The bystander effect contributes to the accumulation of senescent cells in vivo

Senescent cells accumulate with age in multiple tissues and may cause age‐associated disease and functional decline. In vitro, senescent cells induce senescence in bystander cells. To see how important this bystander effect may be for accumulation of senescent cells in vivo, we xenotransplanted senescent cells into skeletal muscle and skin of immunocompromised NSG mice. 3 weeks after the last transplantation, mouse dermal fibroblasts and myofibres displayed multiple senescence markers in the vicinity of transplanted senescent cells, but not where non‐senescent or no cells were injected. Adjacent to injected senescent cells, the magnitude of the bystander effect was similar to the increase in senescence markers in myofibres between 8 and 32 months of age. The age‐associated increase of senescence markers in muscle correlated with fibre thinning, a widely used marker of muscle aging and sarcopenia. Senescent cell transplantation resulted in borderline induction of centrally nucleated fibres and no significant thinning, suggesting that myofibre aging might be a delayed consequence of senescence‐like signalling. To assess the relative importance of the bystander effect versus cell‐autonomous senescence, we compared senescent hepatocyte frequencies in livers of wild‐type and NSG mice under ad libitum and dietary restricted feeding. This enabled us to approximate cell‐autonomous and bystander‐driven senescent cell accumulation as well as the impact of immunosurveillance separately. The results suggest a significant impact of the bystander effect for accumulation of senescent hepatocytes in liver and indicate that senostatic interventions like dietary restriction may act as senolytics in immunocompetent animals.     

Senescent cells spread the word: non‐cell autonomous propagation of cellular senescence

Nat Cell Biol advance online publication, June162013; doi:10.1038/ncb2784Senescence has long been considered a cell autonomous arrest programme restricting the propagation of damaged cells in tissues. Now there is accumulating evidence that senescent cells can communicate with their environment. In a recent report by Gil and colleagues (Acosta et al, 2013), it now seems senescence can be transmitted in a paracrine fashion in several in vitro and in vivo contexts. In addition to broadening our understanding of the biology of senescence, these new findings may have interesting implications for tissue homeostasis and future cancer therapies.Senescence is a form of stress-induced cell cycle arrest that restricts the proliferative capacity of damaged and/or potentially harmful cells (Rodier and Campisi, 2011), thereby promoting tissue homeostasis and tumour suppression. While the senescence-associated cell cycle arrest involves the well-studied Rb and p53 pathways, senescent cells also possess the less understood ability to secrete growth factors, cytokines and chemokines into their environment. This process, collectively known as the senescence-associated secretory phenotype (SASP; Rodier and Campisi, 2011), was originally used to mark senescent cells, but is now known to enforce cell cycle arrest, modify the microenvironment and trigger immune surveillance of senescent cells (Xue et al, 2007; Krizhanovsky et al, 2008; Rodier and Campisi, 2011).Adding to our understanding of this process, a recent report by Gil and colleagues showed that the SASP can also mediate paracrine transmission of cellular senescence (Acosta et al, 2013). By co-culturing cells undergoing oncogene-induced senescence (OIS) with normal cells, the authors showed that the senescence phenotype could be transmitted to surrounding cells via the soluble SASP proteins. Coupling quantitative proteomics with small-molecule inhibitor screens, they identified key players mediating the paracrine transmission of senescence, including TGFB, VEGF and CCL2 pathways. A search for upstream regulators of SASP pointed at IL-1 signalling and the inflammasome, molecules that operate cell autonomously to control SASP production and non-cell autonomously to spread the senescent phenotype via the SASP (Figure 1). Complementing the in vitro senescence findings, experiments using mouse and human models of OIS demonstrated evidence for paracrine senescence transmission in vivo.Open in a separate windowFigure 1Cell autonomous and non-cell autonomous effects of cellular senescence. Stress stimuli such as activation of oncogenes and DNA damage can trigger normal mitotic cells to go into senescence. This involves inflammosome-mediated activation of IL-1 signalling, which initiates the SASP response. The SASP acts cell autonomously (autocrine) to reinforce the senescent phenotype via cytokines such as IL-6. The SASP also acts non-cell autonomously (paracrine) to influence the cells in the surrounding environment. For example, SASP components such as VEGF, TGFB and CCL2 can trigger bystander senescence on neighbouring cells. Paradoxically, the SASP can also exert pro-mitogenic stimulation of neighbouring cells via cytokines like IL-6, which appear to play dual roles depending on the context. Furthermore, the SASP can act on the immune system via pro-inflammatory cytokines, leading to immune cell recruitment and subsequent targeting and clearance of senescent cells. Alternatively, the SASP can trigger upregulation of p16 and p21 levels on neighbouring immune cells, the functional consequences of which are not yet so clear.The ability of senescent cells to propagate their phenotype is consistent with previous studies identifying IGFBP7 as a paracrine senescence regulator (Wajapeyee et al, 2008) and provides important insights into senescence biology. It is conceivable to think that the induction of paracrine cell cycle arrest could expand the senescence footprint of the pre-neoplastic lesion to the surrounding epithelium. This could potentially serve to amplify the tissue damage signal, recruit more immune cells and ensure more efficient clearance of damaged cells. In parallel, the induction of paracrine senescence in other cell types within the tissue, for example tumour-associated fibroblasts, could repress their reported paracrine tumour-promoting effects (Krtolica et al, 2001).Despite the biological implications, a number of questions remain. Why, for instance, is paracrine senescence triggered in some cells surrounding pre-neoplastic lesions but not in others? Similarly, what is the functional significance of paracrine senescence induction in the surrounding immune cells? Intriguingly, recent evidence implies that p16 can also be induced in tumour-infiltrating immune cells (Burd et al, 2013). It will be important to determine whether the paracrine p16 induction in immune cells leads to the same consequences as in non-immune cells and whether the induction of a potential arrest programme compromises the ability of the immune cell to clear senescent cells.Beyond the biological implications, the key regulators of paracrine senescence have potential to be manipulated therapeutically. It is commonly believed, for instance, that senescent cells accumulate in aging tissues and disrupt tissue architecture and function (Rodier and Campisi, 2011). In this context, antagonists of paracrine senescence might limit the spread of senescence and prove beneficial for some age-associated disorders. In the context of cancer, both chemotherapeutic drugs and radiation are known to induce senescence in tumour cells (Schmitt, 2007; Prise and O''Sullivan, 2009). The use of agents agonizing paracrine senescence as adjunctive therapy could potentially increase the effectiveness of chemo- and radiotherapy by triggering a bystander response.Nonetheless, it is critical to keep in mind that the SASP may not always relay an arrest-inducing message onto the surrounding cells. Indeed, the SASP component IL-6 has been shown to elicit a pro-mitogenic response in a paracrine fashion (Kuilman et al, 2008). Similarly, the SASP has been shown to be pro- and anti-tumorigenic depending on the microenvironment (Krtolica et al, 2001; Xue et al, 2007; Lujambio et al, 2013; Figure 1). Collectively, these findings suggest that the ultimate outcome of senescence within a tissue is highly dependent on the context. But what then determines this context? One decisive factor could be whether or not the senescence signal engages in sufficient modulation of the immune system to provoke clearance. In cases where the senescent cells in a tissue are not cleared, the pro-mitogenic arm of the SASP signal could persist long enough to have an overall pro-tumorigenic effect. It will thus be important to understand all the flavours of SASP to modulate it safely for therapeutic purposes.     

Disc cell senescence in intervertebral disc degeneration: Causes and molecular pathways

The accumulation of senescent disc cells in degenerative intervertebral disc (IVD) suggests the detrimental roles of cell senescence in the pathogenesis of intervertebral disc degeneration (IDD). Disc cell senescence decreased the number of functional cells in IVD. Moreover, the senescent disc cells were supposed to accelerate the process of IDD via their aberrant paracrine effects by which senescent cells cause the senescence of neighboring cells and enhance the matrix catabolism and inflammation in IVD. Thus, anti-senescence has been proposed as a novel therapeutic target for IDD. However, the development of anti-senescence therapy is based on our understanding of the molecular mechanism of disc cell senescence. In this review, we focused on the molecular mechanism of disc cell senescence, including the causes and various molecular pathways. We found that, during the process of IDD, age-related damages together with degenerative external stimuli activated both p53-p21-Rb and p16-Rb pathways to induce disc cell senescence. Meanwhile, disc cell senescence was regulated by multiple signaling pathways, suggesting the complex regulating network of disc cell senescence. To understand the mechanism of disc cell senescence better contributes to developing the anti-senescence-based therapies for IDD.     

The role of senescent T cells in immunopathology

The development of senescence in tissues of different organs and in the immune system are usually investigated independently of each other although during ageing, senescence in both cellular systems develop concurrently. Senescent T cells are highly inflammatory and secrete cytotoxic mediators and express natural killer cells receptors (NKR) that bypass their antigen specificity. Instead they recognize stress ligands that are induced by inflammation or infection of different cell types in tissues. In this article we discuss data on T cell senescence, how it is regulated and evidence for novel functional attributes of senescent T cells. We discuss an interactive loop between senescent T cells and senescent non‐lymphoid cells and conclude that in situations of intense inflammation, senescent cells may damage healthy tissue. While the example for immunopathology induced by senescent cells that we highlight is cutaneous leishmaniasis, this situation of organ damage may apply to other infections, including COVID‐19 and also rheumatoid arthritis, where ageing, inflammation and senescent cells are all part of the same equation.     

During muscle ageing the activation of the mitogenic signalling is not sufficient to guarantee cellular duplication

Satellite cells are quiescent cells that can be induced to proliferate by a variety of stimuli such as injury and exercise, providing in this way a source of new myoblasts that repopulate the damaged muscle. It is well known that, as senescence progresses, the muscle regenerative potential progressively diminishes, but the molecular mechanisms underlying this process are not yet completely defined. Many growth factors, including Platelet Derived Growth Factor (PDGF-BB)*, have been associated to satellite cells activation, acting as potent mitogenic agents for these cells. The aim of this study is to explore if the diminished response of senescent myoblasts to growth stimuli could be due to the inability to receive and transduce hormonal signals. Herein, we demonstrate that that although PDGF-r expression is down-regulated during senescence, the receptor is fully able to be phosphorylated and to transmit the signal. Although senescent myoblasts display increased level of phosphotyrosine phosphatases (PTPs), neither the PDGF receptor (PDGF-r) phosphorylation level nor the citosolic signal transduction machinery is affected. Indeed, we demonstrated that senescent human myoblasts are able to initiate a proper mitogenic signalling cascade, since the activation of mitogen-activated protein kinases (MAPK) and phosphatydil inositole 3 kinase (PI-3K) pathways is similar in young and senescent cells. Our data underline that, despite a conserved capability to activate PDGF-r after agonist stimulation and a functional signal transduction machinery, the mitogenic signal initiated by growth factors in senescent cells does not lead to cell division, being unable to overcome the cell cycle block, likely caused by the accumulation of the inhibitor p21WAF1.     

Dissecting the influence of cellular senescence on cell mechanics and extracellular matrix formation in vitro

Tissue formation and healing both require cell proliferation and migration, but also extracellular matrix production and tensioning. In addition to restricting proliferation of damaged cells, increasing evidence suggests that cellular senescence also has distinct modulatory effects during wound healing and fibrosis. Yet, a direct role of senescent cells during tissue formation beyond paracrine signaling remains unknown. We here report how individual modules of the senescence program differentially influence cell mechanics and ECM expression with relevance for tissue formation. We compared DNA damage-mediated and DNA damage-independent senescence which was achieved through over-expression of either p16^Ink4a or p21^Cip1 cyclin-dependent kinase inhibitors in primary human skin fibroblasts. Cellular senescence modulated focal adhesion size and composition. All senescent cells exhibited increased single cell forces which led to an increase in tissue stiffness and contraction in an in vitro 3D tissue formation model selectively for p16 and p21-overexpressing cells. The mechanical component was complemented by an altered expression profile of ECM-related genes including collagens, lysyl oxidases, and MMPs. We found that particularly the lack of collagen and lysyl oxidase expression in the case of DNA damage-mediated senescence foiled their intrinsic mechanical potential. These observations highlight the active mechanical role of cellular senescence during tissue formation as well as the need to synthesize a functional ECM network capable of transferring and storing cellular forces.     

Deep senescent human fibroblasts show diminished DNA damage foci but retain checkpoint capacity to oxidative stress

Critically shortened telomeres trigger a DNA damage response in replicatively senescent cells. Here we report that while DNA damage foci can be detected in newly senescent cells, these foci eventually diminished in deep senescent cells. However, DNA checkpoint signalling and repair machinery in response to oxidative stress remain uncompromised in these deep senescent cells. Activation of p53 by oxidative stress is unaffected despite a marked decrease in expression of platelet-derived growth factor alpha-receptor. These findings suggest that cellular senescence is not a static process hence care must be taken in the selection of biomarkers of senescence in studies of ageing.     

The struggle of a good friend getting old: cellular senescence in viral responses and therapy

Cellular senescence is a state of stable cell cycle arrest associated with macromolecular alterations and secretion of pro‐inflammatory cytokines and molecules. Senescence‐associated phenotypes restrict damage propagation and activate immune responses, two essential processes involved in response to viral infections. However, excessive accumulation and persistence of senescent cells can become detrimental and promote pathology and dysfunctions. Various pharmacological interventions, including antiviral therapies, lead to aberrant and premature senescence. Here, we review the molecular mechanisms by which viral infections and antiviral therapy induce senescence. We highlight the importance of these processes in attenuating viral dissemination and damage propagation, but also how prematurely induced senescent cells can promote detrimental adverse effects in humans. We describe which sequelae due to viral infections and treatment can be partly due to excessive and aberrant senescence. Finally, we propose that pharmacological strategies which eliminate senescent cells or suppress their secretory phenotype could mitigate side effects and alleviate the onset of additional morbidities. These strategies can become extremely beneficial in patients recovering from viral infections or undergoing antiviral therapy.     

Insulin-like growth factor binding proteins 4 and 7 released by senescent cells promote premature senescence in mesenchymal stem cells

Cellular senescence is the permanent arrest of cell cycle, physiologically related to aging and aging-associated diseases. Senescence is also recognized as a mechanism for limiting the regenerative potential of stem cells and to protect cells from cancer development. The senescence program is realized through autocrine/paracrine pathways based on the activation of a peculiar senescence-associated secretory phenotype (SASP). We show here that conditioned media (CM) of senescent mesenchymal stem cells (MSCs) contain a set of secreted factors that are able to induce a full senescence response in young cells. To delineate a hallmark of stem cells SASP, we have characterized the factors secreted by senescent MSC identifying insulin-like growth factor binding proteins 4 and 7 (IGFBP4 and IGFBP7) as key components needed for triggering senescence in young MSC. The pro-senescent effects of IGFBP4 and IGFBP7 are reversed by single or simultaneous immunodepletion of either proteins from senescent-CM. The blocking of IGFBP4/7 also reduces apoptosis and promotes cell growth, suggesting that they may have a pleiotropic effect on MSC biology. Furthermore, the simultaneous addition of rIGFBP4/7 increased senescence and induced apoptosis in young MSC. Collectively, these results suggest the occurrence of novel-secreted factors regulating MSC cellular senescence of potential importance for regenerative medicine and cancer therapy.     

Pathway analysis of senescence-associated miRNA targets reveals common processes to different senescence induction mechanisms

Multiple mechanisms of senescence induction exist including telomere attrition, oxidative stress, oncogene expression and DNA damage signalling. The regulation of the cellular changes required to respond to these stimuli and create the complex senescent cell phenotype has many different mechanisms. MiRNAs present one mechanism by which genes with diverse functions on multiple pathways can be simultaneously regulated. In this study we investigated 12 miRNAs previously identified as senescence regulators. Using pathway analysis of their target genes we tested the relevance of miRNA regulation in the induction of senescence. Our analysis highlighted the potential of these senescence-associated miRNAs (SA-miRNAs) to regulate the cell cycle, cytoskeletal remodelling and proliferation signalling logically required to create a senescent cell. The reanalysis of publicly available gene expression data from studies exploring different senescence stimuli also revealed their potential to regulate core senescence processes, regardless of stimuli. We also identified stimulus specific apoptosis survival pathways theoretically regulated by the SA-miRNAs. Furthermore the observation that miR-499 and miR-34c had the potential to regulate all 4 of the senescence induction types we studied highlights their future potential as novel drug targets for senescence induction.     

Integrated Stochastic Model of DNA Damage Repair by Non-homologous End Joining and p53/p21- Mediated Early Senescence Signalling

Unrepaired or inaccurately repaired DNA damage can lead to a range of cell fates, such as apoptosis, cellular senescence or cancer, depending on the efficiency and accuracy of DNA damage repair and on the downstream DNA damage signalling. DNA damage repair and signalling have been studied and modelled in detail separately, but it is not yet clear how they integrate with one another to control cell fate. In this study, we have created an integrated stochastic model of DNA damage repair by non-homologous end joining and of gamma irradiation-induced cellular senescence in human cells that are not apoptosis-prone. The integrated model successfully explains the changes that occur in the dynamics of DNA damage repair after irradiation. Simulations of p53/p21 dynamics after irradiation agree well with previously published experimental studies, further validating the model. Additionally, the model predicts, and we offer some experimental support, that low-dose fractionated irradiation of cells leads to temporal patterns in p53/p21 that lead to significant cellular senescence. The integrated model is valuable for studying the processes of DNA damage induced cell fate and predicting the effectiveness of DNA damage related medical interventions at the cellular level.     

Cell senescence contributes to tissue regeneration in zebrafish

Cellular senescence is a stress response that limits the proliferation of damaged cells by establishing a permanent cell cycle arrest. Different stimuli can trigger senescence but excessive production or impaired clearance of these cells can lead to their accumulation during aging with deleterious effects. Despite this potential negative side of cell senescence, its physiological role as a pro‐regenerative and morphogenetic force has emerged recently after the identification of programmed cell senescence during embryogenesis and during wound healing and limb regeneration. Here, we explored the conservation of tissue injury‐induced senescence in a model of complex regeneration, the zebrafish. Fin amputation in adult fish led to the appearance of senescent cells at the site of damage, and their removal impaired tissue regeneration. Despite many conceptual similarities, this tissue repair response is different from developmental senescence. Our results lend support to the notion that cell senescence is a positive response promoting tissue repair and homeostasis.     

Accumulation of apoptosis‐insensitive human bone marrow‐mesenchymal stromal cells after long‐term expansion

Cells undergo replicative senescence during in vitro expansion, which is induced by the accumulation of cellular damage caused by excessive reactive oxygen species. In this study, we investigated whether long‐term‐cultured human bone marrow mesenchymal stromal cells (MSCs) are insensitive to apoptotic stimulation. To examine this, we established replicative senescent cells from long‐term cultures of human bone marrow MSCs. Senescent cells were identified based on declining population doublings, increased expression of senescence markers p16 and p53 and increased senescence‐associated β‐gal activity. In cell viability assays, replicative senescent MSCs in late passages (i.e. 15–19 passages) resisted damage induced by oxidative stress more than those in early passages did (i.e. 7–10 passages). This resistance occurred via caspase‐9 and caspase‐3 rather than via caspase‐8. The senescent cells are gradually accumulated during long‐term expansion. The oxidative stress‐sensitive proteins ataxia‐telangiectasia mutated and p53 were phosphorylated, and the expression of apoptosis molecules Bax increased, and Bcl‐2 decreased in early passage MSCs; however, the expression of the apoptotic molecules did less change in response to apoptotic stimulation in late‐passage MSCs, suggesting that the intrinsic apoptotic signalling pathway was not induced by oxidative stress in long‐term‐cultured MSCs. Based on these results, we propose that some replicative senescent cells may avoid apoptosis signalling via impairment of signalling molecules and accumulation during long‐term expansion. Copyright © 2016 John Wiley & Sons, Ltd.     

DNA double strand break responses and chromatin alterations within the aging cell

Cellular senescence is a state of permanent replicative arrest that allows cells to stay viable and metabolically active but resistant to apoptotic and mitogenic stimuli. Specific, validated markers can identify senescent cells, including senescence-associated β galactosidase activity, chromatin alterations, cell morphology changes, activated p16- and p53-dependent signaling and permanent cell cycle arrest. Senescence is a natural consequence of DNA replication-associated telomere erosion, but can also be induced prematurely by telomere-independent events such as failure to repair DNA double strand breaks. Here, we review the molecular pathways of senescence onset, focussing on the changes in chromatin organization that are associated with cellular senescence, particularly senescence-associated heterochromatin foci formation. We also discuss the altered dynamics of the DNA double strand break response within the context of aging cells. Appreciating how, mechanistically, cellular senescence is induced, and how changes to chromatin organization and DNA repair contributes to this, is fundamental to our understanding of the normal and premature human aging processes associated with loss of organ and tissue function in humans.     

Cloning and characterization of cellular senescence-associated genes in human fibroblasts by suppression subtractive hybridization

Cellular senescence marks the end of the proliferative life span of normal cells in tissue culture and occurs after cells have undergone a certain number of population doublings (PDLs). It is accompanied by alterations in the pattern of gene expression. A specific human embryonic lung diploid fibroblast cell line, 2BS, has been studied as a model of senescence in our laboratory. Here, we report a set of cellular senescence-associated genes identified from suppression subtractive cDNA libraries from senescent and young 2BS cells. They include three novel genes and six previously identified genes of unknown function. The genes whose functions are known belong to various functional pathways that have been reported to change with the onset of senescence. These include three pre-mRNA splicing factors with reduced expression in senescent cells, indicating that the regulation of mRNA splicing is altered during cell senescence. In addition, the expression of the gene TOM1 (target of Myb 1), which has not previously been associated with cellular senescence, is shown to increase in senescent cells, and we demonstrate that the expression of antisense TOM1 gene in 2BS cells can delay the progress of senescence.     

Analysis of individual cells identifies cell‐to‐cell variability following induction of cellular senescence

Senescent cells play important roles in both physiological and pathological processes, including cancer and aging. In all cases, however, senescent cells comprise only a small fraction of tissues. Senescent phenotypes have been studied largely in relatively homogeneous populations of cultured cells. In vivo, senescent cells are generally identified by a small number of markers, but whether and how these markers vary among individual cells is unknown. We therefore utilized a combination of single‐cell isolation and a nanofluidic PCR platform to determine the contributions of individual cells to the overall gene expression profile of senescent human fibroblast populations. Individual senescent cells were surprisingly heterogeneous in their gene expression signatures. This cell‐to‐cell variability resulted in a loss of correlation among the expression of several senescence‐associated genes. Many genes encoding senescence‐associated secretory phenotype (SASP) factors, a major contributor to the effects of senescent cells in vivo, showed marked variability with a subset of highly induced genes accounting for the increases observed at the population level. Inflammatory genes in clustered genomic loci showed a greater correlation with senescence compared to nonclustered loci, suggesting that these genes are coregulated by genomic location. Together, these data offer new insights into how genes are regulated in senescent cells and suggest that single markers are inadequate to identify senescent cells in vivo.     

腺病毒介导的p33ING1b过表达显著促进衰老细胞的DNA损伤修复

p33^ING1b是一个较晚发现的肿瘤抑制基因ING1的主要表达形式,自从被成功克隆以后得到了广泛的研究,已有的研究表明,p33^ING1b参与了细胞的生长抑制、凋亡、染色质重塑、DNA损伤修复、肿瘤抑制和细胞衰老等。但是它在细胞衰老过程中的作用特别是对衰老细胞DNA损伤修复的影响还没有被地阐明,在本研究中,我们首先用2BS细胞构建了细胞衰老模型,通过RT-PCR和Western blot技术证实p33^ING1b在衰老细胞中的表达水平是下调的,然后通过构建和包装包含p33^ING1b基因的腺病毒,将p33^ING1b导入年轻和衰老细胞中并使其过表达,用HCR（host cell reactivation）方法检测年轻细胞和衰老细胞DNA损伤修复能力。我们的实验首次表明,相对于年轻细胞,p33^ING1b的过表达使衰老细胞的DNA的损伤修复能力显著增加,这说明p33^ING1b在衰老细胞中的表达下调与衰老细胞DNA损伤修复能力的下降有关,也进一步证实了p33^ING1b在细胞衰老过程中起着十分重要的作用。     

To clear,or not to clear (senescent cells)? That is the question

Cellular senescence is an anti‐proliferative program that restricts the propagation of cells subjected to different kinds of stress. Cellular senescence was initially described as a cell‐autonomous tumor suppressor mechanism that triggers an irreversible cell cycle arrest that prevents the proliferation of damaged cells at risk of neoplastic transformation. However, discoveries during the last decade have established that senescent cells can also impact the surrounding tissue microenvironment and the neighboring cells in a non‐cell‐autonomous manner. These non‐cell‐autonomous activities are, in part, mediated by the selective secretion of extracellular matrix degrading enzymes, cytokines, chemokines and immune modulators, which collectively constitute the senescence‐associated secretory phenotype. One of the key functions of the senescence‐associated secretory phenotype is to attract immune cells, which in turn can orchestrate the elimination of senescent cells. Interestingly, the clearance of senescent cells seems to be critical to dictate the net effects of cellular senescence. As a general rule, the successful elimination of senescent cells takes place in processes that are considered beneficial, such as tumor suppression, tissue remodeling and embryonic development, while the chronic accumulation of senescent cells leads to more detrimental consequences, namely, cancer and aging. Nevertheless, exceptions to this rule may exist. Now that cellular senescence is in the spotlight for both anti‐cancer and anti‐aging therapies, understanding the precise underpinnings of senescent cell removal will be essential to exploit cellular senescence to its full potential.