A geroscience perspective on immune resilience and infectious diseases: a potential case for metformin

Geroscience. 2021 Jun;43(3):1093-1112. doi: 10.1007/s11357-020-00261-6. Epub 2020 Sep 9.

Abstract

We are in the midst of the global pandemic. Though acute respiratory coronavirus (SARS-COV2) that leads to COVID-19 infects people of all ages, severe symptoms and mortality occur disproportionately in older adults. Geroscience interventions that target biological aging could decrease risk across multiple age-related diseases and improve outcomes in response to infectious disease. This offers hope for a new host-directed therapeutic approach that could (i) improve outcomes following exposure or shorten treatment regimens; (ii) reduce the chronic pathology associated with the infectious disease and subsequent comorbidity, frailty, and disability; and (iii) promote development of immunological memory that protects against relapse or improves response to vaccination. We review the possibility of this approach by examining available evidence in metformin: a generic drug with a proven safety record that will be used in a large-scale multicenter clinical trial. Though rigorous translational research and clinical trials are needed to test this empirically, metformin may improve host immune defenses and confer protection against long-term health consequences of infectious disease, age-related chronic diseases, and geriatric syndromes.

Keywords: Aging; COVID-19; Geroscience; Immunity; Metformin.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Aged
  • COVID-19*
  • Communicable Diseases* / drug therapy
  • Humans
  • Metformin* / therapeutic use
  • Multicenter Studies as Topic
  • RNA, Viral
  • SARS-CoV-2

Substances

  • RNA, Viral
  • Metformin