Aging is a physiological mechanism that induces a progressive loss of functional capacities of several tissues. In aged people, this is highlight by an increase in frailty and a decrease in physical and cognitive performances. Consequently, aging exposes to loss of autonomy and major consequences (notably malnutrition), which results in heavy treatments, blunting of quality of life,, important costs, and hospitalisation. In this context, malnutrition is a major factor of loss of autonomy. Physical function depends on strong and coordinate interactions between several physiological mechanisms and systems, i.e. nervous, skeletal and muscular systems. Both aging and malnutrition have pejorative issues on functional abilities by inducing negative alteration of these systems. To date, there is no significative difference in the management of malnutrition between elderly and younger people. Additionnally, nutritional strategy or dietary complement specifically dedicated to aged malnourished people are not available. Nutritional products for malnourished aged patients are needed since the capacity of elderly persons to respond successfully to renutrition is less than in younger persons. In addition, their nutritional requirements are different. Clinician needs new approaches for a more efficient dietary management of malnutrition in elderly patients. The aim of the PRESAGE project is to study the efficiency of a specific oral complement for improving functional abilities of undernourished elderly people and more globally to prevent the loss of autonomy. The program is based on 5 inter-dependent tasks. Products under study will contain a mix of nutriments with action on muscle mass and function, on bone metabolism and function and on inflammation and cognition. We anticipate a synergistic action of these compounds to improve functional activity of malnourished aged patients. This concept is new since it puts together different nutrients with for each very well-known beneficial effects during malnutrition and ageing. According to this formulation, the project will be organized to answer several questions. The aim of the first part (task 1) is to evaluate the absorption rate and the availability of the product in malnourished aged patients. In a second task (task 2), the product will be given to nursing home residents with the aim to evaluate its effect on nutritional status, cognition, functional capacities and autonomy. To go further in the mechanisms, we also plan to refed aged malnourished rats with either the complete formula or with each of the compounds separately and to evaluate their metabolic and functional effects on several tissues such as skeletal muscle, bone and brain (tasks 3 and 4). The project will enable scientists from public and private structures involved to work together on an ambitious programme aimed at observing and experimenting the potential interest of a new nutritional concept for elderly malnourished people. Therefore, the results of this study will be communicated and transferred to the industrial and scientific communities by oral communication, articles and organisation of meetings (task 5). Finally, these data would be of industrial interest to market a product with this new formulation.

Microfibrillated cellulose (MFC) appears like the next generation of biorefinery high value added product. During the last decade, the interest towards these new bio-based materials exponentially increased due to their outstanding properties and the announced industrialization in 2011. In this project, we intend to use this MFC to develop a novel class of biomaterial substrate device with controlled release of active molecules for improving soft tissue repair. It will offer clear and expected solutions for addressing remaining clinical needs, such as infection, pain and recurrence. Indeed soft tissue repair is one of the major business activities of the medical device industry. It mainly comprises ventral and inguinal hernia repair devices, with a worldwide market over 3 billions € with a mean annual growth rate at 8%. Infection remains the #1 concern for surgeons and healthcare authorities for all soft tissue surgeries. These complications lead to unacceptably high medico-social costs, with re-do surgeries, medical treatments, loss of quality of life and, particularly for oncologic surgeries, reduced life expectancy. Given the importance of these medico-socio payloads, there is clear need for soft tissue repair solutions controlling the local delivery of antiseptics for infection control or analgesics for pain control. Both antiseptics or drugs with different modes of action will be chosen and immobilized (adsorbed or grafted) thanks to the microfibrillated cellulose treated medical device. First, different pre-treatments of biomass, and more precisely cellulose, will be studied to optimize preparation of high-quality grade MFC. In the meantime, active bioconjugates will be synthesized with innovative chemical ligation of oligosaccharides with active molecules. Subsequently, medical devices will be prepared following different possibilities (multilayer or 100% MFC system). The efficiency of the final materials and drug release studies will help confirming the promising effect within a demonstrator material. The main idea is to start from biomass (1 industrial partner, 1 start-up) to biomedical applications (1 industrial partner) with using, functionalizing and characterizing the MFC based substrate (1 technical center & 3 laboratories).