This randomized, double-blind, placebo-controlled trial investigated the effects of urolithin A (UA), a mitophagy inducer, on age-related immune decline in 50 healthy middle-aged adults over a 4-week period. Participants received either 1,000 mg/day of UA or placebo, with assessments at baseline and day 28 13.
UA supplementation led to a significant expansion of peripheral naive-like, less terminally exhausted CD8+ T cells. This was accompanied by an increase in CD8+ T cell fatty acid oxidation capacity, indicating metabolic remodeling towards improved mitochondrial function 15.
Beyond CD8+ T cells, UA also increased the frequency of peripheral CD56dimCD16bright natural killer (NK) cells and nonclassical CD14loCD16hi monocytes. These immune cell populations are important for immune surveillance and inflammation regulation 7.
Mitochondrial biogenesis was augmented in CD8+ T cells of UA-treated participants, demonstrated by elevated expression of PGC-1α, the master regulator of mitochondrial biogenesis. Despite no change in mitochondrial mass or membrane potential at the 28-day timepoint, ex vivo experiments confirmed rapid mitophagy induction by UA, supporting mitochondrial quality control 7852.
UA improved immune cell function as evidenced by enhanced TNF secretion upon T cell activation and increased phagocytosis of Escherichia coli by monocytes. These functional improvements suggest a more robust immune response capability 89.
Single-cell RNA sequencing revealed that UA induced transcriptional changes across immune populations, particularly CD8+ T cells. These changes included upregulation of Wnt-associated stemness factors (TCF7, LEF1), increased IL7R expression, and downregulation of genes linked to T cell exhaustion and immune suppression. Pathways related to T cell receptor signaling, cytoskeletal remodeling, and adhesion were activated, while inhibitory GPCR–Gαs–PKA signaling was suppressed 9105253.
In NK cells and monocytes, UA induced gene expression profiles indicative of a less inflammatory, more mature state. Monocytes showed upregulation of mitochondrial genes and markers associated with anti-inflammatory M2-like polarization, along with downregulation of interferon response genes. B cells also exhibited a reduction in inflammatory gene signatures 1011.
The study concludes that short-term UA supplementation leads to phenotypical, metabolic, functional, and transcriptomic alterations that counteract features of immune aging and inflammaging.
These findings support the potential of UA as a safe and effective intervention to improve immune health during