The ability of senescent cells to trigger an innate immune response via the up-regulation of pro-inflammatory cytokines was first suggested to play a role in limiting tumourigenesis. This immune response was later shown to be important in the elimination of senescent stellate cells during liver damage. In natural killer (NK) cell mediated cytotoxicity, NK cells identify senescent cells by the presence of NKG2D ligands on the membrane of senescent cells. The presentation of these ligands on senescent cells might be mediated by a DDR, which was previously shown to induce their expression. In particular, it appears that the ATM-ATR pathway is important for the up-regulation of NKG2D ligands in response to stress. NK cell induced cytotoxicity of senescent cells is mediated by granule exocytosis and perforin-mediated death rather than death-receptor-induced apoptosis. The perforin mediated cytotoxicity decreases in humans with age, and might therefore contribute to accumulation of senescent cells in the organism during ageing and in age-related diseases. As discussed, senescent cells are known to accumulate with age and in disease states, suggesting that senescent cells may be evading immune surveillance or their rate of accumulation is greater than the rate of removal or both. It has been advocated that the accumulation of senescent cells with age might be the consequence of an impaired ageing immune system. In fact, immune cells can also become senescent and these changes may contribute to impaired elimination of senescent cells. Therefore, strategies to restore an ageing immune system are a compelling approach for the elimination of senescent cells and for promoting an increased health-span.
A recent study has shown that senescent HSCs can be eliminated by another component of the innate immune system, the M1-like macrophages during liver damage and tumorigenesis in the liver. Secretory factors from senescent HSCs were shown to aid the elimination of these cells by macrophages. In contrast, cells that could not become senescent due to deletion of p53 and were not targeted by macrophages. Therefore, the innate immune system appears to be an initial early barrier that regulates the presence of senescent cells in physiological conditions such as in wound healing.
The elimination of senescent cells by the adaptive immune system has also been demonstrated. OIS hepatocytes were shown to secrete cytokines to evoke an immune response leading to the elimination of senescent cells by CD4(+) T-cells, a process which required the action of macrophages. The elimination of senescent hepatocytes was required to prevent the development of liver cancer. This study mentions the attraction of T-cells by soluble factors but not the mechanism of senescent cell recognition, an area of research that still needs to be explored. However, there is some indication that RS cells may up-regulate MHC1 expression, possibly via p53. It can be speculated that MHC1 proteins in senescent cells may function to display senescence-associated antigens similar to cancer cells, allowing recognition and elimination by cytotoxic T-cells. Further research will provide multiple insights into the mechanisms and consequences of the interaction of senescent cells with the immune system.