A drug to treat aging may not be a pipe dream

A drug to treat aging may not be a pipe dream

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Life expectancy in the top-performing countries have increased by three months a year every year since the early 1800s. For most of human history, you had roughly a 50-50 chance of making it to your twenties, mainly due to deaths from infectious diseases and accidents. Thanks to advances in medicine, we have gradually discovered ways to avoid and treat such causes of death; the end result is perhaps humanity’s greatest achievement—we have literally doubled what it means to be human, increasing life expectancy from 40 to 80 years. On the other hand, it has allowed one scourge to rise above all others to become the world’s greatest cause of death: aging.

Aging is now responsible for over two-thirds of deaths worldwide – more than 100,000 people every day. That’s because, counterintuitive as it may sound, the main risk factor for most of the leading killers in the modern world is the aging process itself: Cancer, heart disease, dementia, and many other health problems become radically more common as we age. . We all know that factors such as smoking, lack of exercise and poor diet can increase the risk of chronic disease, but these are relatively minor compared to aging. For example, high blood pressure doubles the risk of a heart attack; being 80 rather than 40 multiplies your risk tenfold. As the world’s population ages, the scale of death and suffering caused by aging will only increase.

But that’s not my prediction – besides being depressing, extrapolating a two-century trend for another year is hardly groundbreaking. Much more excitingly, in 2023 we may see the first drug that targets the biology of aging itself.

Scientists now have a good idea of ​​what makes us age biologically: the so-called “hallmarks” of the aging process range from damage to our DNA – the instruction manual inside each of our cells – to proteins that misbehave due to changes to their chemical structure. The most exciting thing is that we already have ideas on how to treat them.

By the end of 2023, it is likely that one of these ideas will be proven to work in humans. One strong contender is “senolytics,” a class of treatments that target old cells — what biologists call senescent cells — that accumulate in our bodies as we age. These cells appear to drive the aging process—from causing cancer to neurodegeneration—and, conversely, removing them appears to slow and perhaps even reverse it.

A 2018 paper showed that in experiments where mice were given a senolytic cocktail of dasatinib (an anti-cancer drug) and quercetin (a molecule found in colorful fruits and vegetables), they not only lived longer, but were at lower risk of diseases including cancer, were less frail (they could run farther and faster on the tiny mouse-sized treadmills used in the experiments), and even had thicker , shinier fur than their roommates who didn’t receive medication.

There are more than two dozen companies looking for safe and effective ways to get rid of these senescent cells in humans. The biggest is Unity Biotechnology, founded by the Mayo Clinic scientists behind this mouse experiment and with investors including Jeff Bezos, which is testing a range of senolytic drugs against diseases such as macular degeneration (a cause of blindness) and pulmonary fibrosis. There are many approaches being explored, including small proteins that target aging cells, vaccines to encourage the immune system to clear them, and even gene therapy from a company called Oisín Biotechnologies, named after an Irish mythological character who traveled to Tir na nÓg, the land of eternal youth.

Senolytics aren’t the only contenders, either: others currently being tested in humans include Proclara Biosciences’ GAIM protein, which clears sticky “amyloid” proteins, or Verve Therapeutics’ gene therapy to lower cholesterol by modifying a gene called PCSK9. The first true anti-aging drug will very likely target a specific age-related disease driven by a particular hallmark rather than aging in general. But the success of a drug targeting an aspect of aging in clinical trials will allow us to look at that higher goal in the not too distant future.

In 2023, the early success of these treatments could spark the biggest revolution in medicine since the discovery of antibiotics. Instead of going to the doctor when we’re sick and picking up age-related problems like cancer and dementia in their late stages, when they’re very difficult to fix, we’ll be taking preventative measures to stop people getting sick in the first place place—and, if these treadmill-shredding mice are anything to go by, we’ll reduce weakness and other problems that don’t always prompt a medical diagnosis at the same time.

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