by Richard
Faragher
They may not be as far off as you think.
There will be almost ten billion people living on Earth by
2050 and two billion of them will be over the age of 60. Growing old is the
primary risk factor for multiple chronic and life threatening conditions such
as diabetes or cardiovascular disease. This burdensome morbidity is the most
distressing aspect of old age – compromising individual independence and
straining collective healthcare systems.
To help older people flourish, we must understand the
biology of aging at the tissue, cellular and molecular levels, and then turn
that understanding into new preventative medicines. Indeed, it was recently
suggested that an “anti-ageing pill” is just around the corner, enabling humans
to live to 150 and regenerate organs by 2020 very cheaply. But how excited should
we be about such claims? Let’s take a look at the evidence.
Since the time of the ancient Greeks people have argued
about the relationship between ageing and disease. Today it seems probable that
essentially all age related diseases are linked to the ageing process. Not all
ageing changes are harmful though. In essence, we have a set of health
maintenance mechanisms which act to keep us in good condition in the early part
of our lives – problems arise as these start to fail with age. An anti-ageing pill
would enhance one or more of these mechanisms and keep people healthy.
Main approaches
We now understand some of these major mechanisms. For
example, senescent cells, dysfunctional cells which build up as we age, are
routinely formed and removed over time. This is a health maintenance mechanism
which has evolved to keep us cancer free. However, when the removal of these
cells fails, they cause damage to tissue – resulting in ageing and ill health.
Removing them under laboratory conditions brings a raft of benefits.
The breakdown and synthesis of proteins is also essential to
ageing. Partially degraded proteins can build up over time, compromising
cellular function. Treatment with the drug rapamycin
has been shown to boost normal protein turnover mechanisms – extending lifespan
in mice and improving immune function in people.
As we age, our organs and tissues lose mass and gain waste
products. When we are young, the periodic replenishment of cells within organs
and tissues by the body’s “reserve army” of uncommitted stem cells (cells that
can become specialized cells) help keep us healthy, somewhat akin to drawing on
your savings when your current account runs low. Stem cell therapy may
therefore help counter ageing.
While delivery of stem cells grown outside the body remains
difficult, there is evidence that activation of a class of proteins known as
the sirtuins can enhance this stem
cell maintenance. For example, treatment with the compound nicotinamide riboside enhances sirtuin
activity and restores muscle stem cell function in mice, suggesting a route to
treatment.
There are mechanisms that could keep us healthy even in old
age.
A variety of different molecules, some of which are found in
the diet, are also able to stop mechanisms that compromise the ability of older
people to resist acute physiological stress.
In addition to these mechanisms, scientists are beginning to
shed light on how the mechanisms that coordinate brain and organ functions are
disrupted by ageing and how this may be delayed in the future. But we already
know enough today about at least some health maintenance processes to devise
means of pepping them up.
Pills on the horizon?
Claims made in an article about recent research raising
hopes for an anti-ageing pill by 2020 are not entirely false, but they aren’t
entirely accurate either. The hyperbole concerning nicotinamide riboside, which may restore muscle stem cell activity,
is a case in point. It certainly is of considerable scientific interest, and is
performing well in mice. But it lacks much relevant human data beyond the
demonstration that levels can be safely increased by supplentation. Nobody yet has
actually shown that these supplements make humans live longer or regrow their
organs.
The vaunted 150-year lifespan is also slightly slippery.
This is a 25% increase on the longest human lifespan ever and while the extent
of lifespan extension is plausible for some experimental animals – such as mice
with their senescent cells removed – starting with the maximum human lifespan
of 120 and adding 25% inflates the figures to produce a “wow!” effect. Even if
you accept that the same percentile extension seen in mice by one method would
hold in humans using another, which is questionable, most of us wouldn’t live
to 150 anyhow (there are less than a
thousand people aged over 105 in the UK).
Ironically, this kind of story misses out on the genuinely
exciting news that pharmaceutical companies are taking the idea of developing
healthspan-enhancing drugs increasingly seriously. This is a notable shift in
attitude, but the chasm between intention and achievement remains wide. In
fact, humanity has only about 1,500 “molecular entities” (drugs) in its
medicine chest.
This is because drug development is a costly and time
consuming process. Ten years of work and US$2.5 billion would be a fair
estimate of the price tag from start to finish. Worse still, when developing a
drug for ageing, researchers face an additional problem: how do you know if it
worked?
A “typical” clinical trial lasts a year or two. Nobody is in a position
to see if a putative wonder drug adds five or ten years to your lifespan, and
who would you test it on anyway?
Fortunately, an elegant solution to this problem has been
proposed. Targeting Aging with Metformin (or TAME) – developed in consultation
with the FDA – is a new clinical trial protocol. TAME is based on the
observation that the time at which an individual develops their initial
age-related impairment, such as osteoporosis, diabetes or cardiovascular
disease, is highly variable between different individuals (65 on average for
heart attack). But the time from first to second impairment – for example,
having diabetes and then developing cardiovascular problems – is much tighter,
happening within a span of two to four years.
That means that a drug which improves health maintenance
mechanisms will lengthen the period between first event and second event –
making it possible to say if it has worked in a short time frame. This would
allow companies to, in principle, prescribe a drug for aging.
So, do be skeptical about claims that you could live to 150
by taking a certain supplement right now – you won’t be able to take an
anti-aging pill tomorrow. But, excitingly, the fundamental scientific
knowledge, translational strategies and many of the technologies to deliver one
are already available today.
Hence, for the practical purpose and peace of mind of the current
70plus population, your anti-aging pill would be the preventive twin supplement
of GROUNDING and regular doses of VIRGIN COCONUT OIL. It’s your best bet to collect the P100,000
benefit of government for those who reach 100.
