Not so long ago, it was my 44th birthday, and I’ve finally decided to write something that I’ve been reflecting on for a while. To some people, a birthday is a cause for celebration; for others, it is viewed as a bad thing.
Yes, if you take the negative view, you could see it as simply a reminder of being another year older and another year closer to the grave. However, this is not how I see it; in fact, I think quite the opposite. I see it as another year closer to our goal: the defeat of age-related diseases due to the progress of rejuvenation biotechnology that offers longer and healthier lives.
From my point of view, viewing birthdays, or, indeed, the passing of time, as a positive or negative thing is largely a question of knowledge and understanding of the aging research field, which ties in with what I want to address today.
Knowledge is power
During my work as a journalist, people often ask me how things are progressing in the field. This is, of course, a perfectly reasonable and understandable question to ask. While I am always more than happy to talk about the field and answer this question, I also urge people to delve deeper into the field so that they can learn and evaluate for themselves rather than simply taking my word for it.
Our website, including the Rejuvenation Roadmap, is a good resource to start learning and to hear the latest news, as are places such as FightAging and the SENS Research Foundation website. Conferences such as Ending Age-Related Diseases and Undoing Aging are also valuable places to learn more about what is happening in the field.
Sometimes, I encounter people outside, but also fairly frequently within, the community who can be somewhat pessimistic about the field and its progress. It is perfectly natural to be cautious about the unknown, but there comes a point at which caution becomes unwarranted pessimism. The “Science Will Not Defeat Aging in My Lifetime, so Why Bother?” argument is a classic example of this, and much of this is caused by a lack of knowledge and understanding of the field.
The Latin phrase scientia potentia est, meaning “knowledge is power”, is particularly apt here. Knowledge and understanding allow us to better evaluate a situation or a proposal and reach a conclusion. It is hard to reach an accurate conclusion about anything without all the facts in place, yet I often see people doing it. Of course, there are always people who will not put in the time and effort required to learn about a topic properly, so they make predictions without all the facts, but there really isn’t much we can do about these people.
However, as advocates and supporters, we can do our best to learn about such things ourselves, and this will also come in useful when speaking to others about the field, as there is nothing like having a good understanding of the topic to help you convey it to others. That does not mean you need to become a biologist and understand things to such deep levels but even a solid understanding of the basics can be a huge help when it comes to engaging with others on the subject and also for understanding where we are currently progress wise.
This relates to a second question people often tend to ask me, which is if I think that they or we have a chance of living long enough to see these technologies arrive.
Obviously, no one can predict the future, so this question, by its very nature, is a tricky one to answer. I generally avoid being too specific on the timeframe in which we will reach the goal of longer lives through science, but I am optimistic that people in my age group, even perhaps older, have a reasonable chance of making the cut.
The reason that I am generally optimistic about the future is mostly that, as a journalist who speaks to hundreds of researchers, each focused on a part of the puzzle, I get an almost unique picture of the field. I can see the broader landscape and how and where things in the field or related fields connect or may connect in the future. A breakthrough in a related medical field may not have immediately apparent utility in aging research at first glance, but a deeper look could reveal hidden potential.
This fairly unique insight, combined with the knowledge that I have collected over the years working in the field, makes me fairly optimistic about the future and my place in it. As I have said a number of times in the past, the defeat of age-related diseases will not suddenly happen overnight; there is unlikely to be a single moment at which humanity goes from having no choice about aging to having control. It is far more likely that there will be steady progress, with incremental breakthroughs along the road, that will ultimately reach the goal.
Reasons to be cheerful
I would like to touch upon two of the most promising therapies that I am most interested in and believe may have a big impact in the near future (10-20 years) and that may help pave the way for major changes to how society thinks about and treats aging. Both of these therapies directly address one of the nine proposed causes of aging and thus if they work they have the potential to be transformative in healthcare. Of course, there are more therapies in development and at various stages of progress which also address the other causes of aging but these two are what I am most enthusiastic about presently. I urge you to explore the provided links to resources and learn more about each one.
No list of promising technologies would be complete without talking about the senescent cell-clearing drugs and therapies known as senolytics. Senescent cells are aged or damaged cells that should destroy themselves via a process known as apoptosis but, for various reasons, do not do so; instead, they hang around, sending out inflammatory signals that harm nearby healthy cells, block effective tissue repair, and contribute to numerous age-related diseases.
One proposed solution to these problem cells is to remove them by causing them to enter apoptosis, as originally intended, by using senolytic drugs and therapies. Removing these cells in mouse studies has produced some remarkable results, with mice often living healthier and longer lives as well as reversing some aspects of aging.
The race is now on to bring these drugs to people, and a number of companies are developing them right now. So far, UNITY Biotechnology has seen the most progress, and the company is already conducting human trials of its lead candidate drug (UBX0101) for the treatment of osteoarthritis. It has another candidate drug (UBX1967) closely behind; this drug is poised to enter human trials for the treatment of age-related macular degeneration, diabetic macular edema, diabetic retinopathy, and glaucoma. Based on recent comments from UNITY, we are anticipating the initial results of human trials in the next few months; hopefully, the news will be positive.
With the number of companies working on these therapies, it is fair to be optimistic about their potential to address multiple age-related diseases given that senescent cells are a proposed root cause of aging. You can also check out the Rejuvenation Roadmap to see which companies are working on senolytics and how they are progressing.
Partial cellular reprogramming
Cells can be reverted back to an earlier developmental state, known as induced pluripotency, using reprogramming factors, and this process effectively makes aged cells functionally young again in many ways. Ever since its first discovery, there has been a great deal of interest in this area of aging research.
The problem with inducing pluripotency is that the cell loses its identity and forgets what cell type it currently is, as it becomes a new kind of cell capable of being guided into changing into any other cell type, much like our cells during development. This is great for early human development, but as adults, having our cells forget what they are is bad news. Therefore, researchers have wondered if it is possible to reset a cell’s age without resetting its cell memory, and the answer appears to be yes!
Thankfully, during the reprogramming of a cell back to pluripotency, the cell’s age is one of the first things to be reset before the cell memory is wiped, and it appears possible to partially reprogram the cell so that only aging is reset. We have talked about the potential of partial cellular reprogramming and how it is similar to hitting the reset button on aging in a previous article, but, needless to say, if we can find a way to safely partially reprogram our cells, it could have a dramatic impact on how we age and may allow us to remain more youthful and healthy.
In terms of progress, partial reprogramming has already been demonstrated in mice, and now a number of groups, including Turn.Bio, the Salk Institute, Life Biosciences, Youthereum Genetics, and AgeX, are developing therapies based on partial reprogramming, which is essentially the resetting of cells’ epigenetic states (what genes are expressed) from an aged profile to a more youthful one, again directly targeting one of the proposed root causes of aging.
This approach is likely to be quite a few years away, but I think it is plausible that it could be in human trials in the next decade, and it is probably the approach that interests me the most in the field.
The truth is we cannot predict the future because it is not set in stone, so we cannot be totally certain if or when rejuvenation technologies will arrive. The best we can do is learn as much as we can about the field and try to reach a reasonable conclusion based on the situation as it is now.
The field is advancing steadily, and we should be optimistic but not complacent about progress. We should be mindful of being too negative and, equally, of being too positive without ample justification. Blind optimism is as bad as blind pessimism, and we should always strive for informed optimism.
That said, given the progress being made, I am optimistic about my chances based on the evidence to date. This is why I do not mind birthdays and why I find them positive experiences rather than negative ones. Arm yourself with knowledge, and perhaps you too will agree with me and understand why I am future positive.
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June 7, 2019
a great article steve. very positive and hopeful. lets all work together and bring the promised land closer
June 8, 2019
As always Steve, a great article! I see that birds eye view too, which many even in the field do not see as concentrated on a particular puzzle piece.If we could even ratchet up the research a few notches, we would get there much faster.
June 10, 2019
The reason I am cautious is going back into the historic record. The claim for a break through is always 20-30 years.
Why? Because that is plausibly long enough for a new technology to arrive but also a short enough time span to save the person making the prediction.
I want a cure for ageing but I will believe it is possible when drugs actually come onto the market.
June 10, 2019
There are now a number of therapies in human trials that target aging with a number of others not far behind. While we should not count our chickens before they hatch I am cautiously optimistic about the field, this is based on what I see happening in the labs and from speaking with dozens perhaps even hundreds of scientists in the field, rather than the simple blind optimism that some people in the community indulge in.
June 10, 2019
There are also tons of experts who think we are not going to get there in 20 or 30 years. So I don’t really know how we can’t die of old age if we only have two incomplete therapies addressing aging.
June 10, 2019
The two I list are the two which interest me the most. There are plenty of others that address other hallmarks in development I just mentioned my two personal favorites which each address a hallmark of aging directly. We will have to wait and see how things go anyway but I am cautiously optimistic based on what I know about the field.
June 11, 2019
Another great article Steve, and one which I completely agree with. Most scientists seem to be too focused on their individual “tree” to appreciate what is happening in the wider “forest”. With a higher vantage point it is possible to see all the different avenues being worked on, and although most of them are bound to fail, I am optimistic that at least some of them, such as senolytics or reprogramming, will prove to be beneficial.
June 17, 2019
Nice piece, Steve. As you know from our discussions with Michael Fossel and others there are some concerns that simply getting rid of senescent cells is a short term fix that may lead to more problems down the road b/c you’ve eliminated those cells (and the work they did) rather than rejuvenating them. Are you optimistic that stem cells can replace the lost cells? What about using senolytics multiple times as lifespans get longer and longer, eliminating more and more cells? And if partial reprogramming is achieved reliably in humans would this technique moot the use of senolytics b/c we are then able to simply turn back the clock on senescent cells?
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