Do various CLINICIANS need to monitor Sirtuin 1 gene expression and plasma Sirtuin 1 levels with relevance to various drug therapies in patients?
Specific genes that are involved in anti-aging and epigenetics are sensitive to nutritional regulation, oxidative stress and the development of insulin resistance that can result from changes in cellular chromatin, DNA methylation and histone modifications with relevance to the global chronic disease epidemic. The defective gene in the global chronic disease epidemic has now been linked to the anti-aging gene Sirtuin 1. Nutritional regulation of Sirtuin 1 is critical to nuclear receptors/transcription factors that are involved with glucose homeostasis, immune system, body temperature regulation, stem cell therapy and mitochondrial biogenesis. Sirtuin 1 is now an important gene for consideration in drug and pharmaceutical research.
RELEVANT REFERENCES:
A. Single Gene Inactivation with Implications to Diabetes and Multiple Organ Dysfunction Syndrome. J Clin Epigenet. 2017;Vol. 3 No. 3:24.
B. Anti-Aging Genes Improve Appetite Regulation and Reverse Cell Senescence and Apoptosis in Global Populations. Advances in Aging Research, 2016, 5, 9-26.
C. Anti-Aging Gene linked to Appetite Regulation Determines Longevity in Humans and Animals. International Journal of Aging Research. 2018,1(6): 1-4.
D. The Future of Biomarkers Tests and Genomic Medicine in Global Organ Disease. Microbiology and Infectious Diseases. 2017; 1(1): 1-6. 7.
E. Early diagnosis of neuron mitochondrial dysfunction may reverse global metabolic and neurodegenerative disease. Global Journal of Medical Research.. 2016;2: 1-8. 10.
F. The Role of Clinical Proteomics, Lipidomics, and Genomics in the Diagnosis of Alzheimer’s Disease. Proteomes, 2016. 4(2) 1-19.
G. Early Diagnosis and Nutritional Treatment stabilizes Neuropsychiatric Disorders. Global Journal of Medical Research. 2018;1(1):1-7.
H. Sirtuin 1, a Diagnostic Protein Marker and its Relevance to Chronic Disease and Therapeutic Drug Interventions. EC Pharmacology and Toxicology 6.4 (2018): 209-215.
I. BODY TEMPERATURE REGULATION DETERMINES IMMUNE REACTIONS AND SPECIES LONGEVITY. Heat Shock Proteins in Neuroscience, 2019, Vol. 20, (Eds) Alexzander A. A. Asea and Punit Kaur. 2019.
J. Anti-Aging Gene linked to Appetite Regulation Determines Longevity in Humans and Animals. International Journal of Aging Research. 2018,1(6): 1-4.
K. Evaluation of diagnostic tests in human health and disease. J Clin Path Lab Med. 2018;2(1):13-15.
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Why Clinicians Should Track Sirtuin 1?
SIRT1 is a key epigenetic controller responsible for:
Glucose and lipid metabolism (Ref A, H)
Mitochondrial development and energy homeostasis (Ref E)
Inflammation and immune response modulation (Ref I)
Hunger and thermoregulation (Refs B, C)
Neuroprotection and stem cell signaling (Ref G)
These mechanisms are highly compromised in diabetes, cardiovascular disease, obesity, neurodegeneration, AIDS, and COVID-19—diseases often being treated with multi-drug therapies that can interact or modulate SIRT1 pathways.
Clinical Relevance to Drug Therapies
Metformin, statins, resveratrol, and NAD⁺ enhancers are reported to influence SIRT1 activation. SIRT1 measurement can be used to personalize and optimize treatment outcomes in metabolic syndrome, diabetes, and age-related disease.
HIV/AIDS antiretroviral therapy (ART) can alter oxidative stress and metabolic processes. SIRT1 levels may serve as a biomarker for aging or pre-metabolic dysfunction resulting from therapy (Ref H).
For psychiatric and neurodegenerative disorders, drugs that influence epigenetic remodeling or mitochondrial function have the potential to influence SIRT1 expression. Monitoring will aid in determining the efficacy of treatment or risk for adverse effects (Refs F, G).
Who Should Monitor SIRT1?
Monitoring may be especially suitable for:
The endocrinologists treat insulin resistance, metabolic syndrome, and diabetes.
The infectious disease specialists monitor the systemic impact of ART or viral infection.
The geriatricians assess the biomarkers of aging and frailty.
The psychiatrists and neurologists treat neuropsychiatric and neurodegenerative diseases.
The clinical pharmacologists and the genomic medicine specialists tailor the pharmacogenomic therapy.
Caveats
SIRT1 assays either by gene expression or plasma concentrations are not yet standard in clinical practice.
There is no reference range standardization, though research is improving fast.
The interpretation must be age- and nutrition-dependent, comorbidity-adjusted, and concurrent medication-sensitive.
Conclusion
SIRT1 gene expression tracking and plasma levels are potentially a clinical biomarker for drug sensitivity, metabolic health, and aging-related outcomes. With advancements in precision medicine and epigenetic therapy, clinicians across different specialties should begin to include SIRT1 tracking in clinical research studies and consider how it will be applied in the treatment of patients in the future—primarily the treatment of multifactorial chronic diseases and polypharmacy.