Cited by 198Telomeres, Telomerase, and SenescenceGenetics, Aging, and Longevity in Model OrganismsPhagocytosis and Immune Regulation

The DOI matches its Crossref record; 164 of the 164 references it cites were found in a registry or an index; none of the 107 sources its claims cite is checked for support yet.

Immune Clearance of Senescent Cells to Combat Ageing and Chronic Diseases

Open access

Abstract

Senescent cells are generally characterized by permanent cell cycle arrest, metabolic alteration and activation, and apoptotic resistance in multiple organs due to various stressors. Excessive accumulation of senescent cells in numerous tissues leads to multiple chronic diseases, tissue dysfunction, age-related diseases and organ ageing. Immune cells can remove senescent cells. Immunaging or impaired innate and adaptive immune responses by senescent cells result in persistent accumulation of various senescent cells. Although senolytics—drugs that selectively remove senescent cells by inducing their apoptosis—are recent hot topics and are making significant research progress, senescence immunotherapies using immune cell-mediated clearance of senescent cells are emerging and promising strategies to fight ageing and multiple chronic diseases. This short review provides an overview of the research progress to date concerning senescent cell-caused chronic diseases and tissue ageing, as well as the regulation of senescence by small-molecule drugs in clinical trials and different roles and regulation of immune cells in the elimination of senescent cells. Mounting evidence indicates that immunotherapy targeting senescent cells combats ageing and chronic diseases and subsequently extends the healthy lifespan.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review argues that excessive senescent cells drive ageing and chronic diseases, and that immune-mediated clearance by macrophages, NK cells, cytotoxic T cells, and dendritic cells is a promising anti-ageing strategy. It surveys senolytics and small-molecule drugs in preclinical and clinical development and outlines immune mechanisms and future directions for senescence immunotherapy.

Key findings

  • Senescent cells accumulate with age and causally contribute to tissue dysfunction, organ ageing, and chronic diseases including cardiovascular disease, cancer, neurodegenerative diseases, and osteoarthritis; immune cells can remove them, but immunosenescence and impaired innate/adaptive responses promote persistent accumulation.
  • Senescence immunotherapy is emerging as an alternative or complement to senolytics: macrophages, NK cells, cytotoxic T cells, and dendritic cells recognize distinct senescent-cell ligands, such as NKG2D ligands MICA/ULBP2 on senescent cells, while HLA-E–NKG2A interaction inhibits NK/CD8+ T-cell clearance.
  • Small molecules and senolytics show reported benefits: dasatinib plus quercetin (D + Q) eliminates senescent cells in human adipose tissue and skin and improves physical function in idiopathic pulmonary fibrosis; nicotinamide mononucleotide (NMN) was safe after single oral administration in healthy men; topical rapamycin reduced p16 expression in human skin; metformin has entered multiple clinical trials including MILES and TAME.
  • In human immune ageing, supercentenarians older than 110 years had increased CD4+ cytotoxic T lymphocytes (~25.3% of total T cells) versus only 2.8% in young controls (~50–80 year olds), with a dramatic reduction in B-cell number compared with controls.

Methods

  • Narrative review synthesizing preclinical animal models, human samples, mechanistic studies, and clinical trials; no systematic review or meta-analysis is described.
  • Main analysis is qualitative and organized around senescent-cell features, senescent-cell-driven diseases and tissue ageing, small-molecule regulation of senescence, and immune cell types involved in senescent-cell clearance.
  • Clinical trial examples cited include NCT03151239 for NMN safety, NCT03103893 for topical rapamycin, the Metformin in Longevity Study (MILES), NCT02570672 for metformin and frailty, NCT02915198 for metformin in pre-diabetes and atherosclerotic cardiovascular disease, and the proposed TAME trial.

Limitations

  • The paper states that the precise mechanism underlying senescent cell accumulation within tissues is still debatable, and it is unknown whether this is due to senescent cell increase exceeding immune clearance or immune cell dysfunction.
  • The paper states that whether macrophages remove senescent cells in aged or diseased systems remains to be elucidated, and it remains extremely unknown whether and how dendritic cells eliminate apoptotic or senescent cells to prevent chronic diseases including atherosclerosis.
  • The paper states that senescence immunotherapy is not cost-free and does have side effects, and future investigations are needed for personal ageing biomarkers, unique senescent-cell antigens or ligands, and inclusion of both genders; evident from the text, many proposed immunotherapies such as CAR-T/CAR-NK targeting senescent cells and anti-NKG2A strategies are still speculative or not yet established in clinical senescence settings.

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Integrity signals

Registry

Crossref · 10.3390/cells9030671

Cites

164 of 164 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

0 of 107 cited sources checked · 0 supported · 0 flagged

  • It may state two separate claims as one. 25
  • Probably not a substantial claim. 5
28 of 28
  • The paper relies on this without support.

    Findings from animal models and preclinical studies of senescent cell clearance will translate to human ageing and chronic diseases.

    “Mounting evidence indicates that immunotherapy targeting senescent cells combats ageing and chronic diseases and subsequently extends the healthy lifespan.”
  • The paper relies on this without support.

    Targeting or clearing senescent cells can be done safely without eliminating beneficial functions of acute or transient senescence.

    “Usually, sudden or acute senescence will exert beneficial functions such as anti-fibrosis [20] and wound healing [21].”
  • The paper relies on this without support.

    Maintaining immune system function is sufficient to prevent or reduce pathological accumulation of senescent cells.

    “A study investigating human ageing at the individual level by frequent sampling and prolonged deep molecular profiling indicates that immune pathways are one of the significant pathways that alter with age [38].”
  • The paper relies on this without support.

    Selectivity and efficiency of cytotoxic T cells decline with age.

    “However, the selectivity and efficiency of cytotoxic T cells decline with age.”
  • The paper relies on this without support.

    Senescent cells are beneficial in the short term.

    “Because senescent cells are also beneficial in the short term, the homeostasis of senescent cells is critical for healthy ageing.”
5 of 5

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Metadata

Authors
Song, P., An, J., & Zou, M.-H.
Affiliations
Georgia State University (US)
Corresponding author
Song, Ping
Venue
Cells
Publisher
MDPI AG
Published
2020-03-10
Volume
9
Issue
3
Pages
671
ISSN
2073-4409 (ISSN-L)
OpenAlex
W3011483812
Cited by
198
References
164
Citations by year
2026: 22 · 2025: 37 · 2024: 40 · 2023: 23 · 2022: 38 · 2021: 24 · 2020: 12
FWCI
3.09
Type
journal article
Language
en
Open access
Locations
  • Cells (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Foundation for the National Institutes of Health (AG047776, HL089920, HL110488, HL128014, HL132500, HL137371, HL140954, CA213022)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Telomeres, Telomerase, and Senescence
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Aging › Genetics, Aging, and Longevity in Model Organisms
  • Life Sciences › Immunology and Microbiology › Immunology › Phagocytosis and Immune Regulation
Keywords
senescent cells, immune clearance, immunosenescence, senolytics, aging, chronic disease, tissue aging, immune cells, apoptosis, healthspan, small molecule drugs
MeSH terms
Aging, Chronic Disease, Humans, Immunotherapy, Cellular Senescence

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