Inflammatory Bowel Disease and the Elderly: A Review

Taleban, Sasha; Colombel, Jean Fréd́eric; Mohler, M. Jane; Fain, Mindy J.

doi:10.1093/ecco-jcc/jjv059

Cited by 149 publications

(116 citation statements)

References 83 publications

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“…The elderly population with IBD is poorly represented in clinical trials [4], as many trials exclude individuals aged > 65 years. This results in a relatively poor evidence DOI: 10.1159/000490053 base to guide appropriate therapeutic management decisions in this population.…”

Section: Introductionmentioning

confidence: 99%

The Management of Inflammatory Bowel Disease in Elderly: Current Evidence and Future Perspectives

2017

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Data on the elderly population with inflammatory bowel disease (IBD) are scarce, as this population is normally excluded from clinical trials. With an ageing population and an overall increasing prevalence of IBD; the incidence of IBD in elderly is rising. Comorbidities, wide differential diagnosis and polypharmacy make the diagnosis and management of the disease in elderly more challenging compared to that in younger adults. The knowledge of specific requirements for the management and treatment of IBD in advanced age may help in the framing of the definition of the appropriate care of this patient group. This manuscript reviews the most recent knowledge in the epidemiology, diagnosis and management of IBD in this population.

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Section: Introductionmentioning

confidence: 99%

The Management of Inflammatory Bowel Disease in Elderly: Current Evidence and Future Perspectives

2017

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“…Chronic inflammatory bowel disease (IBD), in its own, is associated with unresolved inflammation at the level of gut mucosa, being commonly found in the elderly [31]. Dysbiosis and dysregulation of the immune system have been found to play a major role in IBD, leading to enhanced permeability to bacterial components and loss of physiological transport systems.…”

Section: Age-related Inflammatory Diseases Of High Prevalencementioning

confidence: 99%

“…Despite multiple effective medical and surgical treatment strategies for adults with Crohn's disease and ulcerative colitis, efficacy studies typically have excluded older subjects. A rapidly aging population and increasing rates of Crohn's and ulcerative colitis make the paucity of data in older adults with IBD an increasingly important clinical issue [31].…”

Section: Age-related Inflammatory Diseases Of High Prevalencementioning

confidence: 99%

“…Aged people tend to present an array of intestinal dysfunctions, including those associated with gut mucosa transport and dysbiosis [31][32][33]. Since glutamine is of absolute requirement as a fuel substrate for the enterocyte, intestinal utilization of glutamine is important for maintaining the integrity of the intestinal barrier, with subsequent prevention of bacterial translocation and, through stimulation of the gut-associated immune system, prevention of gut barrier atrophy.…”

Section: Physical Exercise Glutamine and Hs Response In Agingmentioning

confidence: 99%

“…Since intestinal dysfunctions are commonly found in the elderly that hamper the ability of aged people to maintain a good nutritional state [31][32][33], more efficient ways to deliver glutamine into the circulation have been permanently being investigated. In this regard, the excellent effects of glutamine dipeptides on glutamine availability have been attributed to the fact that enterocytes have a more efficient transport mechanism for the absorption of dipeptides and tripeptides than for the absorption of free amino acids [316].…”

Section: Physical Exercise Glutamine and Hs Response In Agingmentioning

confidence: 99%

See 2 more Smart Citations

Physiological regulation of the heat shock response by glutamine: implications for chronic low-grade inflammatory diseases in age-related conditions

Leite

Cruzat

Krause

et al. 2016

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Aging is an intricate process modulated by different molecular and cellular events, such as genome instability, epigenetic and transcriptional changes, molecular damage, cell death and senescence, inflammation, and metabolic dysfunction. Particularly, protein quality control (chaperone systems) tends to be negatively affected by aging, thus leading to cellular senescence in metabolic tissues and, as a consequence, to the increasing dissemination of inflammation throughout the body. The heat shock (HS) response and its associated expression of the 70 kDa family of heat shock proteins (HSP70), which are anti-inflammatory molecular chaperones, are found to be markedly decreased during muscle inactivity and aging, while evidence supports the loss of HSP70 as a key mechanism which may drive muscle atrophy, contractile dysfunction, and reduced regenerative capacity. In addition, abnormal stress response is linked with higher incidence of neurodegenerative diseases as well as low-grade inflammatory diseases that are associated with physical inactivity and obesity. Therefore, strategies to increase or, at least, to maintain the levels of HSP70, and its accompanying HS response to stress, are key to reduce biological cell dysfunctions that occur in aging. In this sense, physical exercise is of note as it is the most powerful inducer of the HS response, comparable only to heat stress and fever-like conditions. On the other hand, the amino acid L-glutamine, whose production within the skeletal muscle and liberation into the blood stream is dependent on muscle activity, is a potentializer of HSP70 expression and HS response, particularly via its entering in hexosamine biosynthetic pathway (HBP). Herein, we discuss the collaborative role of glutamine (and its donors/precursors) and physical exercise (mostly responsible for glutamine release into the circulation) as potential tools to increase HSP70 expression and the HS response in the elderly.

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Role of epigenetic modifications and aging in inflammatory bowel disease

Du,

Li,

Zhou

et al. 2023

MedComm – Future Medicine

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Inflammatory bowel disease (IBD), which encompasses ulcerative colitis (UC) and Crohn's disease (CD), refers to a chronic and recurrent nonspecific inflammatory condition affecting the mucosal and submucosal layers of the intestines. A positive family history has been identified as a risk factor for the onset of IBD, likely influenced by genetic and environmental factors. In addition to intestinal damage, patients may have extraintestinal manifestations such as inflammation of the skin, eyes, and joints, inflammation of the liver or bile ducts, kidney stones, iron‐deficiency anemia, and growth retardation in children, which may complicate diagnosis and treatment. Therefore, investigating the mechanisms of IBD and finding precise therapeutic targets provides enormous benefits to patients with IBD. Multiple studies have consistently demonstrated the influential role of dietary metabolism and aging in the development of IBD. Moreover, emerging evidence suggests that aging often coincides with alterations in epigenetic modifications, while diet metabolism mediates these epigenetic changes. Epigenetics has emerged as a prospective field for identifying novel biomarkers to facilitate the diagnosis, prognosis, and treatment of diseases. Therefore, in this perspective, we summarize the cross‐talk between epigenetic modifications, diet metabolism, and aging in the pathogenesis of IBD and attempt to identify new potential therapeutic targets and strategies.

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Inflammatory Bowel Disease and the Elderly: A Review

Cited by 149 publications

References 83 publications

The Management of Inflammatory Bowel Disease in Elderly: Current Evidence and Future Perspectives

The Management of Inflammatory Bowel Disease in Elderly: Current Evidence and Future Perspectives

Physiological regulation of the heat shock response by glutamine: implications for chronic low-grade inflammatory diseases in age-related conditions

Role of epigenetic modifications and aging in inflammatory bowel disease

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