: A Mendelian Randomization Study","authors":"Yujun Xiong,&nbsp;Xingyun Zhu,&nbsp;Huazhao Xu,&nbsp;Zitian Zheng,&nbsp;Qingfeng Luo","doi":"10.1002/agm2.70009","DOIUrl":"https://doi.org/10.1002/agm2.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Diabetic nephropathy (DN) is a severe complication of diabetes mellitus, and its pathogenesis remains incompletely understood. Emerging evidence suggests a potential link between gut microbiota and DN. This study aimed to explore the causal relationship between gut microbiota and DN using a two-sample Mendelian randomization (MR) approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Gut microbiota data were obtained from the MiBioGen consortium, which provides the most comprehensive genome-wide association studies (GWAS) on gut microbiota. Summary-level genetic data for DN were sourced from publicly available GWAS data provided by the FinnGen consortium. The primary analysis was conducted using the inverse variance–weighted (IVW) method, complemented by sensitivity analyses to evaluate pleiotropy and heterogeneity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourteen gut microbiota species demonstrated significant genetic associations with DN in the MR analysis, including five negatively and nine positively associated species, as determined by the IVW method. No evidence of pleiotropy or heterogeneity was observed, ensuring the robustness of the findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study provides novel insight into the causal role of gut microbiota in DN pathogenesis, uncovering specific microbial species that may contribute to disease progression. These findings offer a promising avenue for future research and therapeutic development targeting gut microbiota.</p>\u0000 </section>\u0000 </div>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diamagnetic Signature of Beta-Amyloid (Aβ) and Tau (τ) Tangle Pathology in Alzheimer's Disease: A Review","authors":"Sadegh Ghaderi,&nbsp;Sana Mohammadi,&nbsp;Farzad Fatehi","doi":"10.1002/agm2.70006","DOIUrl":"https://doi.org/10.1002/agm2.70006","url":null,"abstract":"<p>The complex interplay between diamagnetic and paramagnetic substances within the brain, particularly in the context of Alzheimer's disease (AD), offers a rich landscape for investigation using advanced quantitative neuroimaging techniques. Although conventional approaches have focused on the paramagnetic properties of iron, emerging and promising research has highlighted the significance of diamagnetic signatures associated with beta-amyloid (Aβ) plaques and Tau (τ) protein aggregates. Quantitative susceptibility mapping (QSM) is a complex post-processing technique that visualizes and characterizes these subtle alterations in brain border tissue composition, such as the gray–white matter interface. Through voxel-wise separation of the contributions of diamagnetic and paramagnetic sources, QSM enabled the identification and quantification of Aβ and τ aggregates, even in the presence of iron. However, several challenges remain in utilizing diamagnetic signatures of Aβ and τ for clinical applications. These include the relatively small magnitude of the diamagnetic signal compared to paramagnetic iron, the need for high-resolution imaging and sophisticated analysis techniques, and the standardization of QSM acquisition and analysis protocols. Further research is necessary to refine QSM techniques, optimize acquisition parameters, and develop robust analysis pipelines to improve the sensitivity and specificity of detecting the diamagnetic nature of Aβ and τ aggregates. As our understanding of the diamagnetic properties of Aβ and τ continues to evolve, QSM is expected to play a pivotal role in advancing our knowledge of AD and other neurodegenerative diseases.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel agent targeting APRIL: A new hope for elderly patients of IgA nephropathy","authors":"Xin Liu,&nbsp;Li Zuo","doi":"10.1002/agm2.12370","DOIUrl":"https://doi.org/10.1002/agm2.12370","url":null,"abstract":"&lt;p&gt;Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis worldwide, characterized by mesangial IgA deposition. Asymptomatic hematuria with varying degrees of proteinuria is the most common clinical presentation, and 20%–40% of patients progress to end-stage kidney disease within 20 years after disease onset.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Currently, the “four-hit hypothesis” explains the pathogenesis of IgAN.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; This hypothesis suggests that IgAN begins with elevated levels of circulating abnormally glycosylated galactose-deficient IgA1 (gd-IgA1), followed by the formation of immune complexes with anti-gd-IgA1 antibodies that ultimately deposit in the glomerular mesangium, leading to kidney injury. With the progressive studies of the pathogenesis of IgAN, key molecules in the pathogenesis have gradually become potential targets for future treatment strategies, and corresponding new drugs have been constantly emerging, as shown in Table 1. A proliferation inducing ligand (APRIL) is the 13th member of the TNF superfamily (TNFSF13), and as one of the growth factors of B cells, it can participate in the occurrence and development of IgAN by promoting B cell activation and the generation of gd-IgA1.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; The analysis of genome-wide association studies further suggests that TNFSF13 is a genome-wide locus significantly associated with IgAN, identifying the pathogenic signaling pathway and providing important evidence support for targeted drug development.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Blocking APRIL activity is a potential therapeutic approach to reduce circulating levels of gd-IgA1 and its associated immune complexes.&lt;/p&gt;&lt;p&gt;The traditional treatment strategy of IgA nephropathy is mainly based on supportive treatment, combined with immunosuppressive therapy. In recent years, great progress has been made in the pathogenesis of IgA nephropathy, and put forward a new viewpoint on the treatment of IgA nephropathy. The new view is that the treatment needs to manage the two basic drivers of continuous nephron loss in IgAN at the same time. The focus of management in most patients should be to prevent or reduce IgA immune complex formation and immune complex-mediated glomerular injury. In parallel, manage the consequences of existing IgAN-induced nephron loss.&lt;/p&gt;&lt;p&gt;Sibeprenlimab (VIS649) is a humanized IgG2 monoclonal antibody that binds to and neutralizes the activity of APRIL. Blocking APRIL activity presents a potential method of treatment to reduce circulating levels of galactose-deficient IgA1 and associated immune complexes. The Phase II multicenter, double-blind, randomized, placebo-controlled trial of sibeprenlimab aims to evaluate the efficacy and safety of the drug in treating adult patients, who had biopsy-confirmed IgAN.&lt;span&gt;&lt;sup&gt;16&lt;/sup&gt;&lt;/span&gt; Eligible patients with estimated glomerular filtration rate (eGFR) ≥30 mL per minute per 1.73 m&lt;sup&gt;2&lt;/sup&gt; (as calculated with the use of the 20","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12370","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143117444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intestinal flora composition and fecal metabolic phenotype in elderly patients with sleep disorders combined with type 2 diabetes","authors":"Zhuohao Yin,&nbsp;Huaze Xie,&nbsp;Fuyuan Liu,&nbsp;Xue Kong,&nbsp;Wei Chen,&nbsp;Yangfan Gong,&nbsp;Wei Ge","doi":"10.1002/agm2.12376","DOIUrl":"10.1002/agm2.12376","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to determine whether type 2 diabetes (T2D) is an independent risk factor for sleep disorders in the elderly and explore the possible intestinal flora factors of sleep disorders combined with T2D in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All hospitalized patients with sleep disorders aged ≥65 years between June and November 2023 were retrospectively analyzed, and they were divided into a sleep disorder group (<i>n</i> = 134) and a control group (<i>n</i> = 109). The logistic regression method was utilized to clarify the causal relationship between T2D and sleep disorders. For stool analyses, 42 patients were randomly extracted, which included the control group (<i>n</i> = 14), diabetes group (<i>n</i> = 14), and elderly patients with sleep disorders combined with the T2D group (ESdD) (<i>n</i> = 14). The composition feature of intestinal flora and metabolomics in the ESdD group was described through high-throughput 16S rDNA sequencing and nontargeted analysis based on liquid chromatography–mass spectrometry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Gender, body mass index (BMI), T2D, intestinal discomfort, and anxiety depression were independent risk factors for sleep disorders in the elderly. Notably, older individuals with T2D were 3.3 times more likely to experience sleep disorders than normal individuals. Compared with the control group, the ESdD group had decreased relative abundance of <i>Barnesiella</i> and <i>Marvinbryantia</i>, with 47 metabolites upregulated and 53 metabolites downregulated. The ESdD group showed a decrease in <i>Lachnospiraceae_UCG_010</i>, with 62 metabolites upregulated and 43 metabolites downregulated, compared with the diabetes group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Diabetes is an independent risk factor for sleep disorders in the elderly patients. Variations in intestinal flora and metabolism significantly influence the onset and progression of the ESdD group.</p>\u0000 </section>\u0000 </div>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 6","pages":"689-698"},"PeriodicalIF":2.2,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11702488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}