A pathological convergence theory for non‐communicable diseases

IF 2.2 Q3 GERIATRICS & GERONTOLOGY Aging Medicine Pub Date : 2023-11-05 DOI:10.1002/agm2.12273
Alicia Padrón‐Monedero
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Abstract

Abstract The current paradigm considers the study of non‐communicable diseases (NCDs), which are the main causes of mortality, as individual disorders. Nevertheless, this conception is being solidly challenged by numerous remarkable studies. The clear fact that the mortality, by virtually all NCDs, tends to cluster at old ages (with the exception of congenital malformations and certain types of cancer, among a few others); makes us intuitive to assume that the common convergence mechanism that exponentially increases mortality by almost all NCDs in older ages is cell aging. Moreover, when we study NCDs, we are not analyzing which disorders cause the mortality of the populations, rather that which disorders kill us before others do, because the aging of the individuals causes inevitably their death by one cause or another. This is not a defeatist perspective, but a challenging and efficient one. These intuitive assumptions have been supported by studies from the pathophysiologic, epidemiologic, and genetic fields, leading to the affirmation that, as NCDs share genetic and pathophysiological mechanisms (derived from mostly the same risk factors), they should no longer be considered independently. Those studies should make us reconsider our current conceptions of studying NCDs as individual disorders, and to hypothesize about a paradigm that would consider most NCDs (cancer, neurological pathologies, cardiovascular diseases, type II diabetes mellitus, chronic respiratory diseases, osteoarthritis, and osteoporosis, among others) different manifestations of the same process: the cell aging.
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非传染性疾病的病理趋同理论
当前的范式将非传染性疾病(NCDs)作为个体疾病进行研究,这是导致死亡的主要原因。然而,这一观念正受到众多杰出研究的有力挑战。一个明显的事实是,几乎所有非传染性疾病的死亡率都倾向于集中在老年人身上(除了先天性畸形和某些类型的癌症之外);让我们凭直觉假设,几乎所有非传染性疾病在老年人中以指数方式增加死亡率的共同趋同机制是细胞衰老。此外,当我们研究非传染性疾病时,我们不是在分析哪些疾病导致人口死亡,而是分析哪些疾病在其他疾病之前杀死我们,因为个人的衰老不可避免地导致他们因这样或那样的原因死亡。这不是一种失败主义的观点,而是一种挑战和有效的观点。这些直观的假设得到了病理生理学、流行病学和遗传学领域的研究的支持,这些研究证实,由于非传染性疾病具有共同的遗传和病理生理机制(主要来自相同的风险因素),因此不应再单独考虑它们。这些研究应该使我们重新考虑我们目前将非传染性疾病作为个体疾病研究的概念,并假设一种范式,该范式将考虑大多数非传染性疾病(癌症,神经系统疾病,心血管疾病,II型糖尿病,慢性呼吸系统疾病,骨关节炎和骨质疏松症等)同一过程的不同表现:细胞衰老。
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来源期刊
Aging Medicine
Aging Medicine Medicine-Geriatrics and Gerontology
CiteScore
4.10
自引率
0.00%
发文量
38
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