Table 3.
Emerging pharmacological interventions for sarcopenia.
| Pharmacological Intervention |
Mechanism(s) of Action |
Potential Benefits | Challenges/ Side-Effects |
References |
|---|---|---|---|---|
| Myostatin inhibitors | Block myostatin signaling, which inhibits muscle growth | Increase muscle mass and strength | Inconsistent results in improving muscle function and reducing physical frailty in clinical trials. Significant side-effects. | [19,25] |
| Anti-inflammatory therapies | Reduce chronic inflammation which impairs muscle regeneration | Potentially enhance muscle regeneration and reduce muscle atrophy | Significant side-effects, especially in older adults (e.g., NSAIDs), | [30,157] |
| Stem cell therapy | Promotes muscle regeneration by leveraging stem cell populations | Enhances muscle repair and regeneration through cell-based therapies | Promising results from clinical trials; further data on efficacy and safety are needed. | [44,46] |
| Gene editing (CRISPR/Cas9) | Targets genetic pathways to enhance muscle growth and repair | Potential to correct genetic mutations and increase muscle mass | Ethical considerations and early-stage clinical applications. | [42,43] |
| Mitochondrial enhancers | Improve mitochondrial biogenesis and function | Enhance muscle energy metabolism and reduce muscle fatigue | Require further validation in clinical settings. | [61,78] |
| Selective androgen receptor modulators |
Promote muscle growth without the adverse effects of anabolic steroids | Increase muscle mass and strength | Potential risks and long-term safety concerns. | [85,156] |
| Acetylcholinesterase inhibitors | Prevent the breakdown of acetylcholine, enhancing neuromuscular junction function | Mitigate muscle weakness associated with sarcopenia | Side-effects related to acetylcholine metabolism. | [165,168] |
| MicroRNA modulation | Modulates gene expression to enhance muscle regeneration | Novel approach to target specific pathways involved in muscle regeneration | Early stage of research; potential off-target effects. | [43,48] |
| Exosome-based therapies | Utilize small extracellular vesicles for targeted delivery of bioactive molecules | Promote NMJ repair and muscle regeneration | Still in early research stages; potential delivery challenges. | [177,180] |
Abbreviations: CRISPR, Clustered Regularly Interspaced Short Palindromic Repeats, NMJ, neuromuscular junction; NSAIDs, non-steroidal anti-inflammatory drugs.