Methods Measurements of AMPK, ACC, and fatty acid oxidation in primary hepatocytes.Hepatocytes were isolated from male Sprague Dawley (SD) rats by collagenase digestion (18). For the AMPK assay, cells were seeded in six-well plates at 1.5 × 10 6 cells/well in DMEM containing 100 U/ml penicillin, 100 µg/ml streptomycin, 10% FBS, 100 nM insulin, 100 nM dexamethasone, and 5 µg/ml transferrin for 4 hours. Cells were then cultured in serum-free DMEM for 16 hours followed by treatment for 1 hour or 7 hours with control medium, 5-amino-imidazole carboxamide ribo-

Methods Measurements of AMPK, ACC, and fatty acid oxidation in primary hepatocytes.Hepatocytes were isolated from male Sprague Dawley (SD) rats by collagenase digestion (18). For the AMPK assay, cells were seeded in six-well plates at 1.5 × 10 6 cells/well in DMEM containing 100 U/ml penicillin, 100 µg/ml streptomycin, 10% FBS, 100 nM insulin, 100 nM dexamethasone, and 5 µg/ml transferrin for 4 hours. Cells were then cultured in serum-free DMEM for 16 hours followed by treatment for 1 hour or 7 hours with control medium, 5-amino-imidazole carboxamide ribo-

Burroughs Wellcome Fund and American Diabetes Association.

Background: Cellular senescence is a key mechanism that drives age-related diseases, but has yet to be targeted therapeutically in humans. Idiopathic pulmonary fibrosis (IPF) is a progressive, fatal cellular senescenceassociated disease. Selectively ablating senescent cells using dasatinib plus quercetin (DQ) alleviates IPF-related dysfunction in bleomycin-administered mice. Methods: A two-center, open-label study of intermittent DQ (D:100 mg/day, Q:1250 mg/day, three-days/week over three-weeks) was conducted in participants with IPF (n = 14) to evaluate feasibility of implementing a senolytic intervention. The primary endpoints were retention rates and completion rates for planned clinical assessments. Secondary endpoints were safety and change in functional and reported health measures. Associations with the senescence-associated secretory phenotype (SASP) were explored. Findings: Fourteen patients with stable IPF were recruited. The retention rate was 100% with no DQ discontinuation; planned clinical assessments were complete in 13/14 participants. One serious adverse event was reported. Non-serious events were primarily mild-moderate, with respiratory symptoms (n = 16 total events), skin irritation/bruising (n = 14), and gastrointestinal discomfort (n = 12) being most frequent. Physical function evaluated as 6-min walk distance, 4-m gait speed, and chair-stands time was significantly and clinicallymeaningfully improved (p b .05). Pulmonary function, clinical chemistries, frailty index (FI-LAB), and reported health were unchanged. DQ effects on circulat.ing SASP factors were inconclusive, but correlations were observed between change in function and change in SASP-related matrix-remodeling proteins, microRNAs, and proinflammatory cytokines (23/48 markers r ≥ 0.50). Interpretation: Our first-in-humans open-label pilot supports study feasibility and provides initial evidence that senolytics may alleviate physical dysfunction in IPF, warranting evaluation of DQ in larger randomized controlled trials for senescence-related diseases. ClinicalTrials.gov identifier: NCT02874989 (posted 2016-2018).