“Orally-Active, Clinically-Translatable Senolytics Restore Α-Klotho in Mice and Humans”, Yi Zhu, Larissa G. P. Langhi Prata, Erin O. Wissler Gerdes, Jair Machado Espindola Netto, Tamar Pirtskhalava, Giorgadze, Utkarsh Tripathi, Christina L. Inman, Kurt O. Johnson, Ailing Xue, Allyson K. Palmer, Tingjun Chen, Schaefer, Jamie N. Justice, Anoop M. Nambiar, Nicolas Musi, Stephen B. Kritchevsky, Jun Chen, Sundeep Khosla, Jurk, Marissa J. Schafer, Tamar Tchkonia, James L. Kirkland2022-03-13 (senolytics)⁠:

Background: α-Klotho is a geroprotective protein that can attenuate or alleviate deleterious changes with ageing and disease. Declines in α-Klotho play a role in the pathophysiology of multiple diseases and age-related phenotypes. Pre-clinical evidence suggests that boosting α-Klotho holds therapeutic potential. However, readily clinically-translatable, practical strategies for increasing α-Klotho are not at hand. Here, we report that orally-active, clinically-translatable senolytics can increase α-Klotho in mice and humans.

Method: We examined α-Klotho expression in 3 different human primary cell types co-cultured with conditioned medium (CM) from senescent or non-senescent cells with or without neutralizing antibodies. We assessed α-Klotho expression in aged, obese, and senescent cell-transplanted mice treated with vehicle or senolytics. We assayed urinary α-Klotho in patients with idiopathic pulmonary fibrosis (IPF) who were treated with the senolytic drug combination, Dasatinib plus Quercetin (D+Q).

Results: We found exposure to the senescent cell secretome reduces α-Klotho in multiple non-senescent human cell types. This was partially prevented by neutralizing antibodies against the senescence-associated secretory phenotype (SASP) factors, activin A and Interleukin 1α (IL-1α). Consistent with senescent cells’ being a cause of decreased α-Klotho, transplanting senescent cells into younger mice reduced brain and urine α-Klotho. Selectively removing senescent cells genetically or pharmacologically increased α-Klotho in urine, kidney, and brain of mice with increased senescent cell burden, including naturally-aged, diet-induced obese (DIO), or senescent cell-transplanted mice. D+Q increased α-Klotho in urine of patients with IPF, a disease linked to cellular senescence.

Interpretation: Senescent cells cause reduced α-Klotho, partially due to their production of activin A and IL-1α. Targeting senescent cells boosts α-Klotho in mice and humans. Thus, clearing senescent cells restores α-Klotho, potentially opening a novel, translationally-feasible avenue for developing orally-active small molecule, α-Klotho-enhancing clinical interventions. Furthermore, urinary α-Klotho may prove to be a useful test for following treatments in senolytic clinical trials.

[Keywords: cellular senescence, α-Klotho, senolytics]