Go to JCI Insight
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Advertising
  • Job board
  • Contact
  • Clinical Research and Public Health
  • Current issue
  • Past issues
  • By specialty
    • COVID-19
    • Cardiology
    • Gastroenterology
    • Immunology
    • Metabolism
    • Nephrology
    • Neuroscience
    • Oncology
    • Pulmonology
    • Vascular biology
    • All ...
  • Videos
    • ASCI Milestone Awards
    • Video Abstracts
    • Conversations with Giants in Medicine
  • Reviews
    • View all reviews ...
    • Neurodegeneration (Mar 2026)
    • Clinical innovation and scientific progress in GLP-1 medicine (Nov 2025)
    • Pancreatic Cancer (Jul 2025)
    • Complement Biology and Therapeutics (May 2025)
    • Evolving insights into MASLD and MASH pathogenesis and treatment (Apr 2025)
    • Microbiome in Health and Disease (Feb 2025)
    • Substance Use Disorders (Oct 2024)
    • View all review series ...
  • Viewpoint
  • Collections
    • In-Press Preview
    • Clinical Research and Public Health
    • Research Letters
    • Letters to the Editor
    • Editorials
    • Commentaries
    • Editor's notes
    • Reviews
    • Viewpoints
    • 100th anniversary
    • Top read articles

  • Current issue
  • Past issues
  • Specialties
  • Reviews
  • Review series
  • ASCI Milestone Awards
  • Video Abstracts
  • Conversations with Giants in Medicine
  • In-Press Preview
  • Clinical Research and Public Health
  • Research Letters
  • Letters to the Editor
  • Editorials
  • Commentaries
  • Editor's notes
  • Reviews
  • Viewpoints
  • 100th anniversary
  • Top read articles
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Advertising
  • Job board
  • Contact
Cellular senescence and the senescent secretory phenotype: therapeutic opportunities
Tamara Tchkonia, Yi Zhu, Jan van Deursen, Judith Campisi, James L. Kirkland
Tamara Tchkonia, Yi Zhu, Jan van Deursen, Judith Campisi, James L. Kirkland
View: Text | PDF
Review Series

Cellular senescence and the senescent secretory phenotype: therapeutic opportunities

  • Text
  • PDF
Abstract

Aging is the largest risk factor for most chronic diseases, which account for the majority of morbidity and health care expenditures in developed nations. New findings suggest that aging is a modifiable risk factor, and it may be feasible to delay age-related diseases as a group by modulating fundamental aging mechanisms. One such mechanism is cellular senescence, which can cause chronic inflammation through the senescence-associated secretory phenotype (SASP). We review the mechanisms that induce senescence and the SASP, their associations with chronic disease and frailty, therapeutic opportunities based on targeting senescent cells and the SASP, and potential paths to developing clinical interventions.

Authors

Tamara Tchkonia, Yi Zhu, Jan van Deursen, Judith Campisi, James L. Kirkland

×

Figure 3

A number of inducers can act alone or in combination to push cells into the senescent cell fate through pathways involving p16INK4a/Rb, p53/p21, and likely other pathways.

Options: View larger image (or click on image) Download as PowerPoint
A number of inducers can act alone or in combination to push cells into ...
Triggers may include DNA damage (e.g., telomere shortening and single- and double-strand breaks); oncogenic mutations (e.g., Ras, Myc, B-Raf); reactive metabolites (e.g., ROS, ceramides, fatty acids, high glucose); high mitogen and nutrient signals that increase mTOR activity; and proteotoxic stress (e.g., protein aggregation and unfolded proteins). These may contribute to widespread changes in gene expression and chromatin remodeling (heterochromatin formation) that underlie senescence-associated growth arrest, the SASP, and changes in morphology. In these respects, cellular senescence can be viewed as a cell fate reminiscent of differentiation, replication, or apoptosis (external and internal inducers, transcription factor cascades, gene expression changes and chromatin remodeling, leading to changes in function). Evidence is better for some of the initiators and mediators of senescence than for others, and future research is likely to uncover additional initiators and mediators. Intracellular autocrine loops reinforce progression to irreversible replicative arrest, heterochromatin formation, and initiation of the SASP over a matter of days to weeks. In addition to removing cells from the progenitor/stem cell pool, senescence may contribute to tissue dysfunction and chronic disease predisposition through the SASP and associated chronic sterile inflammation and degradation of the extracellular matrix.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

Sign up for email alerts