Low-amplitude persisting systemic inflammation is frequently found in elderly people and is causally linked to several markers of frailty, including sarcopenia, low mood and higher dependency, as well as higher all-cause mortality. Older patients with such “inflammation” have raised baseline blood levels of several pro-inflammatory cytokines, such as tumor necrosis factor alpha and interleukin-1 beta, and chronically raised C-reactive protein. There is a clear need to identify interventions, including drugs that can ameliorate such inflammation by helping to re-set the innate immune system to a less inflamed baseline. Several classes of drugs have such properties. In this review the authors have summarized the background science with respect to the relationship between ageing, inflammation and frailty, then described the established role of methyl-xanthines, particularly theophylline, as immune modulating drugs before positing a case for the use of 4-aminoquinolines, such as chloroquine, in a similar role. The probable mechanisms of anti-inflammatory action for those classes of drugs are compared, leading to a proposal that formal clinical trials should be conducted of chloroquine as an adjunctive immune modulator for “inflammaging” and persisting post-acute inflammation in old age.
{"title":"The Potential to use Chloroquine and other 4-Aminoquinoline Analogues to Modulate Persisting Inflammation in Old Age","authors":"S. Allen, D. Tiwari","doi":"10.36876/smggr.1020","DOIUrl":"https://doi.org/10.36876/smggr.1020","url":null,"abstract":"Low-amplitude persisting systemic inflammation is frequently found in elderly people and is causally linked to several markers of frailty, including sarcopenia, low mood and higher dependency, as well as higher all-cause mortality. Older patients with such “inflammation” have raised baseline blood levels of several pro-inflammatory cytokines, such as tumor necrosis factor alpha and interleukin-1 beta, and chronically raised C-reactive protein. There is a clear need to identify interventions, including drugs that can ameliorate such inflammation by helping to re-set the innate immune system to a less inflamed baseline. Several classes of drugs have such properties. In this review the authors have summarized the background science with respect to the relationship between ageing, inflammation and frailty, then described the established role of methyl-xanthines, particularly theophylline, as immune modulating drugs before positing a case for the use of 4-aminoquinolines, such as chloroquine, in a similar role. The probable mechanisms of anti-inflammatory action for those classes of drugs are compared, leading to a proposal that formal clinical trials should be conducted of chloroquine as an adjunctive immune modulator for “inflammaging” and persisting post-acute inflammation in old age.","PeriodicalId":448309,"journal":{"name":"SM Gerontology and Geriatric Research","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115234495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The significant rise in life expectancy and the growing ageing of the world’s population are accompanied by an increase in the prevalence of neurodegenerative diseases. These disorders have a multidimensional impact on the quality of life for both patients and their caregivers and constitute a major challenge for social protection systems. Alzheimer’s Disease (AD) represents an increasing burden for patients, their caregivers and the society. For that reason, it is necessary to assess all the factors involved in the disease pathogenesis of AD in order to address a more comprehensive approach to the management of the disease. In the absence of diseasemodifying pharmacological treatments, interest for in non-pharmacological therapies has recently increased as a complement to other types of interventions in people with AD and other dementias. Non-pharmacological interventions for behavioral and psychological symptoms in dementia patients should take into account the caring environment as well as the support and education of the caregivers. Individualized and person-centered models tailored to the tastes and preferences of each patient could offer better results than the more traditional ones. Information and communication technologies can also provide assistance to people with dementia and to their caregivers. We can conclude that there is a need for developing pharmacological and non-pharmacological treatments aimed to different therapeutic targets and that can be applied in the early stages of the disease development. A more comprehensive approach to the management of AD and an increasing interest in dementia prevention could contribute to the development of new therapeutic strategies. These interventions are expected to have positive impact on the quality of life of people with AD and their caregivers.
{"title":"Towards a more Comprehensive Approach to Non-Pharmacological Therapies for Alzheimer’s Disease and other Dementias","authors":"R. Redolat, Mercedes Fernández-Ríos","doi":"10.36876/smggr.1019","DOIUrl":"https://doi.org/10.36876/smggr.1019","url":null,"abstract":"The significant rise in life expectancy and the growing ageing of the world’s population are accompanied by an increase in the prevalence of neurodegenerative diseases. These disorders have a multidimensional impact on the quality of life for both patients and their caregivers and constitute a major challenge for social protection systems. Alzheimer’s Disease (AD) represents an increasing burden for patients, their caregivers and the society. For that reason, it is necessary to assess all the factors involved in the disease pathogenesis of AD in order to address a more comprehensive approach to the management of the disease. In the absence of diseasemodifying pharmacological treatments, interest for in non-pharmacological therapies has recently increased as a complement to other types of interventions in people with AD and other dementias. Non-pharmacological interventions for behavioral and psychological symptoms in dementia patients should take into account the caring environment as well as the support and education of the caregivers. Individualized and person-centered models tailored to the tastes and preferences of each patient could offer better results than the more traditional ones. Information and communication technologies can also provide assistance to people with dementia and to their caregivers. We can conclude that there is a need for developing pharmacological and non-pharmacological treatments aimed to different therapeutic targets and that can be applied in the early stages of the disease development. A more comprehensive approach to the management of AD and an increasing interest in dementia prevention could contribute to the development of new therapeutic strategies. These interventions are expected to have positive impact on the quality of life of people with AD and their caregivers.","PeriodicalId":448309,"journal":{"name":"SM Gerontology and Geriatric Research","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125185733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}