Fisetin for Senolytic Activity

Senolytic Activity — scientific infographic poster

In October 2018, EBioMedicine published a paper by Matthew Yousefzadeh, Yi Zhu, James Kirkland, Paul Robbins, Laura Niedernhofer and colleagues at the Scripps Research Institute and the Mayo Clinic that drew attention to fisetin, a flavonoid found in strawberries and other plants. The team screened a panel of 10 flavonoids for “senolytic” activity — the ability to selectively clear senescent cells — and found fisetin the most potent of those tested. In wild-type mice fed a fisetin diet from 85 weeks of age (which the authors describe as roughly equivalent to age 75 in humans), median and maximum lifespan were extended. A later lifespan study in genetically heterogeneous mice (Harrison 2024) found no significant lifespan effect of fisetin at the dose and schedule it used. In people, the Mayo Clinic AFFIRM and AFFIRM-LITE trials are registered on ClinicalTrials.gov and, as of October 2026, list no posted results. This page reports what senescent cells are, what the 2018 paper found, what is and is not known about how fisetin acts on senescent cells, the related dasatinib + quercetin (D+Q) research, and where the human evidence stands.


Table of Contents

  1. What Senescent Cells Are — The Zombie Cell Primer
  2. The SASP — Why Senescent Cells Damage Whole Tissues
  3. The Yousefzadeh 2018 EBioMedicine Paper
  4. Mechanism — SCAPs and What Is Known for Fisetin
  5. The Mayo Clinic Translational Program (Kirkland & Tchkonia)
  6. The Dasatinib + Quercetin (D+Q) Context
  7. AFFIRM, AFFIRM-LITE, and Other Registered Fisetin Trials
  8. The “Hit and Run” Dosing Rationale
  9. Senescence Biomarkers Used in Research
  10. The Animal-vs-Human Evidence Gap
  11. What Is Reported About Fisetin Doses and Safety
  12. Key Research Papers
  13. Connections
  14. Featured Videos

What Senescent Cells Are — The Zombie Cell Primer

Cellular senescence is a cellular response to stress — DNA damage, telomere shortening, oncogene activation, or oxidative stress — in which a cell stops dividing essentially permanently while remaining metabolically active and resistant to apoptosis (programmed cell death). Senescent cells are commonly identified by markers such as the cell-cycle inhibitors p16INK4a and p21CIP1, senescence-associated β-galactosidase activity, and a distinctive secretory profile (the SASP, described in the next section).

Senescence is not simply harmful. It suppresses cancer by halting the division of damaged cells, and reviews describe further roles in development and tissue repair (van Deursen 2014). The problem, as reviews describe it, is that senescent cells accumulate in various tissues with ageing and at sites of disease in many chronic conditions (Kirkland and Tchkonia 2017), where they stay in place and keep secreting inflammatory factors.

Whether senescent cells drive age-related decline became testable with a transgenic mouse (INK-ATTAC) in which p16INK4a-positive cells can be eliminated on demand with a drug. In progeroid BubR1 mice, life-long removal of these cells delayed age-related changes in adipose tissue, skeletal muscle and the eye, and late-life clearance slowed disorders already under way (Baker et al., Nature 2011). In normal (wild-type) mice, removing p16INK4a-positive cells from one year of age extended median lifespan in both sexes, delayed tumour formation and lessened age-related deterioration of the kidney, heart and fat (Baker et al., Nature 2016). These were genetic tools in mice, not drugs, but they motivated the search for senolytic drugs.

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The SASP — Why Senescent Cells Damage Whole Tissues

The mechanism by which senescent cells are thought to damage surrounding tissue is the senescence-associated secretory phenotype or SASP. Coppé and colleagues (2010) describe the SASP as turning senescent fibroblasts into pro-inflammatory cells able to promote tumour progression. Factors measured as SASP markers in the studies on this page include:

Reviews attribute several downstream effects to the SASP. Kirkland and Tchkonia (2017) list senescence-related inflammation, metabolic dysregulation, stem cell dysfunction, ageing phenotypes, chronic diseases, geriatric syndromes and loss of resilience among the conditions the SASP can contribute to, and Tchkonia and colleagues (2013) describe senescence as a source of chronic inflammation through the SASP. In mice, transplanting relatively small numbers of senescent cells into young animals caused persistent physical dysfunction and spread senescence to the host's own tissues (Xu 2018).

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The Yousefzadeh 2018 EBioMedicine Paper

The paper is Yousefzadeh MJ, Zhu Y, McGowan SJ, Angelini L, Fuhrmann-Stroissnigg H, Xu M, Ling YY, Melos KI, Pirtskhalava T, Inman CL, McGuckian C, Wade EA, Kato JI, Grassi D, Wentworth M, Burd CE, Arriaga EA, Ladiges WL, Tchkonia T, Kirkland JL, Robbins PD, Niedernhofer LJ. “Fisetin is a senotherapeutic that extends health and lifespan.” EBioMedicine 2018; 36: 18-28. Its background states that the group had earlier shown D+Q to be a potent senolytic and that the goal was to find flavonoids with more potent senolytic activity. What it reports:

The authors concluded that fisetin has senotherapeutic activity in mice and in human tissues and that these characteristics suggest the feasibility of translation to human clinical studies. The paper discloses that several authors and the Mayo Clinic have a financial interest related to the research (patents on senolytic drugs).

A larger lifespan test came later. In the National Institute on Aging Interventions Testing Program's genetically heterogeneous UM-HET3 mice, Harrison and colleagues (2024, GeroScience) found that fisetin did not significantly increase lifespan in either sex at the dose and method of administration tested. Mouse lifespan results for fisetin therefore differ between studies.

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Mechanism — SCAPs and What Is Known for Fisetin

Kirkland and Tchkonia (2020) describe the most harmful senescent cells as resistant to apoptosis because they up-regulate anti-apoptotic pathways — the “senescent-cell anti-apoptotic pathways,” or SCAPs — which defend them against their own inflammatory SASP. Senolytics transiently disable these pathways, causing apoptosis of senescent cells. In the 2015 Aging Cell paper that introduced senolytics, Zhu and colleagues found that silencing key nodes of these pro-survival networks killed senescent cells but not proliferating or quiescent cells. The nodes they named were:

For fisetin specifically, the cell-type picture is mixed. Zhu and colleagues (2017, Aging) reported that fisetin selectively induced apoptosis in senescent, but not proliferating, human umbilical vein endothelial cells, and that it was not senolytic in senescent IMR90 human lung fibroblasts or in primary human preadipocytes. In the Yousefzadeh 2018 mouse fibroblasts it suppressed senescence markers without evidence of cell killing. The cited papers do not establish which specific SCAP protein fisetin acts on.

The same 2017 paper reported that two selective BCL-xL inhibitors (A1331852 and A1155463) are senolytic in some cell types and noted that the broader BCL-2-family inhibitor navitoclax is associated with hematological toxicity; the authors suggested the newer agents may be better candidates for eventual translation.

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The Mayo Clinic Translational Program (Kirkland & Tchkonia)

James Kirkland and Tamar Tchkonia at the Mayo Clinic Robert and Arlene Kogod Center on Aging are senior authors on the founding senolytic papers. Their 2015 Aging Cell paper (“The Achilles' heel of senescent cells”) introduced senolytics and identified dasatinib plus quercetin by targeting the pro-survival networks of senescent cells; their 2017 Aging paper reported fisetin as senolytic in one human cell type; and the Yousefzadeh fisetin paper, a collaboration with the Scripps group, extended the screen to a flavonoid panel. Kirkland and Tchkonia (2020) list dasatinib, quercetin, fisetin and navitoclax as the first senolytic drugs.

The work has followed a sequence of discovery in cell culture, testing in aged and progeroid mice, and then small human studies — the D+Q pilots described in the next section and the fisetin trials registered by the Mayo Clinic and other centres.

In their 2020 review, Kirkland and Tchkonia wrote that early pilot trials suggest senolytics decrease senescent cells, reduce inflammation and alleviate frailty in humans, and that “until such studies are done, it is too early for senolytics to be used outside of clinical trials.” The review discloses that the authors have a financial interest related to this research and that Mayo Clinic holds patents on senolytic drugs. Online marketing claims that fisetin is a proven longevity intervention go beyond what the published clinical literature reports.

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The Dasatinib + Quercetin (D+Q) Context

The first senolytic combination to enter human trials was dasatinib + quercetin (D+Q). Dasatinib is a prescription kinase inhibitor approved for certain leukemias; quercetin is a flavonol related to fisetin. In the Zhu 2015 paper, dasatinib eliminated senescent human fat-cell progenitors, quercetin was more effective against senescent human endothelial cells and mouse bone-marrow stem cells, and the combination was effective against senescent mouse embryonic fibroblasts — the reason the two are used together. In naturally aged mice, intermittent oral D+Q increased post-treatment survival by 36% and reduced the mortality hazard to 65% (Xu 2018, a mouse study).

The early and later human D+Q studies (details, and the randomized trials, are on the Quercetin Senolytic Activity page):

The practical difference between the two approaches is a factual one. Dasatinib is a prescription cancer drug whose FDA label (DailyMed: dasatinib labels) warns of myelosuppression and serious bleeding, fluid retention including pleural effusion, cardiovascular toxicity, pulmonary arterial hypertension, QT prolongation, severe skin reactions, tumour lysis syndrome, hepatotoxicity and fetal harm, based on continuous daily treatment of leukemia. Fisetin is a dietary flavonoid sold without prescription. No head-to-head human comparison of fisetin and D+Q has been published among the papers cited here.

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AFFIRM, AFFIRM-LITE, and Other Registered Fisetin Trials

The Mayo Clinic AFFIRM trials (Alleviation by Fisetin of Frailty, Inflammation, and Related Measures) are the best-known human studies of fisetin as a senolytic. Their ClinicalTrials.gov entries, as last updated in May 2026, describe them as follows:

A ClinicalTrials.gov search for fisetin as an intervention returned 37 registered studies of all statuses on 14 October 2026, including withdrawn studies and studies of multi-ingredient products. Among those testing fisetin as a senolytic or anti-inflammatory agent:

No peer-reviewed report of a randomized trial showing a clinical benefit of fisetin as a senolytic was found in PubMed as of October 2026. The published human fisetin papers found were trial protocols and design descriptions; an uncontrolled pilot in which 19 participants took D+Q plus fisetin for 6 months and DNA-methylation “epigenetic clocks” were measured (Lee 2024; the authors report non-significant changes in epigenetic age acceleration with the combination); and a laboratory study of a blood senescence marker that reports lower values in a small subgroup of participants taking fisetin (Hambright 2024).

A table of the fisetin senolytic evidence cited on this page, listing each study’s model, size and main finding, with cell and mouse studies marked grey and human trials marked in the key colour. FISETIN AS A SENOLYTIC: WHAT HAS BEEN TESTED model, size and main reported finding · from each paper or registry entry STUDYMODELSIZEMAIN FINDING Zhu 2017 senescent human cells cells in culture — senolytic in endothelial cells; not in lung fibroblasts or preadipocytes Yousefzadeh 2018 fisetin diet from 85 weeks wild-type mice 8–9 / group median and maximum lifespan extended Harrison 2024 Interventions Testing Program UM-HET3 mice — no significant lifespan effect in either sex Knee osteoarthritis NCT04210986, completed randomized vs placebo 34 + 40 adverse events similar: 28 of 34 vs 33 of 40 (registry results) AFFIRM women aged 70 or older randomized vs placebo 40 planned enrolling by invitation; no results posted AFFIRM-LITE adults aged 70 or older randomized vs placebo 40 planned enrolling by invitation; no results posted cells or mice: not results in people human trial, status as listed on ClinicalTrials.gov, October 2026

The fisetin senolytic evidence cited on this page, by model and size. Mouse and cell figures are from each paper; trial figures and status are from the ClinicalTrials.gov registry.

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The “Hit and Run” Dosing Rationale

Conventional drugs for chronic conditions are usually taken daily to keep blood levels up. Senolytics are studied differently. Kirkland and Tchkonia (2020) explain that because senescent cells take weeks to reaccumulate, senolytics can be given intermittently — a “hit-and-run” approach. The Yousefzadeh 2018 mouse data fit that idea: in progeroid mice, the p16INK4a reporter signal stayed lower during a 4-week period off fisetin, which the authors describe as consistent with senescent cells being cleared or senescence being reversed rather than fisetin needing to be present continuously. Hickson and colleagues (2019) likewise note that dasatinib and quercetin have elimination half-lives under 11 hours, yet senescent-cell counts were lower 11 days after their 3-day D+Q course.

Fisetin regimens listed in trial registrations:

These are research regimens chosen by trial teams; the mouse studies used diets and gavage doses that do not translate directly to people. None of these trials has published a result establishing an effective or safe dose, frequency or duration of fisetin for any clinical outcome.

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Senescence Biomarkers Used in Research

There is no routine clinical test for senescent-cell burden. The studies on this page used research measurements:

Biological ageing tests are discussed further in the broader Longevity Protocols page.

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The Animal-vs-Human Evidence Gap

The fisetin senolytic evidence is mainly from cells and mice, and the human evidence is preliminary:

Kirkland and Tchkonia (2020) wrote that “it is too early for senolytics to be used outside of clinical trials.” Decisions about supplements and medicines belong with a clinician.

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What Is Reported About Fisetin Doses and Safety

The senolytic research is one of several areas in which fisetin has been studied. For the neuroprotective research in animal models, see the Fisetin Brain Health page. For the broader anti-aging context, including mitochondrial and AMPK effects, see the Fisetin Anti-Aging page.

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Key Research Papers

  1. Yousefzadeh MJ, Zhu Y, McGowan SJ, et al. (2018). Fisetin is a senotherapeutic that extends health and lifespan. EBioMedicine 36:18-28. — PubMed PMID: 30279143
  2. Zhu Y, Tchkonia T, Pirtskhalava T, et al. (2015). The Achilles' heel of senescent cells: from transcriptome to senolytic drugs. Aging Cell 14:644-658. — PubMed PMID: 25754370
  3. Kirkland JL, Tchkonia T (2020). Senolytic drugs: from discovery to translation. Journal of Internal Medicine 288:518-536. — PubMed PMID: 32686219
  4. Hickson LJ, Langhi Prata LGP, Bobart SA, et al. (2019). Senolytics decrease senescent cells in humans: preliminary report from a clinical trial of dasatinib plus quercetin in individuals with diabetic kidney disease. EBioMedicine 47:446-456. — PubMed PMID: 31542391
  5. Justice JN, Nambiar AM, Tchkonia T, et al. (2019). Senolytics in idiopathic pulmonary fibrosis: results from a first-in-human, open-label, pilot study. EBioMedicine 40:554-563. — PubMed PMID: 30616998
  6. Xu M, Pirtskhalava T, Farr JN, et al. (2018). Senolytics improve physical function and increase lifespan in old age. Nature Medicine 24:1246-1256. — PubMed PMID: 29988130
  7. Baker DJ, Wijshake T, Tchkonia T, et al. (2011). Clearance of p16Ink4a-positive senescent cells delays ageing-associated disorders. Nature 479:232-236. — PubMed PMID: 22048312
  8. Baker DJ, Childs BG, Durik M, et al. (2016). Naturally occurring p16Ink4a-positive cells shorten healthy lifespan. Nature 530:184-189. — PubMed PMID: 26840489
  9. Kirkland JL, Tchkonia T (2017). Cellular senescence: a translational perspective. EBioMedicine 21:21-28. — PubMed PMID: 28416161
  10. van Deursen JM (2014). The role of senescent cells in ageing. Nature 509:439-446. — PubMed PMID: 24848057
  11. Tchkonia T, Zhu Y, van Deursen J, Campisi J, Kirkland JL (2013). Cellular senescence and the senescent secretory phenotype: therapeutic opportunities. Journal of Clinical Investigation 123:966-972. — PubMed PMID: 23454759
  12. Coppe JP, Desprez PY, Krtolica A, Campisi J (2010). The senescence-associated secretory phenotype: the dark side of tumor suppression. Annual Review of Pathology 5:99-118. — PubMed PMID: 20078217
  13. Zhu Y, Doornebal EJ, Pirtskhalava T, et al. (2017). New agents that target senescent cells: the flavone, fisetin, and the BCL-X(L) inhibitors, A1331852 and A1155463. Aging (Albany NY) 9(3):955-963. — PubMed PMID: 28273655
  14. Harrison DE, Strong R, Reifsnyder P, et al. (2024). Astaxanthin and meclizine extend lifespan in UM-HET3 male mice; fisetin, SG1002 (hydrogen sulfide donor), dimethyl fumarate, mycophenolic acid, and 4-phenylbutyrate do not significantly affect lifespan in either sex at the doses and schedules used. GeroScience 46(1):795-816. — PubMed PMID: 38041783
  15. Farr JN, Atkinson EJ, Achenbach SJ, et al. (2024). Effects of intermittent senolytic therapy on bone metabolism in postmenopausal women: a phase 2 randomized controlled trial. Nature Medicine 30(9):2605-2612. — PubMed PMID: 38956196
  16. Koning M, Kovynev A, Fondevila MF, et al. (2026). Senolytics dasatinib and quercetin in metabolic dysfunction-associated steatohepatitis: a proof-of-principle randomized, controlled trial. Nature Metabolism. — PubMed PMID: 42823536
  17. Lee E, Carreras-Gallo N, Lopez L, et al. (2024). Exploring the effects of Dasatinib, Quercetin, and Fisetin on DNA methylation clocks: a longitudinal study on senolytic interventions. Aging (Albany NY) 16(4):3088-3106. — PubMed PMID: 38393697
  18. Hambright WS, Duke VR, Goff AD, et al. (2024). Clinical validation of C12FDG as a marker associated with senescence and osteoarthritic phenotypes. Aging Cell 23(5):e14113. — PubMed PMID: 38708778
  19. ClinicalTrials.gov registry entries (accessed 14 October 2026): AFFIRM, NCT03430037; AFFIRM-LITE, NCT03675724; knee osteoarthritis fisetin trial with posted results, NCT04210986; postmenopausal bone trial with a fisetin arm, NCT04313634.

PubMed Topic Searches

  1. PubMed: Fisetin senolytic clinical trial
  2. PubMed: AFFIRM fisetin trials
  3. PubMed: SCAPs and senescent-cell biology
  4. PubMed: D+Q senolytic cocktail
  5. PubMed: SASP cytokine profile
  6. ClinicalTrials.gov — Active fisetin trials

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Connections

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