A geroscience perspective on immune resilience and infectious diseases: a potential case for metformin
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ORIGINAL ARTICLE
A geroscience perspective on immune resilience and infectious diseases: a potential case for metformin Jamie N. Justice & Sriram Gubbi & Ameya S. Kulkarni & Jenna M. Bartley & George A. Kuchel & Nir Barzilai
Received: 1 July 2020 / Accepted: 27 August 2020 # American Aging Association 2020
Abstract We are in the midst of the global pandemic. Though acute respiratory coronavirus (SARS-COV2) that leads to COVID-19 infects people of all ages, severe symptoms and mortality occur disproportionately in older adults. Geroscience interventions that target biological aging could decrease risk across multiple age-related diseases and improve outcomes in response to infectious disease. This offers hope for a new hostdirected therapeutic approach that could (i) improve
J. N. Justice (*) Sticht Center for Healthy Aging and Alzheimer’s Prevention, Internal Medicine – Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA e-mail: [email protected] S. Gubbi Metabolic Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20814, USA A. S. Kulkarni : N. Barzilai Department of Medicine, Division of Endocrinology, Albert Einstein College of Medicine, Bronx, NY 10461, USA A. S. Kulkarni : N. Barzilai Institute for Aging Research, Albert Einstein College of Medicine, Bronx, NY 10461, USA J. M. Bartley : G. A. Kuchel Center on Aging, University of Connecticut School of Medicine, Farmington, CT 06030, USA J. M. Bartley Department of Immunology, University of Connecticut School of Medicine, Farmington, CT 06030, USA
outcomes following exposure or shorten treatment regimens; (ii) reduce the chronic pathology associated with the infectious disease and subsequent comorbidity, frailty, and disability; and (iii) promote development of immunological memory that protects against relapse or improves response to vaccination. We review the possibility of this approach by examining available evidence in metformin: a generic drug with a proven safety record that will be used in a large-scale multicenter clinical trial. Though rigorous translational research and clinical trials are needed to test this empirically, metformin may improve host immune defenses and confer protection against long-term health consequences of infectious disease, age-related chronic diseases, and geriatric syndromes. Keywords Metformin . Aging . Geroscience . Immunity . COVID-19
Geroscience in a time of global pandemic The promise of geroscience is that interventions that target biological aging could fortify organismal resilience and delay the onset or lessen the severity of multiple age-related diseases en masse. Never has this promise been more critical than now, in the midst of the global pandemic. Though acute respiratory coronavirus (SARS-COV2) infects people of all ages, severe symptoms and mortality occur disproportionately in older adults. In the USA, 8 out of 10 deaths occurred in persons over the age of 65
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