Pasquale Mone
Antonio De Luca
Gaetano Santulli- 1Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Campobasso, Italy
- 2Albert Einstein College of Medicine, New York, NY, United States
- 3Department of Mental and Physical Health and Preventive Medicine, Campania University “Luigi Vanvitelli”, Caserta, Italy
- 4International Translational Research and Medical Education (ITME) Consortium, Department of Advanced Biomedical Sciences, “Federico II” University, Naples, Italy
Editorial on the Research Topic
Frailty and oxidative stress
Frailty is a prevailing condition in older adults, increasing the risk of death, hospitalizations, and adverse outcomes, while driving both cognitive and physical impairment. With the increase in life expectancy, aging is steeply rising, leading to frailty with a higher risk of losing independence (Ferrucci and Fabbri, 2018).
Aging is known to be associated with oxidative stress linked to reactive oxygen and nitrogen species (Liguori et al., 2018).
The present Research Topic has been focused on “Frailty and oxidative stress.” In particular, Tong et al. reviewed the functional role of mitochondrial dynamics in retinal pigment epithelial aging and degeneration. An overview of the literature on the mechanistic roles of miRNA-34a in diabetes and frailty evidenced that this miRNA could be involved in diabetes-induced endothelial dysfunction (Mone et al.). Wei et al. systematically reviewed the role of GLP-1 receptor agonists in arrhythmias in diabetic patients.
In an original paper, Song et al. correlated the severity of non-alcoholic fatty liver disease with cardiovascular outcomes in pre-hypertension and hypertension. In another elegant study, Salis et al. focused on frail elders with atrial fibrillation showing a worst frailty in presence of more comorbidities. Last but not least, Qi et al. published a national cross sectional study social frailty in Chinese older adults with cardiovascular and cerebrovascular diseases.
Based on the published papers, we can conclude that frail patients have many comorbidities, including cardiovascular and metabolic diseases (e.g., hypertension, heart failure, diabetes, and metabolic syndrome), which further increase oxidative stress. In this context, managing frail patients represents a great challenge since there is no accepted treatment for oxidative stress in frail older adults with comorbidities (Mone et al., 2022b). Empagliflozin, a sodium-glucose cotransporter-2 inhibitor [SGLT2-inhibitor (Varzideh et al., 2021)], is usually prescribed in diabetic patients and drives strong effects on heart failure, chronic kidney disease, and atherosclerotic cardiovascular disease (ElSayed et al., 2023; Forzano et al., 2023). In a previous investigation, we evidenced the positive effects of Empagliflozin on frailty in hypertensive and diabetic elders, evidencing a significant result on oxidative stress in human endothelial cells (Mone et al., 2022c). Intriguingly, we also observed beneficial effects on endothelial micro-RNAs in frail diabetic elders with heart failure and preserved ejection fraction (Mone et al., 2023). Therefore, based on their antioxidative effects in frailty, SGLT2 inhibitors should be endorsed as anti-frailty drugs (Santulli et al., 2023).
Author contributions
PM: Writing–review and editing. AD: Writing–original draft. GS: Writing–review and editing.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.
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References
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Ferrucci, L., and Fabbri, E. (2018). Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty. Nat. Rev. Cardiol. 15 (9), 505–522. doi:10.1038/s41569-018-0064-2
Forzano, I., Wilson, S., Lombardi, A., Jankauskas, S. S., Kansakar, U., Mone, P., et al. (2023). SGLT2 inhibitors: an evidence-based update on cardiovascular implications. Expert Opin. Investig. Drugs 32 (9), 839–847. doi:10.1080/13543784.2023.2263354
Liguori, I., Russo, G., Curcio, F., Bulli, G., Aran, L., Della-Morte, D., et al. (2018). Oxidative stress, aging, and diseases. Clin. Interv. Aging 13, 757–772. doi:10.2147/CIA.S158513
Mone, P., Gambardella, J., Pansini, A., Martinelli, G., Minicucci, F., Mauro, C., et al. (2022b). Cognitive dysfunction correlates with physical impairment in frail patients with acute myocardial infarction. Aging Clin. Exp. Res. 34 (1), 49–53. doi:10.1007/s40520-021-01897-w
Mone, P., Lombardi, A., Kansakar, U., Varzideh, F., Jankauskas, S. S., Pansini, A., et al. (2023). Empagliflozin improves the MicroRNA signature of endothelial dysfunction in patients with heart failure with preserved ejection fraction and diabetes. J. Pharmacol. Exp. Ther. 384 (1), 116–122. doi:10.1124/jpet.121.001251
Mone, P., Varzideh, F., Jankauskas, S. S., Pansini, A., Lombardi, A., Frullone, S., et al. (2022c). SGLT2 inhibition via Empagliflozin improves endothelial function and reduces mitochondrial oxidative stress: insights from frail hypertensive and diabetic patients. Hypertension 79 (8), 1633–1643. doi:10.1161/HYPERTENSIONAHA.122.19586
Santulli, G., Varzideh, F., Forzano, I., Wilson, S., Salemme, L., de Donato, A., et al. (2023). Functional and clinical importance of SGLT2-inhibitors in frailty: from the kidney to the heart. Hypertension 80 (9), 1800–1809. doi:10.1161/HYPERTENSIONAHA.123.20598
Keywords: frailty, older adults, comorbidities, oxidative stress, SGLT2 inhibitors
Citation: Mone P, De Luca A and Santulli G (2024) Editorial: Frailty and oxidative stress. Front. Aging 4:1345486. doi: 10.3389/fragi.2023.1345486
Received: 27 November 2023; Accepted: 29 November 2023;
Published: 06 March 2024.
Edited and reviewed by:
Jianhua Zhang, University of Alabama at Birmingham, United StatesCopyright © 2024 Mone, De Luca and Santulli. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Pasquale Mone, pasqualemone@hotmail.it