New Horizons: Novel Approaches to Enhance Healthspan Through Targeting Cellular Senescence and Related Aging Mechanisms

Nov 6, 2020The Journal of clinical endocrinology and metabolism

New Ways to Improve Healthy Aging by Targeting Aging Cells and Related Processes

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Abstract

The elderly population is increasing faster than other segments of the population throughout the world.

Age is a leading predictor of chronic diseases, multimorbidity, and impaired recovery from illnesses.
Healthspan, or the duration of health and independence, is considered more desirable than merely extending lifespan.
The geroscience hypothesis suggests that targeting fundamental aging mechanisms may extend healthspan more effectively than addressing individual age-related diseases.
Key aging mechanisms include chronic inflammation, DNA damage, and cellular senescence, which are interrelated.
Interventions targeting multiple aging processes, such as dietary changes and specific drugs, are in early human trials and may enhance healthspan benefits.
There is a need for increased research focus on interventions that target fundamental aging processes.

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The elderly population is increasing faster than other segments of the population throughout the world. Age is the leading predictor for most chronic diseases and disorders, multimorbidity, geriatric syndromes, and impaired ability to recover from accidents or illnesses. Enhancing the duration of health and independence, termed healthspan, would be more desirable than extending lifespan merely by prolonging the period of morbidity toward the end of life. The geroscience hypothesis posits that healthspan can be extended by targeting fundamental aging mechanisms, rather than attempting to address each age-related disease one at a time, only so the afflicted individual survives disabled and dies shortly afterward of another age-related disease. These fundamental aging mechanisms include, among others, chronic inflammation, fibrosis, stem cell/ progenitor dysfunction, DNA damage, epigenetic changes, metabolic shifts, destructive metabolite generation, mitochondrial dysfunction, misfolded or aggregated protein accumulation, and cellular senescence. These processes appear to be tightly interlinked, as targeting any one appears to affect many of the rest, underlying our Unitary Theory of Fundamental Aging Mechanisms. Interventions targeting many fundamental aging processes are being developed, including dietary manipulations, metformin, mTOR (mechanistic target of rapamycin) inhibitors, and senolytics, which are in early human trials. These interventions could lead to greater healthspan benefits than treating age-related diseases one at a time. To illustrate these points, we focus on cellular senescence and therapies in development to target senescent cells. Combining interventions targeting aging mechanisms with disease-specific drugs could result in more than additive benefits for currently difficult-to-treat or intractable diseases. More research attention needs to be devoted to targeting fundamental aging processes.

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New Horizons: Novel Approaches to Enhance Healthspan Through Targeting Cellular Senescence and Related Aging Mechanisms

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