Metformin Restores CNS Remyelination Capacity by Rejuvenating Aged Stem Cells

Summary The age-related failure to produce oligodendrocytesfrom oligodendrocyte progenitorcells (OPCs) is associated with irreversible neurodegeneration in multiple sclerosis (MS). Consequently, regenerative approaches have significant potential for treating chronic demyelinating diseases. Here, we show that the differentiation potential of adult rodent OPCs decreases with age. Aged OPCs become unresponsive to pro- differentiation signals, suggesting intrinsic constraints on therapeutic approaches aimed at enhancing OPC differentiation. This decline in functional capacity is associated with hallmarks of cellular aging, including decreased metabolic function and increased DNA damage. Fasting or treatment with metformin can reverse these changes and restore the regenerative capacity of aged OPCs, improving remyelinationin aged animals following focal demyelination. Aged OPCs treated with metformin regain responsiveness to pro- differentiation signals, suggesting synergistic effects of rejuvenation and pro- differentiation therapies. These findings provide insight into aging-associated remyelinationfailure and suggest therapeutic interventions for reversing such declines in chronic disease.