Fight Aging!

Cryonics refers to the low-temperature storage of the body (or at least the brain) at death to offer the chance that a more technologically capable future can restore that individual to life. It is an unknown chance, possibly a small and unknown chance, but cryonics is certainly a better option that the other end of life alternatives facing someone who is going to age to death before rejuvenation biotechnology and the medical control of aging becomes a reality. Cryonics remains a very good idea that should be far more widely used, significantly supported, and undergoing aggressive technological development to improve capabilities. But it is very far from being widely used and suffers from the same situation that afflicted the aging research community thirty years ago: a minority field with too little financial and popular support to generate the desired degree of progress.

Newfound enthusiasm for the development of means to treat aging has led to a vast (if very unevenly distributed) investment in the field, hundreds of companies working on all sorts of approaches. A tiny fraction of that enthusiasm for doing something to address age-related disease and mortality has spilled over into support for cryonics. Even that tiny fraction is proving to be transformative. I pick on Alcor as the example because I am signed up with Alcor, and therefore do pay more attention to what is going on there, but the field as a whole is showing progress. Europe has its own modern cryopreservation organization these days, Tomorrow.bio, their focus on customer service raising the bar for the community. Meanwhile Until Labs is working on making reversible vitrification of organs a commercial possibility, a best foot forward to generate further capital and legitimacy for cryonics.

After years of little visible progress and too little funding to improve on that situation, Alcor has of late acquired what is for a non-profit a sizable influx of capital. Enough to not just establish new research programs with new equipment, but to address look and feel and customer service priorities, such as a modernization of the website and creating a portal and modern relationship management system for their customers - and no doubt more under the hood than that. Alcor comes to the table with the DNA of decades of year to year struggle as a small non-profit serving a small community. Shedding some of those historical habits and culture will be necessary in order for a commercial industry of cryopreservation to emerge.

In a better world, this could have happened decades ago, driven by a broad popularist realization that cryopreservation to travel into a potentially far better future is the best of all options, turning an end into a hiatus. But it didn't. At least the first increments of such a sea change are happening now. A few excepts from a recent Alcor newsletter follow, for those who don't keep tabs on how this industry is modernizing.

Fundraising & Endowment: 2025 closed out as one of the stronger fundraising years in Alcor's history, including a major gift from the Rothblatt family - one of the largest individual donations Alcor has ever received. About 75% of donations came from people who hadn't given at that level before. The goal is to build an operational endowment similar to what exists for the Patient Care Trust, which is very healthy. The operations and administrative side, however, has historically struggled to keep pace. A comparable endowment would allow Alcor to focus on growth rather than making ends meet. Expect a significant fundraising initiative announcement in the near future.

First-Ever In-House Whole Body CT Scan: The team performed Alcor's first-ever in-house whole body CT scan. The scan itself went smoothly: they used the new ceiling trolley and hoist to transfer the patient from the perfusion table directly onto a radiotranslucent scanning tray, completed the scan in just a few minutes, transferred the patient back, and proceeded directly to cooldown. That patient is now in long-term storage. After everything it took to get here, it was well worth the wait. Being able to validate cryoprotectant distribution in-house and in real time opens up a lot of doors for quality assessment and research.

CT Scanning for Vitrification Assessment: we are putting the CT scanner to good use and have already started producing valuable data. Pre- and post-cooling scans show clear differences between frozen kidneys and vitrified kidneys. The next step: quantifying exactly how much ice forms in different regions using a newly purchased differential scanning calorimeter. This will let the team precisely correlate CT images with ice content - a tool that could become standard for assessing cryopreservation quality in organs and patients alike

Organ Cryopreservation: The team continues refining porcine kidney cryopreservation protocols. About 40% of kidneys show excellent vitrification with minimal ice formation. The other 60% show small ice crystals in the inner medulla - the part of the kidney that's hardest to perfuse.

Brain Slice Cultures: we are developing long-term brain slice cultures that can survive 2-3 weeks in a CO2 incubator. Using assays to measure metabolic activity, they've established a baseline comparing fresh tissue versus straight-frozen tissue. The goal: cryopreserve brain slices, rewarm them, and show maintained viability and functionality over time. This would be a significant contribution to the literature - evidence that brain tissue can remain alive and functional after proper cryopreservation. Additional human brain tissue experiments are also in the works, with a neurosurgery partnership nearly finalized.

New Project: Antifreeze Protein Gene Integration: A particularly exciting update is that we are developing a project to integrate antifreeze protein genes directly into cells via gene therapy. The idea is that if cells can produce their own antifreeze proteins internally, they might survive freezing and thawing better without needing external cryoprotectants. This is early-stage - they're still screening candidate proteins from fish, beetles, and other organisms. Potential applications include improving CAR-T cell therapy, which could be relevant for both cryonics and mainstream medicine.

The protein BDNF is known to encourage neuroplasticity in the brain and otherwise assist in protecting the health and function of neurons. Numerous studies have demonstrated upregulation of BDNF to improve cognitive function in the context of aging and neurodegenerative conditions. Much of this work focuses on very indirect paths to the upregulation of BDNF, such as manipulation of the gut microbiome, but here researchers take the direct approach of a viral gene therapy introduced into brain tissue via stereotactic injection. They show that this can improve cognitive function in mouse models of Alzheimer's disease

Brain-derived neurotrophic factor (BDNF) can protect neurons from apoptosis and maintain normal synaptic structures, indicating a significant potential for Alzheimer's disease (AD) treatment. However, the method of in vivo BDNF delivery requires further optimization, and the therapeutic efficacy of BDNF in AD animal models needs to be further evaluated. Here, we demonstrated that a newly engineered adeno-associated virus (AAV) serotype termed AAVT42 showed better tropism for neurons than AAV9 in the central nervous system (CNS).

We analyzed the therapeutic potentials of AAVT42-delivered BDNF in three AD mouse models: amyloid precursor protein/presenilin-1 (APP/PS1), rTg4510, and 3xTg. Long-term BDNF expression in the hippocampus mitigated neuronal degeneration or loss in these AD mice, and alleviated their cognitive impairment, with no discernible effect on amyloid-β deposition or tau phosphorylation. Furthermore, transcriptomic analysis in 3xTg mice revealed that BDNF orchestrated the up-regulation of genes associated with neuronal structural organization and synaptic transmissions, such as Neuropeptide Y (Npy), Corticotropin-releasing hormone (Crh), Tachykinin precursor 1 (Tac1), and the down-regulation of Bone morphogenetic proteins (Bmps).

Our study highlighted the efficacy of AAVT42 in gene delivery to CNS and validated the therapeutic benefits of BDNF in treating AD, which will be useful for future translational research on AD treatment using an AAV delivery system.

Link: https://doi.org/10.1016/j.gendis.2025.101649

Cancer diagnosis and treatment tends to involve the removal of lymph nodes, leading to impaired flow in the lymphatic system and either transient or permanent lymphedema. In aging, lymph nodes become fibrotic and structural disorganized, impairing the ability of immune cells to use the lymphatic system to coordinate a response to infection. One possible approach to these problems is the generation of artificial lymph nodes, or at least suitable arrangements of cells that will form themselves into a functional lymph node and connect to the lymphatic system once implanted into the body. A number of different groups have made progress towards this goal, to the point of demonstrating the creation of partially functional lymph nodes in animal studies; the research program noted here is the most recent.

The increase in cancer incidence has accelerated the need for secondary lymphedema treatments after lymphadenectomy because lymph nodes cannot be regenerated. Recently, many attempts have been made to treat secondary lymphedema by forming lymphatic vessels using three-dimensional cellular structures. Of these, three-dimensional cellular structures composed of lymphatic endothelial cells (LECs) and fibroblasts fabricated using a cell stacking technique by coating functional proteins on the cell surface were reported to form a lymphatic network inside the structures, demonstrating the formation of a lymphatic lumen structure after transplantation in mice. Unfortunately this cellular structure has not been effective for the treatment of secondary lymphedema. Therefore, lymph node regeneration or reconstruction using therapeutic cells has not been achieved, and the development of a better therapeutic method is desired.

This study aims to develop a bioengineered three-dimensional tissue composed of LECs and mesenchymal stem/stromal cells (MSCs), which has immunomodulatory functions and can prolong the survival of transplants for lymph node reconstruction. To fabricate the bioengineered tissue simply, we establish a centrifugal cell stacking technique with no additives. This bioengineered tissue, termed "centrifuge-based bioengineered lymphatic tissue" (CeLyT), forms a lymphatic network inside the tissue during culture for several days. CeLyTs induce the formation of lymph node-like structures, with characteristics similar to lymph nodes, after transplantation into mice, and the formation of this lymph node-like structure suppress edema following lymphadenectomy in mice. Therefore, CeLyTs composed of LECs and MSCs might be a cell-based therapeutic strategy for secondary lymphedema.

Link: https://doi.org/10.1038/s41467-025-65121-3

Transposable elements, or transposons, are DNA sequences capable of directing the protein machinery surrounding nuclear DNA to haphazardly insert copies of the transposon elsewhere in the genome, potentially breaking other necessary sequences. Transposons are thought to be the remnants of ancient viral infections, but given that transposon activities are most likely an important mechanism of evolution, driving functional changes that can then be selected, that may not be universally true.

Transposons are suppressed in youth, the structure of DNA managed by epigenetic mechanisms to package away transposon sequences into heterochromatin structures and thus hide them from transcription machinery in the cell nucleus. With advancing age the epigenetic control of DNA structure changes in a variety of ways, altering the expression of many genes to contribute to loss of function, but also unleashing transposons to an ever greater degree.

Beyond mutational damage, transposon activity generates molecules that the cell has evolved to recognize as foreign and react to with inflammatory signaling. The activity resembles a viral infection, in essence. It may be that the greatest harm done by transposon activation is not in fact the mutational damage to DNA, but rather the contribution to a state of systemic sterile inflammation that is characteristic of aging, disruptive to tissue structure and function.

The interplay of epigenetic remodelling and transposon-mediated genomic instability in ageing and longevity

Ageing and age-related diseases are the result of complex biological processes that progressively cause deterioration of cellular and tissue function. Among the key hallmarks of ageing are epigenetic alterations and genomic instability, both of which are closely interconnected and significantly contribute to the ageing process. The epigenome, encompassing both DNA and histone modifications, regulates gene expression and maintains genomic integrity throughout life. With age, these regulatory systems become dysregulated, leading to genome-wide changes in chromatin structure, histone modifications, and the reactivation of transposable elements (TEs).

TEs, typically silenced in heterochromatic regions, become active in aged cells, contributing to genomic instability, mutagenesis, inflammation, and metabolic disruption. Despite their significant implications, the role of TEs in the ageing process remains underexplored, and the interplay between epigenomic remodelling and TE activity remains poorly understood. In this review, we explore the molecular mechanisms underlying epigenetic alterations and TE reactivation during ageing, the impact of these changes on genomic stability and the potential therapeutic interventions targeting this interplay. By deciphering the role of epigenetic modifications and TE derepression in the ageing process, we aim to highlight novel avenues for anti-ageing and pro-longevity strategies.

Most of the approaches demonstrated to alter metabolism in ways that modestly slow aging and extend life involve an increased efficiency of autophagy. This includes mild stresses resulting from exercise, calorie restriction, heat, cold, and low levels of toxin exposure. The processes of autophagy act to recycle damaged or otherwise unwanted cellular components into amino acids that can be used for further protein synthesis, improving cell function. Thus there is interest in the scientific community in finding drugs that can induce increased autophagy. The best known, most readily available, and most advanced in the clinic are varieties of mTOR inhibitor, rapamycin being the canonical example. But many other classes of small molecule may prove to be interesting enough to develop into drugs.

Macroautophagy, henceforth referred to as autophagy, is a cellular process that, in part, can act to break down damaged, dysfunctional, or otherwise unwanted components. Autophagy is crucial for maintaining proteostasis and is a necessary system for cellular survival under stressful conditions. Autophagic efficiency declines during aging, leading to the buildup of damaged proteins and organelles, as well as other nonviable cellular debris.

The amino acid response (AAR) pathway is a highly conserved mechanism that reacts to low levels of amino acids with the increased translation of Gcn4 (in yeast), ATF-4 (in worms), and ATF4 (in mammals). We have previously shown that activation of this pathway through the chemical inhibition of tRNA synthetases (tRS) can activate autophagy and extend lifespan in both worms (C. elegans) and yeast (S. cerevisiae).

In this study, we identify four additional tRNA synthetase inhibitors, REP8839, REP3123, LysRS-In-2, and halofuginone, that extend both healthspan and lifespan in C. elegans. These compounds also trigger a significant upregulation of autophagy, specifically at their lifespan-extending doses. These phenotypes partially depend on the conserved transcription factor ATF-4. Our findings further establish tRNA synthetase inhibition as a conserved mechanism for promoting increased lifespan and now healthspan, with potential implications for therapeutic interventions targeting age-related decline in humans.

Link: https://doi.org/10.3390/biom16010073

Cell therapies seem the least likely of approaches to make it into the clinic as a treatment to selectively destroy the senescent cells that linger to cause harm in aged tissues. While it is a very plausible goal to take a CAR T cell therapy and target it to senescent cells, or use adoptive transfer of other immune cell types known to attack senescent cells, as these are just variations on strategies already well demonstrated to work in other contexts, the cost and logistical effort is enormous in comparison to other approaches to the selective destruction of senescence cells. It is far more likely that therapies to adjust the operation of native immune cells, such as the approach under development by Deciduous Therapeutics, or forms of senolytic vaccine, will emerge from this line of thinking.

One of the most significant risk factors for diseases is aging. Interestingly, some organisms, such as naked mole-rats and most turtles, do not exhibit typical aging-like symptoms or increased mortality as they become older. These aspects indicate that aging is not necessarily an essential event for animal life and are avoidable. Overcoming aging would free humans from age-associated diseases (AADs) and prolong lifespans.

Recent studies have demonstrated that one of the causes of age-related organ dysfunction is excessive chronic inflammation caused by the accumulation of senescent cells (SNCs) and their senescence-associated secretory phenotypes (SASPs). Therefore, the development of drugs and medication to remove SNCs is ongoing.

Natural killer (NK) cells are integral components of the innate immune system that are critical for clearing SNCs. Beyond this direct function, NK cells also orchestrate innate and adaptive immunity responses to survey and eradicate these compromised cells. Consequently, preserving NK cell function throughout the aging process is paramount for mitigating AADs and promoting robust health in later life.

Simultaneously, NK cell-based senotherapy presents compelling avenues for addressing the multifaceted challenges associated with SNC accumulation and aging. Recent investigations into adoptive NK cell-based senotherapy have demonstrated considerable promise in rejuvenating immunosenescence, facilitating SNC elimination. The accumulating evidence provides a promising proof-of-concept for adoptive NK cell-based senotherapy, indicating its potential as a development in longevity therapeutics.

Link: https://doi.org/10.3389/fimmu.2025.1737572

The degree to which human longevity is inherited is one of a large number of interesting research topics that, while being related to aging, has little to no relevance to the question of how to treat aging as a medical condition. In developing means to repair or resist the cell and tissue damage that causes degenerative aging, the focus must be on the damage, not the differences from individual to individual. How it is that aging progresses somewhat differently from individual to individual will become increasingly irrelevant as therapies to slow and reverse aging emerge.

That said, today's open access paper on the heritability of longevity is quite interesting. The argument put forward by the authors is that previous efforts to quantify the degree to which individual variance in longevity is determined by one's immediate ancestry have produced underestimates because they failed to properly compensate for the effects of premature death resulting from accidents, infectious disease, and the like. If the strategy for assessment used in the paper is employed instead, then human heritability of longevity is higher than past results, and also more in line with the heritability of other physical traits.

At the same time, the big picture on the genetics of aging that has emerged in recent years, with the advent of very large population databases such as the UK Biobank, is that genetics plays only a small role in determining life expectancy. It is far outweighed by lifestyle choice in the vast majority of people. A high heritability but low contribution of genetic variance suggests that heritability largely exists as a result of the cultural transmission of lifestyle choices; parents that take better care of their health tend to have children who take better care of their health, and vice versa.

Heritability of intrinsic human life span is about 50% when confounding factors are addressed

Understanding the heritability of human life span is fundamental to aging research. However, quantifying the genetic contribution to human life span remains challenging. Although specific life span-related alleles have been identified, environmental factors appear to exert a strong effect on life span. Clarifying the heritability of life span could direct research efforts on the genetic determinants of life span and their mechanisms of action.

Previous studies have estimated the heritability of life span in various populations with results ranging from 15 to 33%, with a typical range of 20 to 25%. Recently, studies on large pedigree datasets estimated it at 6 to 16%. These studies contributed to growing skepticism about the role of genetics in aging, casting doubt on the feasibility of identifying genetic determinants of longevity. Current estimates for the heritability of human life span are thus lower than the heritability of life span in crossbred wild mice in laboratory conditions, estimated at 38 to 55%. They are also lower than the heritability of most other human physiological traits, which show a mean heritability of 49%.

Most life-span studies used cohorts born in the 18th and 19th centuries, with appreciable rates of extrinsic mortality. Extrinsic mortality refers to deaths caused by factors originating outside the body, such as accidents, homicides, infectious diseases, and environmental hazards. Another factor that varies between studies is the minimum age at which individuals must be alive to be included, referred to as the cutoff age. To our knowledge, these two factors - extrinsic mortality and cutoff age - have not been systematically investigated for their effect on heritability estimates of life span.

Here, we explored the effects of extrinsic mortality and cutoff age on twin study estimates of heritability. We used model-independent mathematical analysis and simulations of two human mortality models to partition mortality into intrinsic and extrinsic components. We tested our conclusions on data from three different twin studies, including the SATSA (Swedish Adoption/Twin Study of Aging) study, containing data from twins raised apart that have not been previously analyzed for life-span heritability. To test generalizability to non-Scandinavian cohorts, we also analyzed siblings of US centenarians. We found that extrinsic mortality causes systematic underestimates of the heritability of life span and that cutoff age has a mild nonlinear effect on these estimates. When extrinsic mortality is accounted for, estimates of heritability of life span due to intrinsic mortality rise to about 55%, more than doubling previous estimates.

This is an example of the very earliest stages of research leading to drug discovery, the identification of a potential target protein, here CUL5, that can be manipulated to change cell metabolism in a specific way, here meaning a reduction in the amount of tau protein in the cell. Aggregation of altered tau is a feature of late stage Alzheimer's disease, a cause of cell dysfunction and death in the brain. Reducing tau levels is one possible approach to the problem, though given that tau has a normal and necessary function in the brain, it may not be the best possible approach. At this stage, researchers do not know how CUL5 functions to affect tau levels, and thus a good deal of further work stands between the present discovery and the emergence of any practical outcome.

Aggregation of the protein tau defines tauopathies, the most common age-related neurodegenerative diseases, which include Alzheimer's disease and frontotemporal dementia. Specific neuronal subtypes are selectively vulnerable to tau aggregation, dysfunction, and death. However, molecular mechanisms underlying cell-type-selective vulnerability are unknown. To systematically uncover the cellular factors controlling the accumulation of tau aggregates in human neurons, we conducted a genome-wide CRISPR interference screen in induced pluripotent stem cell (iPSC)-derived neurons.

In comparison to other tau screens previously reported in the literature, our data have broadly similar patterns of hit genes. A previous genome-wide screen for modifiers of tau levels performed in SHY5Y cells has several shared classes of genetic modifiers. Surprisingly, this screen identified CUL5 as a negative modifier of tau levels. Since CUL5 regulates hundreds of substrates, it is not surprising that CUL5 knockdown has different phenotypes in different contexts.

We find CUL5 expression to be correlated with resilience in tauopathies along with genes encoding CUL5 interactors, including ARIH2 and SOCS4. However, the molecular mechanisms by which CUL5 affects neuronal vulnerability in AD remains to be identified. A broad distribution of CUL5 expression is seen in different neuronal subtypes in the Seattle Alzheimer's Disease Brain Cell Atlas suggesting that CUL5 may modulate disease vulnerability via multiple mechanisms. For instance, it is possible that CUL5 expression affects vulnerability via tau ubiquitination. But, considering CUL5's known role in immune signaling, another possibility is that CUL5 expression affects vulnerability via the neuro-immune axis.

Link: https://doi.org/10.1016/j.cell.2025.12.038

Parkinson's disease is driven by the spread of misfolded α-synuclein through the brain. The most evident symptoms result from the death and dysfunction of motor neurons, caused by the presence of misfolded α-synuclein. Once α-synuclein misfolds, it is capable of inducing other molecules of α-synuclein to misfold in the same way, and this dysfunction can slowly spread from cell to cell. In recent years, researchers have shown that in a sizable fraction of Parkinson's disease cases misfolded α-synuclein first emerges in the intestines and then spreads to the brain. Here, researchers uncover more of the mechanisms by which this transmission takes place, with an eye to finding ways to intervene in the earliest stages of the condition in order to prevent later consequences.

Emerging evidence suggests that Parkinson's disease (PD) may have its origin in the enteric nervous system (ENS), from where α-synuclein (αS) pathology spreads to the brain. Decades before the onset of motor symptoms, patients with PD suffer from constipation and present with circulating T cells responsive to αS, suggesting that peripheral immune responses initiated in the ENS may be involved in the early stages of PD. However, cellular mechanisms that trigger αS pathology in the ENS and its spread along the gut-brain axis remain elusive.

Here we demonstrate that muscularis macrophages (ME-Macs), housekeepers of ENS integrity and intestinal homeostasis, modulate αS pathology and neurodegeneration in models of PD. ME-Macs contain misfolded αS, adopt a signature reflecting endolysosomal dysfunction and modulate the expansion of T cells that travel from the ENS to the brain through the dura mater as αS pathology progresses. Directed ME-Mac depletion leads to reduced αS pathology in the ENS and central nervous system, prevents T cell expansion and mitigates neurodegeneration and motor dysfunction, suggesting a role for ME-Macs as early cellular initiators of αS pathology along the gut-brain axis. Understanding these mechanisms could pave the way for early-stage biomarkers in PD.

Link: https://doi.org/10.1038/s41586-025-09984-y

Aging research is not a field marked by its unity. At the high level there is some degree of consensus on the need to treat aging as a medical condition, and that this is a plausible goal given time and effort. But ask questions about any particular detail regarding the mechanisms of aging, how to progress towards therapies, the bounds of the possible, and the state of the field, and you will usually find almost as many opinions as there are researchers to hold them. This is characteristic of a field of study in which far more remains to be discovered than has been mapped to date. The research community cannot be said to fully understand the cell, let alone how an organism made up countless cells of many diverse types changes over time.

Still, enough is known to make inroads. We can target senescent cells for selective destruction. We can replace mitochondria. We can reprogram epigenetic patterns. And so forth. We can have opinions on how well any specific class of therapy will perform, but only by earnestly trying a given approach - building the therapies, conducting the clinical trials, and bringing drug into widespread use - will we actually find out how well that approach works.

As recent history demonstrates, the creation of novel therapies is a slow process in the present environment of medical regulation. Ten years is a rapid pace for the move from idea to first clinical trial. Another decade might pass between that first trial and commercial availability of the resulting drug for the average patient. Success for any given line of research is not inevitable. Viable therapies can be completely ignored because the drugs involved are generic, or the approach otherwise cannot be effectively patented and monopolized. A long road lies ahead, given the way in which medical research and development is presently conducted.

Past, present and future perspectives on the science of aging

Juan Carlos Izpisua Belmonte: In the next decade, I expect aging research to move from describing decline to restoring function. High-resolution human datasets, from single-cell and spatial maps to longitudinal studies, will provide a clearer picture of how aging progresses across tissues. At the same time, systemic biology will become even more important, with interorgan communication and circulating signals serving as key therapeutic entry points. Clinically, biological age measures will help to personalize prevention and allow earlier intervention. In the long term, I am hopeful that these developments will reshape medicine.

Steve Horvath: Over the next 10 years, I expect the field to shift decisively from measuring aging to modulating it in humans. I hope that epigenetic clocks will continue to mature into tools for evaluating interventions in individuals and even at population scale. My hope is that the aging field will identify safe, well-tolerated interventions that are capable of rejuvenating multiple human organ systems.

Bérénice A. Benayoun: In the next decade, I think the future of our field will be precision geroscience - understanding what shapes aging trajectories and which levers can be potentially acted upon to promote long-term health, not only based on private unique genetic variation but also other important factors that we are just beginning to appreciate/

Steve N. Austad: I see a takeover by massive omics. I am not suggesting this is a bad thing. It will certainly lead to a personalization of health and medical treatments, but I don't think it will lead to the kind of breakthrough that something like antibiotics represented. I think there will be more interventions on the market over that time (mostly supplements) - some might even be effective, although I doubt they will outdo what the best lifestyle choices do now. Real breakthroughs, if they come, will be further out than 5-10 years.

Terrie E. Moffitt: Over the next 5-10 years, I envision aging research evolving into an era of close integration between basic and clinical sciences, much like what has been achieved in hypertension, diabetes and cancer research. As our understanding of the molecular mechanisms that regulate aging deepens, we will see the identification of diverse therapeutic targets and an acceleration in the development of drugs, vaccines and other interventional strategies.

Guang-Hui Liu: The coming decade will probably see a shift towards precision geroscience. Multidimensional aging clocks may become clinically useful tools for quantifying biological age and intervention effects. We anticipate early human trials targeting newly recognized aging drivers, and advances in gene and cell-based regenerative strategies. Critically, the field is moving towards a unified medical paradigm: targeting the root causes of aging to prevent multiple chronic conditions together, rather than individually.

Vadim N. Gladyshev: I expect to see organ- and systems-resolved aging maps and clinically qualified aging biomarkers; routine real-time biological age monitoring (omics, digital, wearables, and imaging); embryo-inspired rejuvenation cues; advances in replacement; insights from long-lived species on complex interventions that slow down aging; and advances in the theoretical understanding of aging.

Vera Gorbunova: I expect the first antiaging interventions to be approved and introduced to clinical practice. I see aging biomarkers to become a routine part of a health check-up linked to individualized recommendations on improving healthspan. I also expect the development of safe interventions focused on restoring a more youthful epigenome, and preventative strategies to enhance genome stability and improve DNA repair to become available.

David A. Sinclair: I expect the emergence of interventions that treat common diseases by resetting cellular age and allowing the body to heal itself. This will include Yamanaka factor mediated epigenetic reprogramming, due to be tested in humans in 2026, followed by epigenetic editing, small-molecule reprogramming drugs and AI-guided therapies. Within 10 years, I foresee whole-body rejuvenation.

George A. Kuchel: I firmly believe that the future of geroscience, and also its most important impact, will be in the prevention of multiple chronic conditions, which are among the most prevalent and typical features of aging in humans.

John W. Rowe: First, there will be a dramatic increase in the number of clinical trials focused on senescence and age-related disorders with interventions arising from geroscience. Second, we are lagging behind in care of older persons and geriatric medicine continues to suffer severe workforce inadequacies, especially for those with low or middle income. Societies must recognize the need and develop incentives, including financial, to bolster all facets of the eldercare workforce including public health, acute care and long-term care. Third, we have largely viewed aging as an accumulation of deficits and have systematically neglected the valuable capabilities that older people bring to society.

Oskar Hansson: In the space of neurodegenerative diseases, I think we are now moving into the therapeutic era, and I hope that the research community will develop several effective and safe interventions for these devastating brain diseases. Personally, I have especially high hopes for different genetic medicine approaches.

Anne Brunet: The field is moving forward very rapidly, and it is amazing to be part of it! I think there will be several translational breakthroughs in the next 5 to 10 years, notably for devastating age-related diseases such as Alzheimer's disease. Research-wise, it will be very cool to see what happens because so much more is feasible at the organismal level, and it will be an era of quantitative physiology that can be done at scale.

Ming Xu: In the next 5 to 10 years, I expect that the field of aging research will make incredible progress in these three directions. (1) I expect to see a significant rise in large-scale, human clinical trials for geroscience interventions. (2) Single-cell and spatial omics technologies will allow us to reveal the cellular and tissue-specific heterogeneity of aging. 3) AI will become an indispensable tool for aging research. AI and machine-learning models will be used to understand the complexity of multiomics data, identify novel aging targets and design personalized therapies.

Eiji Hara: Cellular senescence research is currently attracting considerable attention, with growing evidence that senescent cells are deeply involved in aging and various age-related diseases. Many studies suggest that targeting senescent cells could help to prevent or treat age-related conditions. Over the next 5-10 years, I expect we will gain a clearer understanding of several critical questions: which types of senescent cells drive specific pathologies, what are the optimal strategies for selective elimination versus functional modulation of these cells, and what are the potential risks of senolytic interventions.

Jing-Dong J. Han: I envision the next decade as the era when aging research becomes a predictive science. Big data will provide the 'language' of aging - a comprehensive, high-resolution dictionary of biological changes. AI models will be the 'translator', enabling us to read this language to forecast health trajectories, identify vulnerabilities and design personalized interventions long before clinical symptoms appear. The goal will be to move from treating age-related diseases to preemptively managing the aging process itself.

Felipe Sierra: As with all other areas of human activity, the field will be dominated by AI and other computer-based approaches to translate the biology of aging into interventions. In addition, I believe the field will succeed within the next 5 years at identifying predictive and clinically useful biomarkers that will take us into a more quantitative stage of research. I fear that, combined, AI and biomarkers will 'suck up the oxygen' from more basic mechanistic research, and this in turn will lead to progressively diminishing returns from AI and biomarkers.

Matt Kaeberlein: I am optimistic that the importance of geroscience will continue to gain recognition, and lead to greater investment from both public and private sectors. I expect substantial engagement from major pharmaceutical companies and anticipate the first FDA approval for a drug that slows aging, probably in companion animals. That milestone would mark a turning point for translational geroscience. Clinically, the landscape will remain frothy for a while. Some longevity clinics already practice evidence-based medicine, whereas others promote unproven or even unsafe interventions. Over time, I expect consolidation around data-driven, ethical standards.

The development of atherosclerosis is very different in males versus females. In the commonly used mouse models that develop atherosclerotic plaque in response to a high fat diet this is very evident. Interestingly, ovariectomized female mice develop plaque in a very similar way to male mice, indicating the importance of hormones to the mechanisms of atherosclerosis. In humans, atherosclerosis is broadly a male condition up to the age of menopause, at which point women start to catch up to the male extent of atherosclerotic plaque and subsequent cardiovascular disease and mortality.

Cardiovascular disease (CVD) is the leading cause of death for both men and women in the United States, though the age of onset differs by sex. Historical estimates suggest men experience earlier onset of coronary heart disease (CHD) by about 10 years as compared with women. Sex-specific differences in CVD are attributed to multiple different pathways, including hormonal influences, differences in cardiovascular health behaviors and factors, and exposure to adverse social determinants of health. Historically, men had higher rates of smoking, diabetes, and hypertension. However, population shifts in cardiometabolic risk phenotypes have resulted in similar or higher rates of obesity, diabetes, and hypertension in women than men. Additionally, the overall prevalence of smoking has decreased and is similar among men and women.

This study analysed data from the CARDIA (Coronary Artery Risk Development in Young Adults) study, a prospective multicenter cohort study. US adults aged 18 to 30 years enrolled in 1985 to 1986 and were followed through August 2020. Sex differences in the cumulative incidence functions of premature CVD (onset earlier than 65 years), were compared overall and for each subtype (CHD, heart failure, stroke).

Among 5,112 participants with a mean age of 24.8 ± 3.7 years at enrollment and a median follow-up of 34.1 years, men had a significantly higher cumulative incidence of CVD, CHD, and heart failure, with no difference in stroke. Men reached 5% incidence of CVD 7.0 years earlier than women (50.5 versus 57.5 years). CHD was the most frequent CVD subtype, and men reached 2% incidence 10.1 years earlier than women. Men and women reached 2% stroke and 1% heart failure incidence at similar ages. Sex differences in CVD risk emerged at age 35, persisted through midlife, and were not attenuated by accounting for cardiovascular health.

Link: https://doi.org/10.1161/JAHA.125.044922

A recent human trial of α-ketoglutarate supplementation failed to show benefits, but researchers continue to show interest in α-ketoglutarate based on results in cells and animal studies. In this example, researchers link α-ketoglutarate availability to the regulation of cellular senescence via TET. It may be that this interaction is not as important to cellular senescence in humans as it is in mice, or that middle aged people (40 to 60) don't have a large enough burden of senescent cells to make effect sizes resulting from α-ketoglutarate supplementation easily visible, or that the optimal dose is higher than the trial dose. Regardless, it seems a poor substitute for senolytics if the goal is to influence the burden of senescence in older people.

Cellular senescence, a state of stable cell-cycle arrest associated with aging, is characterized by a distinct pro-inflammatory secretome. This study systematically interrogates the critical role of the α-ketoglutarate (AKG)-Ten-eleven translocation (TET) axis in regulating senescence in human somatic cells. Downregulating TET expression and activity, either genetically (siRNA) or pharmacologically (via C35), or limiting AKG bioavailability through a targeting peptide, trigger widespread epigenetic reprogramming, amplify pro-inflammatory signaling, and enhance the senescence-associated secretory phenotype (SASP), ultimately driving cells toward replicative senescence.

Conversely, augmenting AKG bioavailability or TET expression and activity significantly enhances cellular resilience to stress, effectively preventing and reversing senescent phenotypes. These findings not only position the AKG-TET axis as a critical regulatory nexus of cellular senescence but also challenge the traditional view of senescence as a fixed endpoint, revealing its dynamic and plastic nature susceptible to therapeutic intervention.

Link: https://doi.org/10.1016/j.isci.2025.114298

Amyloid is a category, referring to proteins that clump together and precipitate from solution to form solid fibrils or other structures. At least hundreds of different proteins are capable of forming amyloids given suitable alterations to their structure or surrounding conditions, but most of the research attention given to this activity is directed towards toxic, pathological amyloids that form in great excess in the context of neurodegenerative conditions (such as amyloid-β, α-synuclein, and tau), followed by the few amyloids outside the brain that do the same to contribute to severe cardiovascular and other conditions (such as transthyretin or medin).

In today's research materials, researchers provide evidence for a specific type of amyloid formation to be involved in the creation and maintenance of long-term memory. This is very different from the basis for pathological amyloidosis, and involves different proteins, but given the research community focus on that amyloidosis, there has perhaps been a tendency to write off all forms of amyloid as harmful byproducts of cellular metabolism. A brief glance at the history of our understanding of biochemistry suggests that this sort of viewpoint is usually mistaken; if a process exists, evolution will eventually lead to its incorporation into some necessary aspect of cell function.

How Brain May Deliberately Form Amyloids to Turn Experiences Into Memories

The prevailing model of memory hypothesizes that a change in synaptic strength is one of the mechanisms through which information is encoded in neuronal circuits. While changes in synaptic strength require alterations in the synaptic proteome, the mechanisms that initiate and maintain these changes in synaptic proteins remain unclear. Molecular chaperones play a critical role in proteome function, and act as an interface between the environment and the proteome. Chaperones guide proteins to attain the correct folded state. It has long been thought that in the nervous system, chaperones help proteins to either fold correctly or prevent proteins from harmful misfolding and clumping.

A new study found that in Drosophila, one of a family of J-domain protein chaperones, CG10375, which they named "Funes", does something unexpected - it allows proteins to change their shape and form functional amyloids that house long-term memory. "This expands the idea of a protein's capacity to do meaningful things, and suggests there is an unknown universe of chaperone biology that we've long been missing." Thus amyloids are not always harmful unregulated byproducts as previously thought. Amyloids can be carefully controlled - serving as tools the brain uses to store information. Ultimately, the research reveals for the first time a critical step in the process of how long-lasting memories endure.

In fruit flies, a prion-like protein called Orb2 (and its relative protein CPEB in mammals) must undergo self-assembly at the synapses, the gap between two neurons, to maintain a memory. Orb2 belongs to a class of nonpathological amyloids, where amyloid formation enables a protein to acquire a new function. Over time, the researchers began to hypothesize that the difference between a harmful and a helpful amyloid may depend on whether Orb2's assembly process is tightly regulated by other proteins.

The researchers discovered Funes by manipulating the concentrations of 30 different chaperones in the fly's memory centers. Flies with increased levels of Funes showed a remarkable ability to remember an odor-reward link after 24 hours - a standard proxy for long-term memory. But the most surprising discovery came at the molecular level. Researchers engineered Funes variants that could bind Orb2 but could not trigger its transition into amyloid and found the flies' long-term memory failed. This indicated that Funes is an essential component for long-term memory formation.

Diseases of the eye are often the indication of choice for new, advanced forms of medicine, particularly gene therapies. Delivery to the eye is straightforward and proven, effective doses can be very low, and the structures of the interior of the eye are relatively isolated from the rest of the body. All told, the risk to patients is much lower than would be the case for targeting, say, the liver, which makes it a great deal easier to convince investors and regulators to support such a program. Thus we shouldn't be all that surprised to see that the first clinical trial of partial reprogramming to rejuvenate epigenetic control over nuclear DNA structure and gene expression will focus on regeneration of the damaged retina.

The FDA has given the go-ahead for the first ever human trial of a partial epigenetic reprogramming therapy. The FDA's decision clears an investigational new drug application for Life Bioscience's ER-100, a gene therapy designed to rejuvenate damaged retinal cells in people with serious, age-related eye diseases. The biotech is now preparing to commence a Phase 1 first-in-human study to show its therapy can be delivered safely in patients with open-angle glaucoma and non-arteritic anterior ischemic optic neuropathy (NAION).

As a first-in-human trial, Life Bioscience's study is primarily focused on safety and tolerability. Instead of using all four Yamanaka factors, ER-100 employs three of the factors (Oct4, Sox2, and Klf4) delivered transiently to reset age-associated epigenetic markers while keeping cells committed to their original function. By excluding c-Myc, a factor associated with uncontrolled growth, the strategy is intended to lower the risk of tumors that has historically concerned regulators and clinicians. From a safety perspective, the company's preclinical studies in non-human primates demonstrated that ER-100 was well tolerated in NHPs, with no systemic toxicities.

"The therapy uses a doxycycline-inducible system, giving us precise control over when the genes are active and allowing treatment to be paused or stopped if needed. In addition, ER-100 is delivered locally to the eye, limiting systemic exposure. Multiple preclinical animal models have demonstrated controlled gene expression, favorable biodistribution, restoration of epigenetic markers, and improvements in visual function which has collectively provided the foundation for FDA clearance."

Link: https://longevity.technology/news/fda-clears-first-human-trial-of-epigenetic-reprogramming-therapy/

Ferroptosis is a form of programmed cell death associated with iron metabolism. A body of evidence supports a role for excessive ferroptosis in the progression of Alzheimer's disease and other age-related conditions, a maladaptive reaction to forms of age-related damage present in the brain, such as mitochondrial dysfunction, an increased burden of senescent cells, chronic inflammatory signaling, and so forth. Researchers are starting to consider suppression of ferropotosis as an approach to treating neurodegenerative conditions, which leads to papers such as this one, a discussion of the mechanisms by which exercise acts to reduce ferroptosis. That is a step along the road to identifying potential targets for drug development. Attempting to mimic specific outcomes of exercise, calorie restriction, or other environmental effects on metabolism is a widely employed strategy, though it seems unlikely to be capable of more than modestly slowing disease progression or modestly reducing severity.

Ferroptosis, a regulated form of cell death driven by iron-dependent lipid peroxidation, has emerged as a critical link between cellular senescence and Alzheimer's disease (AD). Senescent cells disrupt iron metabolism, promote peroxidation-prone lipid remodeling, and suppress antioxidant defenses, creating a pro-ferroptotic environment that accelerates neuronal degeneration. This review integrates recent mechanistic evidence demonstrating that these senescence-induced changes heighten ferroptotic susceptibility and drive AD pathology through pathways involving protein aggregation, autophagic failure, and inflammatory synaptic loss.

Importantly, physical exercise has emerged as a pleiotropic intervention that counteracts these ferroptotic mechanisms at multiple levels. Exercise restores iron homeostasis, reprograms lipid metabolism to reduce peroxidation risk, reactivates antioxidant systems such as GPX4, enhances mitochondrial and autophagic function, and suppresses chronic neuroinflammation. Moreover, systemic adaptations through muscle, liver, and gut axes coordinate peripheral support for brain health. By targeting ferroptosis driven by cellular senescence, exercise not only halts downstream neurodegenerative cascades but also interrupts key upstream drivers of AD progression.

These findings position ferroptosis as a therapeutic checkpoint linking aging biology to neurodegeneration and establish exercise as a mechanistically grounded strategy for AD prevention and intervention.

Link: https://doi.org/10.3389/fcell.2025.1742209