Degeneration of the cardiovascular, neurological and endocrine systems, leading to coronary heart disease, heart failure and atrial+ fibrillation; dementia (including Alzheimer's disease), Parkinson's disease and glaucoma; diabetes and osteoporosis, accounts for much of the disability and death of our aging population. Cellular senescence of the endocrine glands leading to menopause, acquired androgen and growth hormone deficiency, enhances the development of osteoporosis, visceral
obesity and insulin resistance. Oestrogen deficiency also
aggravates the course of Parkinson's disease, Alzheimer's
disease and ischaemia induced brain injury in stroke patients, the disability associated with which in turn predispose to injury and osteoporotic fractures. Insulin resistance leads to the high prevalence of diabetes (1 in 3 and 5 respectively of women and men over the age of 65 in HK) and metabolic syndrome (17% of HK), which are major causes of coronary artery disease and stroke. Components of the metabolic syndrome (impaired glucose tolerance, hypertension, dyslipidaemia and visceral obesity) are key players in the adverse changes in vascular
biology associated with aging, which lead to accelerated atherosclerosis (and hence heart disease and stroke) and diabetic complications, particularly renal failure.
Mechanistically, chronic inflammation, increasingly recognized to be important in the pathogenesis of diabetes and coronary artery disease, has also been implicated in the development of Alzheimer's disease.
Therapeutically, there is again considerable overlap among the
aging diseases of different systems. For example, the PPAR agonists, used in the treatment of diabetes, also reduces atherosclerosis, through its effect on hypertension, oxidative stress and release of adiponectin, a fat-derived hormone with anti-inflammatory, anti-atherogenic and insulin sensitizing property, the production of which is reduced in diabetes and the metabolic syndrome.
On the other hand, the statins, which are effective in the prevention of heart disease and stroke, have been reported to be beneficial in reducing osteoporosis, Azheimer's disease and glaucoma as well!
It can be readily appreciated, from the above information, that age-related disorders are often inter-related. Therapeutic measures for the regeneration of the function of the cardiovascular, neurological and endocrine systems through drugs, appropriate hormone replacement, cell therapy and tissue engineering can also be developed using similar platforms. Research and management efforts to promote healthy ageing should therefore, ideally, be organized through a multi-disciplinary approach. Four research programmes are developed under the HBHA Research Centre:
- Cell Therapy & Tissue Engineering
- Degeneration & Regeneration
- Diabetes & Metabolic Syndrome
- Vascular Biology