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As a rule, the journalistic community struggles to correctly represent any complex situation, community, or state of affairs. It is outsiders writing on a topic they generally know little of, under a deadline, and with few to no consequences attending mistakes and misrepresentations. To a journalist, any field looks like a confusing bristle of self-promoters and high-profile figures, all of them contradicting one another on points that require a good amount of technical knowledge to understand. It is the blind men and the elephant wherein some of the blind men have book deals to promote, or companies to talk up, and most of the others are just hard to find in the phone directory. The reality of it is under there somewhere, but no professional journalist has either the time or the motivation to find it.
This collection of articles from the MIT Technology Review (and those of us who have been around for a while will appreciate the irony of this particular publication grappling with the topic of treating aging as a medical condition) is fairly typical for the popular science media. It is a disconnected tour of some of the high points that will provide little anchoring context or understanding for those who are unfamiliar with the field. There is the sense that something is underway, yes, but the details are floating disconnected and the true shape of the whole is not conveyed.
What is the true shape of the whole? There is major change and progress ahead, the research community is moving towards literal rejuvenation of the old, and the advent of senolytic drugs to selectively remove harmful senescent cells from old tissues has woken up the scientific and development establishments to the potential to effectively treat aging. Yet near all of the higher profile researchers and other folk are largely working on approaches that are really not that exciting, not capable of producing rejuvenation, and will have only small effects in the grand scheme of what is possible. But because of the general sense of potential in the field, those approaches will be funded, promoted, and widely discussed, simply because they are interventions aimed at aging. It will be quite challenging for a time to sort out the wheat from the chaff.
A growing number of scientists are questioning our basic conception of aging. What if you could challenge your death – or even prevent it altogether? What if the panoply of diseases that strike us in old age are symptoms, not causes? What would change if we classified aging itself as the disease? David Sinclair, a geneticist at Harvard Medical School, is one of those on the front line of this movement. Medicine, he argues, should view aging not as a natural consequence of growing older, but as a condition in and of itself. Old age, in his view, is simply a pathology – and, like all pathologies, can be successfully treated. If we labeled aging differently, it would give us a far greater ability to tackle it in itself, rather than just treating the diseases that accompany it.
It is a subtle shift, but one with big implications. How disease is classified and viewed by public health groups such as the World Health Organization (WHO) helps set priorities for governments and those who control funds. Regulators, including the US Food and Drug Administration (FDA), have strict rules that guide what conditions a drug can be licensed to act on, and so what conditions it can be prescribed and sold for. Today aging isn’t on the list. Sinclair says it should be, because otherwise the massive investment needed to find ways to fend it off won’t appear.
Reprogramming is a way to reset the body’s so-called epigenetic marks: chemical switches in a cell that determine which of its genes are turned on and which are off. Erase these marks and a cell can forget if it was ever a skin or a bone cell, and revert to a much more primitive, embryonic state. The technique is frequently used by laboratories to manufacture stem cells. But Izpisúa Belmonte is in a vanguard of scientists who want to apply reprogramming to whole animals and, if they can control it precisely, to human bodies. Izpisúa Belmonte believes epigenetic reprogramming may prove to be an “elixir of life” that will extend human life span significantly.
James Clement, 63, is a spry man with a shaved head and clear eyes, who spends his days gulping vitamins and trying to figure out how to make people live longer, including himself, his parents, and even me. From a home and several outbuildings in Gainesville, Florida, Clement runs BetterHumans, which he calls the world’s “first transhumanist research organization.” With funds from wealthy elderly men he knows, he is independently exploring drugs known to extend the healthy life span of rodents. Using a calculator, he extrapolates what a suitable human dose might be, and then finds people who will take them.
Who wouldn’t want to reach 110, if not 500? Unlike mere armchair futurists, the life extensionists are prepared to experiment on themselves, and others, using vitamins and prescription cancer drugs, as well as compounds available only by finagling them from chemical suppliers. Lately the idea of living longer, maybe a lot longer, seems more realistic. As biologists uncover the fundamental facts of life, even ivory-tower academics now claim they know what the molecular “hallmarks” of aging are. In their lab animals, at least – roundworms and white mice – they can regularly increase life spans by 20% or 30% and sometimes more.
Given these clues, Clement has financed and supervised four small studies, in volunteers, of treatments found to extend the healthy lives of rodents – the immune drug rapamycin, supplements that increase NAD+ levels, a combination of compounds that kill off senescent cells, and injections of plasma concentrated from umbilical cords. His aim is “to do as many small trials as possible” to generate and publish basic information on safety and possible benefits. With that, he says, people interested in life extension “can decide to take the risk.”
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