Abstract
Aging is an inherent phenomenon that is highly important in the pathological development of numerous diseases. Aging is a multidimensional phenomenon characterized by the progressive impairment of various cellular structures and organelle functions. The basis of human organ senescence is cellular senescence. Currently, with the increase in human life expectancy and the increasing proportion of the elderly population, the economic burden of diseases related to aging is becoming increasingly heavy worldwide, and an in-depth study of the mechanism of cellular aging is urgently needed. Aging, a multifactor-driven biological process, is closely related to mitochondrial dysfunction, which is the core pathological basis of a variety of age-related diseases. This article systematically reviews the molecular pathways by which mitochondrial dysfunction drives aging through multidimensional mechanisms such as metabolic reprogramming, epigenetic regulation, telomere damage, autophagy imbalance, and the senescence-associated secretory phenotype. Metabolic reprogramming promotes tumor progression and exacerbates energy metabolism disorders through abnormal activation of the PI3K/Akt/mTOR signaling pathways. The sirtuin family (such as SIRT1 and SIRT3) maintains mitochondrial homeostasis by regulating PGC-1α, FOXO3 and other targets. Telomere shortening directly inhibits mitochondrial biosynthesis through the p53âPGC-1α axis, leading to oxidative stress accumulation and a decline in organ function. The dual roles of autophagy (removing damaged mitochondria or inducing apoptosis) suggests that its homeostasis is essential for delaying aging. The SASP mediates the inflammatory microenvironment through the cGASâSTING pathway, which is not only a marker of aging but also a driving force of disease progression. Future studies need to integrate multiomics techniques to analyze the interaction network between mitochondria and other organelles, such as the endoplasmic reticulum and lysosomes, and explore precise intervention strategies targeting sirtuins, AMPK and telomerase. Combined therapies targeting metabolic reprogramming or SASP inhibition are expected to provide new ideas for delaying aging and preventing age-related diseases.
O3:
TL;DR â Wei et al. (Biogerontology, 9 July 2025) review how mitochondrial dysfunction drives ageing through five, mutually connected axes: (1) metabolic reprogramming (PI3K/AKT/mTOR hyperactivation, AMPK/SIRT1/PGCâ1α suppression), (2) epigenetic regulation, (3) telomere damage (p53âPGCâ1α axis), (4) autophagy/mitophagy imbalance, and (5) the SASP via cGASâSTINGâNFâÎșB. They argue for multiâomics mapping of mitochondriaâotherâorganelle crosstalk and propose combined interventions (e.g., metabolic reprogramming modulators + SASP inhibitors; sirtuin/AMPK activators; telomerase targeting). The pieceâs main novelty is the integrative framingâpositioning these pathways as a single, bidirectionally wired network and explicitly distinguishing ageing-associated metabolic reprogramming from cancerâs proliferative Warburg program. The review is comprehensive but largely synthesises known pathways, gives little quantitative or tissue/sex-specific resolution, underplays mtDNA heteroplasmy, mitochondrial peptides, fissionâfusion dynamics and mitohormesis, and stays high-level on how, concretely, to execute the proposed multiâomics/combination-therapy agenda. (SpringerLink, SpringerLink, SpringerLink)
1) Structured summary
Scope & claim
- Ageing is framed as cellular senescence-centric, with mitochondria as a core driver that feeds into DNA damage, epigenetic drift, SASP, and impaired intercellular communication. The reviewâs purpose is to integrate disparate mitochondriaâageing mechanisms into a unified schema and outline therapeutic entry points. (SpringerLink)
Key mechanistic pillars
- Metabolic reprogramming
- Senescent cells shift toward glycolysis (GLUT1/HK2 up, PDH complex down), with PI3K/AKT/mTOR hyperactivation and impaired OXPHOS; AMPK/SIRT1/PGCâ1α is the counterâregulatory axis. Distinguishes tumour vs ageing metabolic reprogramming (degenerative, survivalâoriented). (SpringerLink, SpringerLink)
- Epigenetic regulation
- Mitochondrial dysfunction feeds DNA methylation and histoneâmodification changes, but details are mostly surveyed, not expanded experimentally. (SpringerLink)
- Telomere damage â mitochondrial compromise
- p53âPGCâ1α pathway links telomere shortening to reduced mitochondrial biogenesis and ROS accumulation. (SpringerLink)
- Autophagy/mitophagy imbalance
- Dual roles: quality control vs apoptosis induction; homeostasis is essential to delay ageing. AMPK promotes, mTOR suppresses, mitophagy. (SpringerLink, SpringerLink)
- SASP & inflammation
- cGASâSTING and ROSâNFâÎșB axes connect mitochondrial stress to inflammatory SASP propagation (e.g., ILâ6). (SpringerLink, SpringerLink)
Therapeutic suggestions
- Target nodes: Sirtuins (SIRT1/SIRT3), AMPK, telomerase, PI3K/AKT/mTOR, SASP inhibitors/senolytics.
- Strategy: multiâtarget/combination therapies (e.g., metabolic reprogramming modulators + SASP inhibition) and multiâomics integration to map organelle crosstalk (ER, lysosome). (SpringerLink)
2) Whatâs (relatively) novel here?
- A single, explicitly interconnected framework
- The paper treats metabolic, telomeric, epigenetic, autophagic and inflammatory routes as a bidirectionally wired network, not as siloed mechanismsâas many earlier reviews did. (SpringerLink, SpringerLink)
- Clearer articulation of regulatory âhubsâ
- It elevates the SIRT1/PGCâ1α and AMPK/mTOR axes as master switches that decide whether cells lock into glycolysisâlipogenesis vs restore mitochondrial homeostasis. (SpringerLink)
- Framing of ageing metabolic reprogramming as âdegenerative survivalâ vs cancerâs proliferative Warburg shiftâa nuance thatâs often glossed over. (SpringerLink)
- Call for multiâomics plus organelleâinteraction maps (mitochondriaâERâlysosome) to operationalise precision gerotherapeutics. Prior reviews mention multiâomics, but here itâs tightly tied to the crossâtalk model. (SpringerLink)
- Therapeutic emphasis on combination targeting (e.g., metabolic + SASP) rather than single-pathway interventions. (SpringerLink)
3) Critique (limitations & how to improve)
Conceptual / scope
- Mostly a synthesis, not a genuinely new model
- The âintegrationâ is valuable but remains narrativeâno causal/quantitative framework (e.g., network modelling, dynamic systems, or mediation analyses across omics layers). Provide testable predictions or formalised diagrams with directionality/weights. (SpringerLink, SpringerLink)
- Underrepresentation of key mitochondrial topics
- mtDNA heteroplasmy, clonal expansion, replication stress, mitochondrial dynamics (DRP1/OPA1/MFN1/2), and mitochondria-derived peptides (e.g., MOTSâc, humanin) are either missing or cursoryâyet central to ageing and translational prospects. (SpringerLink)
- Mitohormesis & longevity paradoxes are not engaged
- Evidence that mild mitochondrial stress/ROS can extend lifespan (e.g., in C. elegans, mice) isnât reconciled with the âROS â damageâ narrative; this weakens therapeutic generalisations. (SpringerLink)
- Tissue, cell-type, and sex-specific heterogeneity is largely absent
- The review doesnât dissect how the highlighted hubs (e.g., AMPK/mTOR, SIRT1) behave differently in brain vs heart vs immune cells, or in males vs femalesâcritical for precision geroscience. (SpringerLink)
- Clinical translation remains high-level
- âCombine SASP inhibition with metabolic reprogrammingâ is plausible, but no prioritised target pairs, dosing logic, or biomarker strategies are offered (e.g., NADâș/acylcarnitines + SASP panels; mtDNAcn + DNAme clocks). (SpringerLink)
- Organelle crosstalk is proposed but not detailed
- Little mechanistic depth on MAMs (mitochondriaâER contacts), lysosomal signalling (TFEB/TFE3), or peroxisomal ROS/lipid metabolismâall directly relevant to their framework. (SpringerLink)
- Biomarker/clock integration is superficial
- The piece gestures to epigenetics but doesnât integrate mitochondrial readouts (mtDNA mutations, NADâș, acylâCoA pools) with epigenetic clocks / proteomic clocks to form a practical stratification toolkit. (SpringerLink)
- No discussion of safety/adverse tradeâoffs
- Longâterm mTOR inhibition, telomerase activation, or aggressive SASP suppression have tradeâoffs (tumorigenesis, impaired wound healing, immune modulation) that arenât examined. (SpringerLink)
4) How to build on it (actionable research ideas)
- Quantify the network: develop a dynamic, multiâomic causal graph linking mtDNA mutations, NADâș flux, AMPK/mTOR activity, SASP cytokines, and telomere status; validate across tissues and ages.
- Organelle-interactome atlas: map MAM density/function vs ageing phenotypes and overlay with lipidomics + singleâcell ATAC/RNAâseq.
- Combination trials with biomarkers: e.g., NADâș boosters or AMPK activators + senomorphic (JAK/STAT or NFâÎșB inhibitors), tracked by SASP panels, mitochondrial respiration (Seahorse), and DNA methylation clocks.
- Stratify by heteroplasmy burden / mitochondrial peptides to see who benefits from which arm (metabolic vs SASP).
- Mitohormesis window finding: titrate mitochondrial stressors (e.g., mild ETC inhibitors, exercise mimetics) to locate beneficial vs harmful ROS bands.
Bottom line
A well-organised, contemporary review that pulls multiple well-known mitochondrialâageing mechanisms into one network narrative and argues for multi-omics + combination therapies. The incremental novelty lies in the integration and the framing, not in uncovering new mechanisms. To be more impactful, future work should quantify the proposed network, incorporate neglected mitochondrial biology (heteroplasmy, dynamics, peptides), account for heterogeneity, and specify concrete translational roadmaps. (SpringerLink, SpringerLink, SpringerLink)