XXXX in the Elderly: The Case for New Therapeutic Strategies.

@entity1 @entity101 @entity73 @entity9395 @entity158 @entity1118 @entity9
BACKGROUND: Elderly @entity1 in general exhibit a higher incidence of chronic and @entity9 conditions. This group poses a particular clinical challenge due to age-related pharmacokinetic and pharmacodynamic issues, comorbid conditions, and polypharmacy, as well as frailty and @entity73 . Poor control of @entity158 has consistently been identified as an issue for older @entity1 . The identification of safe and efficacious treatments for @entity1118 remains a critical public health concern, especially considering the progressive increase of the world's elderly population. OBJECTIVES: This narrative review deals with the principal alterations of the somatosensory system together with changes in non-neuronal cells in the course of aging. The possibility to control @entity1118 based on an innovative strategy which addresses non-neuronal cell dysregulation control will also be discussed. STUDY DESIGN: Narrative review. RESULTS: Peripheral nerves display functional, structural, and biochemical changes with aging that mainly involve A? fibers. Alteration in the responses to @entity158 in the middle insular cortex and primary somatosensory cortex are also observed in the elderly. In general, @entity158 threshold increases with age while the threshold of @entity158 remains unchanged or decreases. Additionally, other important modifications of the @entity158 perception system in this age group consist in a clear reduction in the descending inhibitory capacity with an associated @entity101 . Furthermore, different changes concern immune system cells, such as mast cells and microglia, that with age show an increase in their sensitivity to noxious stimuli and a decreased capability to be regulated by homeostatic endogenous systems. Since these cells are the primary interlocutors for @entity158 neurons, their alterations lead to changes that promote persistent neuroinflammation, thereby impacting @entity158 neuronal cell functionality. LIMITATION: This review is not an exhaustive review for the current evidence supporting the role of immune cells in influencing @entity158 somatosensory neuron functions. It is also important to stress the small number of studies designed to determine the efficacy and safety of anti- @entity158 therapies in elderly @entity1 . CONCLUSION: Non-neuronal cells of immune system origin such as microglia and mast cells, along with astrocytes, are capable of influencing @entity158 somatosensory neuron functions. These nervous system non-neuronal cells may thus be viewed as innovative targets for persistent @entity158 control. Among therapies aiming at preserving the functionality of non-neuronal cells, @entity9395 , with its high efficacy/risk ratio, may be an excellent co-treatment for the ever-growing elderly population with @entity1118 .
