1. National Institute on Aging Workshop: Repurposing Drugs or Dietary Supplements for Their Senolytic or Senomorphic Effects: Considerations for Clinical Trials
- Author
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Evan C. Hadley, Sergei Romashkan, and Henry Chang
- Subjects
0301 basic medicine ,Senescence ,Aging ,THE JOURNAL OF GERONTOLOGY: Medical Sciences ,Disease ,Bioinformatics ,Education ,03 medical and health sciences ,Clinical Trials, Phase II as Topic ,0302 clinical medicine ,National Institute on Aging (U.S.) ,Humans ,Medicine ,Senolytic ,Cellular Senescence ,Repurposing ,Polypharmacy ,Geroscience ,business.industry ,Drug Repositioning ,United States ,Clinical trial ,030104 developmental biology ,030220 oncology & carcinogenesis ,Dietary Supplements ,Geriatrics and Gerontology ,business ,Cell aging - Abstract
Background Cell senescence is implicated in numerous age-related conditions. Drugs and nutritional supplements developed for a variety of purposes kill senescent cells (senolytics) or suppress their secretions (senomorphics). There is interest in repurposing such drugs to treat or prevent age-related diseases. To date, only small-scale preliminary trials have been conducted. Method At a workshop convened by the National Institute on Aging in August 2019, academic, industry, and government scientists reviewed issues for phase II trials of potentially repurposable drugs, or dietary supplements, to assess benefits and risks of their senolytic (killing senescent cells) or senomorphic (altering senescent cells’ phenotypes) effects in treating or preventing age-related conditions. Results Participants reviewed mechanisms and effects of cellular senescence, senolytics, and senomorphics of several classes and their potential role in treating or preventing disease, modulators of the senescence-associated secretory phenotype, needs for senescence markers, data and specimen resources, infrastructure for planning trials, and potential effects on outcomes in older patients with multimorbidity and polypharmacy. Conclusions Participants noted the importance of considering potential effects of candidate drugs on multiple aging outcomes. It is important to assess drugs’ specificity for killing senescent cells and the balance between senolytic and cytotoxic effects. Markers of specific senescent cell types are needed to assess intervention responses. There are potential interactions with coexisting diseases and their treatments in older persons. Standardized measures could enhance comparisons and pooling of data. Additional characterization of human cell senescent phenotypes is needed for developing better and more specific senolytics and senomorphics.
- Published
- 2021