First, telomeric DNA consists of multicopy tandem repeat arrays and fully possesses all the essential features of a lifespan countdown timer:
(1) It can be replicated during cell division to ensure each daughter cell inherits a copy;
(2) The shortened length of these arrays in somatic cells is replenished in germ cells, and germ cells must harbor the maximum copy number across all cells of an individual to sustain consumption throughout the entire life cycle, from embryonic development to maturation and senescence [31,22];
(3) The shortening rate of the arrays is malleable to adapt to the distinct developmental and senescent rates of different species and different cell types within the same species;
(4) In somatic cells, telomeres are consumed unidirectionally, enabling p53 to generate a concentration gradient along the time axis and form a temporal scale;
(5) All external factors or intrinsic genes that modulate the rate of senescence exert their effects by altering the shortening rate of these arrays;
(6) Given that some organisms can live for over a century—for instance, the Greenland shark has a lifespan of up to 400 years—the candidate driver substance that propels the operation of the genetic program (analogous to the sand in an hourglass) must be extremely stable and lack a half-life. In contrast, proteins, RNA, mitochondrial DNA (mtDNA), and chemical modifications of DNA and histones are highly unstable, have distinct half-lives, and exist in a dynamic equilibrium of constant degradation and replenishment. For example, DNA methylation and demethylation, as well as histone acetylation and deacetylation, occur simultaneously, making it impossible for these molecules to form a temporal measurement and precluding them from acting as a timer. In other words, the fundamental cause of aging does not lie in RNA, proteins, mtDNA, or epigenetic modifications, and research focused on these directions will never uncover the root cause of aging.
Thus, prior to the proposal of the TRCS model, among the numerous theories of cellular senescence, only the telomere theory is valid. In the causal relationship underlying cellular senescence, if telomere shortening is the cause of cellular senescence, then elongating telomere length in senescent cells will inevitably lead to a significant increase in cell replication capacity, accompanied by the reversion to a youthful cellular phenotype. Conversely, if telomere shortening is merely a consequence of cellular senescence, elongating telomere length in senescent cells will not enhance replication capacity nor restore a youthful state. In 2015, scientists at Stanford University first extended the telomere length of skin stem cells by 0.9 kb using hTERT mRNA, which increased the cell replication number by 28 passages [46]; Bodnar (1998) introduced the hTERT gene into human retinal pigment epithelial cells and foreskin fibroblasts, and observed a reduction in the senescence marker β-galactosidase, along with a marked increase in cell replication capacity [47].
Notably, telomere elongation leading to a significant boost in cell replication capacity is an effect that cannot be achieved by any other aging models or intervention strategies.
Experimental studies have also shown that a single tail vein injection of AAV9-mTERT in mice over their lifetime resulted in reduced DNA damage, improved glucose tolerance, alleviated cognitive decline, delayed tumorigenesis, and a 24% extension in the average lifespan of the mice [Bernardes de Jesus B, Vera E, Schneeberger K, et al. Telomerase gene therapy in adult and old mice delays aging and increases longevity without increasing cancer. EMBO Mol Med. 2012 Aug;4(8):691-704. doi: 10.1002/emmm.201200245.].
However, due to the excessively long telomeres in mice, the lifespan-extending effect of telomerase therapy in mice may be weaker than that in humans. Furthermore, telomere shortening decelerates with age and eventually rebounds: for example, human telomere length increases in individuals aged 80–90 years [48-49], and telomere elongation has also been observed in senescent naked mole-rats [50]. Our own research has also demonstrated that a reduction in 45S rDNA copy number leads to elongated telomeres in white blood cells. Therefore, rDNA exerts a greater driving effect on aging than telomeres in the elderly, meaning that the lifespan-extending efficacy of telomere elongation via telomerase alone will gradually diminish. This finding nonetheless confirms the validity of the telomere theory of aging.
Finally, the figure provided shows that leukocyte telomere length is longer in 80-year-old elders than in 20-year-old young adults. However, measuring leukocyte telomere length does not reflect the actual physiological state. Our experimental data indicate that knockout of 45S rDNA leads to telomere elongation in white blood cells, demonstrating that increased leukocyte telomere length is a consequence of aging. Thus, only the measurement of telomere length in stem cells can accurately reflect the true biological state of an organism.