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Comment & Response
March 5, 2019

Therapeutic Approaches to Aging—Reply

Author Affiliations
  • 1Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, Minnesota
JAMA. 2019;321(9):901-902. doi:10.1001/jama.2018.20554

In Reply We agree with the points raised by Dr O’Sullivan and colleagues about our Viewpoint,1 including their comments about implications of targeting senescent cells at different stages during development and aging, intermittent hit-and-run dosing, cancer control, wound healing, and fibrosis.

We agree that there are situations in which generation of senescent cells is beneficial, including during embryogenesis and development. Until more preclinical research is available, we suggest avoiding enrolling children or pregnant women in clinical trials. That said, there is emerging preclinical evidence that certain disorders that begin during development, such as progeroid syndromes (accelerated aging-like states), and that are associated with high senescent cell burden can be alleviated by senolytics in mouse models.2,3 If further preclinical work supports this, situations could be envisaged in which clinical trials with senolytics in children are warranted.