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Tokyo skyline where the Aging and Diseases of Aging conference that covered underlying aging

Aging & Diseases of Aging: Conference in Tokyo, Japan

At The Aging and Diseases of Aging conference in Tokyo, scientists reported on their investigations into the mechanisms underlying the diseases of aging.  Presentations included findings on reduced adiponectin leading to obesity and insulin resistance, how amyloid protein leads to cardiovascular disease, and how specific sirtuins protect against obesity.  Other topics included the role of autophagy in neuro-degenerative disease, understanding cell senescence, and using young blood to restore health in older organisms.

Scientifically reviewed by Dr. Gary Gonzalez, MD, in October 2024. Written by: Ben Best, BS, Pharmacy.

Aging & Diseases of Aging Conference in Tokyo, Japan

If you could go back in time, you’d want to have a pint of your blood removed and frozen every few years so that it would be available to be reintroduced into your aging body.

One reason is that your young blood does not have the inflammatory proteins that are found in old blood. These inflammatory factors have been found to inhibit stem cell function. Young blood also contains more youthful immune system cells (T-lymphocytes and B-lymphocytes). Cells in the immune system become less functional with age.

Another benefit of having your youthful blood available is that it contains more youthful stem cells that can provide a systemic rejuvenating effect.

Progressive medical facilities in the United States now offer a service where they temporarily stimulate stem cells in healthy people to boost their white blood cell production (using granulocyte-colony-stimulating factor). After a week’s time, the doctors withdraw your blood and freeze it until a time in the future when you need it to save your life. There is no time limit for how long your blood can remain frozen.

The time and expense involved in this procedure precludes most people from doing it.

Over forty years ago scientists demonstrated that linking the blood circulation of old rats to young rats could extend the life span of old rats by about 20%.1 The rat experiments worked because the rats were genetically identical, despite being different ages. Elderly humans cannot accept the blood of younger people because of immune rejection of the stem cells unless they are a full tissue match.

Only in the last ten years have scientists begun to discover the reason behind the life-extending benefits for old rats sharing blood circulation with young rats. This was one of the many topics covered in the “Aging and Diseases of Aging” conference held in Tokyo, Japan, on October 22-27, 2012.

Research in Tissue Aging

Research in Tissue Aging  

As described by Thomas Rando, PhD, (Professor of Neurology & Neurological Sciences at Stanford University) the technique of shared blood circulation between rodents of different ages was not used again for decades until 2005 when his graduate student, Irina Conboy, showed that the procedure restored the regenerative capacity of muscle stem cells in the older mice.2 It was also demonstrated that the stem cells in the liver, brain, and bone of an old animal could regain regenerative potential by being exposed to the circulating blood of a young animal.2 Later studies have confirmed that molecules in the blood of old animals depress muscle stem cell activity in both young and old animals.3

More recently, Dr. Rando’s laboratory used shared circulation in mice to discover the chemical CCL11 in the blood of old mice responsible for inhibiting stem cells in the brain.4 CCL11 injected into young mice reduced brain stem cell activity, while impairing learning and memory.4 Excessive inflammatory factors in the blood of old animals, notably TGF-1, are responsible for the inhibition of stem cells in muscle.5

Dr. Rando believes that a major cause of tissue aging is the decline in regenerative capacity of the stem cells of those tissues as a result of blood-borne molecules that increase with age and that inhibit stem cells. He has been investigating the mechanisms by which chemicals in the blood reduce stem cell activity, concluding that DNA expression is being altered.6 Every tissue in the body of an animal is different, but all cells making up these tissues have the same DNA code serving as a blueprint for cell function. What makes a liver cell, skin cell, and brain cell different from one another is that different portions of DNA are being expressed for each cell type.

Amy Wagers, PhD (Associate Professor, Harvard Medical School Department of Stem Cell and Regenerative Biology), was a contributor to the 2005 study of shared blood circulation between rodents of different ages. She was also present at this conference, where she reported that shared circulation could stimulate stem cells in old mouse brains to produce new myelin sheaths for neuronal fibers, a technique that could benefit patients suffering from multiple sclerosis.7 Wagers is also researching the use of stem cells from fat tissue to regenerate heart muscle in patients who have suffered from heart failure or heart attack.8

Understanding Senescent Cells

Judith Campisi, PhD (Professor at the Buck Institute for Research on Aging), is interested in the senescent cells that increase with age as a proportion of the total cells in tissues. Cells, like people, can become senescent, and the increasing number of senescent cells contributes to the senescence of people. For cells, senescence means that they stop dividing, usually because their telomeres have become too short, or because of irreparable DNA damage. Cellular senescence is nature’s way of preventing cells from becoming cancerous, but (ironically) cells that have become senescent begin secreting growth factors, proteins, and inflammatory agents that can cause other cells to become cancerous.9,10

Dr. Campisi’s group has identified IL-6 (Interleukin-6) and IL-8 (Interleukin-8) as inflammatory molecules known as cytokines being produced by senescent cells.11 More recently, her group showed that senescent cells resulting from DNA damage are induced to produce pro-inflammatory cytokines by increased activity of the NF-kB pathway.12 Senescent cells are thus in large part responsible for the chronic inflammation of old age that causes so many age-related diseases such as cancer and atherosclerosis. Dr. Campisi noted a discovery made in 2011 of the rejuvenating effects of eliminating senescent cells in mice.13

Dr. Campisi has wondered whether there is any benefit that results from the secretory products of senescent cells. Her conclusion is that in the presence of senescent cells, wound-healing is less fibrous than it would be otherwise due to the presence of protein-digesting enzymes secreted by the senescent cells (along with the other inflammatory molecules).

Reducing Methylation

Juleen Zierath, PhD (Head of the Section of Integrative Physiology, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden), like Dr. Rando, is interested in control of DNA expression (epigenetics, as distinct from genetics, which studies the effects of DNA differences). Dr. Zierath is specifically investigating the relationship between gene expression and type II (formerly called adult-onset) diabetes.

An important mechanism of epigenetics is addition of methyl molecules (methylation) or removal of methyl molecules (demethylation) to regulatory areas of DNA.14,15 Methylation of biomolecules is an essential biochemical reaction required for maintaining the integrity of biological membranes,16 synthesis of neurotransmitters,16 visual acuity,17 increasing glutathione synthesis in the brain to protect against oxidative stress,18 and protection against depression19 ― among many other vital functions. Methylation and demethylation of DNA is a means by which control is exerted over which genes are expressed and which genes are not. If DNA were completely methylated, no genes would be expressed, whereas if there were no DNA methylation there would be chaotic overexpression of too many genes. Both excessive and inadequate DNA methylation have been associated with cancer.20

Dr. Zierath has been studying DNA methylation effects in type II diabetes. As background, Dr. Zierath described twin studies. Identical twins are genetically identical because they have the same DNA and continue to have the same DNA throughout their lifetimes. Identical twins are epigenetically identical at birth, but become increasingly epigenetically distinct as they become subject to different environmental influences.21 She cited a study which showed that epigenetic effects due to smoking and dietary behavior can be inherited.22

In 2009 Dr. Zierath’s laboratory published a study showing that fatty material in the bloodstream causes methylation of DNA regulatory areas that results in a reduction of mitochondria (and resultant reduction of cellular energy).23 This study was an advance in providing a molecular mechanism that would explain why patients with type II diabetes have fewer mitochondria in their cells. The following year,her team published research indicating that exercise induces epigenetic changes that induce mitochondria function and fat utilization.24

Dr. Zierath has called exercise “the first line of defense against the development of insulin resistance in type II diabetes.” Vigorous exercise at least once per week has been shown to reduce the risk of type II diabetes by 33%.25 Most recently Dr. Zierath’s group published a study showing that exercise increases gene expression of sections of DNA that induce mitochondrial formation.26

Dr. Zierath takes her research personally. When I crossed her path in the hotel gym she asked me, “How’s your methylation?” I did not see anyone else from the conference in the hotel gym.

Stimulating SIRT3

Stimulating SIRT3

Eric Verdin, MD (Senior Investigator at the Gladstone Institute of Virology and Immunology at the University of California, San Francisco), discovered in 2002 that the sirtuin SIRT3 is localized in the mitochondria (energy-producing portions of cells).27 Sirtuins are a family of enzymes that modify protein function by removing an acetyl molecule. The seven known sirtuins in mammals are identified by number: SIRT1, SIRT2...SIRT7. SIRT1 is the most famous because (unlike the others) it has been shown to extend the life span of worms and flies.28 Resveratrol activates SIRT1 but not the other sirtuins.

SIRT1 acts primarily by removing acetyl molecules from the proteins surrounding DNA in the cell nucleus, thereby altering gene expression. DNA in the mitochondria is not surrounded by proteins, so Dr. Verdin has spent much of the last decade trying to determine the function of SIRT3. SIRT3 levels in the mitochondria have been shown to be increased in mice on calorie restriction,29 a dietary alteration that extends the life span of rodents. By removing an acetyl group of the mitochondrial antioxidant enzyme SOD2, SIRT3 reduces free radical oxidation.30

A major breakthrough occurred when Dr.Verdin’s research team demonstrated that mice lacking SIRT3 show accelerated obesity, insulin resistance, and other symptoms of the metabolic syndrome when fed a high fat diet.31 A high fat diet normally has this effect on mice,32 but the effect is much greater when SIRT3 is absent. Dr. Verdin’s team also demonstrated that removing a single fat-processing enzyme that SIRT3 affects could rescue the mice from the effects of the high fat diet, even when SIRT3 was absent.31 Dr. Verdin’s team further demonstrated that a mutation in SIRT3 is associated with the metabolic syndrome in humans.31 Dr. Verdin is hopeful that a molecule can be found that stimulates SIRT3 activity, just as resveratrol stimulates SIRT1 activity.

Research on Adiponectin

Research on Adiponectin  

Takashi Kadowaki, MD, PhD (Professor of Diabetes and Metabolic Diseases, University of Tokyo), has been doing research on adiponectin for over a decade. Adiponectin is a protein secreted exclusively by fat cells. Adiponectin sensitizes the body to insulin, thereby acting as an anti-diabetic agent.33 Insulin resistance (a condition in which cells show reduced insulin-mediated uptake of amino acids, fatty acids, and particularly glucose) precedes and predicts the development of type II diabetes.34 Although adiponectin is produced by fat cells, adiponectin levels are typically low in people who are obese.33 Reduced levels of adiponectin are associated with insulin resistance, lipid dysregulation, and atherosclerosis.33

The first published paper by Dr. Kadowaki on adiponectin reported that adiponectin, particularly when combined with another adipokine known as leptin, could reverse the insulin resistance that a high fat diet produced in mice.35 Kadowski’s research team later demonstrated the key role of adiponectin receptors in mediating the effects of adiponectin suggesting that agents stimulating those receptors could be used to treat insulin resistance and type II diabetes linked to obesity.36 His team has studied the molecular mechanisms behind the reduced mitochondria seen in type II diabetics, linking adiponectin effects to increased activity of the sirtuin SIRT1.37 Mouse experiments suggest that a calorie restricted diet 38 or a EPA/DHA rich omega-3 diet39 can increase blood levels of adiponectin.

Screening Heart Drugs

Rolf Bodmer, PhD (Professor in the Development and Aging Program of the Sandford-Burnham Medical Institute in La Jolla, California), has been studying genetic and environmental influences on heart function. He has been doing this research primarily on fruit flies.

The heart of a fruit fly is basically a tube with an aorta at the upper end. But the muscular effects of fly heart aging are surprisingly similar to humans. As with humans, exercise-training in fruit flies reduces the age-related decline in heart function.40 Dr. Bodmer’s research team has demonstrated that, as with humans, fruit flies show a decrease in heart rate and an increase in heart arrhythmias (irregular heartbeats) as they age. 41 Dr. Bodmer illustrated these effects at the conference by showing a video of a heart operation in young and old fruit flies. Studying fruit flies has the advantages of short life span, ability to genetically manipulate, and ability to precisely quantify the effects.

Fruit flies fed a high fat diet become obese and display features of metabolic syndrome. Dr. Bodmer’s research team demonstrated that the high fat diet affects the heart independently of atherosclerotic effects by directly impairing heart function.42 Dr. Bodmer suggests that fruit flies could be used for primary screening of drugs to be used against cardiac arrhythmias.43

Reducing Amyloid Formation

Edward Lakatta, MD (Chief of the Laboratory of Cardiovascular Science at the National Institute on Aging in Baltimore, Maryland), has been studying stiffening of arteries close to the heart with aging, a process that leads to an increase in blood pressure. He said that 8 out of 10 older adults develop high blood pressure. He noted that artery stiffness is strongly influenced by collagen, elastin, and other proteins in the artery walls.44 Lakatta has been particularly interested in stiffening of the aorta and upper body by an amyloid fibril protein. Insofar as this form of amyloid is found in the aorta of virtually every Caucasian over the age of 50, this amyloid represents a potential overlooked cause of cardiovascular disease. 45 Dr. Lakatta would like to find ways to reduce amyloid formation in the central arteries as a way of reducing cardiovascular aging.

The Role of Autophagy

Ana Maria Cuervo, MD, PhD (Co-Director of the Einstein Institute of Aging Research at the Albert Einstein College of Medicine in Bronx, New York), was introduced as “the Queen of Autophagy.” Her name appears on sixteen peer-reviewed journal articles about autophagy in 2012 alone.

Autophagy is the most important garbage-collection system used by cells to dispose of cellular waste. Autophagy is the process by which waste is taken to (or taken into) a cell’s lysosome (“incinerator”). From the point of view that the lysosome digests cellular material and recycles (reuses) the breakdown products, the lysosome could also be called the “stomach” of a cell.

More than a decade ago, Dr. Cuervo established that autophagy declines with aging.46 In 2007 she established that age-related autophagy decline is primarily due to changes in the lysosome membrane.47

In her presentation Dr. Cuervo focused on the role that autophagy decline or malfunction plays in neurodegenerative disease. Her team has established that protein malformation in Parkinson’s disease blocks autophagy,48 and that a similar problem occurs in Huntington’s disease49 as well as Alzheimer’s disease.50 They also showed that one of the enzymes that is defective in inherited cases of Alzheimer’s disease is required for effective lysosome function.51 And most recently they showed that a high fat diet or a high cholesterol diet reduces autophagy due to incorporation of those fats into the lysosome membrane.52 Decline in autophagy function could explain the increased risk of Alzheimer’s disease associated with obesity.53

Collecting and Storing Your Healthy Adult Stem Cells
Collecting and Storing Your Healthy Adult Stem Cells

Commercial companies and research institutes around the country are offering to harvest your healthy adult stem cells and freeze them for future use. You can find locations near you by entering “storage of adult stem cells” into Google.

In South Florida, we use:
South Florida Bone Marrow/
Stem Cell Transplant Institute

10301 Hagen Ranch Road, Ste.600
Boynton Beach, FL 33437
1-866-235-5736
Email: info@bmscti.org

Summary

Overall, this conference seemed more concerned with diseases of aging than aging itself, except for the discussion of stem cell rejuvenation and senescent cell action. Nonetheless, chronic inflammation and the effects of fat in aging were recurrent themes. A deep inquiry into the particular conditions revealed the significant roles played by fat and inflammation. Fortunately, Life Extension members have been taking supplements that help suppress chronic inflammation like vitamin D, curcumin, luteolin, DHEA, and omega-3s.

If you have any questions on the scientific content of this article, please call a Life Extension® Health Advisor at 1-866-864-3027.

References

  1. Ludwig FC, Elashoff RM. Mortality in syngeneic rat parabionts of different chronological age. Trans N Y Acad Sci. 1972 Nov;34(7):582-7.
  2. Conboy IM, Conboy MJ, Wagers AJ, Girma ER, Weissman IL, Rando TA. Rejuvenation of aged progenitor cells by exposure to a young systemic environment. Nature. 2005 Feb 17;433(7027):
    760-4.
  3. Brack AS, Conboy MJ, Roy S, Lee M, Kuo CJ, Keller C, Rando TA. Increased Wnt signaling during aging alters muscle stem cell fate and increases fibrosis. Science. 2007 Aug 10;317(5839):807-10.
  4. Villeda SA, Luo J, Mosher KI, et al. The ageing systemic milieu negatively regulates neurogenesis and cognitive function. Nature. 2011 Aug 31;477(7362):90-4.
  5. Carlson ME, Conboy MJ, Hsu M, et al. Relative roles of TGF-beta1 and Wnt in the systemic regulation and aging of satellite cell responses. Aging Cell. 2009 Dec;8(6):676-89.
  6. Rando TA, Chang HY. Aging, rejuvenation, and epigenetic reprogramming: resetting the aging clock. Cell. 2012 Jan 20;148(1-2):46-57.
  7. Ruckh JM, Zhao JW, Shadrach JL, et al. Rejuvenation of regeneration in the aging central nervous system. Cell Stem Cell. 2012 Jan 6;10(1):96-103.
  8. Bai X, Yan Y, Song YH, et al. Both cultured and freshly isolated adipose tissue-derived stem cells enhance cardiac function after acute myocardial infarction. Eur Heart J. 2010 Feb;31(4):489-501.
  9. Parrinello S, Coppe JP, Krtolica A, Campisi J. Stromal-epithelial interactions in aging and cancer: senescent fibroblasts alter epithelial cell differentiation. J Cell Sci. 2005 Feb 1;118(Pt 3):485-96.
  10. Rodier F, Coppé JP, Patil CK, et al. Persistent DNA damage signalling triggers senescence-associated inflammatory cytokine secretion. Nat Cell Biol. 2009 Aug;11(8):973-9.
  11. Coppé JP, Patil CK, Rodier F, et al. Senescence-associated secretory phenotypes reveal cell-nonautonomous functions of oncogenic RAS and the p53 tumor suppressor. PLoS Biol. 2008 Dec 2;6(12):2853-68.
  12. Freund A, Patil CK, Campisi J. p38MAPK is a novel DNA damage response-independent regulator of the senescence-associated secretory phenotype. EMBO J. 2011 Apr 20;30(8):1536-48.
  13. Baker DJ, Wijshake T, Tchkonia T, et al. Clearance of p16Ink4a-positive senescent cells delays ageing-associated disorders. Nature. 2011 Nov 2;479(7372):232-6.
  14. Jaenisch R, Bird A. Epigenetic regulation of gene expression: how the genome integrates intrinsic and environmental signals. Nat Genet. 2003 Mar;33 Suppl:245-54.
  15. Jones PA. Functions of DNA methylation: islands, start sites, gene bodies and beyond. Nat Rev Genet. 2012 May 29;13(7):484-92.
  16. Bottiglieri T. S-Adenosyl-L-methionine (SAMe): from the bench to the bedside--molecular basis of a pleiotrophic molecule. Am J Clin Nutr. 2002 Nov;76(5):1151S-7S.
  17. Chiang PK, Gordon RK, Tal J, et al. S-denosylmethionine and methylation. FASEB J. 1996 Mar;10(4):471-80.
  18. De La Cruz JP, Pavía J, González-Correa JA, Ortiz P, Sánchez de la Cuesta F. Effects of chronic administration of S-adenosyl-L-methionine on brain oxidative stress in rats. Naunyn Schmiedebergs Arch Pharmacol. 2000 Jan;361(1):47-52.
  19. Papakostas GI, Mischoulon D, Shyu I, Alpert JE, Fava M. S-adenosyl methionine (SAMe) augmentation of serotonin reuptake inhibitors for antidepressant nonresponders with major depressive disorder: a double-blind, randomized clinical trial. Am J Psychiatry. 2010 Aug;167(8):942-8.
  20. Patra SK, Patra A, Rizzi F, Ghosh TC, Bettuzzi S. Demethylation of (Cytosine-5-C-methyl) DNA and regulation of transcription in the epigenetic pathways of cancer development. Cancer Metastasis Rev. 2008 Jun;27(2):315-34.
  21. Fraga MF, Ballestar E, Paz MF, et al. Epigenetic differences arise during the lifetime of monozygotic twins. Proc Natl Acad Sci U S A. 2005 Jul 26;102(30):10604-9.
  22. Pembrey ME, Bygren LO, Kaati G, et al. Sex-specific, male-line transgenerational responses in humans. Eur J Hum Genet. 2006 Feb;14(2):159-66.
  23. Barrès R, Osler ME, Yan J, et al. Non-CpG methylation of the PGC-1alpha promoter through DNMT3B controls mitochondrial density. Cell Metab. 2009 Sep;10(3):189-98.
  24. Cantó C, Jiang LQ, Deshmukh AS, et al. Interdependence of AMPK and SIRT1 for metabolic adaptation to fasting and exercise in skeletal muscle. Cell Metab. 2010 Mar 3;11(3):213-9.
  25. Manson JE, Rimm EB, Stampfer MJ, et al. Physical activity and incidence of non-insulin-dependent diabetes mellitus in women. Lancet. 1991 Sep 28;338(8770):774-8.
  26. Barrès R, Yan J, Egan B, et al. Acute exercise remodels promoter methylation in human skeletal muscle. Cell Metab. 2012 Mar 7;15(3):405-11.
  27. Schwer B, North BJ, Frye RA, Ott M, Verdin E. The human silent information regulator (Sir)2 homologue hSIRT3 is a mitochondrial nicotinamide adenine dinucleotide-dependent deacetylase. J Cell Biol. 2002 Aug 19;158(4):647-57.
  28. Kenyon C. The plasticity of aging: insights from long-lived mutants. Cell. 2005 Feb 25;120(4):449-60.
  29. Schwer B, Eckersdorff M, Li Y, Silva JC, Fermin D, Kurtev MV, Giallourakis C, Comb MJ, Alt FW, Lombard DB. Calorie restriction alters mitochondrial protein acetylation. Aging Cell. 2009 Sep;8(5):604-6.
  30. Qiu X, Brown K, Hirschey MD, Verdin E, Chen D. Calorie restriction reduces oxidative stress by SIRT3-mediated SOD2 activation. Cell Metab. 2010 Dec 1;12(6):662-7.
  31. Hirschey MD, Shimazu T, Jing E, et al. SIRT3 deficiency and mitochondrial protein hyperacetylation accelerate the development of the metabolic syndrome. Mol Cell. 2011 Oct 21;44(2):177-90.
  32. Petro AE, Cotter J, Cooper DA, Peters JC, Surwit SJ, Surwit RS. Fat, carbohydrate, and calories in the development of diabetes and obesity in the C57BL/6J mouse. Metabolism. 2004 Apr;53(4):454-7.
  33. Yadav A, Kataria MA, Saini V, Yadav A. Role of leptin and adiponectin in insulin resistance. Clin Chim Acta. 2012 Dec 21. [Epub ahead of print]
  34. Eriksson J, Franssila-Kallunki A, Ekstrand A, et al. Early metabolic defects in persons at increased risk for non-insulin-dependent diabetes mellitus. N Engl J Med. 1989 Aug 10;321(6):337-43.
  35. Yamauchi T, Kamon J, Waki H, et al. The fat-derived hormone adiponectin reverses insulin resistance associated with both lipoatrophy and obesity. Nat Med. 2001 Aug;7(8):941-6.
  36. Yamauchi T, Nio Y, Maki T, et al. Targeted disruption of AdipoR1 and AdipoR2 causes abrogation of adiponectin binding and metabolic actions. Nat Med. 2007 Mar;13(3):332-9.
  37. Iwabu M, Yamauchi T, Okada-Iwabu M, et al. Adiponectin and AdipoR1 regulate PGC-1alpha and mitochondria by Ca(2+) and AMPK/SIRT1. Nature. 2010 Apr 29;464(7293):1313-9.
  38. Nagasawa A, Fukui K, Funahashi T, et al. Effects of soy protein diet on the expression of adipose genes and plasma adiponectin. Horm Metab Res. 2002 Nov-Dec;34(11-12):635-9.
  39. Flachs P, Mohamed-Ali V, Horakova O, et al. Polyunsaturated fatty acids of marine origin induce adiponectin in mice fed a high-fat diet. Diabetologia. 2006 Feb;49(2):394-7.
  40. Piazza N, Gosangi B, Devilla S, Arking R, Wessells R. Exercise-training in young Drosophila melanogaster reduces age-related decline in mobility and cardiac performance. PLoS One. 2009 Jun 11;4(6):e5886.
  41. Fink M, Callol-Massot C, Chu A, et al. A new method for detection and quantification of heartbeat parameters in Drosophila, zebrafish, and embryonic mouse hearts. Biotechniques. 2009 Feb;46(2):101-13.
  42. Lim HY, Wang W, Wessells RJ, Ocorr K, Bodmer R. Phospholipid homeostasis regulates lipid metabolism and cardiac function through SREBP signaling in Drosophila. Genes Dev. 2011 Jan 15;25(2):189-200.
  43. Nishimura M, Ocorr K, Bodmer R, Cartry J. Drosophila as a model to study cardiac aging. Exp Gerontol. 2011 May;46(5):326-30.
  44. Clifford PS, Ella SR, Stupica AJ, et al. Spatial distribution and mechanical function of elastin in resistance arteries: a role in bearing longitudinal stress. Arterioscler Thromb Vasc Biol. 2011 Dec;31(12):2889-96.
  45. Larsson A, Peng S, Persson H, et al. Lactadherin binds to elastin--a starting point for medin amyloid formation? Amyloid. 2006 Jun;13(2):78-85.
  46. Cuervo AM, Dice JF. Age-related decline in chaperone-mediated autophagy. J Biol Chem. 2000 Oct 6;275(40):31505-13.
  47. Kiffin R, Kaushik S, Zeng M, et al. Altered dynamics of the lysosomal receptor for chaperone-mediated autophagy with age. J Cell Sci. 2007 Mar 1;120(Pt 5):782-91.
  48. Martinez-Vicente M, Talloczy Z, Kaushik S, et al. Dopamine-modified alpha-synuclein blocks chaperone-mediated autophagy. J Clin Invest. 2008 Feb;118(2):777-88.
  49. Martinez-Vicente M, Talloczy Z, Wong E, et al. Cargo recognition failure is responsible for inefficient autophagy in Huntington’s disease. Nat Neurosci. 2010 May;13(5):567-76.
  50. Wang Y, Martinez-Vicente M, Krüger U, et al. Tau fragmentation, aggregation and clearance: the dual role of lysosomal processing. Hum Mol Genet. 2009 Nov 1;18(21):4153-70.
  51. Lee JH, Yu WH, Kumar A, et al. Lysosomal proteolysis and autophagy require presenilin 1 and are disrupted by Alzheimer-related PS1 mutations. Cell . 2010 Jun 25;141(7):1146-58.
  52. Rodriguez-Navarro JA, Kaushik S, Koga H, et al. Inhibitory effect of dietary lipids on chaperone-mediated autophagy. Proc Natl Acad Sci U S A. 2012 Mar 20;109(12):E705-14.
  53. Luchsinger JA, Gustafson DR. Adiposity and Alzheimer’s disease. Curr Opin Clin Nutr Metab Care. 2009 Jan;12(1):15-21.