Interpreting Geroscience-Guided Biomarker Studies
Menée sur la période 2006-2010 à partir de données de la "UK Biobank" portant sur 472 432 personnes (54 % de femmes ; âge moyen : 57 ans ; durée moyenne de suivi : 12 ans), cette étude analyse l'association entre la longueur des télomères des leucocytes et le risque de développer certaines maladies comme le cancer, ainsi que la mortalité globale et spécifique
Should I pay out of pocket to have my telomeres measured? My telomeres are shorter than average—what does that mean? Are there treatments to lengthen my telomeres?These questions from patients will become increasingly common with the growing access to commercial putative aging biomarker products. Although offering these products directly to consumers is surely premature, the basic and translational science that inspires these products is a serious and exciting endeavor with immense potential. Chronological aging is a major risk factor for most chronic diseases, multimorbidity, and geriatric syndromes, and progresses at the same rate for everyone. Conversely, biological aging, the mechanism by which chronological age affects risk of age-related conditions, changes at different rates based on individual genetics, environmental and early life exposures, and health-related behaviors. Clinicians already use clinical surrogates of biological age, including physical and cognitive function, functional status, and frailty, which increase with age at the population level but vary widely within individuals of the same chronological age. Advances in basic science have led to the identification of multiple biological mechanisms, or “hallmarks” of aging, including genomic instability, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, altered intercellular communication, and telomere attrition or shortening. The geroscience hypothesis posits that modulating these biological mechanisms of aging will delay, prevent, or treat multiple age-related diseases and conditions simultaneously, prolonging the healthy years of life. As part of the effort to test this hypothesis in humans, the development of measures of biological aging (geroscience-guided biomarkers) has become an explicit goal of researchers on aging and geroscience experts. They argue that geroscience-guided biomarkers could inform the understanding of pathophysiologic mechanisms of aging in disease, act as surrogate end points in interventional clinical trials, guide therapies targeting these mechanisms, and strengthen individual age-related risk prediction models. As a growing chorus of thought leaders advocate that both researchers on aging and clinicians who treat older patients embrace geroscience, those new to the field may not be aware of the multiple potential uses of geroscience-guided biomarkers.
JAMA Internal Medicine , éditorial, 2021