华尔街日报 | 炎症性衰老可能严重威胁你的健康

Inflammaging Is Chronic, Stealthy and Can Be a Serious Threat to Your Health


慢性炎症会随年龄增长在体内逐渐积聚。科学家表示，我们应该予以更密切的关注，因为越来越多的研究表明了它可能造成的损害。



“炎症性衰老” (Inflammaging)听起来像是健康类公司抛出来的又一个营销套路。明智的做法是认真对待这种情况。
“Inflammaging” sounds like just another marketing buzzword wellness companies are throwing around. You would be wise to take the condition seriously.
   
这个术语由炎症(inflammation)和衰老(aging)两个词组合而成，描述了一种温水煮青蛙式的炎症（当免疫系统对感知到的威胁作出反应时，就会发生炎症）。这是一种低级别的慢性炎症，随着年龄增长而悄悄积聚。它和一系列疾病的患病风险上升有关，包括心脏病、癌症、阿尔茨海默症和其他病症。
A combination of inflammation and aging, the term describes a simmering form of inflammation—the immune system’s response to a perceived threat—that is chronic and low-grade, and builds stealthily as you age. It is associated with an increased risk of heart attack, cancer, Alzheimer’s and other conditions. 
   
随着年龄的增长，每个人都会或多或少地出现炎症，有些人的情况并不严重。但科学家表示，我们应该予以更密切的关注。越来越多的研究表明了它可能造成的损害。
Inflammaging happens to everyone to some degree as we age, and some people don’t develop much. But scientists say we should pay closer attention. More research is showing the damage it can cause.   
科研人员正在研究潜在的药物治疗方法，有些医生正在推动对慢性炎症进行更多、更好的检测。与此同时，你可以采取一些简单的措施来对抗炎症性衰老：经常锻炼、保证充足的睡眠、多吃蔬菜水果以及少吃红肉。
Researchers are studying potential drug treatments, and some doctors are pushing for more and better tests for chronic inflammation. Meanwhile, there are simple things you can do to fight inflammaging: exercise regularly, get enough sleep and eat a diet that is heavy on fruits and vegetables and light on red meat.
“炎症是所有慢性疾病的固有构成，”国家老龄化研究所(National Institute on Aging)的老年病学家兼科学主任路易吉·费鲁奇(Luigi Ferrucci)博士指出。他对发生在老年人身上的这一现象进行了近三十年的研究。
“Inflammation is an intrinsic component of all chronic disease,” said Dr. Luigi Ferrucci, a geriatrician and scientific director of the National Institute on Aging who has studied the phenomenon in aging people for nearly three decades.

什么是炎症性衰老？

“炎症性衰老”一词是由博洛尼亚大学(University of Bologna)退休免疫学教授克劳迪奥·费兰切斯基(Claudio Franceschi)博士在2000年的一篇论文中创造的。去年，科学家提议将慢性炎症添加到随着年龄增长而显现并可能加速衰老的生物学特征列表中，这个列表被称为“衰老的标志”。
The term “inflammaging” was coined by Dr. Claudio Franceschi, a retired professor of immunology at the University of Bologna, in a 2000 paper. Last year, scientists proposed adding chronic inflammation to a list of biological features that manifest with age and can accelerate it, dubbed the “hallmarks of aging.”
   
炎症本身并不是坏事。这是身体保护自己免受伤害的一种自然方式。它可能有助于人体对抗病毒感染（比如新冠病毒），或者帮助手指上的伤口愈合。一旦身体痊愈，炎症通常就会消退。
Inflammation isn’t inherently bad. It is the body’s natural way of protecting itself from harm. That can be helpful in fighting off a viral infection like Covid, or in healing a cut on the finger. It normally subsides once the healing is done.  
慢性炎症发生的源头也是身体在试图保护自己。但它不会消退，而且可能造成伤害而不是起到治愈作用。随着年龄的增长，人们会出现全身性炎症，因为身体会对它认为异常的物质或状况作出反应：例如腹部脂肪细胞的堆积。
Chronic inflammation also comes from the body trying to protect itself. But it doesn’t subside, and can harm rather than heal. People develop systemic inflammation as they age, as their bodies respond to substances or conditions they perceive as abnormal: a buildup of fat cells in the abdomen, for example. 
炎症性衰老的一种可能源头是细胞衰老，也就是受损的老化细胞停止分裂，积聚并分泌炎性蛋白。
One likely source of inflammaging is cellular senescence, when damaged aging cells stop dividing, build up and secrete inflammatory proteins. 
随着年龄增长，人们的慢性炎症水平会升高，但是，出现这个问题的年龄和严重程度因人而异。“有些人可能从孩提时代就身受其害。还有些人可能直到七、八十岁都一直保持很低的水平，”费兰切斯基说。
Levels of chronic inflammation rise in people as they age, but people develop it at different ages and to different degrees. “In some people, it can start immediately even when you are a child. In other people you can stay at a very low level until age 70 or 80,” Franceschi said. 

炎症性衰老有什么影响？

研究表明，慢性炎症在重大的衰老疾病中起到非常重要的作用，既会引发又会加剧这些疾病。
Studies show how important a role chronic inflammation plays in the biggest diseases of aging, both triggering and worsened by them. 
  
“这是一个恶性循环，”费鲁奇说。“炎症会造成损伤，而组织损伤又会产生炎症。”
“It’s a vicious cycle,” Ferrucci said. “Inflammation creates damage, and the damage in the tissue generates inflammation.”
 
一项研究显示，如果你体内的炎症水平很高，那么因为任何原因导致死亡的风险也会上升——其风险比炎症水平最低的患者高出七倍。这项研究对超过16万名患者的血液样本进行了检测。
High levels of inflammation have been linked to an increased risk of death from any cause—a seven times higher risk compared with those with the lowest levels of inflammation, according to one study examining blood samples from more than 160,000 patients. 
慢性炎症水平较高的女性发生心脏病、中风或因心血管疾病而死亡的风险比炎症水平较低的女性高出70%，这是波士顿布莱根妇女医院(Brigham and Women’s Hospital)的研究人员在8月份发表的另一项研究的结果。他们对上述女性进行了为期30年的跟踪观察。
Women with high levels of chronic inflammation had a 70% greater risk of a heart attack, stroke or death from a cardiovascular cause than those with low levels, according to a separate study published in August by researchers at Brigham and Women’s Hospital in Boston, who followed the women for 30 years.
“单单是炎症这一点就会带来巨大风险，”该研究的主要作者、布莱根妇女医院心血管疾病预防中心主任保罗·里德克(Paul Ridker)博士指出。“我们需要更早开始预防。”
“There’s tremendous risk with inflammation alone,” Dr. Paul Ridker, lead author of the study and director of the Center for Cardiovascular Disease Prevention at Brigham and Women’s. “We need to start prevention a lot earlier.”  
慢性炎症也会导致阿尔茨海默症。多年来积聚在大脑中的斑块和缠结会引发慢性炎症反应，波士顿麻省总医院(Massachusetts General Hospital)麦坎斯脑部健康中心(McCance Center for Brain Health)主任鲁道夫·坦齐(Rudolph Tanzi)指出。
Chronic inflammation also drives Alzheimer’s disease. Plaques and tangles that build up over many years can trigger a chronic inflammatory response, said Rudolph Tanzi, director of the McCance Center for Brain Health at Massachusetts General Hospital in Boston. 
随着年龄增长，人体细胞的损伤会逐渐积聚，引发低级别的慢性炎症，从而导致疾病。例如：
▪ 大脑：认知衰退和阿尔茨海默症
▪ 癌症： 可导致突变，突变会激活肿瘤生长或削弱人体发现和消除癌细胞的能力
▪ 动脉粥样硬化： 动脉壁内脂肪沉积或斑块堆积，可导致动脉破裂并引发心脏病发作
▪ 骨质流失： 影响骨骼修复并导致骨质疏松
▪ 肾脏疾病： 损伤后，肾脏的自我修复能力会受损

检测和治疗

血液检测可以测量炎症标志物，比如超敏C反应蛋白(hs-CRP)、红细胞沉降率(ESR)和铁蛋白，但是大多数检测都无法区分暂时性炎症和长期炎症，也无法确认炎症来源。
Blood tests measure markers of inflammation such as high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR) and ferritin, but most can’t distinguish between temporary and prolonged inflammation. They also don’t pinpoint the source. 
“你体内的炎症到底是因为你的关节炎还是因为你的肝病，或者是因为你患有多肌痛（一种自身免疫性疾病）？”克利夫兰诊所老年医学中心(Cleveland Clinic’s Center for Geriatric Medicine)部门主管阿尔德希尔·哈什米(Ardeshir Hashm)博士说。
“Is it because of your arthritis, or is it because of your liver disease, or is it because you have polymyalgia, an autoimmune sort of thing?” says Dr. Ardeshir Hashmi, section chief for Cleveland Clinic’s Center for Geriatric Medicine. 
英国的一组研究人员分析了16万名接受炎症标志物检测的患者的记录。医生们发现，在炎症标志物高于正常水平的患者当中，有85%的人并没有感染或患有疾病的迹象。
A team of researchers in the U.K. analyzed records from 160,000 patients who had received inflammatory marker tests. In roughly 85% of cases where patients had higher than normal markers, doctors found no evidence of infection or disease. 

治疗慢性炎症可能很棘手

对症的药物必须在不阻断免疫系统的情况下抑制炎症。一些动脉粥样硬化患者或心血管疾病高危人群可以使用低剂量秋水仙碱治疗炎症，美国食品药品管理局(Food and Drug Administration，简称FDA)已于2023年批准该药的这种用途。多年来，这种药物一直被用来治疗痛风（一种关节疼痛疾病）。
A drug has to tamp down inflammation without blocking the immune system. Some patients who have atherosclerosis or are at high risk of cardiovascular disease are treated for inflammation with a low-dose version of the drug colchicine, approved by the Food and Drug Administration in 2023 for that use. The drug has been used for years to treat gout, a joint-pain disease. 
科研人员正在研究其他药物（包括GLP-1）是否可以降低炎症标志物。诺和诺德(Novo Nordisk)与杰特贝林(CSL Behring)正在心血管患者或高危人群当中测试潜在的抗炎药物。
Researchers are studying whether other drugs, including GLP-1s, can lower inflammatory markers. And Novo Nordisk and CSL Behring are testing potential anti-inflammatory medications in patients who have cardiovascular disease or are at high risk.
有些人尝试服用二甲双胍和雷帕霉素等药物来治疗炎症。FDA已经批准了这两种药物的其他用途，它们都显示出了治疗炎症的潜力，但还需要在人体中进行更多研究。
Some people have experimented with taking medications such as metformin and rapamycin to target inflammaging. Both drugs, approved by the FDA for other uses, have shown potential to target inflammaging, but more research in humans is needed. 
除此之外，如今预防炎症的最有效方法是什么？不管怎样，你应该做到以下所有事情：坚持锻炼、不吸烟、保持健康的体重和健康的饮食。
Otherwise, the best ways to ward off inflammaging today? All the things you should be doing anyway: exercising consistently, not smoking, maintaining a healthy weight and eating healthfully. 
一些研究表明，强调坚果、全谷物、鱼类、水果和蔬菜的地中海饮食特别能预防炎症。相比之下，红肉会加剧炎症。
Some research suggests the Mediterranean diet, which emphasizes nuts, whole grains, fish, fruits and vegetables, is particularly protective against inflammation. Red meat, by contrast, promotes inflammation. 
坦齐指出，保持大脑健康最重要的一点就是每晚保证七到八个小时的睡眠。他说，然后大脑就会清除引发炎症的淀粉样蛋白。
Most important for brain health is seven to eight hours of sleep a night, said Tanzi. The brain gets rid of amyloid that triggers inflammation then, he said. 
“每次你从做梦状态或快速眼动睡眠进入到深度睡眠时，我都称之为一个大脑冲洗周期。”
“Every time you go from dreaming or REM to deep sleep, I call it a rinse cycle.”