May 15th, 2026
The accumulation of senescent cells with age is clearly an important aspect of degenerative aging. Senescent cells contribute to chronic inflammation and disrupt tissue structure and function. Of the early senolytic treatments shown to clear a fraction of senescent cells in the tissues of aging, only the dasatinib and quercertin combination has undergone initial clinical trials in human patients, and even there the trials are small and the doses relatively low. Data is promising but not conclusive. The field has moved past the initial interest in clearance without actually implementing that initial interest, albeit a number of companies are working towards clinical trials for their varied senolytic strategies. Meanwhile the research is more focused on understanding differences between senescent cells and has, perhaps, become overly cautious about deploying therapies in advance of building a much more comprehensive map of senescent cells and their activities.
It is true that scenarios could exist in which blunt clearance of senescent cells will cause harms alongside benefits. For example, where senescent cells are a part of the structure of an unstable atherosclerotic plaque. Clearing those cells may tip the plaque over the edge and into fragmentation under the next incidence of pressure stress. There are no doubt other age-related circumstances in which clearance of senescent cells fails the cost-benefit test. How common are these scenarios? It seems to me that no-one is much interested in finding out, and researchers are more focused on generating the groundwork for a next generation of therapies to emerge over the next few decades. Those therapies don't yet exist, but first generation senolytics do exist. A little more thought given to the evaluation of the cost-benefit of their use seems needed, and absent.
