Fight Aging!

Here is a short email that I received yesterday:

I have been reading about [longevity research] for a week now and I was just wondering if you were making progress on this? I read some people think aging can be cured in 2029 could that actually happen?

So today, I'll scribe a brief perspective on recent progress in longevity science. I should preface this by noting that it is probably best to think of the life science and medical research community as an array of largely independent groups and factions, some large, some small. While there is a lot of cross-pollination in their work, they move at different rates towards different goals in medicine and biotechnology, and those goals are of varying degrees of usefulness when it comes to allowing humans to live longer, healthy lives. So I'll note what I see as the areas worthy of particular notice, and omit many other areas, some of which are still important or interesting in their own right:

Early Work on Rejuvenation Biotechnology

The SENS Foundation manages a small-in-budget but large-in-scope research project, and networks with a range of allied scientific groups. The vision is to build true rejuvenation biotechnology, an implementation of the detailed SENS vision for how to repair and reverse the causes of aging. The Foundation is as much about persuading more of the scientific community to undertake aspects of this work as they are about running their own research and development center.

Progress here over the past decade is measured by the fact that the SENS Foundation didn't exist as anything more than the beginnings of an idea back then, in a research community that was far more hostile towards engineered longevity than at present. The Foundation is now an actual entity, with many allies in the aging research community and a million-dollar yearly research budget provided by philanthropic donors. The scientific community itself is now open to work on engineering human longevity, and that is largely due to the efforts of the SENS Foundation principals, supporters, and allies.

You can't change the world with a million dollar budget, alas, but this is just the start of what will hopefully blossom to become the dominant form of aging research - work targeted on the reversal of aging, rather than merely understanding it or slowing it down.

Regenerative Medicine and Tissue Engineering

Stem cell medicine of all forms is growing very rapidly, a worldwide industry that is producing tangible results at a very fast pace: engineering patient-matched tissues and organs, controlling cells to spur regeneration, understanding why stem cells decline with age, and much more. This is a massive research and development community, enormously well funded, enjoying widespread public support, and still growing.

It is not unreasonable to expect that people in middle age today will be able to have lab-grown organs made to order when it comes time to need them, twenty years from now. More importantly, we can also fairly confidently expect to see major advances in reversing stem cell decline with age over that same time frame. Most of the market for stem cell based medicine involves elderly patients, and understanding how to revive stem cell populations in the old will be a necessary part of implementing new therapies. The financial incentives are strong here, and are already being acted on.

Harnessing the Immune System

At the highest level, we can think of regenerative medicine as the inevitable outgrowth of new tools and new understanding that allow stem cells to be manipulated. Control the cells that build tissue, and you can control healing, regeneration, and the ability to maintain tissues in working condition over time. But this very same technology and knowledge also enables immunology and immune therapies: understanding and manipulating the immune system, which is at root just another collection of specialized cells.

The immune system serves many vital purposes in the body, and decays in characteristic ways with advancing age. Many of the frailties of aging are caused by or exacerbated by the progressive failure of the immune system to do its job - not just protecting against pathogens, but policing the cells of the body to destroy those that cause harm.

Just as regenerative medicine will ascend to building new organs over the next few decades, so too will advances in immunology lead to control over the immune system, including restoration from age-related decline. These are closely related fields, and progress in both is enabled by the same underlying biotechnologies. In recent years, we have already seen the first demonstrations of the ability to reprogram, reset, and reverse some of the age-related declines in immune function. At the same time, many new therapies are under development based on manipulation of the immune system: to destroy cancers, repair autoimmune diseases, and so forth.

Calorie Restriction Research and Mimetics

A great deal of resources are pouring into understanding the metabolism of longevity, and one part of that is the quest to understand and replicate the effects of calorie restriction on health and life span. What probably amounts to a few billion dollars over the past ten years have gone into advancing this field, which in that time has grown from a tiny minority interest in a few labs to a large and growing concern that, despite little to show for the investment yet other than knowledge, doesn't look to be slowing down any time soon.

Progress here can probably best be measured in our increased understanding of exactly how metabolism can shift into states that boost health and life span in most species. Increasing numbers of potential drug compounds have been identified that somewhat recapitulate the beneficial effects of eating less, but it seems unlikely that anything other than a carefully designed small molecule drug with very specific biochemical targets will prove to be a true calorie restriction mimetic. As of yet it seems that too little is known to build such a thing, but there is a fairly good idea as which mechanisms it would affect in order to achieve its ends.

The Genetics of Longevity

A great deal more work is taking place on the genetics and epigenetics of longevity than was the case a decade ago. This is a growth field, both for human studies that try to pick apart genetic contributions that lead to long-lived families, and for comparison studies between long-lived and short-lived species, where researchers search out distinctive differences that might explain how large variations in life span come about.

In humans, we can now be more confident that there are many genetic contributions to longevity, varying widely by population, and few if any stand out as large and obvious targets for drug development. Meanwhile the attention paid to long-lived species such as naked mole-rats is producing data that steers the attention of other research communities to the most important determinants of longevity - our mitochondria and their resistance to damage, for example.

The Bottom Line

The bottom line is that the research community and state of the field today is very different from that of even a mere ten years ago. This is a time of rapid change and progress: far more is known and far more impressive feats of medicine can be performed in the lab and the clinic. There is every reason to believe that ten years from now we'll be able to say the same thing. Costs in biotechnology and life science research are falling rapidly, and with that trend more research can be accomplished in each new year.

That said, however, the only way that we'll see significant inroads into the defeat of aging by 2029 is for the SENS Foundation and its attendant research community to undergo the same sort of growth over the next decade as has been exhibited in recent years by regenerative medicine, calorie restriction research, or study of the genetics of longevity. A growth to billions in funding and thousands of researchers, in other words. It will require at least that and a decade of time in order to have a 50/50 shot at reversing aging in old mice in the lab - which is to say something that can make them live at least twice as long as they otherwise would have done.

Of all the items covered in this post, only SENS provides a path towards achieving this end. Even regenerative medicine and complete control over stem cells can't offer the possibility of reversing aging in and of itself - it is only the way to reverse one component of aging, the decline of tissue maintenance and frailty that results from stem cells shutting down. You will still get nailed by your own mitochondria and the build up of metabolic byproducts even if your stem cells are perfectly restored.

So to answer the original question posed in the email, no, there is no plausible road to the defeat of aging by 2029. But there is a plausible road to the first laboratory demonstrations of real, meaningful, but partial age reversal by then, ways to actually repair the root biological causes of aging rather than just slow it down. Whether that happens or not depends absolutely on funding - there are more than enough scientists and research groups out there who would work on the SENS vision for rejuvenation biotechnology if given a budget, but as of yet not enough funding sources to make it a reality.