Better integration of biomarkers of aging into medicine – University of Innsbruck

Ciara Herzog researches biomarkers of aging and helped design new guidelines for their standardization.

Biomarkers of aging can be used to determine people’s biological age and future health status. Ciara Herzog from the European Translational Oncology Prevention and Screening Institute and her colleagues from the “Biomarkers of Aging Consortium” want to close the gaps between research and the use of such biomarkers in health care. You keep it in the magazine Natural aging Published a study on barriers to clinical implementation.

From Ciara Herzog European Institute for Translational Oncology Prevention and Screening (EUTOPS) The University of Innsbruck has been researching so-called biomarkers of aging. Markers are biological characteristics that reveal people’s biological age, including molecular and cellular damage, and risk of future age-related diseases – or regression. This will improve early detection and risk prediction of chronic diseases. Such biomarkers may be helpful in predicting how people react to stressors such as activities, thus taking into account different life situations. These markers offer the opportunity to further personalize clinical or health-promoting therapies.

Especially in recent years, there has been intense research on these biomarkers in the field of epigenetics and other molecular areas. However, their actual application in clinical medicine, research and prevention is still in its infancy. First author Ciara Herzog and colleagues “Biomarkers of the Aging Association”. interviewed experts about implementation at their symposium in California in 2023 and the results are now in a special issue Natural aging Published.

They identify six major barriers to clinical use (data sharing, evaluation criteria, age range, implementation criteria, standardization in healthcare, relation to clinical evidence) and propose guidelines to overcome these barriers. It aims to bridge the gaps between biomarker research and the healthcare setting.

Publication in English:
Ciara Herzog and. Al: Challenges and recommendations for the translation of biomarkers of age. In: Not Aging (2024). DOI: 10.1038/s43587-024-00683-3

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What are the benefits of aging biomarkers for populations and their health?
Ciara Herzog: Due to medical advances, we as a population are aging more and more – but unfortunately not always healthily, as age is the number one risk factor for many diseases. The ZeroScience hypothesis suggests that by slowing down or reversing the biological aging process, several diseases can be prevented simultaneously. This means we can stay healthy for longer. We already know that this is, in principle, possible in animal models and cell culture. We also know that biological age is separated from the chronological one – that is, from when we were born. Using aging biomarkers, we can measure individual aging at a young age and intervene before age-related diseases develop, as well as measure the effectiveness of certain interventions. So this research has enormous potential for people’s long-term health.

What areas of health care already have integrated biomarkers of aging?
Ciara Herzog: The term “biomarker of age” includes all indicators of biological age, and some such indicators we already implicitly use in health care: many conventional blood parameters, for example inflammation or diabetes indicators, but also functional performance indicators (e.g. maximal oxygen uptake ), depending on age. Change. They can provide targeted information about (age-related) processes in our body. In recent decades, there has been increasing interest in integrative, “omic” biomarkers, for example in so-called epigenetics. These biomarkers are particularly exciting because they can provide additional information, but they are not yet in widespread use.

Why are these biomarkers not yet widely used in medicine?
Ciara Herzog: There are many reasons for this. On the one hand, these biomarkers are relatively new and therefore not yet sufficiently tested for clinical use, although the evidence for their importance is growing. On the other hand, many of these biomarkers are being developed with computer-aided models or AI, and as opposed to established laboratory measurements such as blood sugar or blood cholesterol elevation, it is not yet clear exactly which target measures should or could be provided. . In principle, we now need studies that are clear: a person with biomarker X will benefit from intervention Y to prevent disease Z, and lowering the biomarker is associated with a reduction in disease risk. Ultimately, costs also play a role—many of these new biomarker tests are currently only available to self-payers. In the future, such tests should be available to all to prevent disparities in the healthcare system.

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What health areas do you see needing action?
Ciara Herzog: Biomarkers have the potential to positively impact all areas of health. We know that biomarkers of age can indicate increased biological age at an early stage: this means we can intervene and specifically prevent the onset of any symptoms of disease. It also requires rethinking the entire health system to make health promotion and protection a top priority. Currently, less than 3% of health system expenditure is spent on disease prevention.

To what extent can open scientific opinion help?
Ciara Herzog: There are already some promising aging biomarkers, but to facilitate their translation into clinical use, we need to test their properties thoroughly and in as many populations as possible. This requires a lot of data. Frustratingly, many data sets already exist – often funded by public money – but accessing them is usually difficult, time-consuming or simply impossible. Data is often not properly structured, making it unusable in the future. Both would ultimately mean a waste of resources. The EU and other funders are now placing a higher priority on “open science” (i.e. open research, data sharing) to create added value for funding. We also need clear guidelines and the standardization of data sets for new applications – all, of course, while maintaining the security of personal data.

What further steps should be taken to better integrate biomarkers of aging into health care?
Ciara Herzog: In our recent work, we have identified some key points that indicate important next steps. On the one hand, there should be harmonization of large data sets to directly compare which of the different biomarkers actually work (better) and can be tested in clinical use. Communication with researchers and clinicians also plays an important role, as they can provide information for the prioritization and development of such biomarkers – an area in which we actively seek collaboration. Ultimately, there must be adequate funding for high-quality testing of such biomarkers and support for a health system focused on prevention.

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What role could aging biomarkers play in future clinical research and disease prevention?
Ciara Herzog: Our hope is that biomarkers can support a shift to greater prevention, and as a result, fewer people will suffer from chronic diseases. This revision will in the long run relieve the burden on the healthcare system and improve the quality of life of the individual. Although the use of such aging biomarkers in everyday clinical practice will be a few years away, the most promising biomarkers may already be used in clinical research. Biological age leads to better health.

Ciara Herzog is organizing another meeting of the “Biomarkers of Aging Consortium” at Harvard Medical School in 2024 to discuss next steps.

to the person

Chiara Herzog, a neuroscientist and molecular medicine specialist, is a postdoctoral researcher. Youtubes-Institute at the University of Innsbruck. Among other things, he leads several projects on early detection and risk prediction of biomarkers for aging processes and cancer. He helped design new guidelines for benchmarking aging biomarkers. As co-chairman, he accompanies them TirolGESUND surveyIt examines disease prevention and the effects of lifestyle changes (smoking, fasting, exercise).

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