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      Targeting senescent cells alleviates obesity‐induced metabolic dysfunction

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      1 , 2 , 3 , 1 , 4 , 1 , 1 , 1 , 1 , 1 , 5 , 6 , 1 , 1 , 7 , 1 , 1 , 8 , 1 , 8 , 3 , 1 , 9 , 10 , 1 , 9 , 11 , 9 , 1 , 12 , 13 , 14 , 1 , 1 , 7 , 15 , 16 , 17 , 7 , 18 , 19 , 5 , 6 , 8 , 1 , 9 , 20 , 16 , 1 , , 1 , 3 , 9 , 15 ,
      Aging Cell
      John Wiley and Sons Inc.
      adipogenesis, aging, cellular senescence, dasatinib, quercetin, senolytics, type 2 diabetes

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          Abstract

          Adipose tissue inflammation and dysfunction are associated with obesity‐related insulin resistance and diabetes, but mechanisms underlying this relationship are unclear. Although senescent cells accumulate in adipose tissue of obese humans and rodents, a direct pathogenic role for these cells in the development of diabetes remains to be demonstrated. Here, we show that reducing senescent cell burden in obese mice, either by activating drug‐inducible “suicide” genes driven by the p16 Ink4a promoter or by treatment with senolytic agents, alleviates metabolic and adipose tissue dysfunction. These senolytic interventions improved glucose tolerance, enhanced insulin sensitivity, lowered circulating inflammatory mediators, and promoted adipogenesis in obese mice. Elimination of senescent cells also prevented the migration of transplanted monocytes into intra‐abdominal adipose tissue and reduced the number of macrophages in this tissue. In addition, microalbuminuria, renal podocyte function, and cardiac diastolic function improved with senolytic therapy. Our results implicate cellular senescence as a causal factor in obesity‐related inflammation and metabolic derangements and show that emerging senolytic agents hold promise for treating obesity‐related metabolic dysfunction and its complications.

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          Most cited references20

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          The Achilles’ heel of senescent cells: from transcriptome to senolytic drugs

          The healthspan of mice is enhanced by killing senescent cells using a transgenic suicide gene. Achieving the same using small molecules would have a tremendous impact on quality of life and the burden of age-related chronic diseases. Here, we describe the rationale for identification and validation of a new class of drugs termed senolytics, which selectively kill senescent cells. By transcript analysis, we discovered increased expression of pro-survival networks in senescent cells, consistent with their established resistance to apoptosis. Using siRNA to silence expression of key nodes of this network, including ephrins (EFNB1 or 3), PI3Kδ, p21, BCL-xL, or plasminogen-activated inhibitor-2, killed senescent cells, but not proliferating or quiescent, differentiated cells. Drugs targeting these same factors selectively killed senescent cells. Dasatinib eliminated senescent human fat cell progenitors, while quercetin was more effective against senescent human endothelial cells and mouse BM-MSCs. The combination of dasatinib and quercetin was effective in eliminating senescent MEFs. In vivo, this combination reduced senescent cell burden in chronologically aged, radiation-exposed, and progeroid Ercc1 −/Δ mice. In old mice, cardiac function and carotid vascular reactivity were improved 5 days after a single dose. Following irradiation of one limb in mice, a single dose led to improved exercise capacity for at least 7 months following drug treatment. Periodic drug administration extended healthspan in Ercc1 −/Δ mice, delaying age-related symptoms and pathology, osteoporosis, and loss of intervertebral disk proteoglycans. These results demonstrate the feasibility of selectively ablating senescent cells and the efficacy of senolytics for alleviating symptoms of frailty and extending healthspan.
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            Senolytics in idiopathic pulmonary fibrosis: Results from a first-in-human, open-label, pilot study

            Background Cellular senescence is a key mechanism that drives age-related diseases, but has yet to be targeted therapeutically in humans. Idiopathic pulmonary fibrosis (IPF) is a progressive, fatal cellular senescence-associated disease. Selectively ablating senescent cells using dasatinib plus quercetin (DQ) alleviates IPF-related dysfunction in bleomycin-administered mice. Methods A two-center, open-label study of intermittent DQ (D:100 mg/day, Q:1250 mg/day, three-days/week over three-weeks) was conducted in participants with IPF (n = 14) to evaluate feasibility of implementing a senolytic intervention. The primary endpoints were retention rates and completion rates for planned clinical assessments. Secondary endpoints were safety and change in functional and reported health measures. Associations with the senescence-associated secretory phenotype (SASP) were explored. Findings Fourteen patients with stable IPF were recruited. The retention rate was 100% with no DQ discontinuation; planned clinical assessments were complete in 13/14 participants. One serious adverse event was reported. Non-serious events were primarily mild-moderate, with respiratory symptoms (n = 16 total events), skin irritation/bruising (n = 14), and gastrointestinal discomfort (n = 12) being most frequent. Physical function evaluated as 6-min walk distance, 4-m gait speed, and chair-stands time was significantly and clinically-meaningfully improved (p < .05). Pulmonary function, clinical chemistries, frailty index (FI-LAB), and reported health were unchanged. DQ effects on circulat.ing SASP factors were inconclusive, but correlations were observed between change in function and change in SASP-related matrix-remodeling proteins, microRNAs, and pro-inflammatory cytokines (23/48 markers r ≥ 0.50). Interpretation Our first-in-humans open-label pilot supports study feasibility and provides initial evidence that senolytics may alleviate physical dysfunction in IPF, warranting evaluation of DQ in larger randomized controlled trials for senescence-related diseases. ClinicalTrials.gov identifier: NCT02874989 (posted 2016–2018).
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              Identification of a novel senolytic agent, navitoclax, targeting the Bcl‐2 family of anti‐apoptotic factors

              Summary Clearing senescent cells extends healthspan in mice. Using a hypothesis‐driven bioinformatics‐based approach, we recently identified pro‐survival pathways in human senescent cells that contribute to their resistance to apoptosis. This led to identification of dasatinib (D) and quercetin (Q) as senolytics, agents that target some of these pathways and induce apoptosis preferentially in senescent cells. Among other pro‐survival regulators identified was Bcl‐xl. Here, we tested whether the Bcl‐2 family inhibitors, navitoclax (N) and TW‐37 (T), are senolytic. Like D and Q, N is senolytic in some, but not all types of senescent cells: N reduced viability of senescent human umbilical vein epithelial cells (HUVECs), IMR90 human lung fibroblasts, and murine embryonic fibroblasts (MEFs), but not human primary preadipocytes, consistent with our previous finding that Bcl‐xl siRNA is senolytic in HUVECs, but not preadipocytes. In contrast, T had little senolytic activity. N targets Bcl‐2, Bcl‐xl, and Bcl‐w, while T targets Bcl‐2, Bcl‐xl, and Mcl‐1. The combination of Bcl‐2, Bcl‐xl, and Bcl‐w siRNAs was senolytic in HUVECs and IMR90 cells, while combination of Bcl‐2, Bcl‐xl, and Mcl‐1 siRNAs was not. Susceptibility to N correlated with patterns of Bcl‐2 family member proteins in different types of human senescent cells, as has been found in predicting response of cancers to N. Thus, N is senolytic and acts in a potentially predictable cell type‐restricted manner. The hypothesis‐driven, bioinformatics‐based approach we used to discover that dasatinib (D) and quercetin (Q) are senolytic can be extended to increase the repertoire of senolytic drugs, including additional cell type‐specific senolytic agents.
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                Author and article information

                Contributors
                Tchkonia.Tamar@Mayo.edu
                Kirkland.James@Mayo.edu
                Journal
                Aging Cell
                Aging Cell
                10.1111/(ISSN)1474-9726
                ACEL
                Aging Cell
                John Wiley and Sons Inc. (Hoboken )
                1474-9718
                1474-9726
                25 March 2019
                June 2019
                : 18
                : 3 ( doiID: 10.1111/acel.2019.18.issue-3 )
                : e12950
                Affiliations
                [ 1 ] Robert and Arlene Kogod Center on Aging Mayo Clinic Rochester Minnesota
                [ 2 ] Medical Scientist Training Program Mayo Clinic Rochester Minnesota
                [ 3 ] Department of Internal Medicine Mayo Clinic Rochester Minnesota
                [ 4 ] University of Connecticut Center on Aging, University of Connecticut Health Farmington Connecticut
                [ 5 ] Department of Laboratory Medicine University Medical Center Groningen, University of Groningen Groningen The Netherlands
                [ 6 ] Department of Pediatrics University Medical Center Groningen, University of Groningen Groningen The Netherlands
                [ 7 ] Division of Nephrology and Hypertension Mayo Clinic Rochester Minnesota
                [ 8 ] Institute for Ageing, Ageing Research Laboratories Newcastle University Newcastle upon Tyne UK
                [ 9 ] Department of Physiology and Biomedical Engineering Mayo Clinic Rochester Minnesota
                [ 10 ] Department of Anesthesiology Mayo Clinic Rochester Minnesota
                [ 11 ] Department of Surgery Mayo Clinic Rochester Minnesota
                [ 12 ] Department of Nutritional Sciences University of Oklahoma Health Sciences Center Oklahoma City Oklahoma
                [ 13 ] Reynolds Oklahoma Center on Aging University of Oklahoma Health Sciences Center Oklahoma City Oklahoma
                [ 14 ] Harold Hamm Diabetes Center University of Oklahoma Health Sciences Center Oklahoma City Oklahoma
                [ 15 ] Division of Geriatric Medicine and Gerontology Mayo Clinic Rochester Minnesota
                [ 16 ] Buck Institute for Research on Aging Novato California
                [ 17 ] European Research Institute for the Biology of Ageing University Medical Center Groningen, University of Groningen Groningen The Netherlands
                [ 18 ] Department of Pathology Mayo Clinic Rochester Minnesota
                [ 19 ] Department of Chemistry University of Minnesota Minneapolis Minnesota
                [ 20 ] Department of Physical Medicine and Rehabilitation Mayo Clinic Rochester Minnesota
                Author notes
                [*] [* ] Correspondence

                James L. Kirkland and Tamar Tchkonia, Cellular Senescence Program, Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN.

                Emails: Kirkland.James@ 123456Mayo.edu ; Tchkonia.Tamar@ 123456Mayo.edu

                [†]

                These authors contributed equally.

                Article
                ACEL12950
                10.1111/acel.12950
                6516193
                30907060
                a482d7d5-066e-4960-9327-c2c977c383d6
                © 2019 The Authors. Aging Cell published by the Anatomical Society and John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 25 January 2019
                : 16 February 2019
                : 03 March 2019
                Page count
                Figures: 5, Tables: 0, Pages: 15, Words: 9438
                Funding
                Funded by: Connor Group
                Funded by: National Institute on Aging
                Award ID: AG041122
                Award ID: AG044396
                Award ID: AG13925
                Award ID: AG31736
                Award ID: AG46061
                Award ID: AG51661
                Funded by: Minnesota Partnership for Biotechnology
                Award ID: MNP IF #14.06
                Funded by: Robert and Arlene Kogod
                Funded by: Noaber Foundation
                Funded by: Biotechnology and Biological Sciences Research Council
                Award ID: BB/K019260/1
                Award ID: BB/M023389/1
                Funded by: American Federation for Aging Research
                Award ID: Scholarship for Research in the Biology of Aging
                Funded by: National Institute of Diabetes and Digestive and Kidney Diseases
                Award ID: DK50456
                Funded by: Ted Nash Long Life Foundation
                Funded by: Robert J. and Theresa W. Ryan
                Funded by: Glenn Foundation for Medical Research
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                acel12950
                June 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.2.1 mode:remove_FC converted:14.05.2019

                Cell biology
                adipogenesis,aging,cellular senescence,dasatinib,quercetin,senolytics,type 2 diabetes
                Cell biology
                adipogenesis, aging, cellular senescence, dasatinib, quercetin, senolytics, type 2 diabetes

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