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Geromedicine (GER, Online ISSN 3106-8618) is a quarterly, gold open-access journal published by Science Exploration Press, offering a comprehensive platform for research in geroscience. Progress in geroscience - the study of aging - has laid the foundation for geromedicine, which focuses on evidence-based medical interventions to keep individuals and populations healthy and fit. Precision geromedicine will rely on aging biomarkers to assess an individual's biological aging process (gerodiagnosis) and apply targeted interventions to enhance health and longevity (gerotherapeutics). The new journal Geromedicine will lead the development of this emerging medical discipline. more >
Articles
TFEB in stress adaptation, senescence, and aging
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Cells rely on lysosomes and autophagy to maintain homeostasis under fluctuating environmental and metabolic conditions. However, how these degradative systems are dynamically coordinated across stress, senescence, and aging remains incompletely understood. ...
MoreCells rely on lysosomes and autophagy to maintain homeostasis under fluctuating environmental and metabolic conditions. However, how these degradative systems are dynamically coordinated across stress, senescence, and aging remains incompletely understood. Transcription factor EB (TFEB), a member of the microphthalmia/transcription factor E (MiT/TFE) family, has emerged as a key regulator of lysosomal biogenesis and autophagy by controlling the coordinated lysosomal expression and regulation (CLEAR) gene network, integrating nutrient sensing, mitochondrial status, Ca2+, redox signaling, and mechanistic target of rapamycin complex 1 (mTORC1) activity. While TFEB activation promotes lysosomal and metabolic adaptation during acute stress, accumulating evidence indicates that its activity is tightly constrained in time and magnitude, and that altered TFEB dynamics critically shape cellular fate decisions. Here, we synthesize current findings showing that transient TFEB activation supports stress resilience and recovery. In contrast, persistent, insufficient, or dysregulated TFEB signaling contributes to divergent senescence trajectories and age-associated decline in proteostasis. We further discuss how defects in TFEB regulation underlie impaired autophagy–lysosome function during aging across tissues. Notably, both insufficient and excessive TFEB activity can be maladaptive. Together, this framework positions TFEB as a dynamically regulated node linking stress adaptation, senescence progression, and aging, and highlights the need for context- and tissue-specific strategies aimed at restoring TFEB responsiveness rather than constitutively enhancing its activity.
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Lena Guerrero-Navarro, ... Maria Cavinato
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DOI: https://doi.org/10.70401/Geromedicine.2026.0024 - May 09, 2026
Mutagen-induced somatic mutation rate in primary mammalian cells in relation to maximum life span
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Aims: Testing the hypothesis that excess mutations induced in primary fibroblasts by a low dose of N-ethyl-N-nitrosourea (ENU) are inversely correlated with species-specific maximum life span.
Methods: To measure excess mutations ...
MoreAims: Testing the hypothesis that excess mutations induced in primary fibroblasts by a low dose of N-ethyl-N-nitrosourea (ENU) are inversely correlated with species-specific maximum life span.
Methods: To measure excess mutations induced by ENU we treated primary cells of 10 mammalian species, greatly differing in life span. We treated all cells with a low dose, non-toxic dose of ENU (20 ug/ml). We then extracted DNA from all treated and untreated cells and quantified somatic mutation burden by single-molecule sequencing. We measured excessive mutations by calculating the ΔSNVs and we analyzed this across species with linear regression.
Results: The average values for ΔSNV were found to range from 0.773 in mice to 0.367 in whale, resulting in a modest inverse correlation with species-specific maximum life span (R2 = 0.2067, P < 0.001).
Conclusion: We conclude that DNA repair accuracy, the main determinant of genome sequence integrity, modestly correlates with life span suggesting that longer lived species have better repair capacities compared to shorter-lived species, which is in keeping with genome instability being a primary hallmark of aging and highlights its important role for longevity.
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Johanna Heid, ... Jan Vijg
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DOI: https://doi.org/10.70401/Geromedicine.2026.0023 - May 08, 2026
Microglial autophagy and other LC3-dependent pathways in neurodegeneration
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Autophagy is a conserved cellular clearance pathway that supports homeostasis by removing damaged or superfluous intracellular components. Within microglia, autophagy is emerging as a regulator of key processes that modify neurodegeneration, including ...
MoreAutophagy is a conserved cellular clearance pathway that supports homeostasis by removing damaged or superfluous intracellular components. Within microglia, autophagy is emerging as a regulator of key processes that modify neurodegeneration, including phagocytosis, cytokine secretion, and senescence. Many studies that have examined the effect of disrupted autophagy on microglial functions have used genetic knockouts of the machinery required to conjugate microtubule-associated light chain 3 (LC3) to the autophagic membrane. However, much of this molecular machinery is also required for a set of distinct but related pathways known as the conjugation of ATG8s to single membranes (CASM). CASM includes processes of particular importance in microglia, such as LC3-associated phagocytosis and LC3-associated endocytosis. It is thus not clear which of the effects of the disruption of LC3 conjugation in microglia are attributable to the loss of autophagy or the loss of CASM function. In this review, we describe the mechanisms of autophagy and CASM and highlight the effects of the loss of these pathways on key microglial processes relevant to brain ageing and neurodegenerative diseases. We discuss recent literature that has revealed the effects of ageing and neurodegeneration on microglial autophagy, and the effects of microglial autophagy and/or CASM disruption on key microglial functions such as phagocytosis, cytokine secretion, and senescence. Finally, we discuss the potential therapeutic implications of these findings for neurodegeneration and highlight key unanswered questions for future research.
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Jennifer E. Palmer, David C. Rubinsztein
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DOI: https://doi.org/10.70401/Geromedicine.2026.0022 - April 30, 2026
Emerging role of cellular senescence in peritumoral microenvironment on tumor progression
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Accumulating evidence has indicated that the normal tissue adjacent to tumor (NAT) is distinct from both healthy and tumor tissues. It is suggested that the crosstalk between NAT and tumor tissues helps shape the tumor microenvironment and promotes cancer ...
MoreAccumulating evidence has indicated that the normal tissue adjacent to tumor (NAT) is distinct from both healthy and tumor tissues. It is suggested that the crosstalk between NAT and tumor tissues helps shape the tumor microenvironment and promotes cancer progression, but the molecular and cellular evidence for this crosstalk is scarce. In this perspective, we propose that NAT tissue constitutes a unique “peritumoral microenvironment (Peri-TME)” mostly conditioned by the tumor. Furthermore, cellular senescence is identified as a key characteristic of Peri-TME, which accelerates tumor growth, as illustrated in our recent studies in colorectal cancer (CRC). Finally, strategies to target the senescent Peri-TME may represent an effective means to disrupt the vicious interaction between Peri-TME and Tumor and enhance therapeutic efficacy.
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Mantang Zhou, ... Dongwang Yan
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DOI: https://doi.org/10.70401/Geromedicine.2026.0021 - April 24, 2026
Encouraging a move toward precision geromedicine
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Aging is a heterogeneous, multi-system process driven by the interplay between accumulating molecular damage and the progressive erosion of resilience. While damage accumulates in a ubiquitous and homogeneous fashion, resilience is finite and unequally ...
MoreAging is a heterogeneous, multi-system process driven by the interplay between accumulating molecular damage and the progressive erosion of resilience. While damage accumulates in a ubiquitous and homogeneous fashion, resilience is finite and unequally distributed across physiological systems and individuals, yielding distinct biological trajectories that diverge early in life, giving rise to the individual-specific decline in physiological function and the manifestation of a diverse spectrum of organ-specific diseases, and converge only when multisystem dysregulation overwhelms compensatory capacity. Early deviations in mitochondrial function, proteostasis, inflammation, and metabolic regulation often remain clinically silent, detectable only through gerodiagnostics, longitudinal, sensitive biomarkers of aging. Yet most biomarkers were developed to detect disease rather than quantify aging biology, and their mechanistic specificity declines with advancing multimorbidity. Precision geromedicine therefore requires the integration of gerodiagnostics that capture system-level resilience and stress responsiveness with measures of functional reserve, behavior, physiology, and the exposome, enabling the identification of individualized aging trajectories and the biological pathways that drive them. This combined approach clarifies causal pathways, enables earlier detection of vulnerability and supports individualized gerointerventions that modify aging trajectories rather than specifically but narrowly focusing on individual age-related diseases.
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Luigi Ferrucci, ... Guido Kroemer
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DOI: https://doi.org/10.70401/Geromedicine.2026.0020 - April 23, 2026
Hallmarks of aging: Integrating molecular and social determinants
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The biology of aging is increasingly understood through geroscience frameworks integrating molecular, cellular, physiological, and social hallmarks. Recently, we introduced psychosocial factors including mental illness as an important hallmark of ...
MoreThe biology of aging is increasingly understood through geroscience frameworks integrating molecular, cellular, physiological, and social hallmarks. Recently, we introduced psychosocial factors including mental illness as an important hallmark of aging. Indeed, exposome-centered approaches reveal complex interactions among socioeconomic, environmental, behavioral, and genomic factors. Precision Geromedicine aims to target all these determinants in a holistic fashion to improve aging trajectories and extend healthspan.
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Carlos López-Otín, Guido Kroemer
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DOI: https://doi.org/10.70401/Geromedicine.2025.0007 - October 31, 2025
Clinical evidence for the use of NAD+ precursors to slow aging
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Significant progress in clinical care has extended human life expectancy to unprecedented levels. However, this trend has been parallelled by a rise in years lived with poor health, posing profound challenges not only to individual quality of life, but also ...
MoreSignificant progress in clinical care has extended human life expectancy to unprecedented levels. However, this trend has been parallelled by a rise in years lived with poor health, posing profound challenges not only to individual quality of life, but also to substantial medical and socioeconomic burdens at the population level. This underscores the urgent need for strategies that extend healthspan alongside lifespan. In this regard, nicotinamide adenine dinucleotide (NAD+) has emerged as a central metabolic cofactor and signaling molecule that regulates processes fundamental to health and longevity, including energy metabolism, mitochondrial function, inflammation, and DNA repair. Importantly, intracellular NAD+ levels decline with age across multiple tissues and organ systems, and restoring NAD+ content has been shown to reinstate cellular and physiological function in various model systems. Among the strategies to augment NAD+, supplementation with its precursors, namely nicotinic acid/niacin, nicotinamide, nicotinamide riboside, and nicotinamide mononucleotide, represents the most practical and extensively studied approach. Over the past two decades, preclinical research and an increasing number of clinical trials have investigated the therapeutic potential of these precursors in preventing or reversing age-associated decline and pathologies. In this review, we synthesize recent clinical advances, critically evaluate the promise and limitations of NAD+ precursor supplementation, and discuss future directions for leveraging NAD+ metabolism to improve healthspan in a rapidly aging global population.
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Subhash Khatri, ... Simon Sedej
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DOI: https://doi.org/10.70401/Geromedicine.2025.0008 - November 13, 2025
The vocabulary of geromedicine: gerovocabulary
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Guido Kroemer, ... Andrea B. Maier
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DOI: https://doi.org/10.70401/Geromedicine.2025.0002 - May 07, 2025
Geromedicine: A new journal for the clinical application of geroscience
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Guido Kroemer, ... Andrea B. Maier
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DOI: https://doi.org/10.70401/Geromedicine.2025.0001 - May 07, 2025
Implementation of artificial intelligence in the clinical management of longevity
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Artificial intelligence (AI) has become a central driver in healthy longevity medicine (HLM), offering new tools to characterize biological aging trajectories, identify preclinical physiological decline, and optimize interventions aimed at preserving ...
MoreArtificial intelligence (AI) has become a central driver in healthy longevity medicine (HLM), offering new tools to characterize biological aging trajectories, identify preclinical physiological decline, and optimize interventions aimed at preserving function throughout the lifespan by targeting age-related processes. HLM is increasingly recognized as a specialty focusing on the multidimensional process of aging, encompassing molecular, physiological, cognitive, and behavioral components, all of which generate complex, high-dimensional datasets that exceed the analytical capacity of traditional clinical approaches. AI methodologies, including machine learning and deep learning models capable of integrating large, multimodal data streams, provide the computational infrastructure required to produce actionable insights. In the clinical practice of HLM, AI further facilitates integration of converging domains, including continuous digital phenotyping enabled by wearables and sensors, advanced biomarker modeling, predictive modeling capable of forecasting risk trajectories and personalized intervention optimization through life models and digital twins. These models support anticipatory clinical management, shifting care from reactive disease treatment toward continuous preservation of physiological resilience. Despite rapid progress, the integration of AI into routine healthy longevity care requires careful consideration of data quality, algorithmic transparency, regulatory frameworks, population diversity, and clinical interpretability. Nonetheless, AI-driven healthy longevity management is beginning to allow biological aging to be quantified, targeted, and longitudinally monitored in clinical practice.
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Evelyne Bischof, ... Dominika Wilczok
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DOI: https://doi.org/10.70401/Geromedicine.2026.0014 - January 29, 2026
Hallmarks of aging: Integrating molecular and social determinants
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The biology of aging is increasingly understood through geroscience frameworks integrating molecular, cellular, physiological, and social hallmarks. Recently, we introduced psychosocial factors including mental illness as an important hallmark of ...
MoreThe biology of aging is increasingly understood through geroscience frameworks integrating molecular, cellular, physiological, and social hallmarks. Recently, we introduced psychosocial factors including mental illness as an important hallmark of aging. Indeed, exposome-centered approaches reveal complex interactions among socioeconomic, environmental, behavioral, and genomic factors. Precision Geromedicine aims to target all these determinants in a holistic fashion to improve aging trajectories and extend healthspan.
Less -
Carlos López-Otín, Guido Kroemer
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DOI: https://doi.org/10.70401/Geromedicine.2025.0007 - October 31, 2025
Clinical evidence for the use of NAD+ precursors to slow aging
-
Significant progress in clinical care has extended human life expectancy to unprecedented levels. However, this trend has been parallelled by a rise in years lived with poor health, posing profound challenges not only to individual quality of life, but also ...
MoreSignificant progress in clinical care has extended human life expectancy to unprecedented levels. However, this trend has been parallelled by a rise in years lived with poor health, posing profound challenges not only to individual quality of life, but also to substantial medical and socioeconomic burdens at the population level. This underscores the urgent need for strategies that extend healthspan alongside lifespan. In this regard, nicotinamide adenine dinucleotide (NAD+) has emerged as a central metabolic cofactor and signaling molecule that regulates processes fundamental to health and longevity, including energy metabolism, mitochondrial function, inflammation, and DNA repair. Importantly, intracellular NAD+ levels decline with age across multiple tissues and organ systems, and restoring NAD+ content has been shown to reinstate cellular and physiological function in various model systems. Among the strategies to augment NAD+, supplementation with its precursors, namely nicotinic acid/niacin, nicotinamide, nicotinamide riboside, and nicotinamide mononucleotide, represents the most practical and extensively studied approach. Over the past two decades, preclinical research and an increasing number of clinical trials have investigated the therapeutic potential of these precursors in preventing or reversing age-associated decline and pathologies. In this review, we synthesize recent clinical advances, critically evaluate the promise and limitations of NAD+ precursor supplementation, and discuss future directions for leveraging NAD+ metabolism to improve healthspan in a rapidly aging global population.
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Subhash Khatri, ... Simon Sedej
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DOI: https://doi.org/10.70401/Geromedicine.2025.0008 - November 13, 2025
Implementation of artificial intelligence in the clinical management of longevity
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Artificial intelligence (AI) has become a central driver in healthy longevity medicine (HLM), offering new tools to characterize biological aging trajectories, identify preclinical physiological decline, and optimize interventions aimed at preserving ...
MoreArtificial intelligence (AI) has become a central driver in healthy longevity medicine (HLM), offering new tools to characterize biological aging trajectories, identify preclinical physiological decline, and optimize interventions aimed at preserving function throughout the lifespan by targeting age-related processes. HLM is increasingly recognized as a specialty focusing on the multidimensional process of aging, encompassing molecular, physiological, cognitive, and behavioral components, all of which generate complex, high-dimensional datasets that exceed the analytical capacity of traditional clinical approaches. AI methodologies, including machine learning and deep learning models capable of integrating large, multimodal data streams, provide the computational infrastructure required to produce actionable insights. In the clinical practice of HLM, AI further facilitates integration of converging domains, including continuous digital phenotyping enabled by wearables and sensors, advanced biomarker modeling, predictive modeling capable of forecasting risk trajectories and personalized intervention optimization through life models and digital twins. These models support anticipatory clinical management, shifting care from reactive disease treatment toward continuous preservation of physiological resilience. Despite rapid progress, the integration of AI into routine healthy longevity care requires careful consideration of data quality, algorithmic transparency, regulatory frameworks, population diversity, and clinical interpretability. Nonetheless, AI-driven healthy longevity management is beginning to allow biological aging to be quantified, targeted, and longitudinally monitored in clinical practice.
Less -
Evelyne Bischof, ... Dominika Wilczok
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DOI: https://doi.org/10.70401/Geromedicine.2026.0014 - January 29, 2026
The vocabulary of geromedicine: gerovocabulary
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Guido Kroemer, ... Andrea B. Maier
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DOI: https://doi.org/10.70401/Geromedicine.2025.0002 - May 07, 2025
Tau protein isoforms in neuropathological aging: Gerosuppressors, gerogenes or just travel companions
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In recent years, the terms “gerosuppressors” and “gerogenes” have been introduced to describe factors that respectively delay or accelerate aging. These factors are present across various cell types. Specific proteins, such as tau predominantly expressed ...
MoreIn recent years, the terms “gerosuppressors” and “gerogenes” have been introduced to describe factors that respectively delay or accelerate aging. These factors are present across various cell types. Specific proteins, such as tau predominantly expressed in neurons, may act as neuron-specific gerosuppressors or gerogenes. Tau exhibits a dual role influenced by its post-translational modifications, particularly phosphorylation. In this review, we discuss relevant examples of tau isoforms that demonstrate both roles, underscoring its dual influence on neuronal aging.
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Jesús Avila, ... José Viña
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DOI: https://doi.org/10.70401/Geromedicine.2025.0006 - October 17, 2025
Special Issues
Understudied Directions in Aging Biology, Quantitative and First-Principles Approaches
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Submission Deadline: 30 Jun 2026
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Published articles: 0

