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在公共卫生实践中推广延寿补充剂和药物的实施:成就、挑战和未来展望。

Implementation of longevity-promoting supplements and medications in public health practice: achievements, challenges and future perspectives.

机构信息

Laboratory of Epigenetics, Institute of Gerontology, Vyshgorodskaya St. 67, Kiev, 04114, Ukraine.

Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine.

出版信息

J Transl Med. 2017 Jul 20;15(1):160. doi: 10.1186/s12967-017-1259-8.

Abstract

BACKGROUND

Most modern societies undergo rapid population aging. The rise in life expectancy, nevertheless, is not accompanied, to date, by the same increment of healthspan. Efforts to increase healthspan by means of supplements and pharmaceuticals targeting aging-related pathologies are presently in spotlight of a new branch in geriatric medicine, geroscience, postulating that aging could be manipulated in such a way that will in parallel allow delay the onset of all age-associated chronic disorders.

DISCUSSION

Currently, the concept of the "longevity dividend" has been developed pointed out that the extension of healthspan by slowing the rate of aging is the most efficient way to combat various aging-related chronic illnesses and disabling conditions than combating them one by one, what is the present-day approach in a generally accepted disease-based paradigm. The further elaboration of pharmaceuticals specifically targeted at age-associated disorders (commonly referred to as 'anti-aging drugs') is currently one of the most extensively developed fields in modern biogerontology. Some classes of chemically synthesized compounds and nutraceuticals such as calorie restriction mimetics, autophagy inductors, senolytics and others have been identified as having potential for anti-aging intervention through their possible effects on basic processes underlying aging. In modern pharmaceutical industry, development of new classes of anti-aging medicines is apparently one of the most hopeful directions since potential target group may include each adult individual. Implementation of the geroscience-based approaches into healthcare policy and practice would increase the ratio of healthy to unhealthy population due to delaying the onset of age-associated chronic pathologies. That might result in decreasing the biological age and increasing the age of disability, thus increasing the age of retirement and enhancing income without raising taxes. Economic, social and ethical aspects of applying the healthspan- and lifespan-promoting interventions, however, have to be comprehensively debated prior to their implementation in public health practice.

摘要

背景

大多数现代社会都经历着人口老龄化的快速发展。然而,预期寿命的提高并没有伴随着健康寿命的同等增长。目前,通过针对与衰老相关的病理学的补充剂和药物来增加健康寿命的努力是老年医学、衰老科学的一个新分支的焦点,该分支假设衰老可以被操纵,从而使所有与年龄相关的慢性疾病的发病时间得以延迟。

讨论

目前,“长寿红利”的概念已经被提出,即通过减缓衰老速度来延长健康寿命,是对抗各种与衰老相关的慢性疾病和残疾状况的最有效方法,比目前在普遍接受的基于疾病的范式中逐个对抗它们的方法更有效。目前,专门针对与年龄相关的疾病(通常称为“抗衰老药物”)的药物的进一步开发是现代生物老年学中最广泛发展的领域之一。一些类别的化学合成化合物和营养保健品,如热量限制模拟物、自噬诱导剂、衰老细胞清除剂等,已被确定为具有抗衰老干预的潜力,因为它们可能对衰老的基本过程产生影响。在现代制药行业,开发新类别的抗衰老药物显然是最有希望的方向之一,因为潜在的目标群体可能包括每个成年人。将基于衰老科学的方法纳入医疗保健政策和实践,由于延迟与年龄相关的慢性病理的发病,将增加健康人口与不健康人口的比例。这可能导致生物年龄的降低和残疾年龄的增加,从而增加退休年龄并提高收入,而无需提高税收。然而,在将促进健康寿命和寿命的干预措施应用于公共卫生实践之前,必须全面讨论其经济、社会和伦理方面。

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