Emerging biological therapies for healthy aging: targeting inflammaging, senescence, and regenerative decline

Aging is a complex, multifactorial biological process marked by progressive physiological decline and increased vulnerability to chronic disease. Advances in geroscience have expanded the hallmarks of aging into twelve interrelated mechanisms categorized as primary, antagonistic, and integrative. Emerging biological therapies—including mesenchymal stem cell (MSC) therapies, stem cell-derived extracellular vesicles (EVs), monoclonal antibodies (mAbs), and plasma-based approaches—do not map onto these hallmarks in simple one-to-one relationships; rather, they exert pleiotropic effects across systemic inflammatory, metabolic, and regenerative networks. This review compiles current evidence on emerging biological treatments, highlighting early-phase immunomodulatory effects, cell-free alternatives for matrix remodeling, precision inflammatory control via mAbs, and systemic circulating signals. Despite promising preclinical and early clinical findings, translational challenges—including safety validation, production standardization, scalability, and long-term efficacy—must be addressed to establish mechanism-based anti-aging interventions.