Cellular senescence and the senescent secretory phenotype: therapeutic opportunities
Open accessAbstract
Aging is the largest risk factor for most chronic diseases, which account for the majority of morbidity and health care expenditures in developed nations. New findings suggest that aging is a modifiable risk factor, and it may be feasible to delay age-related diseases as a group by modulating fundamental aging mechanisms. One such mechanism is cellular senescence, which can cause chronic inflammation through the senescence-associated secretory phenotype (SASP). We review the mechanisms that induce senescence and the SASP, their associations with chronic disease and frailty, therapeutic opportunities based on targeting senescent cells and the SASP, and potential paths to developing clinical interventions.
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The paper states that p16 is a key trigger of cellular senescence and has been proposed as a biomarker of mammalian aging.
“p16 is a key trigger of cellular senescence16, and its expression increases with aging in several rodent and primate tissues17–19, suggesting its potential use as a biomarker of mammalian aging.”
From Effects of intermittent senolytic therapy on bone metabolism in postmenopausal women: a phase 2 randomized controlled trial (2024) · cites this paper as [16]
The Cellular senescence section (page unavailable) says that senescence-inducing insults activate the p16INK4a pathway, which helps initiate a senescence response. The References section (page unavailable) lists work describing Ink4a/Arf expression as a biomarker of aging. The paper does not itself establish the more specific claim that p16 expression rises with age across several rodent and primate tissues; it also describes p16 as a pathway activated by triggers, rather than as the trigger itself. (LLM, conf=0.82)
Experimental — accuracy not yet measuredIn 30-70% of senescent cells, the SASP contains pro-inflammatory, proapoptotic, and pro-fibrotic factors, some of which can make previously non-senescent cells senescent locally and at a distance through endocrine action.
“In 30–70% of senescent cells, this SASP entails pro-inflammatory, proapoptotic and pro-fibrotic factors7,31,40,59–64, some of which can cause previously non-senescent cells to become senescent both locally and at a distance in an endocrine manner24,39,47.”
From Cellular senescence and senolytics: the path to the clinic (2022) · cites this paper as [64]
The SASP and Figure 2 passages describe inflammatory SASP factors and suggest that senescence can spread to neighboring cells. They do not establish the 30–70% figure, characterize SASP factors as proapoptotic or pro-fibrotic, or show that they induce senescence at a distance through endocrine action; the paper also frames spreading senescence as a possibility needing further investigation. Page numbers were not available in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredSASP factors, senescence markers, and markers of other aging processes such as α-Klotho can be assayed in body fluids including urine, saliva, blood, and cerebrospinal fluid.
“SASP factors, senescence markers and markers of other fundamental aging processes (for example, α-Klotho) can be assayed in body fluids such as urine, saliva, blood or cerebrospinal fluid7,19,48,59,61,64,132,133.”
From Cellular senescence and senolytics: the path to the clinic (2022) · cites this paper as [64]
The Research issues section (page unavailable) proposes blood biomarkers of senescent-cell burden based on detecting SASP products. It does not establish that such assays are available, or address α-Klotho or assays in urine, saliva, or cerebrospinal fluid. Searches for those fluids and α-Klotho found no supporting passage. (LLM, conf=0.85)
Experimental — accuracy not yet measuredCellular senescence is one fundamental aging mechanism that contributes to many age-related diseases.
“One fundamental aging mechanism that underlies numerous age-related diseases is cellular senescence (5).”
From Senolytic Drugs: Reducing Senescent Cell Viability to Extend Health Span (2021) · cites this paper as [5]
The Cellular senescence section calls senescence a basic process that may contribute to age-related dysfunction and reports evidence that senescent cells drive multiple age-related pathologies. But it limits the clear experimental evidence to a progeroid mouse model and says it remains to be tested in chronologically aged models. The citing sentence states the broader role without those qualifications. (LLM, conf=0.85)
Experimental — accuracy not yet measuredSenescent cells secrete SASP, which alters the extracellular matrix, impairs stem cell functions, promotes transdifferentiation, can spread senescence to surrounding cells, and causes systemic chronic inflammation.
“Importantly, senescent cells secrete a complex set of pro-inflammatory cytokines, known as the senescence-associated secretory phenotype (SASP). This alters the composition of the extracellular matrix, impairs stem cell functions, promotes cell transdifferentiation and can spread the senescence phenotype to surrounding cells, thereby causing systemic chronic inflammation12.”
From Telomere dysfunction in ageing and age-related diseases (2022) · cites this paper as [12]
The Figure 2 passage links the SASP to extracellular-matrix degradation and says it appears to spread between cells. The SASP section says its cytokines can cause epithelial-to-mesenchymal transitions, but describes systemic inflammation as potential and context-dependent. Figure 2 attributes removal from the progenitor/stem-cell pool to senescence, not specifically to SASP-mediated impairment of stem-cell function. (LLM, conf=0.87)
Experimental — accuracy not yet measured
Cellular senescence is associated with cardiovascular dysfunction in humans.
“Cellular senescence is associated with cardiovascular dysfunction in humans (Tchkonia et al., 2013; Kirkland & Tchkonia, 2014), a major cause of morbidity and mortality in the elderly.”
From The Achilles' heel of senescent cells: from transcriptome to senolytic drugs (2015) · cites this paper as Tchkonia et al., 2013
The References section names a study of senescence in endothelial cells from patients with atherosclerosis, supporting a human cardiovascular association. The Cellular senescence section discusses age-related dysfunction more broadly, but the review does not explicitly establish an association with cardiovascular dysfunction in humans generally. No page is available for these passages in our copy. (LLM, conf=0.78)
Experimental — accuracy not yet measuredThe accumulation of senescent cells contributes to tissue and organismal aging and is a well-known aging hallmark.
“The accumulation of senescent cells contributes to tissue and organismal aging and is a well-known aging hallmark.56”
From Spatial transcriptomic landscape unveils immunoglobin-associated senescence as a hallmark of aging (2024) · cites this paper as [66]
The Cellular senescence section says senescent cells increase in multiple tissues with chronological aging and describes evidence that they drive age-related pathologies. But it limits the evidence from clearing senescent cells to a progeroid mouse model and says the finding remains to be tested in chronologically aged models. The claim states their contribution to tissue and organismal aging more definitively than the source does. (LLM, conf=0.85)
Experimental — accuracy not yet measuredInterventions that reduce the burden of senescent cells could ameliorate age-related disabilities and chronic diseases as a group.
“Thus, interventions that reduce the burden of senescent cells could ameliorate age-related disabilities and chronic diseases as a group (Tchkonia et al., 2013; Kirkland & Tchkonia, 2014).”
From The Achilles' heel of senescent cells: from transcriptome to senolytic drugs (2015) · cites this paper as Tchkonia et al., 2013
Cellular senescence likely contributes to chronic diseases and age-related dysfunction.
“A fundamental aging mechanism that likely contributes to chronic diseases and age-related dysfunction is cellular senescence (Kirkland, 2013b,a; Tchkonia et al., 2013; Kirkland & Tchkonia, 2014).”
From The Achilles' heel of senescent cells: from transcriptome to senolytic drugs (2015) · cites this paper as Tchkonia et al., 2013
As senescent cells do not divide, drug resistance would be expected to be less likely than with antibiotics or cancer treatment, in which cells proliferate and can acquire resistance.
“as senescent cells do not divide, drug resistance would be expected to be less likely than is the case with antibiotics or cancer treatment, in which cells proliferate and so can acquire resistance”
From The Achilles' heel of senescent cells: from transcriptome to senolytic drugs (2015) · cites this paper as Tchkonia et al., 2013
Senescent cells have been identified at sites of pathology in multiple diseases and disabilities or may have systemic effects that predispose to others.
“Senescent cells have been identified at sites of pathology in multiple diseases and disabilities or may have systemic effects that predispose to others (Tchkonia et al., 2013; Kirkland & Tchkonia, 2014).”
From The Achilles' heel of senescent cells: from transcriptome to senolytic drugs (2015) · cites this paper as Tchkonia et al., 2013
Senescent cells can initiate a deleterious positive feedback mechanism by promoting the spread of senescence to nearby cells.
“Senescent cells can also initiate a deleterious positive feedback mechanism by promoting the spread of senescence to nearby cells (17–19).”
From Cellular Senescence in Type 2 Diabetes: A Therapeutic Opportunity (2015) · cites this paper as [18]
Senescent cells express and secrete many proinflammatory cytokines, chemokines, growth factors, and proteases, a set collectively called the senescence-associated secretory phenotype (SASP).
“senescent cells display extensive changes in gene expression, including the expression and secretion of many proinflammatory cytokines, chemokines, growth factors, and proteases; collectively these features are termed the senescence-associated secretory phenotype (SASP) (2, 7–10).”
From The DNA damage response induces inflammation and senescence by inhibiting autophagy of GATA4. (2015) · cites this paper as [10]
The SASP does not depend on p53 or p16INK4a, suggesting that it is controlled by a separate branch of the senescence regulatory network.
“the SASP does not depend on either p53 or p16INK4a, which suggests that it is controlled by an independent branch of the senescence regulatory network (2, 10, 20, 26).”
From The DNA damage response induces inflammation and senescence by inhibiting autophagy of GATA4. (2015) · cites this paper as [10]
Factors secreted by senescent cells may promote chronic inflammation, which is thought to be a major factor in many age-related diseases.
“factors secreted by senescent cells may directly or indirectly promote chronic inflammation that is thought to be a major factor in many, if not all, age-related diseases (2, 9, 10).”
From The DNA damage response induces inflammation and senescence by inhibiting autophagy of GATA4. (2015) · cites this paper as [10]
Accumulation of senescent cells as organisms age is thought to promote aging-related phenotypes and diseases, including cancer and neurodegeneration, in a cell-nonautonomous manner.
“the accumulation of senescent cells as organisms age is thought to promote aging-related phenotypes and aging-associated diseases, including cancer and neurodegeneration, in a cell-nonautonomous manner (2, 3, 10).”
From The DNA damage response induces inflammation and senescence by inhibiting autophagy of GATA4. (2015) · cites this paper as [10]
These inflammatory cytokines promote senescence locally in a paracrine manner and perhaps at a systemic level.
“These inflammatory cytokines promote senescence locally in a paracrine manner30 and perhaps, at a systemic level.111”
From Senescence-induced inflammation: an important player and key therapeutic target in atherosclerosis (2020) · cites this paper as [111]
Activation of the p38 pathway is directly involved in loss of telomerase activity and proliferative capacity, as well as increased production of inflammatory cytokines similar to the senescence-associated secretory phenotype in fibroblasts.
“Activation of the p38 pathway is directly involved in the loss of telomerase activity and of proliferative capacity, as well as the increased production of inflammatory cytokines similar to the senescence-associated secretory phenotype in fibroblasts”
From Successful and Maladaptive T Cell Aging (2017) · cites this paper as Tchkonia et al., 2013
The senescence associated secretory phenotype is considered important for remodelling of ageing tissues.
“This is known as the senescence associated secretory phenotype or SASP and is considered to be important for remodelling of ageing tissues [41, 42].”
From Senescence of T Lymphocytes: Implications for Enhancing Human Immunity (2016) · cites this paper as [42]
Cellular senescence can cause chronic inflammation through the SASP, and this chronic non-microbial sterile inflammation is thought to be the prime cause of many age-related disorders such as atherosclerosis, autoimmunity, cancers and dementias.
“Cellular senescence can cause chronic inflammation through the SASP and this chronic nonmicrobial (sterile) inflammation is thought to be the prime cause of many age-related disorders such as atherosclerosis, autoimmunity, cancers and dementias [42].”
From Senescence of T Lymphocytes: Implications for Enhancing Human Immunity (2016) · cites this paper as [42]
Cellular senescence is marked by permanent cell-cycle arrest, altered gene expression, activation of tumour suppression, chromatin changes, apoptosis resistance, and higher protein synthesis.
“Cellular senescence is characterized by an irreversible cell cycle arrest, changes in gene expression, tumour suppression activation, altered chromatin, resistance to apoptosis and increased protein synthesis89.”
From Mitochondrial and metabolic dysfunction in ageing and age-related diseases (2022) · cites this paper as [89]
The accumulation of senescent cells during aging is implicated as a causal factor in aging-associated inflammation and disruptions of ECM.
“Because of this the accumulation of senescent cells during aging is implicated as a causal factor in aging-associated inflammation and disruptions of ECM.”
From Programmed cell death in aging (2015) · cites this paper as Tchkonia et al., 2013
The composition and intensity of the SASP response can be affected by the senescence-inducing mechanism, cell type, and time since senescence initiation, indicating that there is no singular SASP.
“The composition and intensity of the SASP response can be affected by several factors including the senescence-inducing mechanism, cell type, and the amount of time passed since senescence initiation, indicating that there is no singular SASP.12–17”
From Paracrine roles of cellular senescence in promoting tumourigenesis (2018) · cites this paper as [17]
Dysregulation or inappropriate activation of senescence contributes to tumour progression and malignancy.
“There is mounting evidence that dysregulation or inappropriate activation of senescence contributes to tumour progression and malignancy.5,7,17”
From Paracrine roles of cellular senescence in promoting tumourigenesis (2018) · cites this paper as [17]
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Chronic Inflammation (Inflammaging) and Its Potential Contribution to Age-Associated Diseases
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“examined in animalmodels of other conditionsor diseases towhich cellular senescence may contribute to pathogenesis, including diabetes, neurodegenerative disorders, osteoarthritis, chronic pulmonary disease, renal diseases, and others (Tchkonia et al., 2013; Kirkland & Tchkonia, 2014).”
BackgroundInfluentialSelf-citationSenolytics improve physical function and increase lifespan in old age
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Self-citationSarcopenia: Aging-Related Loss of Muscle Mass and Function
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Innate immune sensing of cytosolic chromatin fragments through cGAS promotes senescence
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“A prominent hallmark of senescent cells is the secretion of inflammatory mediators, including various cytokines, chemokines, extracellular matrix proteins and growth factors, collectively referred to as the senescence-associated secretory phenotype (SASP)3 4.”
Targeting cellular senescence prevents age-related bone loss in mice
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Self-citationCellular senescence and senolytics: the path to the clinic
Chaib, S., Tchkonia, T., & Kirkland, J. L. (2022) · Nature Medicine · doi:10.1038/s41591-022-01923-y · Cited by 1,105 · see citing works
Self-citationA new gene set identifies senescent cells and predicts senescence-associated pathways across tissues
Saul, D., Kosinsky, R. L., Atkinson, E. J., Doolittle, M. L., Zhang, X., LeBrasseur, N. K., Pignolo, R. J., Robbins, P. D., Niedernhofer, L. J., Ikeno, Y., et al. (2022) · Nature Communications · doi:10.1038/s41467-022-32552-1 · Cited by 1,060 · see citing works
Self-citationFisetin is a senotherapeutic that extends health and lifespan
Yousefzadeh, M. J., Zhu, Y., McGowan, S. J., Angelini, L., Fuhrmann-Stroissnigg, H., Xu, M., Ling, Y. Y., Melos, K. I., Pirtskhalava, T., Inman, C. L., et al. (2018) · EBioMedicine · doi:10.1016/j.ebiom.2018.09.015 · Cited by 1,032 · see citing works
Self-citationCellular senescence: a translational perspective
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Self-citationThe DNA damage response induces inflammation and senescence by inhibiting autophagy of GATA4.
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Self-citationThe Continuum of Aging and Age-Related Diseases: Common Mechanisms but Different Rates
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Mitochondrial and metabolic dysfunction in ageing and age-related diseases
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Self-citationChronic inflammation induces telomere dysfunction and accelerates ageing in mice
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Mechanisms and therapeutic implications of cellular senescence in osteoarthritis
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Mitochondria are required for pro-ageing features of the senescent phenotype
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mTOR regulates MAPKAPK2 translation to control the senescence-associated secretory phenotype
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Telomere dysfunction in ageing and age-related diseases
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Identification of HSP90 inhibitors as a novel class of senolytics
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Self-citationRole of Telomeres and Telomerase in Aging and Cancer
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The Role of Inflammation in Age-Related Sarcopenia
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Age and immunity: What is “immunosenescence”?
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Interventions to slow aging in humans: are we ready?
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Targeting senescent cells enhances adipogenesis and metabolic function in old age
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- Authors
- Tchkonia, T., Zhu, Y., van Deursen, J., Campisi, J., & Kirkland, J. L.
- Affiliations
- Mayo Clinic (US)
- Buck Institute for Research on Aging (US)
- Corresponding author
- Kirkland, James L.
- Venue
- Journal of Clinical Investigation
- Published
- 2013-03-01
- Volume
- 123
- Issue
- 3
- Pages
- 966-972
- ISSN
- 0021-9738 (ISSN-L)
- PMC
- PMC3582125
- OpenAlex
- W2108887402
- Cited by
- 1,774
- References
- 112
- Citations by year
- 2026: 129 · 2025: 138 · 2024: 163 · 2023: 150 · 2022: 142 · 2021: 180 · 2020: 162 · 2019: 145 · 2018: 138 · 2017: 122 · 2016: 105 · 2015: 92 · 2014: 72 · 2013: 33 · 2012: 1
- FWCI
- 11.09
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Investigation (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Funders
- Ellison Medical Foundation
- Noaber Foundation
- National Institutes of Health (AG041122)
- National Institute on Aging (AG041122, P01AG041122)
- Topics
- Health Sciences › Medicine › Physiology › Telomeres, Telomerase, and Senescence
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Aging › Genetics, Aging, and Longevity in Model Organisms
- Health Sciences › Medicine › Geriatrics and Gerontology › Sirtuins and Resveratrol in Medicine
- Keywords
- cellular senescence, senescence-associated secretory phenotype, aging, chronic inflammation, age-related diseases, frailty, senolytics, senolytic therapy
- MeSH terms
- Aging, Animals, Clinical Trials as Topic, DNA Damage, DNA Repair, Humans, Phenotype, Signal Transduction, Cellular Senescence, Inflammation Mediators, Molecular Targeted Therapy
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