The inherent challenges of classifying senescence—Response

doi:10.1126/science.abb4073

GSTDTAP > 气候变化

DOI	10.1126/science.abb4073
	The inherent challenges of classifying senescence—Response
	Stuart R. G. Calimport; Barry L. Bentley; Claire E. Stewart; Graham Pawelec; Angelo Scuteri; Manlio Vinciguerra; Cathy Slack; Danica Chen; Lorna W. Harries; Gary Marchant; G. Alexander Fleming; Michael Conboy; Adam Antebi; Gary W. Small; Jesus Gil; Edward G. Lakatta; Arlan Richardson; Clifford Rosen; Karoly Nikolich; Tony Wyss-Coray; Lawrence Steinman; Thomas Montine; João Pedro de Magalhães; Judith Campisi; George Church
	2020-05-08
发表期刊	Science
出版年	2020
英文摘要	Zhavoronkov questions the timing of our Policy Forum's publication in relation to the release and adoption of the International Classification of Diseases (ICD) 11, but the World Health Organization accepts ICD submissions and updates on a rolling basis across the review and maintenance phases, and it is regularly revised, versioned, and updated ([ 1 ][1]). Zhavoronkov also posits that senescence cannot be added to ICD without substantial further research. We challenge this view: Given the World Health Organization's decision-making history, classification and staging consensus, development, and submissions to ICD are needed now. Organismal senescence at the organ level has already been classified in the ICD as “intrinsic aging of the skin” and “photoaging of the skin,” with an accompanying staging scale for aging skin ([ 2 ][2]). It is therefore entirely feasible to classify organismal senescence across the organs and tissues of the body, along with all other aging-related diseases and disorders. Our Policy Forum cites the substantial literature that already exists for such an effort [e.g., ([ 3 ][3], [ 4 ][4])]. We agree with Zhavoronkov that there is still much to learn about aging-related diseases. However, many diseases within the ICD were not comprehensively understood before classification. Our understanding of skin aging increased after classification ([ 5 ][5]) as a result of improved recognition and further study. Alzheimer's disease was recognized as a leading cause of death only after its inclusion in ICD-9 led to improved epidemiology and statistics ([ 6 ][6]). If diseases and disorders are identifiable, distinct, and associated with a substantial body of knowledge, they should be classified. In contrast to Zhavoronkov, we see a place for staging senescence in the ICD framework. It is common for diseases to be classified and staged before the approval of clinical biomarkers. An initial staging of organismal senescence could be achieved for all organs based on macroscopic and histologic measures, similar to the Glogau scale for skin ([ 5 ][5]). Longitudinal studies in animals and humans will be required, as Zhavoronkov states, to further develop the staging of organismal senescence across organs for clinical endpoints and precision medicines. Organismal senescence may be a continuous process that begins early in life, but the ICD classification should be able to distinguish between early age-related degenerative change and any initial processes of organismal development. Zhavoronkov is correct that severity staging systems do not require ICD approval. However, “severity scale value” may be appended in the ICD for statistical purposes. Staging systems are usually developed and maintained by international disease-specific medical societies. We would welcome the development of international initiatives to develop a comprehensive set of staging systems, biomarkers, and interventions for senescence and aging-related diseases. 1. [↵][7]WHO, Geneva, “ICD revision process: Beta phase and finalization” (WHO, 2013), [www.who.int/classifications/icd/revision/icdrevisionprocess.pdf][8]. 2. [↵][9]1. R. G. Glogau , Semin. Cutan. Med. Surg. 15, 134 (1996). [OpenUrl][10][CrossRef][11][PubMed][12] 3. [↵][13]1. C. López-Otín et al ., Cell 153, 1194 (2013). [OpenUrl][14][CrossRef][15][PubMed][16][Web of Science][17] 4. [↵][18]1. D. Muñoz-Espín, 2. M. Serrano , Nat. Rev. Mol. Cell Biol. 15, 482 (2014). [OpenUrl][19][CrossRef][20][PubMed][21] 5. [↵][22]1. P. S. Peres et al ., J. Photochem. Photobiol. B. 10, 93 (2011). [OpenUrl][23] 6. [↵][24]1. A. M. Miniño, 2. S. L. Murphy, 3. J. Xu, 4. K. D. Kochanek , Natl. Vital Stat. Rep. 59, 1 (2011). [OpenUrl][25][PubMed][26] In addition to the competing interests listed at [www.sciencemag.org/content/366/6465/576/suppl/DC1][27], C.E.S. is chair of the British Society for Research on Ageing, and L.W.H. has a priority GB patent filed (PCT/GB2019/052125). [1]: #ref-1 [2]: #ref-2 [3]: #ref-3 [4]: #ref-4 [5]: #ref-5 [6]: #ref-6 [7]: #xref-ref-1-1 "View reference 1 in text" [8]: http://www.who.int/classifications/icd/revision/icdrevisionprocess.pdf [9]: #xref-ref-2-1 "View reference 2 in text" [10]: {openurl}?query=rft.jtitle%253DSeminars%2Bin%2Bcutaneous%2Bmedicine%2Band%2Bsurgery%26rft.stitle%253DSemin%2BCutan%2BMed%2BSurg%26rft.aulast%253DGlogau%26rft.auinit1%253DR.%2BG.%26rft.volume%253D15%26rft.issue%253D3%26rft.spage%253D134%26rft.epage%253D138%26rft.atitle%253DAesthetic%2Band%2Banatomic%2Banalysis%2Bof%2Bthe%2Baging%2Bskin.%26rft_id%253Dinfo%253Adoi%252F10.1016%252FS1085-5629%252896%252980003-4%26rft_id%253Dinfo%253Apmid%252F8948530%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [11]: /lookup/external-ref?access_num=10.1016/S1085-5629(96)80003-4&link_type=DOI [12]: /lookup/external-ref?access_num=8948530&link_type=MED&atom=%2Fsci%2F368%2F6491%2F595.2.atom [13]: #xref-ref-3-1 "View reference 3 in text" [14]: {openurl}?query=rft.jtitle%253DCell%26rft.volume%253D153%26rft.spage%253D1194%26rft_id%253Dinfo%253Adoi%252F10.1016%252Fj.cell.2013.05.039%26rft_id%253Dinfo%253Apmid%252F23746838%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [15]: /lookup/external-ref?access_num=10.1016/j.cell.2013.05.039&link_type=DOI [16]: /lookup/external-ref?access_num=23746838&link_type=MED&atom=%2Fsci%2F368%2F6491%2F595.2.atom [17]: /lookup/external-ref?access_num=000319979200007&link_type=ISI [18]: #xref-ref-4-1 "View reference 4 in text" [19]: {openurl}?query=rft.jtitle%253DNat.%2BRev.%2BMol.%2BCell%2BBiol.%26rft.volume%253D15%26rft.spage%253D482%26rft_id%253Dinfo%253Adoi%252F10.1038%252Fnrm3823%26rft_id%253Dinfo%253Apmid%252F24954210%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [20]: /lookup/external-ref?access_num=10.1038/nrm3823&link_type=DOI [21]: /lookup/external-ref?access_num=24954210&link_type=MED&atom=%2Fsci%2F368%2F6491%2F595.2.atom [22]: #xref-ref-5-1 "View reference 5 in text" [23]: {openurl}?query=rft.jtitle%253DJ.%2BPhotochem.%2BPhotobiol.%2BB.%26rft.volume%253D10%26rft.spage%253D93%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [24]: #xref-ref-6-1 "View reference 6 in text" [25]: {openurl}?query=rft.jtitle%253DNational%2Bvital%2Bstatistics%2Breports%2B%253A%2B%2Bfrom%2Bthe%2BCenters%2Bfor%2BDisease%2BControl%2Band%2BPrevention%252C%2BNational%2BCenter%2Bfor%2BHealth%2BStatistics%252C%2BNational%2BVital%2BStatistics%2BSystem%26rft.stitle%253DNatl%2BVital%2BStat%2BRep%26rft.aulast%253DOsterman%26rft.auinit1%253DM.%2BJ.%26rft.volume%253D59%26rft.issue%253D10%26rft.spage%253D1%26rft.epage%253D126%26rft.atitle%253DDeaths%253A%2Bfinal%2Bdata%2Bfor%2B2008.%26rft_id%253Dinfo%253Apmid%252F22808755%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [26]: /lookup/external-ref?access_num=22808755&link_type=MED&atom=%2Fsci%2F368%2F6491%2F595.2.atom [27]: http://www.sciencemag.org/content/366/6465/576/suppl/DC1
领域	气候变化 ; 资源环境
URL	查看原文
引用统计
文献类型	期刊论文
条目标识符	http://119.78.100.173/C666/handle/2XK7JSWQ/249765
专题	气候变化资源环境科学
推荐引用方式 GB/T 7714	Stuart R. G. Calimport,Barry L. Bentley,Claire E. Stewart,等. The inherent challenges of classifying senescence—Response[J]. Science,2020.
APA	Stuart R. G. Calimport.,Barry L. Bentley.,Claire E. Stewart.,Graham Pawelec.,Angelo Scuteri.,...&George Church.(2020).The inherent challenges of classifying senescence—Response.Science.
MLA	Stuart R. G. Calimport,et al."The inherent challenges of classifying senescence—Response".Science (2020).