The Blog

Building a Future Free of Age-Related Disease

Astrocytes

Mice With Reduced Astrocytic Oxidative Stress Live Longer

Scientists have discovered that directly reducing the production of reactive oxygen species (ROS) at their source in astrocytes, mitochondrial complex III, improves neuronal health and significantly increases lifespan in a mouse model of Alzheimer’s [1].

Dangerous species

Reactive oxygen species (ROS) are short-lived, highly reactive oxygen-containing molecules such as superoxide and hydrogen peroxide that are formed as byproducts of normal metabolism, particularly in mitochondria. In small numbers, ROS can be important signaling molecules, but excessive ROS levels trigger oxidative stress, which damages proteins, lipids, and DNA. Oxidative stress has been found to play a major role in age-related conditions, including dementia [2].

Scientists have proposed various antioxidant strategies, and some antioxidants have become popular supplements. The human body also produces natural antioxidants, such as glutathione. However, those scavengers cannot neutralize ROS immediately at the sites of production, so some damage is inevitable [3]. In a new study published in Nature Metabolism, researchers from Weill Cornell Medical College and other institutions attempted a novel, highly targeted approach to brain ROS.

“Decades of research implicate mitochondrial ROS in neurodegenerative diseases,” said Dr. Adam Orr, an assistant professor of research in neuroscience at the Feil Family Brain and Mind Research Institute at Weill Cornell, who co-led this study. “But most antioxidants tested in clinical studies have failed. That lack of success might be related to the inability of antioxidants to block ROS at their source and do so selectively without altering cell metabolism.”

Patching the leak at the source

The same team previously identified small molecules that can target mitochondrial ROS right where they are generated. They call these molecules site-selective electron-leak suppressors (SELs): S3QELs (pronounced “sequels”) for the complex III site and S1QELs (pronounced “cycles”) for the complex I site.

Trying to understand the role of astrocytes, a type of supportive brain cell, in brain pathologies, the researchers exposed them to disease-relevant cues, such as the inflammatory cytokine IL-1α and oligomeric amyloid-β (Aβ), a hallmark of Alzheimer’s disease. Both of these compounds increased mitochondrial hydrogen peroxide (H₂O₂), a major ROS, indicating stimulus-dependent ROS generation at complex III. S3QELs blunted these increases while preserving ATP production.

Importantly, the researchers mapped specific protein cysteine oxidations, showing that ROS produced at complex III serve as signaling inputs. Under pathological cues, however, this signaling becomes overactive, amplifying disease-associated transcriptional changes in astrocytes.

In neuron-astrocyte co-cultures, astrocytes primed to produce complex-III ROS made nearby neurons fare worse than neurons paired with quiescent astrocytes. Crucially, applying S3QELs to the astrocytes (not the neurons) attenuated neuronal harm. The effect also held in a conditioned medium, meaning that neuronal injury was largely driven by the molecules that astrocytes secrete downstream of complex-III ROS.

Interestingly, results differed when neurons were co-cultured with microglia, the brain’s resident macrophages. Primed microglia could also harm neurons, but dialing down complex-III ROS with S3QELs did not rescue neurons the way it did in the astrocyte–neuron setup. The authors suggest that in microglia, neuronal injury depends less on complex-III ROS and more on other pathways.

Longer lifespan in an Alzheimer’s model

Finally, the researchers moved to an in vivo tauopathy model: PS19 mice expressing human tauP301S. In pharmacokinetics experiments, S3QEL2 crossed the blood-brain barrier and was generally well tolerated.

Mice given a six-week bolus regimen (yielding higher brain exposure) showed significantly lower hippocampal phosphorylated tau and reductions in several inflammation markers compared to controls. With chronic chow dosing, pathology effects were minimal and attributed to much lower brain levels compared with bolus feeding. However, in a lifespan cohort, chow-dosed mice still lived longer than controls: median lifespan increased by about 17%, and the oldest ages reached increased by 19.9%; of course, PS19 mice have markedly shorter lifespans than wild-type mice.

The idea of suppressing ROS production at the source may have broader applications. “I’m really excited about the translational potential of this work,” said Dr. Anna Orr, the Nan and Stephen Swid Associate Professor of Frontotemporal Dementia Research at the Feil Family Brain and Mind Research Institute and member of the Appel Alzheimer’s Disease Research Institute at Weill Cornell, who co-led this research. “We can now target specific mechanisms and go after the exact sites that are relevant for disease.”

We would like to ask you a small favor. We are a non-profit foundation, and unlike some other organizations, we have no shareholders and no products to sell you. All our news and educational content is free for everyone to read, but it does mean that we rely on the help of people like you. Every contribution, no matter if it’s big or small, supports independent journalism and sustains our future.

Literature

[1] Barnett, D., Zimmer, T.S., Booraem, C. et al. (2025). Mitochondrial complex III-derived ROS amplify immunometabolic changes in astrocytes and promote dementia pathology. Nat Metab.

[2] Perluigi, M., Di Domenico, F., & Butterfield, D. A. (2023). Oxidative damage in neurodegeneration: roles in the pathogenesis and progression of Alzheimer disease. Physiological Reviews.

[3] Watson, M. A., Wong, H. S., & Brand, M. D. (2019). Use of S1QELs and S3QELs to link mitochondrial sites of superoxide and hydrogen peroxide generation to physiological and pathological outcomes. Biochemical Society Transactions, 47(5), 1461-1469.

Insilico Medicine

Insilico Unveils Portfolio of Unique Cardiometabolic Assets

Nov 7, 2025 – Insilico Medicine (“Insilico”), a clinical-stage generative artificial intelligence (AI)-driven drug discovery and development company, today announced the launch of its innovative cardiometabolic disease portfolio of unique highly-differentiated molecules discovered using generative AI.

Powered by Insilico’s proprietary end-to-end Pharma.AI platform, the portfolio covers a range of diverse mechanisms and stages from early discovery to preclinical development. It consists of eight oral small molecules with unique properties designed to unlock the full potential of established high-confidence targets such as GLP-1R, GIPR, Amylin, APJ, and Lp(a), as well as moderate-novelty targets such as NLRP3 and NR3C1. The two novel GLP-1RAs are designed for improved safety and pharmacokinetics at low dose to allow for multi-pill combinations with the other molecules in the portfolio. One of the GLP-1RAs is designed to sustain once-weekly (QW) dosing.

“Cardiometabolic and antiobesity drugs such as GLP-1RAs may be the first wave of longevity therapeutics increasing both healthspan and lifespan in a large population. With our cardiometabolic strategy we decided to choose several established and moderate-novelty targets but deliver a high level of differentiation through novelty in chemistry focusing on properties to help unlock the full potential of the targets in a variety of diseases and biologic processes and allow for combinations at low dose. Our multi-parameter optimized GLP-1RAs are oral small molecules with very high level of preclinical safety tested in multiple species and unique molecular structure that can potentially sustain once a week (QW) dosing” said Alex Zhavoronkov, PhD, founder and CEO of Insilico Medicine.

Insilico’s Diverse AI-Powered Pipeline for Cardiometabolic Disease Innovation

The introduction of Insilico’s new cardiometabolic portfolio, powered by its Pharma.AI platform, features eight programs targeting seven distinct targets, spanning from lead optimization to IND-enabling stages.

At the center of the portfolio’s lineup are two oral small-molecule candidate agonists targeting the GLP-1 receptor (GLP-1RAs), which have reached preclinical candidate (PCC) stage and form the basis of the portfolio’s metabolic effects designed for mono- and combination therapy with the other molecules. Also nearing the PCC stage, a small molecule targeting NR3C1 is designed to treat hypercortisolism-associated metabolic diseases.

In the early stages of the R&D pipeline, four additional programs targeting GIPR, Amylin, APJ, and Lp(a) are currently in the lead optimization phase. AI-driven development has led to significant differentiation and enhanced properties compared to existing therapies.

Rounding out the newly disclosed programs, ISM8969 stands out as the most advanced candidate, having recently completed IND-enabling studies. ISM8969 is a potentially best-in-class, highly selective, orally available, and brain-penetrant small molecule inhibitor of NLRP3, designed primarily for the treatment of inflammatory and central nervous system (CNS) diseases.

Insilico Cardiometabolic

For more details, please contact: BD@insilico.com

The portfolio is centered around the following targets:

GLP-1RA (QD); Stage: IND-enabling

This is a fully biased once-daily oral GLP-1R agonist that combines low microsomal clearance with minimal CYP inhibition, favorable cross-species pharmacokinetics, delivering favorable long-term anti-obesity efficacy alongside acute food-intake and glucose-control effects.

GLP-1R (QW); Stage: Pre-Developmental Candidate

This is a fully biased oral GLP-1R agonist engineered for once-weekly dosing, offering high solubility, extremely low metabolic and systemic clearance, long predicted half-life supporting the potential for weekly dosing with weight-loss efficacy comparable or superior to daily existing oral GLP-1R agonist.

NR3C1; Stage: Close to Preclinical Candidate

Insilico’s NR3C1 antagonist is a proprietary, selective glucocorticoid receptor blocker that delivers strong solubility, permeability, and no CYP3A4 inhibition. Improved pharmacokinetic properties compared to other NR3C1 inhibitors, with significantly higher exposure and improved in vivo efficacy, translate into stronger low-dose efficacy in reversing cortisol-induced metabolic dysfunction and enhancing semaglutide-mediated weight loss, positioning it for orphan-eligible Cushing’s syndrome and broader hypercortisolism-linked metabolic diseases.

NLRP3; Stage: IND-enabling

This is an orally bioavailable, brain-penetrant small molecule that selectively and potently inhibits NLRP3, shows a promising in vitro safety/PK profile, and delivers robust efficacy across preclinical models of Parkinson’s disease, peritonitis, pancreatitis, multiple sclerosis, collectively giving it a differentiated edge over largely peripherally restricted competitor compounds.

Dual Amylin and Calcitonin Receptor Agonist; Stage: Lead Identification

This program features a potent dual amylin and calcitonin receptor agonist (DACRA) designed to deliver synergistic metabolic benefits by enhancing satiety, reducing food intake, and improving glycemic control. The molecule exhibits novel structure and high receptor potency.

GIPR; Stage: Lead Optimization

The next-generation GIP receptor (GIPR) antagonist is designed to complement GLP-1–based therapies by enhancing insulin secretion, improving lipid metabolism, and amplifying weight-loss efficacy. Leveraging Insilico’s generative AI design capabilities, the molecule exhibits high predicted receptor selectivity, optimized metabolic stability, and favorable oral bioavailability. It is being advanced to achieve synergistic efficacy and improved tolerability in multi-drug combinations, positioning it as a differentiated candidate for obesity and type 2 diabetes treatment.

APJ; Stage: Lead Optimization

Selective activation of the APJ G-protein signaling pathway yields cardiovascular benefits, reduces inflammation, and improves metabolic profiles. In contrast, simultaneous activation of both G protein and β-arrestin pathways may cause cardiac hypertrophy and increased inflammation, while receptor desensitization can compromise long-term efficacy. Utilizing Insilico’s generative AI and multi-parameter optimization framework, the ISM molecule was designed as a potent and highly biased APJ agonist with novel scaffold, showing promise for enhanced safety and therapeutic outcomes. The lead compound lowered blood glucose, promoted body weight loss, and improved lean mass ratio in DIO mice following oral administration, overcoming limitations associated with non-biased agonists.

Lp(a); Stage: Lead Optimization

This molecule features a novel structure which exhibits superior in vivo pharmacokinetic profiles, with higher AUC and longer half-life in animal studies. It demonstrates comparable in vivo efficacy with the clinically validated Lp(a) lowering candidate achieving a reduction in Lp(a) levels in transgenic mouse models, equivalent to the clinically validated candidate. The safety profile is improved, showing significantly less off-target plasminogen inhibition after 5-day BID dosing.

“The AI revolution in drug discovery is no longer theoretical, as demonstrated by our clinical-stage programs in fibrosis, oncology, and inflammation,” said Feng Ren, PhD, Co-CEO and Chief Scientific Officer of Insilico Medicine. “By harnessing our proven generative AI platform to address the complexity of cardiometabolic disease, we are committed to accelerating the discovery and development of differentiated therapies that will benefit millions of patients worldwide and help people live longer and healthier.”

Setting the Benchmark: Insilico’s Breakthroughs in AI-Powered Therapeutics

Since pioneering next-generation AI in drug discovery, Insilico Medicine has built an extensive therapeutic portfolio across high-demand therapeutic areas, rapidly advancing its internal R&D pipeline and setting a new industry benchmark for efficiency. Traditionally, early-stage drug discovery can take 2.5 to 4 years, while Insilico has nominated 22 preclinical candidates at an average pace of just 12 to 18 months per program, synthesizing and testing only 60 to 200 molecules each, which highlights the exceptional capabilities of its AI-driven platform and expert multidisciplinary validation teams.

Within the company’s clinical-stage programs, Rentosertib, the world’s first AI-discovered novel-mechanism anti-fibrotic candidate, has completed Phase 2a proof-of-concept clinical trial, demonstrating promising efficacy trends and a favorable safety profile. ISM5411, the PHD1/2 inhibitor with best-in-class potential for treating inflammatory bowel disease (IBD) has completed two Phase I trials, showing good safety and a gut-restricted PK profile. Additionally, three of Insilico’s anti-tumor programs have now reached the first-in-patient dosing stage, with interim results expected in the near future.

In recent years, Insilico has steadily increased its investment in cutting-edge research, remaining dedicated to sharing its discoveries through peer-reviewed publications. Since the beginning of 2024, the company has published 6 papers in the Nature portfolio:

In March 2024, Insilico published in Nature Biotechnology the journey of the Rentosertib program from inception to Phase 1 clinical trials, along with part of experimental data. In December 2024, Insilico published in Nature Biotechnology the AI-enabled preclinical research journey and partial experimental data for the gut-restricted PHD1/2 inhibitor ISM5411. In January 2025, Insilico, together with partners including the University of Toronto, published research in Nature Biotechnology on exploring generative AI with a quantum-classical hybrid model to design novel KRAS inhibitors. In May 2025, Insilico published collaborative research in Nature Communications on AI-enabled development of pan-coronavirus inhibitors. In the same month, Insilico published another Nature Communications paper on AI-enabled development of next-generation ENPP1 inhibitors for innate immune modulation. Most recently, in June 2025, Insilico reported the Phase IIa clinical result of Rentosertib in a Nature medicine paper.

Leveraging sustained scientific breakthroughs at the intersection of biotechnology, artificial intelligence, and automation, Insilico ranked Top 100 global corporate institutions in Nature Index‘s “2025 Research Leaders: global corporate institutions for biological sciences and natural sciences publications”.

About Insilico Medicine

Insilico Medicine, a leading and global AI-driven biotech company, utilizes its proprietary Pharma.AI platform and cutting-stage automated laboratory to accelerate drug discovery and advance innovations in life sciences research. By integrating AI and automation technologies and deep in-house drug discovery capabilities, Insilico is delivering innovative drug solutions for unmet needs including fibrosis, oncology, immunology, pain, and obesity and metabolic disorders. Additionally, Insilico extends the reach of Pharma.AI across diverse industries, such as advanced materials, agriculture, nutritional products and veterinary medicine.

For more information, visit www.insilico.com.

Media Contact: media@insilicomedicine.com.

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Finding a specific gene

EDA2R May Be an Aging Biomarker and Inflammaging Target

A review in Aging Cell has cataloged the harmful effects of EDA2R, a protein that affects three distinct inflammation-related pathways.

A necessary protein gone bad

Like nearly every other protein with documented harmful effects, this one is required for certain systems to function properly. The EDA gene is needed for proper skin development [1] and hair follicle creation [2], and animals with mutated forms of this gene suffer from ectodermal dysplasia, which causes severe malformations in these areas [3].

However, this gene is a member of the tumor necrosis factor (TNF) superfamily [4], which provides a hint as to its potential undesirable effects; TNF-α is a well-known inflammatory biomarker. As previous work has linked EDA2R to muscle atrophy in cancer [5] and some evidence has already suggested that it may be a biomarker of aging [6], these reviewers have gone through the literature to determine what this gene and its protein are doing.

Beyond the skin

As expected, initial work on EDA2R has found that this gene is expressed in the hair and skin [7]. Further work found that it is expressed in the fat, vasculature, and immune system [8], and a comprehensive tissue expression database found that it is highly expressed in the reproductive and endocrine systems along with many other organs. This gene is located close to androgen-related genes on the X chromosome, so it is unsurprising that it has related effects involving male pattern baldness [9] and that its tissue expression varies between men and women [10]; that particular study also pinpointed EDA2R as a potential biomarker of aging. Furthermore, and perhaps more crucially, its genetic locus has been found to be associated with lipid and lipoprotein metabolism [11].

There are three different pathways by which EDA2R appears to lead to inflammaging. Through TRAF6, the well-known canonical NF-κB pathway and the JNK pathway can be activated, but a different ligand, TRAF3, activates the non-canonical NF-κB pathway. All three of these pathways have been documented to be involved in inflammation [12-14].

EDA2R pathways

There have been several studies suggesting a direct relationship between EDA2R and both inflammatory and age-related diseases. Overexpression of EDA2R is associated with an overexpression of lipids related to acne [15], and it is increased in progeria as well [10]. Another study found that its overexpression is related to many other lipid-related disorders, including characteristics of obesity along with metabolic issues; that study also found a related increase in inflammation [16]. There has also been a documented, significant relationship between EDA2R and frailty [17].

The researchers sum up these findings: “Collectively, the evidence from diverse cohorts, animal models and clinical studies underscores EDA2R gene expression as a robust and versatile biomarker of multiple interconnected pathophysiological processes.”

Further work appears to agree with this assessment. One study that used UK Biobank data found that the EDA2R protein is associated with premature aging, including both frailty and multiple epigenetic aging clocks, such as PhenoAge, along with having a negative healthspan association [18]. A different study found it to be associated with a broad range of cancers [19], another study found it to be linked to metabolic disorders such as diabetes [20], and yet another found a link between EDA2R and dementia [21].

A potentially difficult target

The reviewers took some time to discuss the physical intricacies of EDA2R as a protein, including its shape and the protein it binds to. They note its similarities to EDAR and that there are only two amino acid residues that distinguish the two, which may make it more difficult to develop a drug that targets EDA2R without affecting EDAR. The protein’s folded structure has also not been conclusively determined, although AI-based systems such as AlphaFold have made good guesses and it is possible to use expensive but slow microscopy techniques to have a definitive answer.

However, there are some existing techniques that appear to decrease EDA2R. A mouse study found that ginkgolide B decreases the expression of the gene’s murine counterpart [22], while human studies have found that excessive bed rest increases it [23] while fasting decreases it [24]. This suggests that it may be modulated by the same general treatment recommended everywhere: diet and exercise.

We would like to ask you a small favor. We are a non-profit foundation, and unlike some other organizations, we have no shareholders and no products to sell you. All our news and educational content is free for everyone to read, but it does mean that we rely on the help of people like you. Every contribution, no matter if it’s big or small, supports independent journalism and sustains our future.

Literature

[1] Mikkola, M. L. (2008). TNF superfamily in skin appendage development. Cytokine & growth factor reviews, 19(3-4), 219-230.

[2] Lee, J., & Tumbar, T. (2012, October). Hairy tale of signaling in hair follicle development and cycling. In Seminars in cell & developmental biology (Vol. 23, No. 8, pp. 906-916). Academic Press.

[3] Katthika, V. K., & Auerkari, E. I. (2018, May). Ectodermal Dysplasia. In 11th International Dentistry Scientific Meeting (IDSM 2017) (pp. 230-238). Atlantis Press.

[4] Dostert, C., Grusdat, M., Letellier, E., & Brenner, D. (2019). The TNF family of ligands and receptors: communication modules in the immune system and beyond. Physiological reviews, 99(1), 115-160.

[5] Bilgic, S. N., Domaniku, A., Toledo, B., Agca, S., Weber, B. Z., Arabaci, D. H., … & Kir, S. (2023). EDA2R–NIK signalling promotes muscle atrophy linked to cancer cachexia. Nature, 617(7962), 827-834.

[6] Arif, M., Lehoczki, A., Haskó, G., Lohoff, F. W., Ungvari, Z., & Pacher, P. (2025). Global and tissue-specific transcriptomic dysregulation in human aging: Pathways and predictive biomarkers. GeroScience, 1-20.

[7] Bergqvist, C., Ramia, P., Abbas, O., & Kurban, M. (2017). Genetics of syndromic and non‐syndromic hereditary nail disorders. Clinical Genetics, 91(6), 813-823.

[8] Kanoni, S., Graham, S. E., Wang, Y., Surakka, I., Ramdas, S., Zhu, X., … & Leonard, H. L. (2022). Implicating genes, pleiotropy, and sexual dimorphism at blood lipid loci through multi-ancestry meta-analysis. Genome biology, 23(1), 268.

[9] Prodi, D. A., Pirastu, N., Maninchedda, G., Sassu, A., Picciau, A., Palmas, M. A., … & Pirastu, M. (2008). EDA2R is associated with androgenetic alopecia. Journal of Investigative Dermatology, 128(9), 2268-2270.

[10] Barbera, M. C., Guarrera, L., Re Cecconi, A. D., Cassanmagnago, G. A., Vallerga, A., Lunardi, M., … & Bolis, M. (2025). Increased ectodysplasin-A2-receptor EDA2R is a ubiquitous hallmark of aging and mediates parainflammatory responses. Nature Communications, 16(1), 1898.

[11] Zoodsma, M., Beuchel, C., Yasmeen, S., Kohleick, L., Nepal, A., Koprulu, M., … & Langenberg, C. (2025). A genetic map of human metabolism across the allele frequency spectrum. Nature Genetics, 1-11.

[12] Moneva-Sakelarieva, M., Kobakova, Y., Konstantinov, S., Momekov, G., Ivanova, S., Atanasova, V., … & Atanasov, P. (2025). The role of the transcription factor NF-kB in the pathogenesis of inflammation and carcinogenesis. Modulation capabilities. Pharmacia, 72, 1-13.

[13] Wu, N., Wang, S., Zhang, Y., & Wang, S. (2025). Research Progress on Anti-Inflammatory Mechanism of Inula cappa. International Journal of Molecular Sciences, 26(5), 1911.

[14] Kaltschmidt, C., Greiner, J. F., & Kaltschmidt, B. (2021). The transcription factor NF-κB in stem cells and development. Cells, 10(8), 2042.

[15] Kwack, M. H., Hamida, O. B., Lee, W. J., & Kim, M. K. (2024). EDA-A2 increases lipid production in EDA2R-expressing human sebocytes. Journal of Dermatological Science, 113(1), 34-37.

[16] Arif, M., Lehoczki, A., Haskó, G., Lohoff, F. W., Ungvari, Z., & Pacher, P. (2025). Global and tissue-specific transcriptomic dysregulation in human aging: Pathways and predictive biomarkers. GeroScience, 1-20.

[17[ Perez, K., Ciotlos, S., McGirr, J., Limbad, C., Doi, R., Nederveen, J. P., … & Melov, S. (2022). Single nuclei profiling identifies cell specific markers of skeletal muscle aging, frailty, and senescence. Aging (Albany NY), 14(23), 9393.

[18] Ma, L. Z., Liu, W. S., He, Y., Zhang, Y., You, J., Feng, J. F., … & Yu, J. T. (2025). Plasma proteomics identify novel biomarkers and dynamic patterns of biological aging. Journal of Advanced Research.

[19] Papier, K., Atkins, J. R., Tong, T. Y., Gaitskell, K., Desai, T., Ogamba, C. F., … & Travis, R. C. (2024). Identifying proteomic risk factors for cancer using prospective and exome analyses of 1463 circulating proteins and risk of 19 cancers in the UK Biobank. Nature Communications, 15(1), 4010.

[20] Qian, H., Wu, C., Li, B., Rosenzweig, A., & Wang, M. (2025). Plasma Proteomics Linking Primary and Secondary diseases: Insights into Molecular Mediation from UK Biobank Data. medRxiv, 2025-08.

[21] Gong, J., Williams, D. M., Scholes, S., Assaad, S., Bu, F., Hayat, S., … & Steptoe, A. (2025). Unraveling the role of proteins in dementia: insights from two UK cohorts with causal evidence. Brain Communications, 7(2), fcaf097.

[22] Lee, C. W., Wang, B. Y. H., Wong, S. H., Chen, Y. F., Cao, Q., Hsiao, A. W. T., … & Lee, O. K. S. (2025). Ginkgolide B increases healthspan and lifespan of female mice. Nature aging, 5(2), 237-258.

[23] Fernandez‐Gonzalo, R., Tesch, P. A., Lundberg, T. R., Alkner, B. A., Rullman, E., & Gustafsson, T. (2020). Three months of bed rest induce a residual transcriptomic signature resilient to resistance exercise countermeasures. The FASEB Journal, 34(6), 7958-7969.

[24] Pietzner, M., Uluvar, B., Kolnes, K. J., Jeppesen, P. B., Frivold, S. V., Skattebo, Ø., … & Langenberg, C. (2024). Systemic proteome adaptions to 7-day complete caloric restriction in humans. Nature metabolism, 6(4), 764-777.

IVF

Rapamycin May Delay Age-Related Fertility Decline

In a recent study, researchers identified that an increase in the expression of ribosome-related genes and a loss of protein homeostasis contribute to the age-related decline in female fertility. Rapamycin restored this balance and increased fertility rates in a human trial [1].

The first system to age

The loss of fertility is one of the first signs of aging in women, with the first signs of fertility decline occurring around the mid-thirties. This fertility decline is primarily attributed to decreased oocyte quality and quantity. However, many more molecular changes occur in the oocyte and the surrounding cells, such as cumulus and granulosa cells.

In this study, the researchers investigated molecular changes in aging oocytes and cumulus cells and tested a possible intervention for improving clinical fertility outcomes.

Loss of balance

Analyzing the gene expression of the oocytes and cumulus cell samples donated for this study, along with an independent cohort dataset of oocytes from women of different ages, showed age-related changes with a “distinct shift in oocyte gene expression profiles” that “emerged around the age of 34.” Among the various pathways that were impacted by age, the researchers specifically noted that increased age was correlated with an enrichment in ribosome signaling and increased expression of ribosome-related genes, suggesting a link between ribosome dysregulation and oocyte aging.

Cumulus cells showed even more age-related changes in gene expression. Among many affected processes, those related to ribosomes were also increased in aging cumulus cells.

Ribosomes are cell structures where the translation of RNA into protein occurs; therefore, disruptions in ribosome-related processes might suggest disrupted protein homeostasis, which is exactly what researchers have observed in the cumulus cells. Specifically, those cells showed the presence of protein aggregates. The authors suggest that such aggregates can be there for two reasons: an increase in synthesis or a decrease in degradation.

The researchers observed both problems. There was decreased gene expression relating to lysosomes and proteasomes, both of which play a role in protein degradation, and a decrease in the activity of lysosomes with age. 18S and 28S rRNAs, key structures in ribosomes, were increased with age in cumulus cells, which suggests a related increase in translation and protein synthesis. This was further confirmed by additional tests.

However, the researchers also noted that rapamycin, a well-known drug in the aging field, reduced the increase in age-related protein synthesis in cumulus cells, helping restore the disrupted protein homeostasis.

Regulating gene accessibility

Changes in gene expression can result from changes in DNA methylation. The researchers observed that DNA methylation levels were modestly increased in aging oocytes, and the pattern of changes suggests that methylation might be responsible for the age-related changes in gene expression in oocytes, at least for some genes.

Cumulus cells showed minimal changes in DNA methylation; however, the changes that were present suggested that they might impact the expression of ribosome-related genes.

Along the same lines, the researchers observed changes in chromatin composition. Chromatin is a DNA and protein complex. Changes in its composition can make genes more accessible (euchromatin) or less accessible (heterochromatin) for transcription.

The heterochromatin levels in cumulus cells differed in young and old cells, showing an overall decrease in the level of heterochromatin with age. In young cells, heterochromatin-rich areas were associated with genes related to ribosome biogenesis, while in the old cells, heterochromatin-rich regions were associated with negative regulation of translation. Additionally, heterochromatin levels related to ribosome-related genes were decreased in old cumulus cells. All this suggests that the transcription of ribosomal biogenesis- and translation-related genes might be inhibited at the chromatin level in young cells, but aging reduces this inhibition, resulting in increased transcription of ribosomal genes.

Such regulation on the chromatin composition level was also observed for the lysosome-related genes, and it was correlated with a decrease in the expression of lysosome-related genes.

Delaying fertility loss in mice

Since the researchers observed an increase in ribosome-related gene expression, which suggests an increase in translation in aged oocytes and cumulus cells, they hypothesized that decreasing these processes might help delay the reduction in fertility. They first tested this assumption in mice, which showed similarities in gene expression changes with humans.

Comparison of rapamycin-treated ovaries from young (2-month-old) and old (10-month-old) mice showed that rapamycin reduced translation and ribosome biogenesis. In old cells, rapamycin inhibited the activity of senescence-related markers and decreased reactive oxygen species (ROS) levels. Rapamycin also reduced chromosomal abnormalities that are increased in aged oocytes, which suggests that rapamycin helps to delay oocyte aging.

More babies

Most importantly, the researchers continued by conducting a controlled clinical trial with 100 women undergoing in vitro fertilization (IVF). Half of the participants received only the standardized GnRH agonist long protocol, a standard IVF treatment; the other half received the same treatment, combined with 1mg rapamycin treatment for 21-28 days.

The authors note that “significantly more zygotes, embryos, and good-quality embryos were obtained in the rapamycin group than in the control group.” Comparing oocyte retrieval and embryo development between the groups, the researchers concluded that rapamycin treatment “can effectively improve oocyte quality and subsequent embryo development following the fertilization of retrieved oocytes.”

They also observed higher rates of pregnancy in females who took rapamycin compared to controls (50.0% vs. 28.2%) without a negative impact on live birth. However, they note that when they compared data regarding different stages of embryo transfer, they observed that it might be more beneficial for patients who take rapamycin to transfer their embryos at the 5- to 6-day stage instead of the 3-day stage.

Real-life benefits

All in all, in this study, the researchers identified that increased levels of ribosome-related genes and disruptions in proteostasis have a negative impact on oocytes and surrounding cells, contributing to age-related fertility problems.

Using rapamycin to remedy those issues resulted in improved ovarian functioning and increased fertility not only in mouse models but in human females undergoing IVF. While the trial results are encouraging, the researchers suggest optimization of dosage and duration of treatment might yield even better effects; however, for this, a trial with a higher number of participants might be required.

We would like to ask you a small favor. We are a non-profit foundation, and unlike some other organizations, we have no shareholders and no products to sell you. All our news and educational content is free for everyone to read, but it does mean that we rely on the help of people like you. Every contribution, no matter if it’s big or small, supports independent journalism and sustains our future.

Literature

[1] Li, J., Wang, H., Zhu, P., Chen, H., Zuo, H., Liu, C., Liu, L., Ye, X., Feng, G., Wu, Y., Liu, Q., Yang, T., Keefe, D. L., Bai, X., Shang, W., Wu, X., & Liu, L. (2025). Ribosome dysregulation and intervention in age-related infertility. Cell reports. Medicine, 102424. Advance online publication.

Skin capillaries

Skin Aging Underlined by Loss of Capillary Macrophages

A new study ties the disappearance of capillary-associated macrophages to age-related vascular degeneration in the skin. Boosting their function with a growth factor offers a possible avenue for anti-aging interventions [1].

Macrophages, capillaries, and skin aging

Skin aging might not be the most dangerous aspect of aging, but it certainly is one of the most conspicuous. It also provides a valuable model for studying aging as a whole.

Skin thinning and pesky wrinkles have mutiple origins, including diminished blood supply from the capillaries that permeate the skin [2]. In this study published in Nature, researchers from New York University School of Medicine investigated the role of capillary-associated macrophages (CAMs): immune cells that reside near the capillaries, where they clean debris, fight pathogens, and facilitate tissue repair.

Aging tissues lose resident macrophages [3] and microvascular function, but how these are linked in living organisms is not clear. This study aimed to determine if CAMs in skin decline with age, if such a loss impairs capillary perfusion and repair, and if they can be restored.

In vivo imaging reveals waning function

The researchers used an ingenious technique for in vivo imaging, which allowed them to analyze blood flow and skin condition of live mice longitudinally, from 1 to 18 months of age. “Older tissues show fewer blood vessels,” said Kailin R. Mesa, currently assistant professor at Princeton and the study’s corresponding author. “To understand how these changes develop and lead to age-related dysfunction, we built a multiphoton light microscopy imaging system to track tissue aging in living mice.”

Time-lapse imaging showed that upper-dermal CAMs decline faster than epidermal or lower-dermal macrophages and faster than capillary rarefaction itself. Thus, “macrophage-deficient” vascular niches are created, with capillaries devoid of CAMs. These capillaries without nearby CAMs experience higher rates of obstructed red blood cell (RBC) flow.

Human skin samples analyzed by the researchers showed the same pattern: CAM decline outpaced capillary loss, implying diminished coverage with age. Acute macrophage depletion reduced blood flow even more. According to this paper, aging leads CAMs to significantly skew towards loss rather than proliferation, contributing to their decline.

Injury and a growth factor boost macrophage recruitment

The study also revealed that CAMs are required for capillary repair and preservation. Following precise laser clotting of single capillaries, nearby CAMs were rapidly recruited within about two days and engulfed RBC debris. Capillaries with local CAMs were significantly better at re-establishing blood flow after injury than CAM-devoid ones. Ablation of CAMs prior to clot induction impaired capillary repair, indicating their critical role in vascular recovery.

The researchers then applied larger laser wounds to the upper dermis or the overlying epidermis to test whether more serious tissue damage triggers CAM replenishment, which it did. “We found that large laser-induced epidermal damage resulted in a lasting increase in CAMs below the damaged regions compared with in the neighboring control regions,” the paper says. Basically, while CAMs hardly renew on their own in aging skin, the study suggests that environmental changes, such as injury, can stimulate CAM replenishment and enhance vascular function in older mice.

Colony-stimulating factor 1 (CSF1) is a growth cue that tells macrophages to survive and divide. The team used CSF1-Fc, an enhanced version that makes the signal hang around longer in tissue to test whether it can improve CAM function by micro-injecting it into the skin of old mice (20-24 months) once a day for four days. This treatment resulted in more capillary-associated macrophages (CAMs) lining the tiny vessels without noticeably changing the balance between long-lived resident cells and freshly recruited ones, which are derived from monocytes.

CSF1-Fc reduced the number of capillary segments with sluggish or blocked red blood cell flow at baseline, and when the researchers created pinpoint clots, treated areas cleared debris and reperfused more reliably over the next week. In other words, topping up the resident macrophage niche in old skin rejuvenated repair capacity. “We also found that dermal macrophage self-renewal and vascular support could be acutely enhanced in aged mice through local CSF1 therapeutic treatment,” the paper says.

The importance of this discovery goes beyond skin, since dense capillary beds in the brain, heart, kidney, and skeletal muscle are also maintained by perivascular macrophages. Their age-related decline probably produces the same pattern seen in skin: sluggish flow, failed micro-repairs, and gradual pruning of the network. Improving things in the macrophage niche might provide a general route to preserving microvascular health in multiple tissues and organs. “When macrophages disappear, skin blood vessels age. Loss of skin macrophages with age blocks blood vessel flow and clot repair, revealing a new cellular trigger of tissue aging,” said Mesa.

We would like to ask you a small favor. We are a non-profit foundation, and unlike some other organizations, we have no shareholders and no products to sell you. All our news and educational content is free for everyone to read, but it does mean that we rely on the help of people like you. Every contribution, no matter if it’s big or small, supports independent journalism and sustains our future.

Literature

[1] Mesa, K. R., O’Connor, K. A., Ng, C., Salvatore, S. P., Dolynuk, A., Lomeli, M. R., & Littman, D. R. (2025). Niche-specific dermal macrophage loss promotes skin capillary ageing. Nature, 1-9.

[2] Bentov, I., & Reed, M. J. (2015). The effect of aging on the cutaneous microvasculature. Microvascular research, 100, 25-31.

[3] Park, M. D., Yatim, N., Zhang, J., Cho, B. A., Yoo, S. K., Schaefer, M. M., … & Merad, M. (2025). Restoring resident tissue macrophages to combat aging and cancer. Nature Aging, 5(8), 1383-1392.

Rejuvenation Roundup October 2025

Rejuvenation Roundup October 2025

The trick-or-treaters have all gone home as the leaves have fallen to the ground, but rejuvenation biotech attempts to prevent human beings from fading away. Here’s what’s been done to fight aging in October.

Team and activities

Public Longevity GroupOur Campaign for Public Longevity: Public trust is the breakthrough that unlocks all others. The field of longevity science has long needed better tools to measure public sentiment in order to understand what drives that trust, and how to build it.

Thanks to your support, the Public Longevity Group (PLG) campaign is more than halfway to its goal, but there’s still time to make an even greater impact. We’re extending the campaign by two more weeks, with the LRI Board of Directors matching all donations up to $25,000 to push us across the finish line. That means every dollar you give will be doubled to support the launch of the first data-driven sentiment analysis engine for longevity science.

Interviews

Joe Betts-Lacroix InterviewJoe Betts-Lacroix on Retro Bio and Its Recent AI Advancement: Retro Biosciences was founded about five years ago by the tech entrepreneur Joe Betts-Lacroix with a $180 million investment from his friend Sam Altman, the CEO of OpenAI.

Sam Sharifi on Fixing Our DNA: Behind the vision of Sam Sharifi, PhD and Matter Bio’s Chief Scientific Officer, stands some serious science. Matter Bio has matured into a company with a pipeline and a cash flow.

Andrea Maier InterviewAndrea Maier on Longevity Medicine for All: Dr. Andrea Maier, Oon Chiew Seng Professor in Medicine at the National University of Singapore, is a veteran geroscientist and one of the most familiar faces in the rising field of longevity medicine. Andrea has been working on bringing longevity medicine to the public.

Advocacy and Analysis

Meet ALSAE: Improving the Cultural Image of Longevity: To challenge cultural stereotypes and misconceptions about longevity, a new organization aims to engage people who create culture. Its list of “cultural ambassadors” includes Oscar- and Grammy-winning artists.

Research Roundup

Dividing cellsCell Cycle Stage Impacts the Efficacy of Senotherapeutics: A recent study reported that the effectiveness of the senotherapeutic drug ABT-263 depends on the cell’s DNA content, which is based on the cell cycle phase at which the senescent cell was arrested.

Partial Reprogramming Enhances Nerve Repair in Rats: In Advanced Science, a team of researchers has explained how partial cellular reprogramming through the OSKM factors restores nerve repair ability to older animals.

RapamycinImpact of Off-Label Low-Dose Rapamycin on Healthy Adults: A team of scientists has concluded that there is no sufficient evidence that low-dose rapamycin use can extend healthspan and lifespan in healthy humans.

A Public Website for Evaluating Potential Anti-Aging Drugs: Researchers publishing in the International Journal of Molecular Sciences have showcased their creation of PASS GERO, a public-facing application that allows researchers to evaluate potential anti-aging compounds.

NanoparticlesNanoparticles Potently Reverse Alzheimer’s in Mice: Scientists have created polymersomes, a type of nanoparticle, that latch onto a master regulator of amyloid-beta clearance, diverting it towards a more efficient route.

Researchers Identify Key Age-Related Genes: In Aging Cell, researchers have described core genes that apply to a wide variety of species and appear to be causal drivers of aging.

Naked mole ratsWhy Naked Mole Rats Have Better DNA Repair: Scientists have found that the cGAS protein in naked mole rats, a famously long-lived species, boosts DNA repair, while the human version tends to hamper it. The difference boils down to just four amino acids.

Interventions Testing Program Finds Three New Compounds: A new report from the Interventions Testing Program adds three new compounds to the list of lifespan-extending compounds confirmed during their experiments: epicatechin, halofuginone, and mitoglitazone.

Infrared lampInfrared Lasers Clear Harmful Compounds in Mouse Brains: Researchers have discovered that infrared lasers promote the clearance of toxic metabolites from the brains of age-accelerated mice by improving lymphatic drainage.

Female-Specific Mechanism of Neurodegeneration Discovered: Scientists have found that a gene on the X chromosome, which escapes silencing, promotes inflammation and neurodegeneration in a mouse model of multiple sclerosis, but the effects can be reversed with metformin.

International Space StationHow Being in Orbit Affects Stem Cells: In Cell Stem Cell, researchers from the Cedars-Sinai Medical Center have published a review discussing what experiments conducted in space can do for stem cell research and medical research as a whole.

Tiny Brain Organoids Show Promise in Alzheimer’s Research: Scientists have developed a novel multicellular integrated brain model to study neurological diseases, incorporating all six major brain cell types derived from patient-specific induced pluripotent stem cells.

Macular degenerationAddressing Age-Related Vision Decline With Lipid Supplements: Researchers have partially reversed age-related vision decline in mice by injecting lipids directly into the retina.

Measuring Dog Aging With Protein Metabolism: Researchers working with data from the Dog Aging Project have found that post-translationally modified amino acids, which are generated from protein metabolism, are useful in determining the biological ages of dogs.

Neural plaquesAmyloid-Fibrinogen Complexes Exacerbate Alzheimer’s in Mice: A study from Rockefeller University suggests that an unholy duo of two proteins causes harm in much lower concentrations than either of them alone.

Stiff Collagen May Lead to Senescent Cells: A preprint study has found that the stiffness of the extracellular matrix encourages cells to undergo senescence. These researchers placed cells into a hydrogel scaffold that can have its stiffness changed on the fly.

Bacteria under microscopeReview Links Lingering Infections to Senescence: In a comprehensive review, scientists discuss the various mechanisms by which chronic infections drive cellular senescence and aging.

Organ Fat Is Associated With Carotid Atherosclerosis: A recent study discovered an association between visceral and, to a lesser extent, hepatic fat with cardiovascular risk factors and carotid atherosclerosis.

Maintenance Stays Efficient in Healthy Older People’s Cells: Researchers publishing in Aging Cell have found that the efficiency of autophagy, a cellular maintenance process, increases rather than decreases in some T cells derived from healthy older people.

Men Might Need More Exercise to Lower Cardiovascular Risks: A new observational study suggests that men need more than twice as much exercise as women do to achieve the same level of reduction in the risk of cardiovascular heart disease.

Relationship between weekends catch-up sleep and risk of aging: Stratifying by bedtime, the relationship between catch-up sleep and reduced aging risk is only observed in individuals who usually go to sleep before midnight and have catch-up seep less than 2 hours.

Dose-response relationship of resistance training and the effects on circulating biomarkers of inflammation or neuroplasticity in older adults: These findings demonstrate that resistance training can significantly improve circulating biomarkers of neuroplasticity and inflammation and highlight key dose-response relationships critical for optimizing such programs.

An Ad Libitum-Fed Diet That Matches the Beneficial Lifespan Effects of Caloric Restriction: Ad libitum-fed diets can be designed to replicate, and potentially enhance, the geroprotective benefits of caloric restriction, albeit via different mechanisms, potentially offering a more sustainable dietary approach to longevity extension.

α-Lipoic acid mitigates age-related cognitive decline by modulating PPARγ/NF-κB-mediated neuroinflammation: Administration demonstrated significant cognitive-enhancing effects, accompanied by suppression of both microgliosis and astrocytosis, as well as a reduction in pro-inflammatory cytokines in the hippocampus of aged mice.

Effects of lifetime supplementation with ubiquinol 10 on the lifespan and progression of aging in female C57BL/6 mice: Maximum lifespans and survival curves did not significantly differ between the ubiquinol 10 and control groups.

Enhanced Selenium Supplement Extends Lifespan and Delays Multi-Organs Aging by Regulating the Sik1 Pathway Through Maintaining Calcium Homeostasis: This systematic approach provides a solid theoretical foundation and clinical evidence for the application of nano-selenium in anti-aging research.

Glycation-lowering compounds inhibit ghrelin signaling to reduce food intake, lower insulin resistance, and extend lifespan: As a late-life intervention, Gly-Low slows hypothalamic aging signatures, improves glucose homeostasis and motor coordination, and increases lifespan, suggesting its potential benefits in ameliorating age-associated decline.

Effect of the mitophagy inducer urolithin A on age-related immune decline: a randomized, placebo-controlled trial: These findings indicate that short-term urolithin A supplementation modulates human immune cell composition and function, supporting its potential to counteract age-related immune decline and inflammaging.

Combined creatine and HMB co-supplementation improves functional strength independent of muscle mass in physically active older adults: This combined approach represents a promising strategy for preserving functional capacity and promoting healthy ageing.

Pharmacokinetic analysis of intermittent rapamycin administration in early-stage Alzheimer’s Disease: These findings suggest that weekly rapamycin administration in Alzheimer’s patients results in acceptable pharmacokinetic variability, supporting fixed-dose regimens in future trials.

Mesenchymal stem cell derived extracellular vesicles reverses neural aging via OSKM modulation: This study represents a pioneering achievement in regenerative medicine, demonstrating the potential of microRNAs in extracellular vesicles to stimulate OSKM, a significant stride forward in addressing neural aging.

Dual-ligand engineered exosome regulates WNT signaling activation to promote liver repair and regeneration: Collectively, this work revealed the broad therapeutic effects of WNT signaling activation in the liver through the dual-ligand-carrying exosomes.

Effects of low-intensity pulsed ultrasound on muscle mass and Fndc5 mRNA expression in aged male mice: These findings suggest that this technique may serve as a safe, non-invasive intervention to counteract sarcopenia by promoting muscle growth and mitochondrial gene activation in aged skeletal muscle.

Effects of Computerized Cognitive Training on Vesicular Acetylcholine Transporter Levels in Healthy Older Adults: These findings clarify the neurochemical basis of cognitive training benefits, showing that speed training upregulates binding in networks that support attention, memory, and executive function.

The dissipation theory of aging: a quantitative analysis using a cellular aging map: These results provide a novel perspective on aging as a dissipative process and introduce a computational framework that enables measuring age-related changes with molecular resolution.

News Nuggets

Agentic AI Against AgingAgentic AI Against Aging Hackathon: HackAging.ai is the global online hackathon at the intersection of Agentic AI and longevity science, bringing together researchers, founders, and engineers to accelerate solutions that extend healthy human lifespan.

New Foundation Unites Hollywood and the Arts Against Aging: The Alliance for Longevity Science, Arts & Entertainment announced its official launch, pioneering a new nonprofit effort to accelerate progress against the chronic diseases of aging.

NUS_Logo-Stacked-Centered-LineNUS Medicine Launches New Clinical Trial Centre: Spanning 350 square metres, the new Centre brings together state-of-the art facilities within an integrated multidisciplinary framework to enable clinical research and implementation of gerodiagnostics and gerotherapeutics.

We would like to ask you a small favor. We are a non-profit foundation, and unlike some other organizations, we have no shareholders and no products to sell you. All our news and educational content is free for everyone to read, but it does mean that we rely on the help of people like you. Every contribution, no matter if it’s big or small, supports independent journalism and sustains our future.

Older man and woman exercising

Men Might Need More Exercise to Lower Cardiovascular Risks

A new observational study suggests that men need more than twice as much exercise as women do to achieve the same level of reduction in the risk of cardiovascular heart disease [1].

Understanding sex differences

In recent years, scientists have questioned how much exercise is needed for tangible health benefits. Current guidelines from the American Heart Association, the European Society of Cardiology, and the World Health Organization suggest that everyone should be getting at least 150 minutes per week of moderate-to-vigorous physical activity (MVPA) to significantly lower the risk of cardiovascular heart disease (CHD).

Numerous studies have added layers of complexity to these assessments, such as by showing diminishing returns, with the “sweet spot” lying around 7,000 daily steps [2] or even a U-shaped relationship, in which too much exercise can actually be harmful [3]. On many of the questions, the jury is still out.

One important piece of the puzzle, however, remains understudied: the effects of sexual differences on physical activity. Work in animal models, demographic studies, and human studies all point to the two sexes experiencing aging and disease differently. Yet, this difference is rarely accounted for in health recommendations. In this new study, scientists used data from UK Biobank (UKB), a repository of health information on about half a million British citizens, to shed some light on this question.

Men need to work twice as hard

Over 80,000 UKB participants wore wrist accelerometers for one week to record their physical activity. This created a trove of data that many scientists have used. The sample included 5,169 people with CHD at baseline and 3,764 incident CHD events with a median follow-up of about 8 years.

The study’s central finding was that, while women showed less adherence to the guidelines (150 minutes or above), it was also much easier for them to reach an equal reduction in CHD risk. For a 30% risk reduction, women needed about 250 min/week of MVPA, while men needed about 530 min/week: more than twice as much.

Among patients with CHD, physically active females experienced much greater mortality risk reduction than males (70% vs. only 19% in men). However, this finding, impressive as it is, was based on a far smaller CHD mortality sample (6 deaths among 340 adherent women), so estimates are imprecise even if statistically significant. The researchers urge caution and call for validation in larger CHD cohorts with wearable data.

Men women exercise differences

The research went to great lengths to control for possible confounding factors. These included age, geography (England, Scotland, or Wales), ethnicity, education, Townsend deprivation index, BMI, smoking and alcohol consumption status (never/ever/current), sleep duration, a dietary health score, as well as such medical conditions and treatments as diabetes, hypertension, dyslipidemia, use of cholesterol-lowering drugs, blood-pressure medication, insulin therapy, and Charlson comorbidity index.

The researchers also controlled for actual physical activity intensity inside the relatively wide MVPA range by measuring average acceleration. Other important variables taken into account were the polygenic risk score for CHD in incidence models and CHD treatment medications (antiplatelet, antianginal) in the mortality models. People who are already sick are likely to undergo less physical activity, but this reverse causality was mitigated by excluding participants who had events that occurred in the first year after accelerometer wear.

The team ran multiple model specifications with different covariate sets to confirm that the sex-interaction findings were not model-dependent. This did not fundamentally change the results: women benefited more per unit of MVPA across all these specifications, time scales, and strategies.

Possible explanations

The authors also hypothesized possible biological underpinnings of their results. For instance, higher circulating estrogen in women can shift fuel use toward greater lipid oxidation during exercise, which is linked to better CHD outcomes. Sex differences in fiber-type composition (women have more type I fibers, while men have more type II) and oxidative capacity could make women more “PA-sensitive,” yielding larger clinical benefit per minute.

The study’s observational design means that it cannot establish causality, only correlation, and causality and mechanisms will have to be elucidated by future research. Still, the pattern is consistent with prior accelerometer studies in older women [4].

The take-home message is important both for men and women. Since adherence is generally lower in women, knowing that they need much less effort to achieve the same CHD risk reduction may be encouraging. On the other hand, men should know that adhering to the current “sex-blind” guidelines might not be enough.

We would like to ask you a small favor. We are a non-profit foundation, and unlike some other organizations, we have no shareholders and no products to sell you. All our news and educational content is free for everyone to read, but it does mean that we rely on the help of people like you. Every contribution, no matter if it’s big or small, supports independent journalism and sustains our future.

Literature

[1] Chen, J., Wang, Y., Zhong, Z., Chen, X., Zhang, L., Jie, L., … & Wang, Y. (2025). Sex differences in the association of wearable accelerometer-derived physical activity with coronary heart disease incidence and mortality. Nature Cardiovascular Research, 1-11.

[2] ing, D., Nguyen, B., Nau, T., Luo, M., del Pozo Cruz, B., Dempsey, P. C., … Owen, K. (n.d.). Daily steps and health outcomes in adults: a systematic review and dose-response meta-analysis. The Lancet Public Health.

[3] Schnohr, P., O’Keefe, J. H., Marott, J. L., Lange, P., & Jensen, G. B. (2015). Dose of jogging and long-term mortality: the Copenhagen City Heart Study. Journal of the American College of Cardiology, 65(5), 411-419.

[4] LaMonte, M. J., Buchner, D. M., Rillamas‐Sun, E., Di, C., Evenson, K. R., Bellettiere, J., … & LaCroix, A. Z. (2018). Accelerometer‐measured physical activity and mortality in women aged 63 to 99. Journal of the American Geriatrics Society, 66(5), 886-894.

Maintenance Stays Efficient in Healthy Older People’s Cells

Researchers publishing in Aging Cell have found that the efficiency of autophagy, a cellular maintenance process, increases rather than decreases in some T cells derived from healthy older people.

Keeping cells healthy

The researchers introduce their paper by discussing autophagy and its decline in aging. They focus specifically on its effects on T cells, noting that a decline in autophagy causes mitochondrial dysfunction in CD4+ T cells due to old mitochondria not being cleared [1] and is associated with DNA damage in CD8+ T cells [2].

This paper focuses specifically on CD4+ T cells, building upon previous work demonstrating that an age-related deficiency of a glycolytic enzyme prevents these cells from using autophagy as an energy source [3] and that better autophagy in these cells is hereditary and associated with longer lifespans [4].

This study began by measuring the base rate of autophagy in CD4+ T cells derived from one group of 28- to 35-year-olds and another group of 67- to 93-year-olds. The first analysis was of compartments (puncta) that tested positive for microtubule-associated protein 1A/1B-light chain 3 (LC3), a marker of autophagosomes.

No autophagic decline in cells from healthy people

Interestingly, while the number of LC3+ puncta trended towards being lower in the older group, this did not reach the level of statistical significance. The number of protein-destroying lysosomes was also similar, as was the number of autolysosomes, which are combinations of autophagosomes and lysosomes that actually destroy unwanted mitochondria and organelles.

Experimentation with an inhibitor of autophagic degradation found that there is an increase in autophagic flux with age. This led to the researchers’ surprising conclusion: in CD4+ T cells, a reduction in the number of lysosomes is compensated for by an increase in efficiency, allowing these cells to maintain themselves through autophagy. The researchers suggest that “when autophagy is stimulated, the greater increase in older adults may be the result of a much larger amount of damaged material that needs to be processed.”

Autophagy in older people

There was also some evidence that the autolysosomes of older CD4+ T cells are more heterogenous and possibly less stable, and introducing a molecule that affects autophagy through stress revealed that these cells may have a reduced ability to respond to this stress.

Unexpected results

Overall, these findings ran counter to the researchers’ assumptions, who noted that previous work has found a decline in autophagy with age in various models, including human cells, and that autophagy has been repeatedly found to play a role in aging [5]. However, the researchers also suggest that animal models may not translate well to humans in this respect, as it is plausible that increased autophagic maintenance is one of the reasons we live longer. Furthermore, some previous work has found that certain conditions, such as Type 2 diabetes, have been found to increase rather than decrease autophagic flux [6].

These experiments were performed only on a certain subset of T cells, and these findings may not be universal across cell types. Additionally, this study included only cells derived from healthy donors, and the researchers note that this may have played a large role in its negative results: “A burning question is whether the preservation of effective autophagy in these healthy individuals free of chronic diseases is one of the reasons for the maintenance of their healthy status.” They recommend further studies that compare health status to autophagic maintenance.

We would like to ask you a small favor. We are a non-profit foundation, and unlike some other organizations, we have no shareholders and no products to sell you. All our news and educational content is free for everyone to read, but it does mean that we rely on the help of people like you. Every contribution, no matter if it’s big or small, supports independent journalism and sustains our future.

Literature

[1] Bektas, A., Schurman, S. H., Gonzalez-Freire, M., Dunn, C. A., Singh, A. K., Macian, F., … & Ferrucci, L. (2019). Age-associated changes in human CD4+ T cells point to mitochondrial dysfunction consequent to impaired autophagy. Aging (Albany NY), 11(21), 9234.

[2] Phadwal, K., Alegre-Abarrategui, J., Watson, A. S., Pike, L., Anbalagan, S., Hammond, E. M., … & Simon, A. K. (2012). A novel method for autophagy detection in primary cells: impaired levels of macroautophagy in immunosenescent T cells. autophagy, 8(4), 677-689.

[3] Yang, Z., Fujii, H., Mohan, S. V., Goronzy, J. J., & Weyand, C. M. (2013). Phosphofructokinase deficiency impairs ATP generation, autophagy, and redox balance in rheumatoid arthritis T cells. Journal of Experimental Medicine, 210(10), 2119-2134.

[4] Raz, Y., Guerrero-Ros, I., Maier, A., Slagboom, P. E., Atzmon, G., Barzilai, N., & Macian, F. (2017). Activation-induced autophagy is preserved in CD4+ T-cells in familial longevity. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 72(9), 1201-1206.

[5] Aman, Y., Schmauck-Medina, T., Hansen, M., Morimoto, R. I., Simon, A. K., Bjedov, I., … & Fang, E. F. (2021). Autophagy in healthy aging and disease. Nature aging, 1(8), 634-650.

[6] Bensalem, J., Teong, X. T., Hattersley, K. J., Hein, L. K., Fourrier, C., Liu, K., … & Sargeant, T. J. (2023). Basal autophagic flux measured in blood correlates positively with age in adults at increased risk of type 2 diabetes. Geroscience, 45(6), 3549-3560.

Fatty liver

Organ Fat Is Associated With Carotid Atherosclerosis

A recent study discovered an association between visceral and, to a lesser extent, hepatic fat with cardiovascular risk factors and carotid atherosclerosis. This association persists even after adjusting for cardiovascular risk factors [1].

Beyond BMI

Body mass index (BMI) is a metric that compares height to total weight, including fat located under the skin (subcetaneous fat). It is easy to calculate, which is part of why it is a standard measurement of health. Some scientific studies use BMI in the assessment of health and disease risk, and they associate high BMI with many health risks, including cardiometabolic risk and various diseases [2].

However, there might be better metrics than BMI for assessing health-related risk. The researchers find that accumulation of fat around the visceral organs (visceral adipose tissue) and fat within the liver (hepatic fat) are both related to cardiometabolic risk and arteriosclerosis and can be a better reflection of those risks than BMI. Visceral fat is also linked to multiple conditions, such as type 2 diabetes mellitus (T2DM), hypertension, elevated cholesterol, increased inflammation, reduced cognitive function, and cancers [3, 4].

Large cohorts with precise data

In a recent study, the researchers set out to investigate whether visceral adipose tissue and hepatic fat are associated with carotid atherosclerosis, a condition defined as a buildup of plaques in the carotid arteries that supply blood to the brain.

They used the data from two cohorts: The Canadian Alliance for Healthy Hearts and Minds (CAHHM), which included 6,760 Canadians with a mean age of 57.1, and the UK Biobank (UKB), which included 26,547 participants with a mean age of 54.7. While the number of analyzed participants makes it a large sample size, which adds to the strength of the analysis, the cohort was mainly of European heritage, which limits the generalizability of the results to other races and ethnicities.

The datasets included information regarding health, demographics, and lifestyle. To measure carotid atherosclerosis, they used an MRI scan of the abdomen and carotid arteries (CAHHM) and an ultrasound of carotid intima-media thickness (CIMT), which is the thickness of the inner two layers of the carotid arterial wall (UKB). The authors note that the MRI assessment yields the most accurate data; it is more sensitive than an ultrasound of carotid intima-media thickness and is much better than some indirect measures, such as waist circumference or elevated liver function tests.

Positive associations

The Canadian cohort reported that visceral adipose tissue and hepatic fat fraction were associated with higher cardiovascular risk factor burden and higher odds of hypertension, diabetes mellitus, and dyslipidemia. They also noted that an increase in visceral adipose tissue volume, but not hepatic fat fraction, was associated with a higher carotid wall volume, which persisted after adjustment for cardiovascular risk factors.

The United Kingdom cohort showed a positive association between visceral adipose tissue volume and carotid-intima media thickness, as well as between hepatic fat fraction and carotid-intima media thickness, even after adjustment for cardiovascular risk factors.

The researchers also pooled the data from both studies. This analysis showed a positive association of visceral adipose tissue and hepatic fat fraction with metrics of carotid atherosclerosis, even after adjustment for cardiovascular risk factors. However, authors advise caution when interpreting those results, as the two polled studies used different measurements of carotid atherosclerosis.

Adding to the evidence

“This study shows that even after accounting for traditional cardiovascular risk factors like cholesterol and blood pressure, visceral and liver fat still contribute to artery damage,” said Russell de Souza, co-lead author of the study and a faculty member in the Mary Heersink School of Global Health and Social Medicine, and member of the Centre for Metabolism, Obesity and Diabetes Research (MODR) and at McMaster. “The findings are a wake-up call for clinicians and the public alike.”

This study adds to the growing body of evidence about visceral fat’s impact on health and cardiovascular disease risks. Previous studies on hepatic fat are less clear about its relationship to the development of cardiovascular diseases; some show the association between hepatic fat and the risk of such diseases, while others don’t [5-8].

Visceral fat is emerging as an important biomarker for cardiovascular conditions. As the authors wrote, “the International Atherosclerosis Society and International Chair on Cardiometabolic Risk Working Group on Visceral Obesity hold the position that among adiposity measures, visceral fat is the strongest predictor of adverse CV risk and is a better predictor of subclinical atherosclerosis than waist circumference” [3].

Visceral or liver “fat is metabolically active and dangerous; it’s linked to inflammation and artery damage even in people who aren’t visibly overweight. That’s why it’s so important to rethink how we assess obesity and cardiovascular risk,” said Sonia Anand, the corresponding author of the study, a vascular medicine specialist at Hamilton Health Sciences and a professor in the Department of Medicine at McMaster. “You can’t always tell by looking at someone whether they have visceral or liver fat.”

As of now, the primary way to reduce visceral and hepatic fat is through changing behavior, and in this study, the authors recommend exercising, maintaining a healthy body weight, and changing to a Mediterranean diet while avoiding food generally considered ‘unhealthy’, such as foods that are fried, heavily processed, or have dded sugar. They also suggest that time-restricted eating, very low-calorie ketogenic diets, and low-fat vegan diets may have a positive effect.

We would like to ask you a small favor. We are a non-profit foundation, and unlike some other organizations, we have no shareholders and no products to sell you. All our news and educational content is free for everyone to read, but it does mean that we rely on the help of people like you. Every contribution, no matter if it’s big or small, supports independent journalism and sustains our future.

Literature

[1] de Souza, R. J., Pigeyre, M. E., Schulze, K. M., Lamri, A., Al-Khazraji, B. K., Awadalla, P., Beyene, J., Desai, D., Despres, J. P., Dummer, T. J. B., Friedrich, M. G., Hicks, J., Ho, V., LaRose, É., Lear, S. A., Lee, D. S., Leipsic, J. A., Lettre, G., Moody, A. R., Noseworthy, M. D., … Anand, S. S. (2025). Visceral adipose tissue and hepatic fat as determinants of carotid atherosclerosis. Communications medicine, 5(1), 424.

[2] Brixner, D., Ghate, S. R., McAdam-Marx, C., Ben-Joseph, R., & Said, Q. (2008). Association between cardiometabolic risk factors and body mass index based on diagnosis and treatment codes in an electronic medical record database. Journal of managed care pharmacy : JMCP, 14(8), 756–767.

[3] Neeland, I. J., Ross, R., Després, J. P., Matsuzawa, Y., Yamashita, S., Shai, I., Seidell, J., Magni, P., Santos, R. D., Arsenault, B., Cuevas, A., Hu, F. B., Griffin, B., Zambon, A., Barter, P., Fruchart, J. C., Eckel, R. H., International Atherosclerosis Society, & International Chair on Cardiometabolic Risk Working Group on Visceral Obesity (2019). Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement. The lancet. Diabetes & endocrinology, 7(9), 715–725.

[4] Anand, S. S., Friedrich, M. G., Lee, D. S., Awadalla, P., Després, J. P., Desai, D., de Souza, R. J., Dummer, T., Parraga, G., Larose, E., Lear, S. A., Teo, K. K., Poirier, P., Schulze, K. M., Szczesniak, D., Tardif, J. C., Vena, J., Zatonska, K., Yusuf, S., Smith, E. E., … Canadian Alliance of Healthy Hearts and Minds (CAHHM) and the Prospective Urban and Rural Epidemiological (PURE) Study Investigators (2022). Evaluation of Adiposity and Cognitive Function in Adults. JAMA network open, 5(2), e2146324.

[5] Al Rifai, M., Silverman, M. G., Nasir, K., Budoff, M. J., Blankstein, R., Szklo, M., Katz, R., Blumenthal, R. S., & Blaha, M. J. (2015). The association of nonalcoholic fatty liver disease, obesity, and metabolic syndrome, with systemic inflammation and subclinical atherosclerosis: the Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis, 239(2), 629–633.

[6] Mellinger, J. L., Pencina, K. M., Massaro, J. M., Hoffmann, U., Seshadri, S., Fox, C. S., O’Donnell, C. J., & Speliotes, E. K. (2015). Hepatic steatosis and cardiovascular disease outcomes: An analysis of the Framingham Heart Study. Journal of hepatology, 63(2), 470–476.

[7] Pisto, P., Santaniemi, M., Bloigu, R., Ukkola, O., & Kesäniemi, Y. A. (2014). Fatty liver predicts the risk for cardiovascular events in middle-aged population: a population-based cohort study. BMJ open, 4(3), e004973.

[8] Kotronen, A., & Yki-Järvinen, H. (2008). Fatty liver: a novel component of the metabolic syndrome. Arteriosclerosis, thrombosis, and vascular biology, 28(1), 27–38.

Bacteria under microscope

Review Links Lingering Infections to Senescence

In a comprehensive review, scientists discuss the various mechanisms by which chronic infections drive cellular senescence and aging [1].

Lurking in the body

People are mostly aware of acute infections, such as the common cold, COVID-19, and malaria. Science has made great strides against these kinds of infectious diseases, making them less deadly and even eradicating some of the most dangerous ones.

Chronic infections, on the other hand, continue to fly under the radar. Most people would be generally surprised to learn how many different pathogens call their body their permanent home.

Some pathogens are surprisingly prevalent [2]. 90-95% of adults worldwide have been infected at least once with the Epstein-Barr virus (EBV), which then lingers in the body indefinitely; the prevalence of cytomegalovirus (CMV) is thought to exceed 80%; the bacterium Helicobacter pylori can be found in almost half of the population; and there are many other examples. In short, it would be safe to say that nobody is safe.

Since many chronic infections do not cause acute symptoms, conventional medicine rarely bothers treating or even diagnosing them. However, there is increasing evidence that chronic infections can be extremely harmful, including the pre-existing infections that play a role in syndromes such as “long COVID” [3].

Some of the most important aspects of aging, such as chronic inflammation and immunosenescence, might also be driven by chronic infections. Essentially, even if pathogens do not trigger acute conditions, that doesn’t mean they are harmless.

Causing senescence via multiple routes

This new review published in Immunity and Ageing seeks to address one aspect of this relationship: the ways in which chronic infections drive cellular senescence. As the introduction puts it, “while senescence is traditionally associated with aging, growing evidence reveals that chronic infections such as viral, bacterial, and protozoan parasites can serve as powerful inducers of senescence, contributing to premature aging and long-term tissue damage.”

The researchers start with viruses. “Persistent viral infections,” they note, “have been shown to promote cellular aging through mechanisms such as the induction of cell cycle arrest, accumulation of DNA damage, and sustained secretion of proinflammatory cytokines.”

For example, hepatitis C virus (HCV) upregulates several senescence markers, such as p16, p21, p27, and γ-H2AX, in hepatocytes and promotes senescence in T cells by shortening their telomeres. Hepatic senescence-associated beta galactosidase (SA-β-gal) activity is increased in approximately 50% of patients with chronic HCV.

Human cytomegalovirus (HCMV) induces senescence in fibroblasts and renal cells, increasing pro-inflammatory senescence-associated secretory phenotype (SASP) factors like IL-6 and IL-8. Human immunodeficiency virus (HIV) promotes senescence through viral proteins like Tat, which upregulate senescence markers and disrupt mitochondrial function.

Bacterial infections can trigger cellular senescence, too. Some strains of Escherichia coli produce the toxin colibactin, which has been shown to cause senescence by inducing cell cycle arrest via DNA damage. E. coli-mediated senescence is associated with elevated levels of proinflammatory cytokines such as IL-6, TNF-α, and IFN-γ, which can promote tumor growth in colorectal cancer models.

Helicobacter pylori, another ubiquitous bacterium, causes telomere shortening and genomic instability through inflammation-induced oxidative stress. Here, evidence shows that senescent phenotypes persist post-eradication and extend beyond the gut. Chronic Mycobacterium tuberculosis infection results in persistent inflammation; elevated SASP proteins including TNF-α, CXCL9, and CXCL10; T-cell senescence and exhaustion; and an average increase in epigenetic age of 12-14 years.

Colonies of Borrelia burgdorferi (the parasite behind Lyme disease), the authors argue, “profoundly alter host cellular processes, causing persistent symptoms in patients and creating a physiological state reminiscent of inflammaging”, the simmering inflammation that gets stronger as we age. They cite increased levels of SA-β-gal in chronic Lyme infection, molecules found in bacterial cell walls (peptidoglycans) lingering in the liver and causing immune stimulation, and a broad inflammatory response from astrocytes in the brain triggered by B. burgdorferi’s basic membrane protein A (BmpA).

Long-Term Bacterial Effects

Treating chronic infections for longevity

The researchers round their review up with protozoans, single-celled eukaryotes that invade other living cells. Protozoan parasites largely follow the same “playbook.” Toxoplasma gondii causes oxidative stress, which leads to increases in the senescence markers p16 and p21, loss of the crucial structural protein Lamin B1, another hallmark of senescence, and more SASP in gut tissue.

Plasmodium infection shortens telomeres and elevates p16 and inflammatory cytokines in humans, while cerebral malaria features senescent astrocytes. Trypanosoma cruzi induces SA-β-gal, oxidative stress, DNA damage, and contractile decline in cardiomyocytes, eventually leading to cardiomyopathy in about one-third of infected patients.

This review raises important questions about the role of persistent pathogens in aging. While cellular senescence and inflammaging have multiple causes, chronic infections might be the most overlooked among them. Many chronic infections can be cured or at least reigned in with antibiotics. Doing so might slow aging, although this demands further investigation.

We would like to ask you a small favor. We are a non-profit foundation, and unlike some other organizations, we have no shareholders and no products to sell you. All our news and educational content is free for everyone to read, but it does mean that we rely on the help of people like you. Every contribution, no matter if it’s big or small, supports independent journalism and sustains our future.

Literature

[1] Johnson, A., Rought, T., Aronov, J., Pokharel, P., Chiu, A., & Nasuhidehnavi, A. (2025). The impacts of chronic infections on shaping cellular senescence. Immunity & Ageing, 22(1), 37.

[2] Naghavi, M., Mestrovic, T., Gray, A., Hayoon, A. G., Swetschinski, L. R., Aguilar, G. R., … & Murray, C. J. (2024). Global burden associated with 85 pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet Infectious Diseases, 24(8), 868-895.

[3] Peluso, M. J., Deveau, T. M., Munter, S. E., Ryder, D., Buck, A., Beck-Engeser, G., … & Henrich, T. J. (2023). Chronic viral coinfections differentially affect the likelihood of developing long COVID. The Journal of clinical investigation, 133(3).

Blood vessels

Stiff Collagen May Lead to Senescent Cells

A preprint study has found that the stiffness of the extracellular matrix (ECM) itself encourages cells to undergo senescence.

An unexplored relationship

ECM stiffness and cellular senescence are both well-known aspects of aging. The cross-linked collagens, such as glucosepane, that lead to a less-flexible ECM accumulate with time and have long been the subject of aging research efforts. Senescent cells, which have lost their capacity to divide and do not always perform their proper functions, are among the most studied subjects in aging.

However, despite ECM stiffness being known to affect cellular function [1], particularly in the vasculature [2], the idea that ECM stiffness may be a direct contributor to senescence has gone almost entirely unexplored. This is not an easy relationship to study, as specialized modeling systems are required to properly isolate stiffness from confounding stimuli [3].

To that end, these researchers placed vascular endothelial cells (ECs) into a hydrogel scaffold that can have its stiffness changed on the fly without impacting ECs in unrelated ways. This allowed them to mimic different ECM conditions while keeping biochemical cues constant, thus ensuring that stiffness is the only variable being tested. The hydrogel stiffnesses used in this study were similar to the ECM stiffnesses of naturally aging mice.

When vascular cells stop forming vasculature

In their first experiment, the researchers cultivated colony-forming ECs for 48 hours in their hydrogel substrate, then altered the stiffnesses of different groups for another 48 hours. In a hydrogel where the ECM remained soft, the ECs continued to proliferate and form blood vessel networks; however, once the stiffness was increased to moderate or severe levels, vessel formation dropped dramatically, becoming minimal in the moderate group and nearly nonexistent in the severe group.

This change in vessel formation was matched by increases in gene expression levels of CDKN1A, which produces p21, and CDKN2A, which produces p16. Their proteins were similarly increased along with the well-known senescence marker SA-β-gal. However, they did not secrete the same phenotype as many other senescent cells do (the SASP); the SASP cytokines IL-6, IL-8, and CXCL1 were notably downregulated, while IL-33, IL-1α, and IFN-γ were upregulated instead. The researchers hypothesized that this suggests a “divergent SASP trajectory under mechanical stress” that uses different pathways.

Further experimentation confirmed this hypothesis. One of these alternative pathways involves Notch signaling, which was found to be increased with increasing ECM stiffness. Notch is associated with several other senesence-related pathways, including JNK; however, a different senescence pathway, c-JUN, was unaffected, which explains the lack of IL-6 and IL-8. Inhibiting Notch by administering nirogacestat mitigated stiffness-related senescence.

Similar effects in humans

Synthetic breast implants often cause localized areas of fibrosis, a stiff tissue that contains substantial quantities of senescent cells. RNA sequencing of this tissue found that Notch and senescence-related signaling were upregulated compared to the surrounding tissue. Perhaps most concerning was the finding that fibrosis-related genes were upregulated in the local ECs; while these cells are not the primary cause of fibrosis, this suggests that ECM stiffness may lead such cells to encourage its progression.

The researchers hold that ECM stiffness plays an upstream role in the progression of cellular senescence, at least in this circumstance. This means that addressing molecular cross-links through glucosepane breakers and other treatments may be more vital than previously anticipated; if these findings are validated, not only are such cross-links leading to the physical problems associated with tissue stiffness, they are also contributing to even more long-term damage in the process.

We would like to ask you a small favor. We are a non-profit foundation, and unlike some other organizations, we have no shareholders and no products to sell you. All our news and educational content is free for everyone to read, but it does mean that we rely on the help of people like you. Every contribution, no matter if it’s big or small, supports independent journalism and sustains our future.

Literature

[1] Selman, M., & Pardo, A. (2021). Fibroageing: An ageing pathological feature driven by dysregulated extracellular matrix-cell mechanobiology. Ageing Research Reviews, 70, 101393.

[2] Schnellmann, R., Ntekoumes, D., Choudhury, M. I., Sun, S., Wei, Z., & Gerecht, S. (2022). Stiffening matrix induces age‐mediated microvascular phenotype through increased cell contractility and destabilization of adherens junctions. Advanced Science, 9(22), 2201483.

[3] Wang, E. Y., Zhao, Y., Okhovatian, S., Smith, J. B., & Radisic, M. (2022). Intersection of stem cell biology and engineering towards next generation in vitro models of human fibrosis. Frontiers in Bioengineering and Biotechnology, 10, 1005051.

Neural plaques

Amyloid-Fibrinogen Complexes Exacerbate Alzheimer’s in Mice

A study from Rockefeller University suggests that an unholy duo of two proteins causes harm in much lower concentrations than either of them alone. This points to a possible route for intervention [1].

When amyloid met fibrinogen

Amyloid beta (Aβ) and tau proteins are the usual suspects in Alzheimer’s disease. However, focusing on either of them has not been enough to explain all the intricacies of this deadly illness. This group has previously demonstrated that such complexes might be relevant to its progression, and this study expands the search by investigating the complexes that Aβ42, the most damaging type of amyloid peptide, forms with another protein, fibrinogen.

Fibrinogen is the precursor to fibrin, the protein that regulates blood clotting. Normally, fibrinogen should not be present in brain tissue. However, as the blood-brain barrier (BBB) deteriorates, which is one of the hallmarks of Alzheimer’s, fibrinogen seeps through it [2] and interacts with Aβ peptides. The question the researchers asked was, if Aβ and fibrinogen bind to each other, does their partnership actively damage synapses and the BBB?

Wreaking more havoc together

The team started with an ex vivo mouse model: organotypic hippocampal slice cultures (OHCs), which are living 400-µm slices that preserve local circuitry. The researchers treated the slices with Aβ42 and/or fibrinogen in various concentrations, or their pre-assembled complexes, measuring the levels of two proteins indicative of synaptic activity, SYP and PSD-95.

A low dose of Aβ42 (150 nM) by itself or fibrinogen (50 nM) by itself left SYP and PSD-95 levels unchanged, while a high dose of Aβ42 (500 nM) depressed both, as expected. However, when the same low doses (150 nM Aβ42 + 50 nM fibrinogen) were administered as complexes, synaptic proteins plummeted as much as with the high Aβ dose.

“It takes a larger amount of Aβ or fibrinogen alone to cause serious damage in the Alzheimer’s brain,” said Erin Norris, research associate professor in the laboratory of Sidney Strickland at Rockefeller. “But when the two complex together, you only need very small amounts of each to cause damage. There’s a synergistic effect with Aβ and fibrinogen.”

When the researchers pre-incubated Aβ42 with a molecule that blocks the fibrinogen-binding site, the synaptic loss was prevented. This pins the effect on Aβ-fibrinogen binding, not merely on having both molecules present.

The team moved on to in vivo experiments in mice. After an intracerebroventricular (ICV, directly into the brain) infusion, mice that received pre-formed complexes showed reduced hippocampal SYP and PSD-95. Conversely, equal or even higher single-agent doses did not cause this effect. Blocking complex formation erased the synaptic damage signal, just as in slices.

The damage to the brain caused by the Aβ42/fibrinogen complexes went beyond synapses. The researchers also examined phosphorylated tau181 (p-tau181), a widely used early Alzheimer’s biomarker and a biochemical sign that tau is entering a pathogenic state. Just like in the previous experiments, only the complex triggered an increase in hippocampal p-tau181, while neither Aβ42 nor fibrinogen alone did.

Microglial activation occurs when microglia, the brain’s supporting cells, enter a pro-inflammatory state. Two of its markers, CD68 and GFAP, showed a similar picture in that they were boosted by the complex but not by Aβ42 or fibrinogen alone.

A vicious circle?

Finally, the same happened with four key markers of BBB integrity. Consistent with a BBB breach, the endogenous mouse fibrinogen and albumin, two blood proteins that should not be in brain parenchyma, appeared at elevated levels in the hippocampus after complex infusion.

“We wanted to really show the damage – to zoom in on exactly how pre- and post-synaptic terminals were being harmed,” said Research Associate Elisa Nicoloso Simões-Pires. “We showed that the complex actually induces blood-brain barrier leakage, when the proteins alone did not. Disruption of the blood-brain barrier allows for blood proteins to cross into the brain, which leads to additional harm.”

“Only recently, with a number of breakthroughs in the field, did people begin to believe that the vascular system is involved in AD pathogenesis,” said Norris. “Since our initial findings, we’ve been focused on studying the mechanisms that explain how a dysfunctional vascular system impacts AD.”

The researchers also ruled out a different known mechanism of fibrinogen, which binds the protein Mac-1 on microglia to drive harmful activation and dendritic spine loss. In Mac-1 knock-out mice, Aβ42/fibrinogen complexes were just as harmful, suggesting that the effect was Mac-1-independent.

These findings could offer new directions for the study of Alzheimer’s, which has not been particularly successful in the last decades. They also underscore the importance of early intervention when Aβ levels are still low but the cardiovascular damage is already happening. Interstingly, previous work by the same group shows that lecanemab, an approved drug for Alzheimer’s, acts on Aβ/fibrinogen complexes [3], but it is probably not the optimal way to tackle them.

“It’s not a simple disease,” Simões-Pires said. “A lot of other factors can induce neurotoxicity, and we certainly do not propose that inhibiting this complex formation would cure AD. But perhaps targeting this complex would alleviate some of the pathologies and be even more effective in combination with other therapies.”

We would like to ask you a small favor. We are a non-profit foundation, and unlike some other organizations, we have no shareholders and no products to sell you. All our news and educational content is free for everyone to read, but it does mean that we rely on the help of people like you. Every contribution, no matter if it’s big or small, supports independent journalism and sustains our future.

Literature

[1] Simões‐Pires, E. N., Torrente, D., Singh, P., Strickland, S., & Norris, E. H. (2025). Synergistic effects of the Aβ/fibrinogen complex on synaptotoxicity, neuroinflammation, and blood–brain barrier damage in Alzheimer’s disease models. Alzheimer’s & Dementia, 21(5), e70119.

[2] Sweeney, M. D., Sagare, A. P., & Zlokovic, B. V. (2018). Blood–brain barrier breakdown in Alzheimer disease and other neurodegenerative disorders. Nature Reviews Neurology, 14(3), 133-150.

[3] Singh, P. K., Simões-Pires, E. N., Chen, Z. L., Torrente, D., Calvano, M., Sharma, A., … & Norris, E. H. (2024). Lecanemab blocks the effects of the Aβ/fibrinogen complex on blood clots and synapse toxicity in organotypic culture. Proceedings of the National Academy of Sciences, 121(17), e2314450121.

Old and young dogs

Measuring Dog Aging With Protein Metabolism

Researchers working with data from the Dog Aging Project have found that post-translationally modified amino acids (ptmAAs), which are generated from protein metabolism, are useful in determining the biological ages of dogs.

The Dog Aging Project

With enrollment beginning in 2020, the Dog Aging Project (DAP) is an initiative to study canine aging [1], and its well-known co-director Matt Kaeberlein sits on our Scientific Advisory Board. Its purpose is twofold: to see how aging and age-related diseases affect these companion animals and to give researchers useful data that may be applied to human beings. Unlike laboratory mice in controlled conditions, the dogs enrolled in the DAP live with humans, so environmental effects are similar. The DAP is akin to human cohorts such as UK Biobank, although follow-ups can be conducted much more rapidly due to dogs’ naturally shorter lifespans.

There has been previous work done on analyzing the changes in canine metabolism with age, and it revealed substantial differences associated with age, diet, sex, and breed [2]. Breed is a major factor in analyzing dog aging; some breeds live twice as long as others [3].

This study builds on that work by using data from the DAP’s precision cohort, which initially consisted of 784 dogs that were specifically selected for deep molecular screening [4]. These dogs represent a cross-section of canine companions in the United States; five-sixths of them were neutered or spayed, the sex ratio was balanced, and there was a representative mix of breeds, including mixed-breed dogs. These dogs were also healthier overall than the dogs in the main DAP, a much larger cohort that contains roughly 50,000 animals.

A broad base of metabolites

A total of 133 metabolites was analyzed in this study, including carbohydrates, fatty acids and fatty esters, phosphate molecules, and amino acid derivatives. A principal component analysis found that, unsurprisingly, many of these metabolites varied strongly by factors other than age; sex, breed, weight, and sterilization status had notable effects, and genetic relatedness had even stronger effects than breed.

Age, however, did affect 48 of the 133 metabolites. Two groups were particularly enriched with age: carnitines and ptmAAs. Many other metabolites decreased with age, and not all ptmAAs were increased, either; methionine sulfoxide and hydroxyproline decreased, while tryptophan, glutamine, alanine, and N-terminally acetylated phenylalanine were increased. There were also “ambiguous” amino acids that are not consistently post-translationally modified, and the researchers omitted them from further analysis.

The metabolic connection

The changes to the abundance of ptmAAs with aging was found to be uncorrelated with changes to the abundance of their precursors. Therefore, these changes must result from either changes in how they are formed or changes in how they are removed. The researchers found evidence that these abundance changes were caused by a common source that affects all of these amino acids at the same time.

Further work found that these changes were not related to diet; being fed by ordinary people, some of these dogs had diets that varied from the common baseline of dry kibble, but dietary differences did not affect the age-related ptmAA differences.

Instead, these changes were found to be most likely due to changes in kidney function and protein catabolism. BUN, a well-known marker of kidney health, was strongly correlated with changes to ptmAAs, as was creatinine, a marker of protein turnover. In the case of hydroxyproline, there was a strong association with urine specific gravity (uSG), another marker of kidney health.

While relatively limited in scope, this study lays the groundwork for better understanding at least one key aspect of canine aging. In human beings, these proteins have been found to be useful as biomarkers [5]; using them in dogs is a step towards more completely assessing how they age.

We would like to ask you a small favor. We are a non-profit foundation, and unlike some other organizations, we have no shareholders and no products to sell you. All our news and educational content is free for everyone to read, but it does mean that we rely on the help of people like you. Every contribution, no matter if it’s big or small, supports independent journalism and sustains our future.

Literature

[1] Creevy, K. E., Akey, J. M., Kaeberlein, M., & Promislow, D. E. (2022). An open science study of ageing in companion dogs. Nature, 602(7895), 51-57.

[2] Puurunen, J., Ottka, C., Salonen, M., Niskanen, J. E., & Lohi, H. (2022). Age, breed, sex and diet influence serum metabolite profiles of 2000 pet dogs. Royal Society Open Science, 9(2), 211642.

[3] Yordy, J., Kraus, C., Hayward, J. J., White, M. E., Shannon, L. M., Creevy, K. E., … & Boyko, A. R. (2020). Body size, inbreeding, and lifespan in domestic dogs. Conservation genetics, 21(1), 137-148.

[4] Prescott, J., Keyser, A. J., Litwin, P., Dunbar, M. D., McClelland, R., Ruple, A., … & Promislow, D. E. (2025). Rationale and design of the Dog Aging Project precision cohort: a multi-omic resource for longitudinal research in geroscience. GeroScience, 1-24.

[5] Johnson, L. C., Martens, C. R., Santos-Parker, J. R., Bassett, C. J., Strahler, T. R., Cruickshank-Quinn, C., … & Seals, D. R. (2018). Amino acid and lipid associated plasma metabolomic patterns are related to healthspan indicators with ageing. Clinical science, 132(16), 1765-1777.

Andrea Maier Interview

Andrea Maier on Longevity Medicine for All

Dr. Andrea Maier, Oon Chiew Seng Professor in Medicine at the National University of Singapore, is a veteran geroscientist and one of the most familiar faces in the rising field of longevity medicine, which aims to translate the early successes of geroscience into clinical practice. Parallel to her scientific career, Andrea runs her own longevity medicine company, Chi Longevity, and is the founding president of the Healthy Longevity Medicine Society.

However, where others are perfectly happy providing lucrative concierge services to wealthy customers, Andrea has been working on bringing longevity medicine to the masses. A few days ago, NUS announced the launch of the Clinical Trial Centre of the NUS Academy for Healthy Longevity “to enhance research capabilities and accelerate the clinical translation of geroscience into real-world solutions,” and we decided it was a great moment to catch up with Andrea and talk about precision geromedicine and longevity for all.

What was your personal journey to the longevity field, and what does human longevity mean to you?

I love the human body, as well as those of animals and plants. I love creatures – everything that grows and has the capacity to rejuvenate. I think I am simply in love with the biology of aging. That’s why I really want to maintain whatever has been built, understand why it’s deteriorating, and what consequences that has.

In terms of my journey, I was always good at biology and mathematics. Don’t ask me to speak multiple languages, though. I think I finished high school with the lowest possible marks in Latin and Greek. As you know, I studied medicine. I love being an internal medicine specialist and geriatrician, but psychologically, I’m more of a surgeon. I love making decisions, I love the knife, I love action. So, I think I’m a mixture of loving biology, making decisions, and being a bit of a politician.

I didn’t know that. Did you have a career as a surgeon?

No, but as a student, I did three different jobs to finance my medical studies. One was working night shifts in a bar – I’m very good at making cocktails. The second, if any of the readers drives an old VW Passat, the back of the car might have been built by me. I worked in the car industry for a long time to earn money. And the third was helping out in the surgical departments on Saturdays and Sundays, especially in the operating room.

I saw many appendectomies and colectomies, and I loved working with my hands in people’s abdomens. I discovered that surgery is wonderful because you can touch the organs, and it’s a sort of art. However, it’s also very repetitive. I love to work with my hands, but not with that much repetition.

So, like some other people in the field, you were trained as an MD but ended up doing geroscience.

When I was in my second year of medical studies, I started doing research on monocytes, macrophages, and lung diseases because I wanted to discover why people get COPD. Then, in my third and fourth years, I did research on cytomegalovirus (CMV) and aging in Groningen, so I was already moving between countries. From the beginning of my medical studies, I was involved in research, and from the third or fourth year on, I was specifically involved in aging research.

Later, I did research in a psychiatric medical units and started to study traditional Chinese medicine. I also went to China to study further, and I think that’s where it all clicked. I remember one morning at 4:00 AM – far too early – when I had to do Tai Chi with a very old lady. She seemed very young to me, although she was over 90 years old. And I thought, “I want to discover why.” I can still see her in front of me. I wanted to understand why she was so healthy, lean, and flexible. And I decided then that I wanted to do geriatrics, because at that time, we thought geriatrics was the aging field.

I still see myself in 1999, trying to write an email from a small town in China to Groningen, which was the place to do geriatrics at the time, to see if I could do research with them. They accepted me. So, I’m a bit of a dinosaur in this field.

That’s an amazing story. Are you still practicing Tai Chi?

I was sort of forced to do Tai Chi every morning, but if you give me the opportunity, I’ll choose kickboxing. I’m much better at that. So, it’s absolutely not for me, but I do see its strengths – the balance, the relaxation component. It’s quite rewarding. But I prefer kickboxing.

Today, you are at the National University of Singapore (NUS), which has become a huge longevity hub. How did you get there, and what is Singapore’s place in the current longevity landscape?

I first went to Melbourne. While I was already considering that move, because I got a headhunting offer to manage the non-surgical part of the Royal Melbourne Hospital and lead the internal medicine research at the University of Melbourne, Singapore also knocked on my door. I initially said no because I had signed my contract in Melbourne.

But the attractiveness of Singapore was its real dedication to making healthy longevity work. There’s a dedication to change, to having a long-term impact, and to bringing evidence-based science and clinical care to the table. This is driven by the fact that Singapore will have a super-aged population in the coming years. There’s a recognized need to change, and there’s a long-term vision, which makes it very attractive.

Of course, it’s also a hub in the APAC region. If you want to start public-private partnerships, it’s much easier here than in Australia. Asia is the new hub for longevity investment, and Singapore is partly driving that.

The university is superb, great partnerships are already in place, and – most importantly – there is a driver for the entire field, which is the dean, Professor Chong Yap Seng. He is an unbelievable driver of this ecosystem. Twelve years ago, he was already thinking about what we now call healthy longevity medicine and how to make it happen.

He was revolutionary, studying children even before they were born to understand the early determinants of aging. This is all captured in the “human potential” programs. Human potential applies to every age group, and I now use that term very often. We’re talking about fulfilling human potential at every life stage.

Maximizing longevity as fulfilling human potential, I like it. Is the university the central player, or is there also government support, like in Saudi Arabia?

Oh yes, the government is hugely invested. A couple of years ago, the government launched “Healthier SG” [Healthier Singapore]. This program is embedded in the public health structure, where every Singaporean has a primary family physician. That GP is tasked with bringing preventative care into that individual’s life. It’s a huge initiative.

We are starting rigorous, science-based screening programs from the age of 40 onwards. But it’s not just about screening; it’s about helping families make lifestyle changes and focusing on the early detection and prevention of age-related diseases.

What we see now is a fusion of these ideas. You have a strong public health sector, we are discovering how to apply healthy longevity medicine in clinical practice, and now we’re investigating how to merge the two. We are figuring out how to bring the academic thought of healthy longevity medicine into the public health sector. That’s the stage we are at right now.

That brings us to the new Centre for Healthy Longevity Clinical Trials. The press release says its purpose is to “accelerate precision geroscience medicine research.” What does that mean?

Healthy longevity medicine is the public-facing term. Precision geroscience medicine is the academic term we use in the specialized field. Healthy longevity medicine is defined as optimizing health and healthspan by targeting aging processes across the lifespan. Precision geroscience medicine is simply precision medicine for the aging field.

Everyone now knows what precision medicine is – it’s taking individual characteristics into account, looking at the individual level rather than the group level. In oncology, we have precision oncology. In endocrinology, adapting insulin levels based on a continuous glucose monitor is precision medicine.

My colleague Guido Kroemer and I had many conversations about how we should term our field, and we came up with “precision geromedicine.” We are also introducing terms like “gerodiagnostics” and “gerotherapeutics” because we need our own grown-up vocabulary that everyone understands.

To establish this field, we need trials. That’s why we started the NUS Academy for Healthy Longevity Clinical Trials Unit. We’ve been operational for about four years and have already finished trials, but we didn’t have the capacity to run parallel trials and truly grow the space. Now we do.

We have developed standardized operating procedures for measuring things like women’s health, oral health, and cognition, especially for middle-aged individuals. This is a sector where we often lack the necessary diagnostic tools; everything either comes from geriatrics, where you have ceiling and flooring effects, or from primary care, where tools lack sensitivity.

We have established biological, clinical, and digital biomarkers of aging, and we are matchmaking them with therapeutics in both unimodal and multimodal interventions. Think about nutraceutical trials, drug trials, or combinations of lifestyle with nutraceuticals. This is what our field needs. We know one supplement or one drug might work, but that’s not real life. In real life, people do several things, and the effects might depend on sleep or physical exercise. We now have the capacity and infrastructure to study that.

Multimodal trials are tricky, and you also have the challenge of finding good endpoints and biomarkers. What is your solution?

It’s actually not that hard. I think we are in a space where we can allow ourselves to try and to make errors. We are toddlers in this field, not yet grown-ups. We don’t know what really works yet.

So, we take a combined de-risked and high-risk approach. Our trials always have primary outcomes that are known by the FDA. This could be something like VO2 max, where we know its predictive value for long-term outcomes, or HbA1c, a marker everyone understands. We borrow sophisticated clinical or biological parameters from other fields where I, as the principal investigator, know how hard or easy it is to change them.

We mix that conventional trial design with innovative elements. For example, in our ABLE study, we tested calcium alpha-ketoglutarate (AKG) for six months. We only included 40- to 60-year-olds whose biological age was greater than their chronological age, which we measured by combining four different epigenetic clocks. At the time, three or four years ago, we combined two first-generation and two second-generation clocks because we had no idea which was better. Of course, this was super risky. Now we know more about their accuracy, especially the second-generation clocks. But the idea was to only include individuals who might actually need a molecule that interferes with epigenetic changes.

For the first time, the primary outcome parameter in a trial like this was the change in those same epigenetic clocks. The secondary outcomes were all the conventional clinical parameters we already know.

I think that’s the way we should go. We have the safety and recognition from the broader field of trialists, showing that we know how to randomize, we use the right software, and we apply tests properly. Then, as the cherry on top, we add all our other biomarkers to get a better understanding of how these interventions act. In other trials, we might use immune parameters or HbA1c as the primary outcome, and then new biomarkers of aging – based on the microbiome or epigenetics – as secondary outcomes.

Let’s talk about one of your most interesting trials, PROMETHEUS, which reached the semi-finals in the XPRIZE Healthspan competition. The idea is to build personalized regimens. What kind of signal can you get from regimens that are different for each person, and what type of functional decline are you trying to reverse, given that recovery of function is the XPRIZE criterion?

We are using the XPRIZE outcomes, which focus on immune, cognitive, and musculoskeletal function. We are measuring everything they require: CD4/CD8 ratio, muscle mass, muscle strength, and brain function using the NIH toolbox. Alongside that, we are including many other parameters like proteomics, epigenetics, microbiome data, and digital biomarkers to track changes in health.

The PROMETHEUS intervention is based on “gerotypes.” We only include individuals who are between the 25th and 75th percentile for these three functions. We exclude those who are doing very poorly and those who are doing very well. We are including the average person, like you and me.

Based on these three areas – cognition, immune function, and muscle – we build a personalized regimen that includes lifestyle interventions, dietary recommendations, nutraceuticals, and, in the next stage, drugs targeting the individual’s specific gerotype. For example, if someone is low in muscle strength and mass, we would add urolithin A to their regimen, in addition to protein and creatine. We wouldn’t do that for someone who doesn’t have that specific weakness.

We built grids and flowcharts to standardize this personalized approach. It’s a huge list of nutraceuticals, including urolithin A, NMN, and ergothioneine – compounds where we have at least some human evidence of a signal and a very low likelihood of harm.

It sounds like a proof of concept for longevity medicine as a field, where you’re throwing all your knowledge at several cases to see what the best result you can get is.

Exactly. When we finish this trial, which is running now and is very intense – it’s like a boot camp for the participants – we won’t be able to disentangle exactly what worked for any single person. But we will know which combinations we prescribed based on their gerotype. Then, in the post-hoc analysis, we can see what was most likely to help.

But most importantly, we also measure compliance. We have a psychologist in the group who uses nudging techniques and helps us understand what people want to achieve. We are combining diagnostics from psychology to biology to the social environment to give our intervention the highest chance of working.

If it doesn’t work, we have to discover why. It could be because of the multimodal design, or because we don’t know if the effects are additive or if they cancel each other out. However, this is how we think in clinical practice. This is the first time we are strategically bringing that mindset into a clinical trial design.

You have several other trials running with interesting molecules such as AKG, fucoidan, rapamycin, and NMN. Do you have any juicy preliminary results you can share?

Yes. The ABLE study, which I’ve presented at a few conferences, really shows that we can’t just put longevity supplements on a shelf and let people decide for themselves whether to buy them. We do a lot of responder/non-responder analysis, and I think that’s the key issue for our field. We shouldn’t underestimate how heterogeneous the aging process is. Some people might have an epigenetic reprogramming problem, others a DNA damage problem, or issues with proteostasis.

Our AKG trial shows that we find significant epigenetic changes towards a lower biological age in individuals who were already biologically older, just by giving them one gram of calcium AKG for six months. But we find the signal is especially strong in individuals who are more physically active. Here you see that the combination of lifestyle and a supplement is very important. We also see better results in certain demographics. And we only applied it to individuals who were already epigenetically older – why would you charge your phone if it’s already full?

It’s the same for the NMN study we did a couple of years ago. After doing all the post-hoc analysis, we showed that the only individuals with a moderate NAD+ level increase showed clinical benefits from taking the NMN.

For me, it doesn’t matter if a trial’s primary outcome is positive or negative. The most important outcome is that we learn from the data. We have many non-responders in these trials, but we also have an equal number of people who are huge responders. The challenge for us in the coming years is to understand this responsiveness—who are the responders? That will show us who should actually be taking certain interventions in clinical practice.

I think your collaboration with the Alliance of Patient Organizations is particularly interesting. I’ve always thought that geroscience should get more support from patient advocacy groups. After all, we’re all patients when it comes to aging. Is this connection finally happening?

It is. It’s super active right now, though it only started six months ago. I was always looking for patient alliances, but it was hard because they were very specific: autism, menopause, colon cancer, and so on.

I have now found the overarching alliance of all patient organizations [Alliance of Patients Organizations Singapore – APOS]. We are now looking forward to building registries, giving good information to individuals, and recruiting from their members. It’s a hugely active and proactive partnership. I am so happy that we finally have the consumer at the table, in addition to healthcare professionals, industry partners, governments, and policymakers.

As someone who’s spearheading the longevity medicine movement, where does it stand today? I think it’s in an interesting spot. We don’t have many proven interventions, yet longevity clinics are popping up everywhere. And you are trying to build public longevity medicine, which seems critically important.

Healthy longevity medicine should grow both publicly and privately. However, what we really need is a very strong academic basis for it. If I could dream – and it seems the dream is coming true – we will have an alliance of academic clinics working together to build standards. We can test what works and what doesn’t in a non-private environment, from implementation strategies to cost-effectiveness to running randomized controlled trials together.

The reason we need academic centers to stand up is that we currently have zero capacity to teach and train the healthcare professionals who should be in this field. How can we grow private clinics if we have no capacity in normal teaching hospitals for people to be trained? It’s crazy.

We need to do the studies, but we also need teaching, teaching, and more teaching. Every medical specialty grew out of normal teaching capacities. If you go to a surgeon, you want that surgeon to be trained to do the job. Right now, we are just exposing ourselves to physicians who are not properly trained. I can’t exclude myself – I think I know what I’m doing, but I can’t prove that I’m a good physician in this field because there’s no one to certify me.

That’s what we have to solve now. Otherwise, this can become a very dangerous field. There’s a lot of ‘snake oil’ out there. We must establish a rigorous academic basis and have teaching hospitals that can offer rotations of six months, twelve months, or two years. We would never accept this lack of education and certification for oncologists. We would never accept it for surgeons. But we are accepting it at this moment for anyone who calls themselves a “longevity physician.” We have to do better.

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Macular degeneration

Addressing Age-Related Vision Decline With Lipid Supplements

Researchers have partially reversed age-related vision decline in mice by injecting lipids directly into the retina [1].

The lipids in the retina

The membranes that surround our cells are made of lipids and proteins. The composition of lipids, which changes as we age, impacts many biophysical properties of these membranes. In this study, the researchers focused explicitly on the age-related changes in the lipid composition of the retina and their link to age-related macular degeneration (AMD) [2].

AMD was previously linked to the age-related decrease in retinal long- and very long-chain polyunsaturated fatty acids (LC-PUFAs and VLC-PUFAs) [3]. Preserving or replenishing proper lipid composition in the aging retina could be used as a strategy to preserve its proper functioning, and one way to achieve this would be to supplement PUFAs in the diet. However, studies investigating dietary supplementation of different forms of PUFAs have given contradicting results [4-6].

The lack of other therapeutic approaches to prevent the age-related decrease in VLC-PUFAs is partly caused by a lack of understanding of its mechanism. However, this lab had shed some light on this mechanism in its previous studies. These researchers have linked the activity of an enzyme, elongation of very long chain fatty acids protein 2 (ELOVL2) to aging processes in the eye [7]. ELOVL2 is an enzyme that plays an essential function in elongating LC-and VLC-PUFAs. Specifically, ELOVL2 elongates docosapentaenoic acid (DPA) from 22:5n-3 to 24:5n-3, which is further converted to VLC-PUFAs and 22:6n-3 (DHA). Methylation of the ELOVL2 regulatory region is a biomarker of chronological aging [8].

In this study, the researchers delved deeper into the impact of ELOVL2 on the aging retina membranes and their lipid composition and proposed “a potential new therapy to reverse the symptoms of aging in the eye and prevent age-related eye diseases.”

The essential gene

Investigating key enzymes in the PUFA elongation pathway, this study found that Elovl2 expression decreases in the aged mouse retina compared to young mice. To investigate its role in age-related vision loss, the researchers used genetically engineered mice that lacked ELOVL2 enzymatic activity and measured lipid profiles in their retinas. Lower levels of PUFAs were synthesized from ELOVL2 in the 18-month-old genetically engineered mice compared to the age-matched wild-type retinas. The authors also observed a decrease in several metrics of visual function compared with age-matched wild-type animals.

A gene expression analysis found that 18-month-old wild-type mice and 12-month-old genetically engineered mice had similarities in their retinas, while the retinas of 12-month-old wild-type mice were different in gene expression from those two groups.

Lipid injection treatment

Following these observations, the researchers hypothesized that “the lack of direct ELOVL2 product, 24:5n-3, in the aging retina is one of the main culprits of age-related visual decline and that supplementation with this fatty acid may improve vision in aged animals.” To test this, they supplemented these lipids by directly injecting them into the retina (intravitreal injection), which allowed for precise administration.

They found the optimal dose and tested several different PUFAs on aged mice. Treatment with 24:5n-3 improved vision parameters and lipid composition in older mice while not causing any side effects or inflammation.

Comparing 18-month-old control retinas to 4-month-old retinas showed an increased inflammatory response. 24:5n-3 supplementation decreased the upregulation of several of those pathways. The treatment also reduced immune and oxidative stress response levels, which contribute to age-related vision loss.

“It’s a proof-of-concept for turning lipid injection into a possible therapy,” says Skowronska-Krawczyk, PhD, the corresponding author in the study. “We have also shown on a molecular level that it actually reverses the aging features.”

Single vs. repeated

While most previous experiments assess the impact of such treatments relatively shortly after they are administered, for a treatment to be applicable in a clinic, it needs to have a long-term effect. Therefore, the researchers tested this effect in two ways. First, they applied long-term follow-ups at 2 and 4 weeks after the initial injection into 18-month-old mice. Second, they used a repeated injection strategy, with injections every 3 weeks, starting at 16 months old. They collected the retina for analysis after the third injection.

The first strategy showed visual improvement, such as rod and cone photoreceptor function, and improvements in the brain’s visual cortex function were still observed at 2 weeks following the injection. At 4 weeks, improvements in rod and cone photoreceptor function were still observed. For the repeated strategy, the researchers observed some improvements after the first two injections but not after the third one.

An analysis of lipid profiles showed a modest increase in VLC-PUFA-containing phospholipids following the first strategy, which was observed even after long-term follow-up. Five days after the first injection, the researchers also noted an accumulation of multiple DHA-containing fatty acids, but only one of them remained increased after the 4-week follow-up, suggesting that the benefits of the treatment might be limited beyond this point.

The authors suggest two paths that supplemented 24:5n-3 might follow. First, 24:5n-3 is elongated into VLC-PUFAs and incorporated into phospholipids, which can be incorporated into membranes, restoring age-related VLC-PUFA loss and supporting visual improvement. Second, 24:5n-3 is converted into 22:6n-3 and stored in triglycerides.

The repeated injection approach led to the accumulation of several DHA-containing triglycerides and free VLC-PUFA, with no vision improvement. The researchers discuss that this “suggested that excessive lipid supplementation may diminish the beneficial effects of treatment” since no vision improvements were also observed with single injections at higher doses.

Identifying people at higher risk

The demonstrated importance of ELOVL2 in mice prompted the researchers to see whether human data might suggest its importance as well.

Investigation into the association between genetic variants within the ELOVL2 gene and the age of onset of intermediate AMD in the human population showed that two of the ELOVL2 gene variants were correlated with almost 5 months of earlier earlier AMD onset.

“Now we actually have a genetic connection to the disease and its aging aspect,” said Skowronska-Krawczyk, “so we could potentially identify people at higher risk for vision loss progression.”

Optimization needed

Overall, this therapeutic approach reversed several functional and structural signs of aging and restored a more youthful retinal gene expression profile.

However, the authors are also aware of some shortcomings of their approach, and they discuss that if their approach were to be used as a therapy, it would need to be optimized. Their research showed the importance of choosing a proper dose and treatment frequency. The mode of administration would also need to be adjusted to be more feasible, for example, eye drops instead of injection, and most importantly, the results would need to be confirmed in humans.

We would like to ask you a small favor. We are a non-profit foundation, and unlike some other organizations, we have no shareholders and no products to sell you. All our news and educational content is free for everyone to read, but it does mean that we rely on the help of people like you. Every contribution, no matter if it’s big or small, supports independent journalism and sustains our future.

Literature

[1] Gao, F., Tom, E., Rydz, C., Cho, W., Kolesnikov, A. V., Sha, Y., Papadam, A., Jafari, S., Joseph, A., Ahanchi, A., Balalaei Someh Saraei, N., Lyon, D. C., Foik, A., Nie, Q., Grassmann, F., Kefalov, V. J., & Skowronska-Krawczyk, D. (2025). Retinal polyunsaturated fatty acid supplementation reverses aging-related vision decline in mice. Science translational medicine, 17(817), eads5769.

[2] Gordon, W. C., Kautzmann, M. I., Jun, B., Cothern, M. L., Fang, Z., & Bazan, N. G. (2023). Rod-specific downregulation of omega-3 very-long-chain polyunsaturated fatty acid pathway in age-related macular degeneration. Experimental eye research, 235, 109639.

[3] Skowronska-Krawczyk, D., & Chao, D. L. (2019). Long-Chain Polyunsaturated Fatty Acids and Age-Related Macular Degeneration. Advances in experimental medicine and biology, 1185, 39–43.

[4] Gorusupudi, A., Rallabandi, R., Li, B., Arunkumar, R., Blount, J. D., Rognon, G. T., Chang, F. Y., Wade, A., Lucas, S., Conboy, J. C., Rainier, J. D., & Bernstein, P. S. (2021). Retinal bioavailability and functional effects of a synthetic very-long-chain polyunsaturated fatty acid in mice. Proceedings of the National Academy of Sciences of the United States of America, 118(6), e2017739118.

[5] Yang, Z. H., Gorusupudi, A., Lydic, T. A., Mondal, A. K., Sato, S., Yamazaki, I., Yamaguchi, H., Tang, J., Rojulpote, K. V., Lin, A. B., Decot, H., Koch, H., Brock, D. C., Arunkumar, R., Shi, Z. D., Yu, Z. X., Pryor, M., Kun, J. F., Swenson, R. E., Swaroop, A., … Remaley, A. T. (2023). Dietary fish oil enriched in very-long-chain polyunsaturated fatty acid reduces cardiometabolic risk factors and improves retinal function. iScience, 26(12), 108411.

[6] Age-Related Eye Disease Study 2 Research Group (2013). Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. JAMA, 309(19), 2005–2015.

[7] Chen, D., Chao, D. L., Rocha, L., Kolar, M., Nguyen Huu, V. A., Krawczyk, M., Dasyani, M., Wang, T., Jafari, M., Jabari, M., Ross, K. D., Saghatelian, A., Hamilton, B. A., Zhang, K., & Skowronska-Krawczyk, D. (2020). The lipid elongation enzyme ELOVL2 is a molecular regulator of aging in the retina. Aging cell, 19(2), e13100.

[8] Garagnani, P., Bacalini, M. G., Pirazzini, C., Gori, D., Giuliani, C., Mari, D., Di Blasio, A. M., Gentilini, D., Vitale, G., Collino, S., Rezzi, S., Castellani, G., Capri, M., Salvioli, S., & Franceschi, C. (2012). Methylation of ELOVL2 gene as a new epigenetic marker of age. Aging cell, 11(6), 1132–1134.