Abstract Disclosure: R. Dresner-Pollak: Consulting Fee; Self; Opko Biologics LTD.. Speaker; Self; Medison Pharma. N. Lishinsky: None. I. Gurt: None. J. Stokar: None. V. Temkin: None. P. Shivam: None. G. Zatarah: None. J. Milgram: None. R. Shahar: None. Skeletal fragility is a recognized complication of type 1 diabetes (T1D). The risk of hip and non-vertebral fractures is significantly higher in people living with T1D compared to age- and sex-matched non-diabetic controls and those living with type 2 diabetes (T2D). Hip fracture risk is up to six-fold higher in T1D patients; hip fractures occur 10-15 years earlier and the outcome is poorer compared to non-diabetics. Alterations in bone quality are considered major contributors to T1D-related skeletal fragility. As people with T1D live longer, there is a growing need to discover new therapeutics to reduce fracture risk. TID is associated with accelerated biological aging. Cellular senescence is a fundamental mechanism of aging. Senescent cells stop dividing, are resistant to apoptosis and acquire a distinct phenotype that includes secretome changes termed “senescence-associated secretory phenotype” (SASP). Clearing senescent cells with senolytics is recognized as a promising therapeutic approach for multiple conditions in mice and humans We explored the ability of senolytics dasatinib (D), a tyrosine kinase inhibitor, and quercetin (Q), a flavanol, present in fruit and vegetables, drug combination, to alleviate femur fragility in mice with T1D. Ins2Akita mice show a sexual dimorphic effect of the mutant Ins2 allele causing severe hyperglycemia in males. We treated Ins2Akita male and female mice and C57BL/6 wild type (WT) male mice with D + Q administered once monthly for four months beginning at age 3 months. 3-month-old Ins2Akita male mice had higher blood levels of the SASPs components HMGB1, PAI-1, MMP12, and increased gene expression of p53 and senescence effectors p16, p15 and SASPs Il1b, Mmp3, Mmp9, Mmp13, Serpineb2 at the femur diaphysis and in bone marrow mesenchymal stem cells, respectively compared to age-matched WT male mice. In vitro, exposure to glucose levels equivalent to those observed in blood in Ins2Akita male mice induced cellular senescence in IDG-SW3 osteocyte-like cells including a 4-5-fold increase in gene expression of p16INK4a, p21Cip[1], p53, double percentage of SA-β-gal+ cells and P21 protein level. Ingenuity pathway analysis of differentially expressed proteins revealed enrichment for the senescence pathway (Z=1.213; P=1.11E-05). D+Q administration did not affect bone microarchitecture at the spine (L2), distal femur metaphysis and diaphysis assessed by µCT. D+Q administration significantly increased femur resistance to fracture assessed by the 3-point-bending test by increasing whole femur work-to-fracture, the ultimate parameter of bone resistance to failure, and post-yield displacement, an index of matrix composition, organization, and bone quality in Ins2Akita males. No effect was observed in Ins2Akita females or WT male mice, indicating that the intervention is specific for T1D. Senolyitcs D+Q show promise in improving bone health in T1D. Presentation: 6/1/2024
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