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Review Series

Aging

Series edited by James L. Kirkland

Aging plays a central role in many chronic diseases affecting all systems of the body. Nine hallmarks of aging have been identified: genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communication. This new review series on Aging closely examines how these hallmarks contribute to the initiation and progression of disease. Curated by series editor Dr. James Kirkland, topics span aging’s role in immune system function, cancer, cognitive decline and neurodegenerative disease, and metabolism. The reviews also discuss the latest developments in senotherapeutic strategies that destroy senescent cells, reverse senescence, or target specific aging hallmarks with a critical eye.

Articles in series

Epigenetics, DNA damage, and aging
Carolina Soto-Palma, … , Christopher D. Faulk, Xiao Dong
Carolina Soto-Palma, … , Christopher D. Faulk, Xiao Dong
Published August 15, 2022
Citation Information: J Clin Invest. 2022;132(16):e158446. https://doi.org/10.1172/JCI158446.
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Epigenetics, DNA damage, and aging

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Abstract

Over the course of a human lifespan, genome integrity erodes, leading to an increased abundance of several types of chromatin changes. The abundance of DNA lesions (chemical perturbations to nucleotides) increases with age, as does the number of genomic mutations and transcriptional disruptions caused by replication or transcription of those lesions, respectively. At the epigenetic level, precise DNA methylation patterns degrade, likely causing increasingly stochastic variations in gene expression. Similarly, the tight regulation of histone modifications begins to unravel. The genomic instability caused by these mechanisms allows transposon element reactivation and remobilization, further mutations, gene dysregulation, and cytoplasmic chromatin fragments. This cumulative genomic instability promotes cell signaling events that drive cell fate decisions and extracellular communications known to disrupt tissue homeostasis and regeneration. In this Review, we focus on age-related epigenetic changes and their interactions with age-related genomic changes that instigate these events.

Authors

Carolina Soto-Palma, Laura J. Niedernhofer, Christopher D. Faulk, Xiao Dong

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Mitochondrial dysfunction in cell senescence and aging
Satomi Miwa, … , Eduardo Chini, Thomas von Zglinicki
Satomi Miwa, … , Eduardo Chini, Thomas von Zglinicki
Published July 1, 2022
Citation Information: J Clin Invest. 2022;132(13):e158447. https://doi.org/10.1172/JCI158447.
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Mitochondrial dysfunction in cell senescence and aging

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Abstract

Mitochondrial dysfunction and cell senescence are hallmarks of aging and are closely interconnected. Mitochondrial dysfunction, operationally defined as a decreased respiratory capacity per mitochondrion together with a decreased mitochondrial membrane potential, typically accompanied by increased production of oxygen free radicals, is a cause and a consequence of cellular senescence and figures prominently in multiple feedback loops that induce and maintain the senescent phenotype. Here, we summarize pathways that cause mitochondrial dysfunction in senescence and aging and discuss the major consequences of mitochondrial dysfunction and how these consequences contribute to senescence and aging. We also highlight the potential of senescence-associated mitochondrial dysfunction as an antiaging and antisenescence intervention target, proposing the combination of multiple interventions converging onto mitochondrial dysfunction as novel, potent senolytics.

Authors

Satomi Miwa, Sonu Kashyap, Eduardo Chini, Thomas von Zglinicki

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Connecting aging biology and inflammation in the omics era
Keenan A. Walker, … , David M. Wilson III, Luigi Ferrucci
Keenan A. Walker, … , David M. Wilson III, Luigi Ferrucci
Published July 15, 2022
Citation Information: J Clin Invest. 2022;132(14):e158448. https://doi.org/10.1172/JCI158448.
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Connecting aging biology and inflammation in the omics era

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Abstract

Aging is characterized by the accumulation of damage to macromolecules and cell architecture that triggers a proinflammatory state in blood and solid tissues, termed inflammaging. Inflammaging has been implicated in the pathogenesis of many age-associated chronic diseases as well as loss of physical and cognitive function. The search for mechanisms that underlie inflammaging focused initially on the hallmarks of aging, but it is rapidly expanding in multiple directions. Here, we discuss the threads connecting cellular senescence and mitochondrial dysfunction to impaired mitophagy and DNA damage, which may act as a hub for inflammaging. We explore the emerging multi-omics efforts that aspire to define the complexity of inflammaging — and identify molecular signatures and novel targets for interventions aimed at counteracting excessive inflammation and its deleterious consequences while preserving the physiological immune response. Finally, we review the emerging evidence that inflammation is involved in brain aging and neurodegenerative diseases. Our goal is to broaden the research agenda for inflammaging with an eye on new therapeutic opportunities.

Authors

Keenan A. Walker, Nathan Basisty, David M. Wilson III, Luigi Ferrucci

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Mitochondria-derived peptides in aging and healthspan
Brendan Miller, … , Kelvin Yen, Pinchas Cohen
Brendan Miller, … , Kelvin Yen, Pinchas Cohen
Published May 2, 2022
Citation Information: J Clin Invest. 2022;132(9):e158449. https://doi.org/10.1172/JCI158449.
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Mitochondria-derived peptides in aging and healthspan

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Abstract

The mechanisms that explain mitochondrial dysfunction in aging and healthspan continue to be studied, but one element has been unexplored: microproteins. Small open reading frames in circular mitochondria DNA can encode multiple microproteins, called mitochondria-derived peptides (MDPs). Currently, eight MDPs have been published: humanin, MOTS-c, and SHLPs 1–6. This Review describes recent advances in microprotein discovery with a focus on MDPs. It discusses what is currently known about MDPs in aging and how this new understanding could add to the way we understand age-related diseases including type 2 diabetes, cancer, and neurodegenerative diseases at the genomic, proteomic, and drug-development levels.

Authors

Brendan Miller, Su-Jeong Kim, Hiroshi Kumagai, Kelvin Yen, Pinchas Cohen

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Cellular senescence: a key therapeutic target in aging and diseases
Lei Zhang, … , Paul D. Robbins, Yi Zhu
Lei Zhang, … , Paul D. Robbins, Yi Zhu
Published August 1, 2022
Citation Information: J Clin Invest. 2022;132(15):e158450. https://doi.org/10.1172/JCI158450.
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Cellular senescence: a key therapeutic target in aging and diseases

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Abstract

Cellular senescence is a hallmark of aging defined by stable exit from the cell cycle in response to cellular damage and stress. Senescent cells (SnCs) can develop a characteristic pathogenic senescence-associated secretory phenotype (SASP) that drives secondary senescence and disrupts tissue homeostasis, resulting in loss of tissue repair and regeneration. The use of transgenic mouse models in which SnCs can be genetically ablated has established a key role for SnCs in driving aging and age-related disease. Importantly, senotherapeutics have been developed to pharmacologically eliminate SnCs, termed senolytics, or suppress the SASP and other markers of senescence, termed senomorphics. Based on extensive preclinical studies as well as small clinical trials demonstrating the benefits of senotherapeutics, multiple clinical trials are under way. This Review discusses the role of SnCs in aging and age-related diseases, strategies to target SnCs, approaches to discover and develop senotherapeutics, and preclinical and clinical advances of senolytics.

Authors

Lei Zhang, Louise E. Pitcher, Matthew J. Yousefzadeh, Laura J. Niedernhofer, Paul D. Robbins, Yi Zhu

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Metabolic changes in aging humans: current evidence and therapeutic strategies
Allyson K. Palmer, Michael D. Jensen
Allyson K. Palmer, Michael D. Jensen
Published August 15, 2022
Citation Information: J Clin Invest. 2022;132(16):e158451. https://doi.org/10.1172/JCI158451.
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Metabolic changes in aging humans: current evidence and therapeutic strategies

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Abstract

Aging and metabolism are inextricably linked, and many age-related changes in body composition, including increased central adiposity and sarcopenia, have underpinnings in fundamental aging processes. These age-related changes are further exacerbated by a sedentary lifestyle and can be in part prevented by maintenance of activity with aging. Here we explore the age-related changes seen in individual metabolic tissues — adipose, muscle, and liver — as well as globally in older adults. We also discuss the available evidence for therapeutic interventions such as caloric restriction, resistance training, and senolytic and senomorphic drugs to maintain healthy metabolism with aging, focusing on data from human studies.

Authors

Allyson K. Palmer, Michael D. Jensen

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The Achilles’ heel of cancer survivors: fundamentals of accelerated cellular senescence
Shameel Shafqat, … , Areez Shafqat, Shahrukh K. Hashmi
Shameel Shafqat, … , Areez Shafqat, Shahrukh K. Hashmi
Published July 1, 2022
Citation Information: J Clin Invest. 2022;132(13):e158452. https://doi.org/10.1172/JCI158452.
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The Achilles’ heel of cancer survivors: fundamentals of accelerated cellular senescence

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Abstract

Recent improvements in cancer treatment have increased the lifespan of pediatric and adult cancer survivors. However, cancer treatments accelerate aging in survivors, which manifests clinically as the premature onset of chronic diseases, such as endocrinopathies, osteoporosis, cardiac dysfunction, subsequent cancers, and geriatric syndromes of frailty, among others. Therefore, cancer treatment–induced early aging accounts for significant morbidity, mortality, and health expenditures among cancer survivors. One major mechanism driving this accelerated aging is cellular senescence; cancer treatments induce cellular senescence in tumor cells and in normal, nontumor tissue, thereby helping mediate the onset of several chronic diseases. Studies on clinical monitoring and therapeutic targeting of cellular senescence have made considerable progress in recent years. Large-scale clinical trials are currently evaluating senotherapeutic drugs, which inhibit or eliminate senescent cells to ameliorate cancer treatment–related aging. In this article, we survey the recent literature on phenotypes and mechanisms of aging in cancer survivors and provide an up-to-date review of the major preclinical and translational evidence on cellular senescence as a mechanism of accelerated aging in cancer survivors, as well as insight into the potential of senotherapeutic drugs. However, only with time will the clinical effect of senotherapies on cancer survivors be visible.

Authors

Shameel Shafqat, Evelyn Arana Chicas, Areez Shafqat, Shahrukh K. Hashmi

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Biological aging processes underlying cognitive decline and neurodegenerative disease
Mitzi M. Gonzales, … , Ellen Kraig, Miranda E. Orr
Mitzi M. Gonzales, … , Ellen Kraig, Miranda E. Orr
Published May 16, 2022
Citation Information: J Clin Invest. 2022;132(10):e158453. https://doi.org/10.1172/JCI158453.
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Biological aging processes underlying cognitive decline and neurodegenerative disease

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Abstract

Alzheimer’s disease and related dementias (ADRD) are among the top contributors to disability and mortality in later life. As with many chronic conditions, aging is the single most influential factor in the development of ADRD. Even among older adults who remain free of dementia throughout their lives, cognitive decline and neurodegenerative changes are appreciable with advancing age, suggesting shared pathophysiological mechanisms. In this Review, we provide an overview of changes in cognition, brain morphology, and neuropathological protein accumulation across the lifespan in humans, with complementary and mechanistic evidence from animal models. Next, we highlight selected aging processes that are differentially regulated in neurodegenerative disease, including aberrant autophagy, mitochondrial dysfunction, cellular senescence, epigenetic changes, cerebrovascular dysfunction, inflammation, and lipid dysregulation. We summarize research across clinical and translational studies to link biological aging processes to underlying ADRD pathogenesis. Targeting fundamental processes underlying biological aging may represent a yet relatively unexplored avenue to attenuate both age-related cognitive decline and ADRD. Collaboration across the fields of geroscience and neuroscience, coupled with the development of new translational animal models that more closely align with human disease processes, is necessary to advance novel therapeutic discovery in this realm.

Authors

Mitzi M. Gonzales, Valentina R. Garbarino, Erin Pollet, Juan P. Palavicini, Dean L. Kellogg Jr., Ellen Kraig, Miranda E. Orr

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