Determination of a Possible Benefit of 4-Aminoquinoline Drugs to Reset Post-Acute Inflammation in Old Age
Chronic low-amplitude systemic inflammation is common in the elderly, and it contributes to various aspects of the frailty phenotype, including sarcopenia, low mood, and higher degrees of reliance on others for vital activities, as well as increased all-cause mortality. Patients with this type of “inflammaging” had elevated baseline levels of many pro-inflammatory cytokines in their peripheral blood, including tumour necrosis factor alpha and interleukin-1 beta, as well as persistently elevated C-reactive protein. There is an obvious need to find therapies, such as medicines, that can reduce inflammation by assisting the innate immune system in returning to a less inflamed state. Such qualities can be seen in a variety of pharmacological classes. The goal of this chapter is to provide a summary of the background science on the relationship between ageing, inflammation, and frailty, followed by an explanation of the established role of methyl-xanthines, particularly theophylline, as immune modulating drugs, and finally a case for the use of 4-aminoquinolines, such as chloroquine, in a similar role. The anti-inflammatory mechanisms of various groups of medications are compared, leading to the recommendation that formal clinical trials of chloroquine as an adjuvant immune modulator for “inflammaging” and persistent post-acute inflammation in old age be done.
Author(S) Details
Stephen Allen
The Royal Bournemouth Hospital, Dorset, UK and Centre for Postgraduate Medical Research and Education, Bournemouth University, Dorset, UK.
Divya Tiwari
The Royal Bournemouth Hospital, Dorset, UK and Centre for Postgraduate Medical Research and Education, Bournemouth University, Dorset, UK.
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