The Crossroads for Human Longevity
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In these years we stand at the crossroads for human longevity. A long, slow, and largely unintentional upward trend in health and life expectancy has been running for near two hundred years now, caused by increases in wealth and technological progress, each driving the other. Increased longevity in turn helps to increase wealth and speed progress: all of these benefits are individually but facets of the whole gem.

The medical science of the past has blossomed into full-bored biotechnology, and change and growth in this field has become exceptionally rapid over the past twenty years, mirroring progress in computing hardware and software development. Scientists can now individually carry out tasks in a few months that would have required an entire laboratory staff and years of labor in the early 1990s, if it even possible at all back then. Many researchers advocate that now is the time to approach aging as the medical condition it is, to stop treating it with religious awe, as though it were some mystical thing that stands outside of the rest of medicine, and use the tools we have to make it go away.

Some of these researchers are engaged in a form of networked disruptive innovation within aging research that they hope will eventually displace the present mainstream. This is how progress happens in human organizations: the heretics agitate and prove themselves correct via research and development until such time as the old mainstream gives in and agrees that they were right all along.

That is the high road ahead from the crossroads. Upon this road the research community abandons its reluctance to treat aging, the public comes to think of aging in the same way as they presently think of cancer, research funding flows, and great progress is made towards means of halting and reversing the underlying causes of aging. Age-related diseases start to become things of the past, like widespread cholera and tuberculosis, just a few decades past this turning point.

But there are other roads ahead. Disruptive movements don't always win in their first spin around the block. The old guard can last for decades past their time, poisoning the well and ensuring that progress remains slow. Regulation can also suppress new paradigms, and indeed entire fields of human endeavor, for decades at a time - and medical development certain does not lack for obstructive bureaucracy. The treatment of aging is actually forbidden in the US by regulatory fiat, and there is no effective path towards gaining approval for the commercial application of potential therapy to intervene in the causes of aging. This is well known and the chilling effect percolates all the way back up the chain of research and development to create difficulties in fundraising for such goals.

So there are low roads to either side away from the crossroads. These are largely the ruts of status quo and slow progress in which billions of dollars continue to go towards research that increases our knowledge of the details of the molecular dance that is aging, but which can offer no plausible hope or promise of significantly extending life soon enough to matter to us. Life spans continue to edge upward, but we all die just a little older than our parents, and suffer all of the same age-related conditions, just a little less painfully. It is the road on which the study of aging for the sake of knowledge rather than action continues to dominate, and in which the public continues to be largely disinterested in extended healthy life or avoidance of the diseases of aging: marching towards death in their tens of millions, but never raising a hand to do anything about it.

This possibility is why advocacy for the better options in longevity science and human rejuvenation must exist. Without disruptive change in the public perception of aging and medicine for aging, without disruptive change in the attitudes of the scientific community, then the status quo is what we will get - and it will let us die by failing to take full advantage of all that can be done in this age of biotechnology.

The paper quoted below is a joint effort by Jan Vijg and Aubrey de Grey, both scientists who see the potential for big changes to the field in the years ahead and would like to see those changes come about. It isn't open access, unfortunately, but the abstract is a good encapsulation of the crossroads we presently find ourselves at.

Innovating Aging: Promises and Pitfalls on the Road to Life Extension

One of the main benefits of the dramatic technological progress over the last two centuries is the enormous increase in human life expectancy, which has now reached record highs. After conquering most childhood diseases and a fair fraction of the diseases that plague adulthood, medical technology is now mainly preoccupied by age-related disorders. Further progress is dependent on circumventing the traditional medical focus on individual diseases and instead targeting aging as a whole as the ultimate cause of the health problems that affect humankind at old age.

In principle, a major effort to control the gradual accumulation of molecular and cellular damage - considered by many as the ultimate cause of intrinsic aging - may rapidly lead to interventions for regenerating aged and worn-out tissues and organs. While considered impossible by many, there really is no reason to reject this as scientifically implausible. However, as we posit, it is not only scientific progress that is currently a limiting factor, but societal factors that hinder and may ultimately prevent further progress in testing and adopting the many possible interventions to cure aging.

Comments

So if I'm reading this correctly SENS style research will gradually accumulate, aided by fund raisers. Sooner or later this will result in a breakthrough increasing the healthspan and lifespan of mice (you listed glucosepane removal or allotopic expression of mitochondrial genes as the best candidates for this at present). Once those breakthroughs occur, more public opinion may swing behind SENS.

I could be wrong, but I do think breakthroughs like the above are necessary. If you've tried talking to friends about SENS and the possibility of significant lifespan extension you'll know that they tend to dismiss it out of hand. Mainly because you are just a 'regular person' and they don't hear it discussed on the news like they do cancer, AIDS, or Alzheimer's research.

For a television news reporter to discuss a branch of SENS research and imply to the public that they should support it, they need that proof in a mouse.

As you said in a previous post the time to that proof is uncertain due to low levels of funding at present.

I guess this whole field could be catapulted into a higher gear if Dr. Matthew O'Connor or Dr. William Bains find an in-vivo working therapy for glucosepane or mitochondrial rescue.

As I am now in my early 30s it is a bit worrying that this field could languish for a decade or two before a breakthrough occurs. Although the odds of no breakthroughs in 20 years surely has to be low?

Posted by: Jim at April 18, 2014 11:25 PM

@Reason --
"there is no effective path towards gaining approval for the commercial application of potential therapy to intervene in the causes of aging."

I think there is a way. Look at the A4 studies going on right now regarding Alzheimer's. http://www.adcs.org/Studies/A4.aspx

You are saying that there is a disconnect between current thinking/efforts and the SENS targets, but I think there is now a bridge...the very rationale behind the A4 is this, "The A4 study is for people without any outward signs of Alzheimer's disease "

Huh? They did this:
1) identify a disease-target (SENS has done this with all 7 of the aging-categories, yes??)

2) Work backwards to see what 'build-up' or 'damage' may possibly cause this disease (again, SENS, correct??)

3) Justify their efforts to actually GIVE DRUGS TO PEOPLE WHO ARE NOT SICK (I caps-locked b/c there is no bold :) ) -- is this is not preventative medicine, then what the heck is?

So, this new thinking, approved by the FDA, is, it seems, pretty well aligned with SENS, don't you think?

thanks for all you do!!
Eugene

Posted by: Eugene at April 22, 2014 4:19 AM

@Eugene - I think regulation still has a chilling effect on research for preventative therapies.

Those drugs (Alzheimers and Statins) that are going to be trialled for people who are not already exhibiting symptoms were (a) already developed to treat the disease with symptoms and (b) are backed by large pharma companies.

For a company to develop a new drug or treatment from scratch, someone would first have to prove a direct link between the damage and the disease.

I do agree with you that regulation is probably not the major thing holding up SENS style research, it is the need for a few more proof of concept studies in living animals with treatments that could actually be transferred to humans.

The SENS foundation's studies on removing intra-cellular garbage with enzymes may be the first studies to meet this condition (I know that senescent cells were removed in mice, but that was via germline genetic engineering which is not applicable in humans).

I think they have enough money to do this study so fingers crossed that it works and works well in mice.

It sucks that the mid term prospects of SENS style research rely on them and a few others picking winners, and that wrong choices can delay things, but I guess that is the way things are for now.

$4 million per year funding and other labs doing a few studies is still a lot better situation than 10 years ago.

Posted by: Jim at April 22, 2014 10:40 AM
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