추가 적립 안내

“이 책은 노화란 무엇인가에 대한 두 번째 응답이다. 첫 번째 응답은 노화의 원인을 분자생물학적으로 밝히는 ‘노화의 생물학’에서 하였으며, 두 번째 응답으로 노화와 관련된 인체의 변화를 ‘노화생리학’에 담고 있다.”

노화란 무엇인가? 어린 아이가 태어나서 키가 자라 성인이 되듯이 노화가 일어나는 현상도 인간의 발달과정의 하나라고 생각할 수 있다. 노화 자체가 질병은 아니지만 노화가 일어나면서 질병을 가질 확률은 점점 더 증가해간다. 노화를 일으키는 원인에 대해서도 우리의 유전자 안에 수명을 결정하는 프로그램이 짜여 있다는 프로그램설과 우리가 살아가면서 손상을 받는 것이 축적되어 일어난다는 에러설 등 수많은 학설이 존재한다. 조지 윌리암스라는 학자는 어떤 유전자가 생명의 초기에는 유익한 영향을 주다가 생명의 후기에는 해로운 영향을 줄 수 있다는 대립적 다면발현(antagonistic pleiotropy) 이론을 주장하였다. 종양 억제 유전자나 염증 반응 등은 생명의 초기에는 생명체를 보호하는데 강력한 힘을 발휘하지만 생명의 후반부에서는 오히려 노화를 촉진하거나 병적인 상태를 촉진하는 요인으로 작용한다. 따라서 이러한 노화 촉진 인자의 존재는 노화를 일으키는 필수불가결의 요소로 작용하게 되는 것이다. 그런데 진화에 의하여 이와 같은 해로운 인자가 제거되지 않는 이유는 그들이 인생의 전반기에 발휘하는 강력한 생명체 보호작용이 노화를 일으키는 해로운 역할을 능가하기 때문에 선택받을 수 있었던 것이다.
본 노화생리학에서는 생명체에서 노화하면서 일어나는 생리적 기능의 변화에 대하여 알아보고자 하였다. 이러한 고찰은 초고령 사회로 전이하는 현 상황에서 필요한 일이라 생각되며 이러한 과정을 통하여 보다 더 건강한 사회로의 진행에 도움이 될 것으로 생각한다.

이 책은 노화에 지속적인 관심을 기울여온 오상진 교수와 30여 년간 인체생리학을 연구한 임욱빈 교수가 힘을 합해 만든 노화에 대한 생리학적 접근이다. 오상진 교수의 지난 저서 “노화의 생물학”은 노화가 일어나는 원인을 분자생물학적 접근으로 다각적으로 다루고 있다면, 이 “노화 생리학”은 인체의 각 기관이 노화되면서 발생하는 현상과 그에 따르는 질병 등에 대해 다루고 있다.
특히 책의 후반부 8장에서 치매와 관련된 질환을, 9장에서 암을 다룸으로써 대한민국에서 많이 발생하는 노령 질환에 대해 심도 있게 서술하고 있다. 그와 함께 노화와 함께 오는 요실금, 탈모, 근육에 관한 이해 등을 다루고 있다. 따라서 이 책은 노화에 대해서 생리학이라는 학술적 접근을 할 뿐만 아니라 일반 대중에게도 어필할 수 있는 노화 관련 지식과 질환에 대해서 풀어내고 있다.
이 책은 전공자들에게는 노화에 대한 교재로 쓸 수 있고, 인체 노화와 그 질환에 관심이 있는 일반인들은 노화 현상과 그 질환에 대한 전문 지식을 높이는 데 큰 도움이 될 것이다.

머리말 5

1 항상성과 노화｜13
1절 노화와 항상성 협착(homeostenosis) / 13
1) 항상성············································································································ 13
2) 변상성············································································································ 15
3) 생리적 예비 역량····························································································· 16
4) 노화와 내재 역량의 저하 ················································································· 17
2절 체온조절과 노화 / 20
1) 체온조절의 개요······························································································· 20
2) 체온의 항상성 기구························································ ································· 23
3) 열의 보존과 열생산·························································· ······························· 25
4) 열의 발산········································································································ 27
5) 온도감각과 체온조절 기능의 노화······································································· 28

2 근골격계와 노화｜35
1절 골격계 / 36
1) 골격계의 구조와 기능······················································································· 36
2) 뼈의 구조와 형성····························································································· 37
3) 뼈의 노화－골감소증과 골다공증·········································································40
4) 뼈를 튼튼하게 하는 방법··················································································· 42
2절 운동능력과 근육의 노화 / 44
1) 근육의 종류－골격근, 평활근, 심근·······································································44
2) 골격근의 수축·································································································· 46
3) 근육의 수축과 장력의 크기················································································ 47
4) 골격근의 기능과 운동에서 기타 기관의 역할························································ 48
5) 근육감소증······································································································· 52
6) 근력감소증······································································································· 56
7) 근육의 조성 변화······························································································ 57
8) 운동이 근육과 기타 기관의 기능에 미치는 효과···················································· 63

3 심혈관계와 노화｜67
1절 순환계의 구조와 기능 / 67
1) 순환계와 기타 기관과의 협동 관계 ···································································· 69
2) 순환계의 구성·································································································· 69
3) 혈압 조절········································································································ 82
4) 각 기관으로의 혈류량의 조절············································································· 88
2절. 심혈관계의 노화 / 92
1) 심장 구조의 변화······························································································ 93
2) 심장 세포의 변화······························································································ 94
3) 심장박동수의 감소···························································································· 95
4) 심장의 수축력의 약화 ······················································································ 96
5) 심장의 적응 보상과 생리적 역량의 감소 ····························································· 97
6) 동맥의 구조와 혈압의 변화··············································································· 103
7) 모세혈관의 변화 ···························································································· 104
8) 정맥의 변화 ·································································································· 105
9) 노화와 관련된 혈액의 변화··············································································· 106

4 내분비계와 노화｜109
1절 내분비계의 개요 / 109
1) 내분비계의 특징······························································································ 110
2) 사람의 내분비선······························································································ 114
2절 노화에 따른 내분비계의 변화 / 126
1) 성장호르몬과 노화··························································································· 128
2) 인슐린유사성장인자와 노화··············································································· 131
3) 인슐린과 노화································································································· 132
4) 칼슘대사와 노화······························································································ 136
5) 코티졸과 노화································································································· 138
6) DHEA와 노화································································································· 142
7 ) 성호르몬과 노화···························································································· 143

5 비뇨기계와 노화｜145
1절 비뇨기계의 구성과 하는 역할 / 145
1) 비뇨기계의 기능과 체액환경············································································· 147
2) 콩팥의 구조와 기능························································································· 150
3) 네프론은 콩팥의 기능적 단위이다······································································ 152
2절 오줌의 형성과정 / 153
1) 사구체 여과···································································································· 153
2) 세뇨관 재흡수································································································· 158
3) 세뇨관 분비···································································································· 163
4) 오줌의 농축기작······························································································ 164
5) 오줌의 저장 및 배뇨························································································ 168
3절 콩팥 생리 / 171
1) 콩팥 기능 평가······························································································· 172
2) 수분 재흡수 조절···························································································· 174
3) 나트륨 재흡수 조절························································································· 175
4) 산－염기 평형 ······························································································· 178
4절 노화에 따른 비뇨기계의 변화 / 178
1) 콩팥·············································································································· 178
2) 방광·············································································································· 181
3) 요도·············································································································· 182
5절 노화 연관 비뇨기질환 / 183
1) 만성콩팥병····································································································· 183
2) 체액 및 전해질 대사 이상················································································ 184
3) 요실금··········································································································· 185
4) 전립선 질환···································································································· 186

6 면역계와 노화｜191
1절 면역계의 개요 / 191
1) 면역계의 구성································································································· 192
2) 선천면역········································································································ 201
3) 항체매개 면역반응··························································································· 213
4) T 세포의 발달과 활성····················································································· 216
5) 세포매개 면역반응··························································································· 219
2절 노화에 따른 면역기능의 변화 / 220
1) 흉선의 퇴축···································································································· 221
2) CD4 : CD8 비율의 변화·················································································· 223
3) Naive T 세포의 감소와 Memory T 세포의 증가················································ 223
4) 사이토카인의 변화··························································································· 224
5) 점막면역(mucosal immunity)반응의 감소··························································· 225
6) 노화에 따른 선천면역반응의 변화······································································ 225
7) 노화에 따른 B 세포 수 감소············································································ 226
3절 노화와 염증반응 / 227

7 피부계통의 노화｜231
1절 피부의 노화 / 232
1) 피부의 구조···································································································· 232
2) 피부의 기능···································································································· 240
3) 피부장벽········································································································ 243
4) 피부의 노화···································································································· 246
5) 광노화의 기전································································································· 257
2절 탈모 / 263
1) 모발의 구조 및 특징······················································································· 263
2) 모발의 발생 및 성장························································································ 266
3) 모발 성장주기와 생체시계 유전자의 발현··························································· 269
4) 탈모증··········································································································· 272

8 신경계와 노화｜281
1절 인간 뇌의 구조 / 281
1) 뇌가 기능하는 방식························································································· 281
2) 정서적 뇌의 기능···························································································· 283
3) 신경세포의 역할······························································································ 285
4) 기억은 어떻게 저장되는가················································································ 287
2절 파킨슨병 / 288
1) 파킨슨병의 잠재적 원인··················································································· 289
2) 미토콘드리아 기능장애와 파킨슨병···································································· 291
3) 파킨슨병의 병독성··························································································· 291
3절 알츠하이머병 / 293
1) 알츠하이머병은 신경퇴행성질환이다··································································· 293
2) 알츠하이머병의 증상과 특징 ············································································ 295
3) 알츠하이머병의 진행은 몇 단계로 나눌 수 있다·················································· 297
4절 알츠하이머병의 원인 / 299
1) 콜린작동성 가설······························································································ 300
2) 베타아밀로이드 가설························································································ 300
3) Tau 가설······································································································· 313
4) 베타아밀로이드가 세포를 죽이는 기작 ····························································· 315
5) 미토콘드리아 기능장애····················································································· 317

9 암과 노화｜323
1절 암이란 무엇인가? / 324
1) 양성 및 악성 종양··························································································· 325
2) 암의 구분······································································································· 326
3) 암세포의 특성································································································· 329
4) 암의 원인······································································································· 331
5) 암의 진행단계································································································ 337
2절 암과 유전 / 339
1) 세포증식 억제와 관련된 유전자들····································································· 339
2) DNA 수선과 유전적 안정성에 관여하는 유전자·················································· 341
3절 암유전자 / 344
1) 세포의 암유전자는 어떻게 만들어지는가? ························································· 344
2) 암유전자가 생산한 단백질················································································ 348
4절 종양억제유전자 / 352
1) 세포증식과 세포사멸에서의 기능······································································· 352
2) DNA 수선 및 유전체 안정성에서의 기능···························································· 359
5절 노화하면서 암이 증가하는 이유 / 362
1) 암은 유전자의 변화가 축적되어 발생한다··························································· 362
2) 중장년 이후의 염증성의 미세환경이 암을 촉진할 수 있다··································· 363
3) 노화세포는 유전자 복구시스템도 약화되며 이것은 암을 촉진할 수 있다············ 364
4) 노화에 따른 면역기능의 변화가 암을 촉진할 수 있다········································· 365
6절 한국인의 암 / 365
1) 주요 암 발생 현황··························································································· 365
2) 암 사망률 현황······························································································· 369
3) 암 사망률 30년간 변동 추이············································································· 370
4) 암 생존률······································································································· 371

찾아보기 ?374