One of the challenges inherent in patient advocacy for greater human longevity, for more research into aging and rejuvenation, is that journalists and the public at large either cannot or will not put in the effort needed to distinguish between: (a) scientific, plausible, and likely useful projects, those with a good expectation of addressing aging to a meaningful degree; (b) scientific, plausible, and likely unhelpful projects, those that will do little to move the needle on life expectancy, and (c) products and programs that consist of marketing, lies, and little else. This last category is depressingly large, and the first category still depressingly small.
There are examples of useful, high-expectation scientific projects in the senolytics industry, working on the means of removing senescent cells from old tissues. In animal models this is far and away the most impressive approach to rejuvenation attempted to date, applicable to many age-related diseases. The first good senolytic therapy will be revolutionary for human health in later life. As a counterpoint, an example of a poor and unhelpful scientific project is the use of metformin as a geroprotective drug, an approach that appears to very modestly and unreliably slow the progression of aging. Beneficial effects in animal studies are haphazard and small. The single study in diabetic humans shows only a small effect size. If devoting vast expense to clinical trials that target the mechanisms of aging, then why do so for a marginal therapy? Lastly, for examples of marketing and lies, one has to look no further than the established "anti-aging" industry and all of its nonsense and magical thinking. Apple stem cells. Random peptides with cherry-picked studies. Clearly no meaningful effects in the many humans using these products.
As meaningful attempts to produce rejuvenation therapies progress, and begin to attract greater attention in the world at large, we continue to see articles such as the one I'll point out today, in which no attempt is made to differentiate between sleep strategies, stem cell therapies, senolytics, metformin, and other approaches good and bad. High expectation versus low expectation of gains in health, good data versus bad data in animal studies, scientific or unscientific, it is all just lumped into the same bucket. This is unfortunate, as it leads to the situation in which any arbitrary health-focused demagogue selling branded coffee is presented just as legitimate and useful to the field as an industry leader in the clinical development of actual rejuvenation therapies, or another industry leader working on projects that can in principle only produce small gains in late life health. Which is clearly not the case. As a 60-year-old, you can practice changing your sleep and coffee habits, you can take a calorie restriction mimetic, or you can take senolytics, and only one of those three things is going to make a very sizable difference to your health and remaining life expectancy.
Dave Asprey, 48, is the founder of the Bulletproof wellness empire and a vocal champion of the movement to extend human life expectancy beyond 100 years. He's made millions by experimenting on his own body and packaging his home-brewed discoveries into books, a podcast, consulting services and consumer products (you may have even tried his butter-laced coffee). Thanks to a recent explosion of advances in longevity medicine, Asprey's vision of living healthfully into his second century might not be so crazy. In fact, for people in middle age right now, a handful of therapies in clinical trials have the potential, for the first time in human history, to radically transform what "old age" looks like. If the life extensionists are right, a person who's 40 today might reasonably expect to still be downhill skiing, running a 10K or playing singles tennis at 100.
It might be an exaggeration to say BioViva CEO Liz Parrish believes death is optional, but for her, Asprey's goal of living to 180 shows a distinct lack of ambition. "If you can reach homeostasis in the body, where it's regenerating itself just a little bit faster than it's degrading, then what do you die of? An accident or natural disaster, probably. There's no expiration date at 90 or 100 years old." Like Asprey, she has received criticism from the longevity research community for becoming "patient zero" in her own experimental drug trial, aimed at halting aging at the cellular level. In 2015, Parrish underwent telomerase and follistatin gene therapies in Bogotá, Colombia. The procedures involved receiving around a hundred injections of a cocktail of genes and a virus modified to deliver those new genes into her body's cells.
Humans have always aspired to find the fountain of youth, so "people might be skeptical about the fact that anti-aging technologies are working now," says British investor and businessman Jim Mellon. "But the fact is that this is finally happening, and we need to seize the moment." Mellon cofounded Juvenescence, a three-year-old pharmaceutical company that's investing in multiple technologies simultaneously to increase the odds of bringing winning products to market. Mellon, 63, has made his fortune betting on well-timed investment opportunities, and he predicts that a new "stock-market mania" for life extension is just around the corner. "This is like the internet dial-up phase of longevity biotech. If you'd invested in the internet in the very early days, you'd be one of the richest people on the planet. We're at that stage now, so the opportunity for investors is huge." One of Mellon's bets is on a class of drugs called senolytics, which destroy senescent cells. Senescent cells harm the body by secreting compounds that cause inflammation in surrounding tissues. Many age-related conditions - arthritis, diabetes, Alzheimer's, cancer - have an inflammatory component, and studies suggest that a buildup of senescent cells is a large part of the problem.
Eric Verdin, 63, is president and CEO of the Buck Institute, a globally renowned center for aging research just outside San Francisco in Marin County. Verdin is bullish on the promise of living healthfully to at least 100. Today. But 180? Don't count on it. "My prediction, based on everything we know today, is that getting to 120 is about the best we can do for the foreseeable future. I'll bet my house we're not going to see anyone live to 180 for another 200 years, if ever. But making everyone a healthy centenarian, this is something we can do today. And that's something to be excited about." Verdin's own lab at the Buck Institute studies the aging immune system and how it's affected by lifestyle factors, such as nutrition and exercise. Take, for instance, rapalogs, a class of drugs derived from rapamycin that interact with a protein called mTOR, which serves as a linchpin for multiple critical biological processes, including cell growth and metabolism. Rapalog drugs tamp down mTOR, possibly preventing age-related diseases such as diabetes, stroke, and some cancers. One of the many effects of rapamycin is that it mimics the mechanisms of calorie restriction. As Verdin's lab and others have shown, fasting provides a number of anti-aging benefits, including insulin regulation, reduced inflammation and, to put it colloquially, clearing out the gunky by-products of metabolism.