Let’s not just cure cancer: let’s cure aging
One of the most exciting areas of modern scientific research is the investigation of the causes and cures for aging. Not individual diseases like cancer and heart disease, but the processes which make us elderly and frail, and which thereby make us more susceptible to these diseases.
Aubrey de Grey has been at the forefront of anti-aging research for more than 20 years. He founded the Methuselah Foundation in 2003, and the SENS Foundation (Strategies for Engineering Negligible Senescence) in 2009, Most recently, “Aubrey 3.0” is the LEV Foundation (Longevity Escape Velocity), founded this year. He explains his current thinking about the state of anti-aging research in the latest episode of The London Futurists Podcast.
Don’t try to stop aging: repair it instead
Aubrey’s “eureka” moment came after five years working in anti-aging research. He realised the best way to tackle aging was not to try to slow it down or prevent it, but periodically to repair the damage it causes at the molecular and cellular level. It took him a decade to persuade the rest of the community of this “rejuvenation” approach, and there has now been considerable progress with it.
Soon after proposing the damage repair approach, Aubrey suggested that a time would come when every year that passes, medical science will give you an extra year of life by restoring the structure and function of your bodily tissue. He dubbed this “longevity escape velocity” (LEV) because it means we can escape the gravitational pull of aging, and hence death. To most academics in the field, this still seems like an alien idea.
Aging causes many different types of cellular damage, and some are harder to repair than others. Well before we have figured out how to tackle the more difficult types, addressing the easier types should extend our lifespans by say, a decade or two. This will give us time to solve the harder types of damage before they kill us.
Progress in the last decade
Ten years ago, Aubrey would not have been bullish about rejunvenation’s progress. In 2006, Shinya Yamanaka had discovered how to turn normal cells into more versatile and useful stem cells (induced pluripotent stem cells, or IPS), and CRISPR was starting to mature as a gene editing technology. But these were tools, and more theoretical than practical.
For quite some time, we have been able to increase the lifespan of laboratory mice by imposing calorie restriction, or by doing things which mimic the effects of calorie restriction. But within the last decade we have also learned how to use stem cell therapies, and how to maintain telomeres to extend mouse lifespans. (Telomeres are structures which prevent DNA strands from unravelling when cells divide, like the plastic caps on the ends of your shoelaces.) We can also deploy senolytics, which are molecules that kill off the toxic cells within our bodies.
Some of these techniques are now graduating from laboratory mice into humans in clinics. One of the leading senolytics companies reported a successful phase two clinical trial this year. There are also clinical trials of stem cell therapies, notably the use of induced pluripotent stem cells in Japan to tackle Parkinson’s Disease, with a couple more trials due to start in the USA.
Robust mouse rejuvenation
We don’t yet know how comprehensive our portfolio of therapies has to be in order to reach LEV. We just have to keep adding new components until we get there. Mice, sadly, cannot benefit from LEV because their lifespans are too short, so Aubrey has developed a different concept for them: robust mouse rejuvenation (RMR), which is when a middle-aged mouse, with a year left to live, has its life expectancy doubled. This is the flagship research programme for the LEV Foundation, and for this purpose, Aubrey recently bought 1,000 mice.
The Foundations Aubrey has set up are needed because private enterprise cannot afford to take a long enough view. He set up the new one because he felt that the Board of SENS had become too timid to make the rapid progress that he thinks is now possible. Readers of this article may be aware of this controversy, and while I do not intend to go into details here, many former SENS donors believe that Aubrey was unfairly treated, and we fully support his new venture.
Money is no longer the scarce resource
The funding available for rejuvenation research has increased sharply in the last few years, not least thanks to some wealthy and generous people like Vitalik Buterin and Jim Mellon, who decided to spend some of their money on the fight against aging. This has led Aubrey to revise his predictions for when RMR and LEV may happen.
18 years ago, in 2004, he thought there was a 50% chance of achieving RMR by 2014, and a 50% chance of achieving LEV by 2029. Clearly we have not made the necessary progress since then to meet the RMR target, and probably not the LEV one either. But Aubrey notes that almost all the slippage occurred in the first half of the time period. His revised predictions now are a 50% chance of RMR by 2025, and a 50% chance of LEV by 2037.
He believes that money is no longer the main impediment to progress. Instead it is talent, and not the kind of talent that you might imagine. What is lacking is not so much people with deep expertise in biotechnology, but capable entrepreneurs who can speak the language of biotechnology. A few months ago Aubrey and a colleague named Mark Hamalainen ran a workshop in Silicon Valley called “Less Death”. A dozen or so rejuvenation veterans gave talks to around 50 newcomers, many of them entrepreneurs. Gratifyingly, in a survey conducted just two weeks after the workshop, two-thirds of the participants reported that they have now set up partnerships or associations to progress the field. Unsurprisingly, then, another workshop has now been scheduled for January, and there are plans to take them global. If this interests you, go to www.lessdeath.org.
Longevity and the culture wars
Assuming rejuvenation research continues to progress, and is to some degree successful, a lot of our attitudes towards death will change. Much of that change will occur suddenly, once it becomes accepted that LEV is coming – well before it is a reality. Once RMR is achieved, a few dozen high-profile people who are familiar with the arguments will stop censoring themselves, and start talking seriously about it in public. Once that happens, influencers like Oprah Winfrey will devote TV shows to it, and very soon it will be the main topic of conversation around the world.
When it goes viral, this conversation will take unexpected turns, as people start anticipating far greater longevity. Aubrey talks about “anticipating the anticipation”, which means getting policy makers equipped to deal with public demand for information, and for appropriate policy responses. This may be a lot harder than it sounds. Some of the public response will be negative, and angry, in ways we can neither predict nor prevent in a period when culture wars are raging. Not everyone will agree that enabling everyone to live longer is a worthy aim, and many of those who do agree will worry that the benefits will be available only to the rich, or that over-population will become a serious problem. There are good arguments against these concerns, but scares make good sound bites, and good sound bites can take firm hold in the public imagination before a rational argument can be deployed. The road ahead may be bumpy. We should be better prepared.