The severe heart disease of old age, characterized by aortic valve narrowing (aortic stenosis) combined with cardiac amyloidosis, has long been associated with a high risk of death. For years, treatment has focused on replacing the narrowed heart valve, while often leaving the amyloid deposits in the heart muscle untreated. A groundbreaking international study led by MedUni Vienna and University College London has now demonstrated that combining heart valve replacement with specific drug therapy can significantly prolong life for patients with this condition.

Led by Christian Nitsche (Department of Medicine II, Clinical Division of Cardiology, MedUni Vienna) and Thomas Treibel (Department of Cardiovascular Imaging, University College London), the research team analyzed data from 226 patients with aortic stenosis and concomitant cardiac amyloidosis from ten countries. Their study revealed that both aortic valve replacement and treatment with the drug tafamidis for amyloidosis were associated with a lower risk of death.

Most impressively, the survival benefit was highest in patients who received both forms of treatment. “Our results show that patients with both conditions who received valve replacement and specific amyloidosis therapy had similar long-term survival rates to people with aortic stenosis without amyloidosis,” emphasized study leader Christian Nitsche.

The targeted therapy can slow the progression of amyloidosis, while valve replacement treats the mechanical stress caused by the narrowed heart valve. The research suggests that around ten percent of patients with aortic stenosis also have amyloidosis, but this is often not diagnosed in everyday clinical practice.

“Our findings also suggest that patients with severe aortic valve stenosis should be screened for amyloidosis so that we can offer them targeted life-prolonging treatment options,” Christian Nitsche emphasized.

This study offers new hope for patients with severe heart disease and highlights the importance of combining therapy to improve outcomes. By targeting both the mechanical stress caused by aortic stenosis and the debilitating effects of cardiac amyloidosis, doctors can now provide their patients with more effective life-prolonging treatment options.

The treatment of chronic inflammatory bowel diseases has long been a challenge, particularly in young patients where disease manifestation often coincides with critical periods of education and early career development. Prompt diagnosis and treatment are crucial to prevent complications, including the development of bowel cancer. Researchers at Charité – Universitätsmedizin Berlin have made a groundbreaking discovery that significantly contributes to halting ongoing inflammatory processes, published in Nature Immunology.

Crohn’s disease and ulcerative colitis, the two most common chronic inflammatory bowel diseases, can be debilitating and life-altering. While traditional treatments focus on suppressing the immune system as a whole, newer therapies aim to interrupt the inflammatory process by blocking specific messenger substances that drive inflammation in the body.

Prof. Ahmed Hegazy has been studying inflammatory processes in the gut and the immune system’s defense mechanisms for several years. He has identified the interaction between two immune messenger substances – interleukin-22 and oncostatin M – as the driving force behind chronic intestinal inflammation. This uncontrolled chain reaction amplifies inflammation, drawing more immune cells into the intestine like a fire that spreads.

The research team spent five years uncovering how the immune messenger oncostatin M triggers inflammatory responses. They used animal models and examined tissue samples from patients to study the different stages of chronic intestinal diseases. State-of-the-art single-cell sequencing showed that in inflamed gut tissue, there are many unexpected cell types with binding sites for oncostatin M.

Interestingly, interleukin-22 normally protects tissue but also makes the gut lining more sensitive to oncostatin M by increasing its receptors. This interaction between the two immune messengers works together and amplifies inflammation, much like a fire getting more fuel and spreading.

In their models, the researchers specifically blocked the binding sites for oncostatin M and saw a clear reduction in both chronic inflammation and cancer associated with it. The team’s experimental findings may soon translate into real-world therapy by disrupting the harmful interaction between interleukin-22 and oncostatin M.

A clinical trial is already underway to test an antibody that blocks the receptors for oncostatin M. This targeted treatment has the potential to revolutionize the management of chronic inflammatory bowel diseases, particularly in patients with more severe forms of the illness. The discovery offers a new era in chronic inflammation treatment, providing hope for those affected by these debilitating conditions.

The Pace of Aging, a newly refined method for measuring the rate at which individuals experience age-related health decline, offers researchers and policymakers a powerful tool for predicting risks associated with aging, including chronic illness, cognitive impairment, disability, and mortality. Developed by Columbia University Mailman School of Public Health researchers, this approach quantifies how quickly individuals and populations experience age-related health decline.

The existing toolkit for population health research on aging did not distinguish differences caused by early-life factors from those caused by ongoing changes in people’s bodies due to aging. The findings from the study published in Nature Aging highlight the importance of this new method.

“Our Pace of Aging method is an essential approach for understanding population aging,” explained Arun Balachandran, PhD, a postdoctoral researcher at the Columbia Aging Center and lead author of the study. “Our existing toolkit doesn’t include methods that can separate out the legacies of early life from the changes caused by aging.”

Daniel Belsky, PhD, associate professor of Epidemiology at Columbia Mailman School and member of the Robert N. Butler Columbia Aging Center, elaborated on this point: “We developed the Pace of Aging method to evaluate the effectiveness of interventions targeting the biology of aging. The new approach introduced in this paper is designed to do the same for social policies and public health programs.”

The researchers analyzed data from two large-scale studies: the U.S. Health and Retirement Study (HRS) and the English Longitudinal Study of Aging (ELSA). These long-term studies follow adults aged 50 and older, along with their spouses, collecting detailed information on health, cognition, socioeconomic status, and family dynamics.

The new approach makes use of data from dried blood spots, physical exams, and performance tests given to participants in their homes at up to three timepoints over eight-year follow-up intervals. The researchers examined the Pace of Aging in 19,045 participants who contributed data over 2006-2016, with additional follow-up to determine disease, disability, and mortality through 2022.

In the US study, the Pace of Aging was measured from C-reactive protein (CRP), Cystatin-C, glycated hemoglobin (HbA1C), diastolic blood pressure, waist circumference, lung capacity (peak flow), balance, grip strength, and gait speed. The researchers found that their method can measure important variability in the pace of aging in older people with a relatively limited set of measurements.

“Our findings establish that we can measure important variability in the pace of aging in older people with a relatively limited set of measurements,” said Belsky. “Our findings open up possibilities to study pace of aging in cohorts around the world.”

The researchers also found signs of accelerated aging in people with lower levels of education and reported differences in aging trajectories across population subgroups. Originally developed using data from the Dunedin Study, a longitudinal study of individuals born in 1972-73, the initial Pace of Aging tool focused on changes from young adulthood through midlife.

The newly adapted method extends its utility to population-based studies of aging, offering planners and policymakers a valuable resource for monitoring and improving population health and longevity. “Beyond medicine and gerontology, this work has important implications for sociology and economics,” added Belsky.

“It can help us understand how life transitions – such as retirement, caregiving, and bereavement – affect the aging process and support the development of more effective public health and social policies.” The researchers highlighted that the differences in aging speed found were not just statistically significant but meaningful, with people aging faster much more likely to get sick, become disabled, or die sooner.

The study was supported by National Institutes of Health grants R01AG061378, T32AI114398, and U01AG009740; the Russel Sage Foundation; BioSS Grant 1810-08987; and the Robert N. Butler Columbia Aging Center.