Since 16th-century explorers set sail in search of an elusive “fountain of youth,” humans have yearned for ways to turn back the clock. Today, science is closer than it has ever been to unlocking the secrets of aging—thanks, potentially, to an emerging class of drugs called senolytics.
Senescent cells, sometimes called “zombie cells,” stop replicating over time and can be removed by the immune system, but otherwise do not die. Instead, they pile up in the body and, through inflammation and other biological processes, speed up aging and physical deterioration.
Senolytics takes aim at these cells. In turn, the hope is they can prevent, stall and treat many connected diseases of age—from cancer to frailty—with a single treatment.
“We know 2% of what we need to know. This is a completely new area of medicine. If it works, it would change everything.”
Senolytic supplements, such as fisetin and quercetin, are everywhere—from your local pharmacy and supermarket shelves to your social media feed. You might be tempted to see what they can do for you: After all, many of us would love to get back the energy we had in college or the knees we used to run with in high school. Experts, though, encourage extreme caution with the drugs.
“People have to be very, very concerned about what they buy,” said James Kirkland, MD, director of Cedars-Sinai’s new Center for Advanced Gerotherapeutics. “Don’t take advice over the internet and pay exorbitant prices for things that may or may not work.”
In fact, he stressed that most should avoid senolytics altogether, “until and unless we have really rigorous, reproducible scientific data that pharmaceutical regulators and the medical community accept.”
More Harm Than Good
Nicolas Musi Gomez, MD
IM Endocrinology
Over-the-counter supplements aren’t regulated by the FDA, so they aren’t held to the same standard as approved medications. Regardless of what is advertised, you can’t be sure of their ingredients, quality or compound amounts, especially if bought online.
Senolytic supplements are typically sold at much lower doses than needed to be effective, according to Cedars-Sinai Translational Research Vice Chair Nicolas Musi, MD.
“Some interventions that target fundamental aging processes could even cause a lot of harm,” Kirkland warned.
These pills could interfere with other medications you take or how your body metabolizes them—even if they are “natural” products that seem harmless—and cause unexpected side effects. Each body is different: Scientists have also found extremely varied responses to how some senolytic drugs are absorbed across ethnic groups.
Experts recommend consulting with your doctor, or a trained pharmacist or clinical pharmacologist, before taking any new treatment or even lifestyle steps. That includes rigid diets or caloric restriction, which can have similarly diverse effects.
Despite its vast promise, there are still more questions than answers about senolytics.
“We know 2% of what we need to know,” explained Kirkland, a pioneer in the field. “This is a completely new area of medicine. If it works, it would change everything.”
Safely Incorporating Senolytics
Senolytics could be crucial for patients who have serious conditions, including diabetes, osteoporosis, and skin or rheumatologic diseases, according to experts, because some already-approved drugs (metformin, for example) also could be “geroprotective.” They recommend asking your doctor about possibly swapping them for your current drug regimen.
Certain patients—and even future generations—could benefit from a clinical trial at an academic medical center.
“Currently, good manufacturing practices for senolytics can only really be obtained through a research protocol,” explained Musi, who is also director of Cedars-Sinai’s Diabetes and Aging Center and the Kathi and Gary Cypres Chair in Diabetes Research.
His team is studying a cocktail of senolytic drugs, investigating their safety and potential to remove senescent cells in healthy people. Another trial is investigating if exercise and nutrition can lower senescence. Researchers are exploring their impact on measures such as bone density, glucose, inflammation, and lung, kidney and muscle function. The goal is to treat diabetes and age-related diseases, and ultimately live longer, healthier lives.
In the meantime, Musi suggests living well now: Common fruits such as apples and strawberries are loaded with anti-aging properties.
“Some exercise is always recommended for everyone,” Musi said, “so, that is something people can do to promote their health, health span and longevity.”
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