Liver and Aging-1990.
If stalemate between theoretical schools characterizes the early days of a science this book demonstrates that in geropharmacology those days are over. Schmucker et al. and Woodhouse et al. are to be found here as co-authors explaining their previous different data in terms of species specificity: in primates like us, observed reduction in hepatic conjugation and oxidation during healthy ageing are due to reduced liver volume and blood flow not levels of mono-oxygenase activity. If only all scientific disputes could be so maturely resolved!
The next breakthrough came from Newcastle where elegant studies identified (vaguely defined) frailty in old people as a key factor predicting reduced hepatic conjugation. The paper by Aoba et al. from Japan adds special interest to this collection with evidence that the acute phase response (e.g. fall in albumin) is age dependent. With clinical correlative data these authors hypothesize, plausibly, mechanisms whereby morbidity (as defined by raised C-reactive protein) in old people is associated with slowed neuroleptic drug clearance, higher protein-bound levels and, more heretically, that these can lead to high target organ concentrations and pharmacodynamic differences. |Frailty' therefore acquires a more precise, quantitative and clinically applicable definition: old patients with low albumins need lower doses of lipophilic drugs because of demonstrated age-related differences in the acute phase response.
Half the papers are therefore useful to teachers and practitioners of geropharmacology; the other half comprise a most useful collection on the chemical and ultra-structural changes that might characterize the ageing process itself.
It seems that in the UK we are unduly critical of animal models in ageing research, perhaps reflecting our relative dearth of Institutes for the Study of Biology of Ageing. Even bearing this in mind it is difficult to avoid criticizing some of the animal-based research in this collection: in addition to the above-mentioned species differences in ageing liver enzymes systems, differences in bile acid production are described. The |slowed ageing' of calorie-restricted rodents always raises the question as to how |normal' or perhaps stressed is the ad libitum fed laboratory rodent that ages faster. And, lastly, the |human population is more outbred than the inbred laboratory rat', Dr Schmucker warns as he explains the species differences in age-related variation.
This fascinating collection of symposium papers comes at an important time in these fields. Specialists in old age medicine will find this book useful for teaching, research and practice.
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|Title Annotation:||Proceedings of the Fourth Tokyo Symposium on Liver and Aging, held in Tokyo, Japan on 15-17 August 1990|
|Publication:||Age and Ageing|
|Article Type:||Book Review|
|Date:||Sep 1, 1992|
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