Harnessing immunomodulation to combat sarcopenia: current insights and possible approaches

Ning Zhang; Liting Zhai; Ronald Man Yeung Wong; Can Cui; Sheung-Wai Law; Simon Kwoon-Ho Chow; Stuart B Goodman; Wing-Hoi Cheung

doi:10.1186/s12979-024-00458-9

Harnessing immunomodulation to combat sarcopenia: current insights and possible approaches

Immun Ageing. 2024 Aug 5;21(1):55. doi: 10.1186/s12979-024-00458-9.

Authors

Ning Zhang^{1

2}, Liting Zhai³, Ronald Man Yeung Wong⁴, Can Cui^{4

5}, Sheung-Wai Law⁴, Simon Kwoon-Ho Chow⁶, Stuart B Goodman^{6

7}, Wing-Hoi Cheung^{8

9}

Affiliations

¹ Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China. ningzhang@cuhk.edu.hk.
² Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China. ningzhang@cuhk.edu.hk.
³ School of Life Sciences, The Chinese University of Hong Kong, Hong Kong, China.
⁴ Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China.
⁵ Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China.
⁶ Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA.
⁷ Department of Bioengineering, Stanford University, Stanford, CA, USA.
⁸ Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China. louischeung@cuhk.edu.hk.
⁹ Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China. louischeung@cuhk.edu.hk.

Abstract

Sarcopenia is a complex age-associated syndrome of progressive loss of muscle mass and strength. Although this condition is influenced by many factors, age-related changes in immune function including immune cell dynamics, and chronic inflammation contribute to its progression. The complex interplay between the immune system, gut-muscle axis, and autophagy further underscores their important roles in sarcopenia pathogenesis. Immunomodulation has emerged as a promising strategy to counteract sarcopenia. Traditional management approaches to treat sarcopenia including physical exercise and nutritional supplementation, and the emerging technologies of biophysical stimulation demonstrated the importance of immunomodulation and regulation of macrophages and T cells and reduction of chronic inflammation. Treatments to alleviate low-grade inflammation in older adults by modulating gut microbial composition and diversity further combat sarcopenia. Furthermore, some pharmacological interventions, nano-medicine, and cell therapies targeting muscle, gut microbiota, or autophagy present additional avenues for immunomodulation in sarcopenia. This narrative review explores the immunological underpinnings of sarcopenia, elucidating the relationship between the immune system and muscle during ageing. Additionally, the review discusses new areas such as the gut-muscle axis and autophagy, which bridge immune system function and muscle health. Insights into current and potential approaches for sarcopenia management through modulation of the immune system are provided, along with suggestions for future research directions and therapeutic strategies. We aim to guide further investigation into clinical immunological biomarkers and identify indicators for sarcopenia diagnosis and potential treatment targets to combat this condition. We also aim to draw attention to the importance of considering immunomodulation in the clinical management of sarcopenia.

Keywords: Autophagy; Gut microbiota; Immune system; Immunomodulatory approaches; Sarcopenia.

Publication types

Review

Abstract

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