Now that I have received my FOXO order, does anyone have any thoughts on simultaneously taking three senolytics: FOXO4, D&Q, Rapamycin. My theory would be that the three taken simultaneously would catch more snescent cells... Any thoughts?
DO NOT combine FOXO4-DRI with Rapamycin. If you do, you will almost certainly be undermining the senolytic effect of FOXO4-DRI.
Rapamycin is not a senolytic, but a "senomorphic". It doesn't kill senescent cells, but only temporarily reduces/suppresses their secretions
[1].
In
the de Keizer paper[2] they tested FOXO4-DRI in combination with various compounds that either enhance or mitigate SASP. Compounds enhancing SASP (IL-1alpha, Lipopolysaccharides (LPS))
increased FOXO4-DRI's potency against senescent cells. Compounds suppressing SASP (IL1 receptor antagonist, cortisol)
reduced FOXO4-DRI's potency against senescent cells (killing proportionately fewer at any given dose, thereby reducing FOXO4-DRI's various Selectivity Indices).
They write:
"[W]e wondered how FOXO4-DRI would function under such high-SASP conditions. In vitro experiments showed FOXO4-DRI to be more potent against senescent cells in which SASP was transiently boosted by recombinant IL1a/b or lipopolysaccharide (LPS), whereas an IL1 receptor antagonist or the general anti-inflammatory drug cortisol reduced its potency (Figures 6H and 6I). Thus, FOXO4-DRI actually is most effective against senescent cells expressing high levels of SASP and could as such be particularly effective against loss of renal function."
→ source (external link)
Relevant signal transduction pathways:
- LPS --> TLR4 --> NF-kB --> {IL-1alpha <--> NF-kb feedback loop} (LPS agonizes TLR4 receptor, which upregulates NF-kB, which in turn fuels (adds feedback to) the IL-1alpha/NF-kB positive feedback loop that underlies most of the inflammatory secretions of SASP[1].)
- Cortisol --| [IL-1alpha --> {IL-1alpha <--> NF-kb feedback loop}] (Cortisol antagonizes IL-1a receptor, which downregulates/blocks the SASP IL-1alpha/NF-kB positive feedback loop[1][3]. See "Figure 2" in [3].)
If you were to combine FOXO4-DRI with Rapamycin, you would get:
- Rapamycin --| [mTORC1 --> {IL-1alpha <--> NF-kb feedback loop}] (Rapamycin inhibits mTORC1, which is a necessary intermediary in the same SASP feedback loop by enabling translation of IL-1alpha[1][3]. See "Figure 2" in [3].)
From [1]:
"We propose that rapamycin selectively targets the SASP-initiating cytokine IL1A through translational inhibition, thereby suppressing establishment of the signalling cascade that activates NF-kB and the transcription of many genes encoding SASP factors (Supplementary Fig. 7)."
→ source (external link)
The effect would be very similar to using cortisol: comparatively very few senescent cells would die (see the solid red line in Figure 6I of the de Keizer paper
[2]), and you would effectively be wasting your FOXO4-DRI.
I think someone even found some unpublished data from de Keizer et al and posted it earlier in this very thread, where his group had specifically tested Rapamycin in combination with FOXO4-DRI and confirmed it to have the above expected Nerf-ing effect, rendering the FOXO4-DRI largely impotent.
Similarly, any anti-inflammatory drugs/compounds/supplements you may be taking likely downregulate NF-kB (thereby suppressing SASP), directly or indirectly, and thus would have similar counterproductive effects in combination with FOXO4-DRI. These must be washed out before beginning your FOXO4-DRI session. That might include Quercetin, which you mentioned explicitly. Even though it is a senolytic in itself, we don't know that its mechanism of action is synergistic with FOXO4-DRI's.
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Also, I think you mentioned earlier in the thread that you are Han Chinese. This greatly increases your risk of having an adverse reaction to Allopurinol, if you were thinking of using it for hyperuricemia prophylaxis. Febuxostat is an alternative.
Actually, I see now that you have already sequenced your DNA. That ought to tell you whether you have
the high-risk allele[4].
References:
[1] MTOR regulates the pro-tumorigenic senescence-associated secretory phenotype by promoting IL1A translation. DOI: 10.1038/ncb3195
[2] Targeted Apoptosis of Senescent Cells Restores Tissue Homeostasis in Response to Chemotoxicity and Aging. DOI: 10.1016/j.cell.2017.02.031
[3] Therapeutic interventions for aging: the case of cellular senescence. DOI: 10.1016/j.drudis.2017.01.004