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Anti-Aging Medicine As It Relates to Dermatology 1 Rafaela M

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Anti-Aging Medicine As It Relates to Dermatology 1 Rafaela M Chapter 1 Anti-Aging Medicine As It Relates to Dermatology 1 Rafaela M. Quiroga 1.7 Growth Hormone in the Aging Process 6 Core Messages 1.8 Consequences í of Reduced Growth Hormone Secretion Anti-aging medicine physicians, scien- on the Skin . 6 tists, and researchers are dedicated to the belief that the process of physical 1.9 Can Human Growth Hormone Reverse the Effects of Aging? . 8 aging in humans can be slowed, stop- 1.9.1 Growth Hormone Secretagogues . 8 ped, or even reversed through existing medical and scientific interventions. 1.10 Side Effects of Growth Hormone Therapy . 9 í Possible theories of the aging process 1.11 A Brief Guide include the free radical theory of to Anti-Aging Supplements and Growth-Hormone-Releasing aging, oxidation, cell senescence, and Nutrients for the Skin . 10 cleavage of telomere during DNA syn- thesis. 1.12 Oral Antioxidant Nutrients . 10 1.12.1 Vitamin C . 10 1.12.1.1 Food Sources . 11 í A good diet slows the aging process 1.12.1.2 Risks with High Doses . 11 and adds healthier years to life. 1.12.2 Vitamin E . 11 1.12.2.1 Role in the Body and Consequences í A therapeutic guide for vitamin sup- of Deficiency . 11 plements and recommended anti- 1.12.2.2 Recommended Daily Allowance . 11 1.12.2.3 Food Sources . 12 aging doses is provided. 1.12.2.4 Risks with High Doses . 12 1.12.2.5 Interactions with Other Nutrients and Drugs . 12 1.12.3 Carotenoids . 12 1.12.3.1 Role in the Body and Consequences Contents of Deficiency . 12 1.12.3.2 Recommended Daily Allowance . 13 1.1 Introduction . 2 1.12.3.3 Food Sources . 13 1.12.3.4 Risks with High Doses . 13 1.2 The Clinical Science of Anti-Aging Medicine . 2 1.12.4 Selenium . 13 1.12.4.1 Role in the Body and Consequences 1.3 The Aging Process . 2 of Deficiency . 13 1.12.4.2 Recommended Daily Allowance . 13 1.4 Free Radical Theory of Aging . 3 1.12.4.3 Food Sources . 13 1.4.1 Antioxidizing Processes . 3 1.12.4.4 Risks with High Doses . 14 1.5 Diet and Nutrition . 3 1.12.4.5 Interactions with Other Nutrients . 14 1.6 Hormonal Regulation of Aging . 4 1.13 Glycemic Index . 14 1.6.1 Adrenopause . 5 1.14 Final Remarks . 14 1.6.2 Menopause . 5 References . 14 1.6.3 Andropause . 5 1.6.4 Somatopause . 6 2 Rafaela M. Quiroga 1 1.3 The Aging Process O ld age is the most unexpected of all things that happen to man. Aging can be viewed as the accumulation of Leon Trotsky changes in cells and tissues resulting from a greater disorderliness of regulatory mecha- ’’ nisms that result in reduced robustness of the organism to encountered stress and disease. The notion of greater disorderliness in aging is illustrated by the erosion of the orderly neuro- endocrine feedback regulation of the secretion 1.1 Introduction of luteinizing hormone (LH), follicle stimulat- ing hormone (FSH), adrenocorticotropic hor- Changes in diet and increasing exercise, togeth- mone (ACTH) and growth hormone (GH). er with a regimen of antioxidants, nutritional These changes are manifested as menopause, supplements, and growth factors, can alter how andropause, adrenopause, and somatopause. the genes express themselves. Both factors can Skin aging is part of the slow decline in ap- greatly enhance the healing capability of the pearance and function that appears to be at- skin and can improve the results of cosmetic tributed in large part to the drastic decline of surgeries. hormones in the body after adulthood. At the Beyond the obvious advantages of a bal- cellular level, several processes are involved in anced diet and exercise there are the physiolog- the physiology of aging and the development of ical ones that help people feel more alive with some age-related diseases.The process of apop- renewed and vital well-being. tosis signifies the process of nontraumatic and noninflammatory cell death [1]. Dysregulation of apoptosis has been impli- 1.2 The Clinical Science cated in the increased incidence of cutaneous of Anti-Aging Medicine malignancies that are more prevalent in older individuals, such as basal cell carcinoma, squa- Anti-aging medicine is practiced by physicians, mous cell carcinoma, and malignant melano- scientists, and researchers dedicated to the be- ma. Cell senescence limits cell divisions in nor- lief that the process of physical aging in hu- mal somatic cells and may play a central role in mans can be slowed, stopped, or even reversed age-related diseases. Telomeres are thought to through existing medical and scientific inter- play a role in cellular aging and might contrib- ventions. This specialty of medicine is based on ute to the genetic background of human aging the very early detection and prevention of age- and longevity. It has been speculated that the related diseases. Physicians practicing anti-ag- limited proliferation potential of human cells is ing medicine seek to enhance the quality of life a result of the telomere shortening that occurs as well as its length, limiting the period of ill- during DNA synthesis at each cell division. ness and disability toward the end of one’s life. Photoaging may accelerate the shortening of Anti-aging medicine encompasses lifestyle telomeres and push cells into senescence soon- changes (diet and exercise); hormone replace- er.That could be the reason why various growth ment therapies, as needed, determined by a factors may affect the speed and quality of physician through blood testing (DHEA, melat- wound healing [2]. Biochemical insults also onin, thyroid, human growth hormone, estro- arise within aging cells, in part from the action gen, testosterone); antioxidants and vitamin of reactive oxygen species generated and scav- supplements; and testing protocols that can enged incompletely throughout the cell cycle. measure not only hormone levels and blood Aging-associated changes also occur between chemistry but every metabolic factor right and among cells via alterations in the intercel- down to the cellular level. lular matrix, the intercellular exchange of Anti-Aging Medicine As It Relates to Dermatology Chapter 1 3 trophic factors, the release of inflammatory cy- oxidant metabolites are glutathione (GSH) and tokine mediators, and the degree of infiltration vitamin C (ascorbic acid), which reside primar- by other associated cell types. In addition, the ily in the cytoplasm and mitochondria. Many quantity and distribution of various growth water-soluble enzymes also catalyze these reac- factors may affect wound healing [2]. Decline of tions. Glutathione peroxidase catalyzes the re- DNA repair in combination with loss of mela- action between GSH and hydrogen peroxide to nin increases the risk of photocarcinogenesis form water and oxidized GSH, which is stable and can also cause the decline of enzymatically [6].Vitamin E and the carotenoids are the prin- active melanocytes (10–20% each decade) that cipal lipid-soluble antioxidants. Vitamin E is contributes to increased sensitivity to ultravio- the major lipid-soluble antioxidant in cell let (UV) radiation. membranes that can break the chain of lipid However, it is not known why free radical peroxidation. Therefore, theoretically, it is the damage does not adversely affect all of the most important antioxidant in preventing oxi- body’s cells (e.g., gonadal germ cells) [3]. dation of these fatty acids.Vitamin E is recycled by a reaction with vitamin C [7]. Despite the actions of antioxidant nutrients, 1.4 Free Radical Theory of Aging some oxidative damage will occur, and accu- mulation of this damage throughout life is be- Antioxidizing nutrients are believed to play a lieved to be a major contributing factor to aging role in the prevention and treatment of a varie- and disease [6]. ty of chronic diseases. The proposed mecha- nism by which antioxidants protect cells from oxidative stress is by scavenging free radicals 1.5 Diet and Nutrition and halting lipid peroxidation chain reactions, which can cause DNA damage [4]. A good diet slows aging and can improve over- all success of surgical procedures and wound healing. Among other benefits, a good diet: 1.4.1 Antioxidizing Processes Two forms of chemical reactions, oxidation and í Provides the food,water,and oxygen that reduction, occur widely in nature. Oxidation is cells need to reproduce, transmit infor- the loss of electrons, and reduction is the gain mation, and repair damage of electrons. Oxidation and reduction reactions always occur in pairs. Highly reactive mole- í Assures the body of a continuous supply cules can oxidize molecules that were previous- of usable energy, which improves emo- ly stable and may cause them to become un- tional stability and energy levels stable species, such as free radicals. A free radi- í Helps eliminate free radical damage, cal is a chemical with an unpaired electron that damage that can increase risk of cancer can be neutral, positively charged, or negatively and other degenerative diseases charged. Thus, without termination by an agent such as an antioxidant, a single free radical can í Decreases the risk of cancer, arterioscle- damage numerous molecules. A certain amount rosis, hypertension, heart disease, osteo- of oxidative function is necessary for proper porosis, senility, and depression health. For example, oxidation processes are í Synchronizes the body, helping people used by the body’s immune systems to kill mi- function physically, mentally, and emo- croorganisms [5]. tionally at peak efficiency Cells contain a number of antioxidants that have various roles in protecting against free í Adds healthier years to life radical reactions. The major water-soluble anti- 4 Rafaela M.
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