Senescence targeting re-enables injury-responsive repair in a human RPE aging model

Abstract

Aging is associated with progressive tissue dysfunction and impaired repair after injury. In the retinal pigment epithelium (RPE), these changes contribute to age-related macular degeneration (AMD), yet the mechanisms limiting repair remain incompletely understood. Here, we establish a longitudinal human embryonic stem cell (hESC)-derived RPE aging model that recapitulates key features of aged human donor RPE and combine it with mosaic cell ablation to assess injury-responsive repair. Although aged RPE cells initiate DNA synthesis after injury, they exhibit impaired mitotic progression, uncoupling S-phase entry from epithelial repopulation. Transcriptomic profiling links this defect to a senescence-associated program marked by inflammatory signaling and suppressed mitotic networks. Pharmacologic reduction of senescent cells with Navitoclax shifts aged RPE toward a younger transcriptional profile but does not induce repopulation by itself. Instead, senolytic treatment primes aged RPE for repair, improving epithelial density and homeostatic function only in response to injury, a strategy we term "senolytic priming." These findings establish a human stem-cell-derived platform for investigating age-associated epithelial repair failure and show that aged human RPE retains latent repair capacity that can be re-enabled by targeting cellular senescence.