Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, Minnesota 55905, USA.
Endocrinology. 2021 Aug 1;162(8). doi: 10.1210/endocr/bqab058.
Therapeutics that target cellular senescence, including novel "senolytic" compounds, hold significant promise for treating or preventing obesity-induced metabolic dysfunction, type 2 diabetes, and the multiple complications of diabetes and obesity. Senolytics selectively clear senescent cells, which accumulate with aging and obesity and represent a fundamental mechanism of aging that contributes to metabolic dysfunction and diabetes pathogenesis. In addition to improving metabolic function, targeting senescent cells holds promise as a preventive strategy to reduce the incidence and severity of diabetes complications. The intermittent administration schedule used for senolytic therapy may confer benefits in terms of improving adherence and limiting adverse effects. It is necessary to design effective clinical trials that will safely translate discoveries from preclinical models into human studies that may pave the way for a novel therapeutic class for treating obesity, diabetes, and their complications. In this review, we outline what is known regarding the role of cellular senescence in the pathogenesis of type 2 diabetes and its complications, present evidence from preclinical models that targeting cellular senescence is beneficial, review senolytic drugs, and outline the features of clinical trials investigating the role of targeting senescent cells for diabetes.
靶向细胞衰老的治疗方法,包括新型“衰老细胞清除剂”化合物,为治疗或预防肥胖引起的代谢功能障碍、2 型糖尿病以及糖尿病和肥胖的多种并发症提供了巨大的希望。衰老细胞清除剂选择性地清除衰老细胞,这些细胞随着衰老和肥胖而积累,是导致代谢功能障碍和糖尿病发病机制的衰老的基本机制。除了改善代谢功能外,靶向衰老细胞作为一种预防策略,有望降低糖尿病并发症的发生率和严重程度。衰老细胞清除剂的间歇性给药方案可能在提高依从性和限制不良反应方面具有益处。有必要设计有效的临床试验,将临床前模型中的发现安全地转化为人类研究,为治疗肥胖、糖尿病及其并发症开辟新的治疗途径。在这篇综述中,我们概述了细胞衰老在 2 型糖尿病及其并发症发病机制中的作用,介绍了来自临床前模型的证据,证明靶向细胞衰老具有益处,回顾了衰老细胞清除剂,并概述了针对衰老细胞在糖尿病中作用的临床试验的特点。