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Exploring the Dual Role of Senescence in Liver Disease: Insights and Emerging Therapies from the Chinese Medical Journal

  • The dual role of cellular senescence in liver disease is highlighted by the secretion of pro-inflammatory factors from senescent liver cells that contribute to chronic inflammation, damage to liver tissue, and maladaptive repair processes. Chronic senescence leads to persistent inflammatory states and serves as precursors for increased fibrosis and cancer incidence. Cellular senescence plays a protective role in halting the progression of potentially cancerous cells, but it also poses pathological challenges in liver health. Senescence contributes to mitochondrial dysfunction, reactive oxygen species accumulation, and the inflammatory state, ultimately impairing liver regeneration capabilities. Senolytic therapies have emerged as a hopeful frontier in addressing the challenges posed by senescence in chronic liver diseases. The personalization of treatment strategies based on the metabolic and inflammatory landscape of each patient's condition can ultimately lead to breakthroughs in the management of liver diseases and enhance our understanding of aging and its associated challenges.
  • Cellular senescence represents a central biological phenomenon that characterizes the irreversible arrest of the cell cycle, which is initiated in response to intrinsic and extrinsic stressors such as oxidative stress, DNA damage, and telomere shortening.
  • Senescent liver cells, including hepatocytes, liver sinusoidal endothelial cells, and Kupffer cells, transition to the senescence-associated secretory phenotype (SASP), and the accumulation of senescent liver cells correlates with chronic liver diseases such as non-alcoholic fatty liver disease (NAFLD), liver fibrosis, cirrhosis, and hepatocellular carcinoma (HCC).
  • The markers of senescence, such as p16INK4a and p21CIP1, are key players in the metabolic dysregulation observed in liver pathology, and elevated levels of these proteins exacerbate liver inflammation, mitochondrial dysfunction, and reactive oxygen species accumulation.
  • Senescent hepatic stellate cells contribute to excessive extracellular matrix deposition, leading to fibrosis and, in severe cases, cirrhosis, and the pro-inflammatory milieu generated by senescent cells can facilitate tumorigenesis, with advanced liver diseases frequently culminating in HCC.
  • As research evolves, senolytic therapies aim to selectively eliminate senescent cells from tissues, potentially reversing or halting the pathological processes they drive. Promising compounds such as dasatinib and quercetin have shown efficacy in preclinical models, paving the way for innovative treatments for chronic liver diseases.
  • Personalized approaches that recognize the dual nature of senescence may ultimately lead to breakthroughs in the management of liver diseases and enhance our understanding of aging and its associated challenges.
  • The growing body of evidence positions senescence as both a critical mediator of liver disease progression and a potential therapeutic target. Continued exploration into the underlying mechanisms of senescence will be vital in devising strategies that leverage its protective benefits while mitigating its detrimental impacts.
  • The research surrounding senescence is set to reshape future interventions for liver health, as biology, therapeutics, and clinical practice converge to devise innovative avenues for treatment, providing hope for patients affected by chronic liver diseases.
  • As cellular senescence remains at the forefront of research in liver health, the convergence of biology, therapeutics, and clinical practice is set to reshape future interventions.
  • A recent study revealed that chronic senescence leads to persistent inflammatory states, which serve as precursors for increased fibrosis and cancer incidence, highlighting why targeted therapeutic approaches may be essential for mitigating the adverse effects of senescence in liver pathology.

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