Therapeutic Potential of Micheliolide and ACT001 in Age-Related Diseases: Molecular Mechanisms and Clinical Prospects.
Aging is the predominant risk factor for several chronic disorders; therefore, elucidating the molecular and cellular mechanisms underlying age-related pathologies is essential for therapeutic advancement. Micheliolide (MCL), a naturally occurring guaianolide sesquiterpene lactone derived from Michelia champaca and Michelia compressa, has attracted increasing attention for its pharmacological potential. Its derivative, ACT001, enables the sustained release of MCL into the plasma in vivo, thereby enhancing oral bioavailability and improving therapeutic efficacy. ACT001 has recently received orphan drug designation for glioblastoma treatment, highlighting its clinical feasibility and safety profile. Increasing evidence indicates that MCL regulates age-related diseases by modulating inflammation, cell cycle, mitochondrial dysfunction, oxidative stress, and autophagy. By targeting key signaling pathways, including NF-κB, STAT3, NRF2, AMPK, and NLRP3, MCL/ACT001 demonstrated its protective effect against age-related diseases. This paper summarizes the current mechanistic insight and disease-specific evidence regarding MCL/ACT001 and further evaluates their therapeutic repositioning potential for age-related diseases, including cardiovascular and cerebrovascular diseases, fibrotic conditions, immune disorders, metabolic diseases, and tumors. Additionally, we discussed key translational challenges.