A drug to treat aging may not be a pipe dream

Life span 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 about a 50-50 chance of living to 20, mostly due to deaths from infectious diseases and accidents. Through medical advances, we have gradually found 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 by increasing life expectancy from 40 to 80 years. On the other hand, it has allowed one scourge to rise above all others and become the leading cause of death in the world: aging.

Aging is now responsible for more than two-thirds of deaths worldwide—more than 100,000 people every day. This is because, as ironic as it may sound, the main risk factor for most of the world’s leading killers is the aging process itself: cancer, heart disease, dementia and many other health problems are becoming more common as we age. getting older. We all know that factors such as smoking, sedentary lifestyle and poor diet can increase the risk of chronic diseases, but they are relatively minor compared to aging. For example, high blood pressure doubles the risk of a heart attack; being 80 instead of 40 increases your risk tenfold. As the world’s population ages, the amount of death and suffering caused by aging will only increase.

But that’s not my prediction—besides being depressing, extrapolating the 200-year trend to next year is hardly groundbreaking. Much more interesting is that in 2023 we may see the first drug that targets the biology of aging itself.

Scientists now have a clear idea of ​​what makes us age biologically: the so-called “signs” of the aging process range from damage to our DNA (the operating instructions in each of our cells) to proteins that misbehave due to changes. to their chemical structure. The most interesting thing is that now we have ideas how to handle them.

By the end of 2023, it is likely that one of these ideas will work in humans. One strong contender is “senolytics,” a class of drugs that target senescent cells, which biologists call senescent cells that build up in our bodies as we age. These cells appear to drive the aging process – from cancer to neurodegeneration – and conversely, removing them appears to slow it down and perhaps even reverse it.

A 2018 paper showed that in experiments in which mice were given a senolytic cocktail of dasatinib (a cancer drug) and quercetin (a molecule found in colorful fruits and vegetables), not only did they live longer, they were also at lower risk of disease. including cancer, were less weak (they could run farther and faster on the tiny mouse-sized treadmills used in the experiments), and even had thicker, shinier coats than their unmedicated littermates.

More than two dozen companies are looking for safe and effective ways to get rid of these aging cells in humans. The largest of these is Unity Biotechnology, founded by the Mayo Clinic scientists behind the mouse experiment and investors including Jeff Bezos, which is testing a range of senolytic drugs for diseases such as macular degeneration (a cause of blindness) and pulmonary fibrosis. Many approaches are currently being explored, including small proteins that target aging cells, vaccines that stimulate the immune system to destroy them, and even a gene therapy from Oisín Biotechnologies, named after an Irish mythological character who travels to Tir na Nog. . land of eternal youth.

Senolytics aren’t the only contenders: Other drugs currently in human trials 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 real anti-aging drug is likely to target a specific age-related disease caused by a particular symptom, rather than aging in general. But the success of a drug that targets the aspect of aging in clinical trials will allow us to consider that higher target in the not too distant future.

In 2023, the early success of these treatments could usher in the greatest revolution in medicine since the discovery of antibiotics. Instead of going to the doctor when we are sick and detecting age-related problems such as cancer and dementia in the advanced stages when they are very difficult to cure, we will intervene preventively so that people do not get sick. and, judging by those mice gnawing on the treadmill, we’ll reduce weakness and other problems that don’t always require a medical diagnosis.