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Researchers found that metformin -- a drug that has been around for more than a half-century to regulate blood sugar -- may have a different ability: It can target senescent cells that affect muscle function. These "zombie-like" cells release chemicals linked with inflammation that can harden or scar tissues. Metformin works against these senescent properties, and also reduced muscle wasting in the study.
"Metformin may be able to be repurposed for other muscle-loss-related clinical applications -- for instance in recovery from hip or knee surgeries in elderly individuals where there is much inflammation and muscle atrophy," said lead researcher Jonathan Petrocelli, a graduate research assistant in physical therapy and athletic training at the University of Utah in Salt Lake City.
"We are just skimming the surface of what is possible for metformin," he said. "This study suggests that there is still much to understand regarding the recovery from periods of disuse."
Researchers were able to make some new connections between cellular senescence and fibrosis, or scarring, that Petrocelli said raises many new questions.
For the study, Petrocelli's team recruited 20 healthy men and women 60 years of age or older. Over two weeks, they were either given metformin or a placebo. Then, each group continued their treatment while resting in bed for five days.
The idea was to see whether metformin could protect against the muscle loss and scarring often seen in older adults who are recovering from an injury or illness. Researchers used MRIs to track muscle loss during participants' inactive period.
"We saw protective effects against muscle loss, fibrosis, markers of inflammation and were able to link some of these effects to metformin's anti-cellular properties," Petrocelli said.
Targeting these cells and their secretions with therapies like metformin may promote better muscle recovery, he said.
"However, much research is needed such as exploration in the use of metformin or similar acting therapies given during the recovery period to see if recovery can be enhanced or even achieved faster," Petrocelli added.
Dr. Irina Dashkova is associate medical director of geriatric and palliative care at Northwell Health Stern Family Center for Rehab in Manhasset, N.Y.
She called the findings impressive -- if metformin could really play a role in slowing aging.
"But you cannot start metformin in the hospital for many reasons -- it's just for sugar control," Dashkova said.
Metformin can affect kidney function, and it is not possible now to tell if using the drug to protect muscle would end up damaging the kidneys, Dashkova added.
At this point it would be unwise to take metformin in hopes of protecting muscle function and slowing aging, she said.
"It does have side effects, some of them deadly," Dashkova said, adding that more research is needed before metformin can be considered an anti-aging drug.
The findings were published July 25 in the journal Aging Cell.
SOURCES: Jonathan Petrocelli, PhD, graduate research assistant, Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City; Irina Dashkova, MD, associate medical director, Division of Geriatric and Palliative Care, Northwell Health Stern Family Center for Rehab, Manhasset, N.Y.; Aging Cell, July 25, 2023
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