Katrina Abuabara, MD, MA, MSCE, University of California, San Francisco (UCSF), and University of California, Berkeley; Timothy Berger, MD, UCSF; Steven Cummings, MD, San Francisco Coordinating Center and UCSF; Theodora Mauro, MD, UCSF and Veterans Administration Health Care System; and Charles E. McCulloch, PhD, UCSF
Competition Sponsor: U.S. National Academy of Medicine
Like all organs, skin function declines with age. This is particularly important because the skin is the body’s primary barrier and is essential for protection from toxins and microbes. Clinically, age-related barrier decline may only manifest as dry, itchy skin. However, sub-clinically, it results in chronic stimulation of inflammatory processes designed to protect against external exposures. Although intermittent increases in inflammation are critical for survival during physical injury and infection, a growing body of research shows that chronic inflammation is one of the key biological processes underlying aging. Termed ‘inflammaging,’ chronic elevations in blood inflammatory markers have been linked to disability, frailty, and premature death. The skin is the body’s largest surface for direct contact with external factors and first layer of immune defense, and preliminary data suggests that age-associated skin barrier decline is an important source of chronic inflammation. Our overarching hypothesis is that skin barrier dysfunction is an important source of chronic inflammation, and that skin barrier restoration with emollients can reduce inflammatory levels and equitably improve the healthspan of older adults. This idea is particularly compelling because emollients are safe, low-cost, widely available, and can be used in community settings across racial/ethnic, urban/rural, and socioeconomic contexts. We seek to provide confirmatory experimental evidence that skin barrier restoration in humans lowers blood inflammatory markers, and to leverage a large ongoing study of aging to define how skin barrier function is correlated with longer-term health outcomes.
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