This is why we need to start treating ageing as a disease
The next medical frontier is extending the human lifespan. But changing the definition of ageing is still a huge obstacle
by David A. Sinclair and Nir Barzilai
https://www.wired.co.uk/article/medicine-disease-ageing
In June 2018, the World Health Organization (WHO) released the 11th edition of its International Classification of Diseases. It contained an important addition: “Code MG2A: Old age.”
This tiny line of text could be one of the most important documents in human history, potentially leading to medicines designed to tackle the world’s most common ailment – ageing itself – and one that causes almost all others. It could lead to a new regulatory attitude to ageing (currently the United States Food and Drug Administration does not see ageing as a legitimate target for healthcare), and to doctors being able to prescribe medicines to slow the condition.
That change in regulatory attitude may still be far off, but in the meantime, research is pressing ahead, and in 2019 we will see significant breakthroughs in the sector. The American Federation for Aging Research is planning a large clinical trial to investigate the possibility that metformin, a widely-used treatment for type 2 diabetes, could be used to delay the onset of age-related conditions, including cancer, cardiovascular disease and Alzheimer’s disease. This study, which will run for several years to achieve maximal outcomes, is designed to get an FDA indication that the condition of ageing is a treatable composite of age-related diseases.
That’s not the only research effort worth noting.
The biopharmaceutical company resTORbio is studying a compound that has been shown to improve immunity against age-related viral infections. The same drug may actually prevent numerous other manifestations of ageing.
The number of startups in the field is also growing fast. Calico, part of Alphabet, is exploring ways of capitalising on the anti-ageing work of geneticist Cynthia Kenyon. The California startup Unity Biotechnology is working to develop drugs that could remove the “zombie-like” cells that accumulate with age.
Metro Biotech is developing a broad set of pharmaceuticals for diseases of ageing that ostensibly mimic a healthy diet and exercise. CohBar is attempting to harness the power of mitochondria-based therapeutics aimed at slowing ageing’s effects. Life Biosciences is a consortium of biotech longevity companies based on the principle that everyone is entitled to therapies that improve their quality of life, regardless of race, creed, nationality, economic standing – or, indeed, age.
Investors are taking a keen interest. In August this year, Citibank included anti-ageing medicines along its top-ten “disruptive innovations”, alongside 5G technologies, smart voice-activated assistants and autonomous vehicles.
Contrary to what most people think, there is no biological law that says we must age. Indeed, as ageing is the most significant risk factor for almost all diseases, the true promise of ageing research isn’t simply extending lifespan; it’s the obliteration of disease itself. And, while, in some cases, the processes for extending life are complicated, in many cases, as the metformin trial seeks to show, it may be as simple as repurposing medications that are already available, in some countries even over the counter.
Changes to the definition of ageing and the rapid advances in this sector are challenging long-held beliefs. Most people are resistant to the idea of extending their years because their greatest fear is becoming frail and sick. But the technologies being developed now won’t just give us extra years of life, they will give us extra years of youth. In 2019, we will begin to understand that ageing is something that can be reversed. Whether we will live long enough to benefit from innovation in this sector – or be the last generation to live a relatively short life – will depend on our collective will.
Nir Barzilai MD is a professor of medicine and genetics at Albert Einstein College of Medicine. David A. Sinclair PhD AO is a professor of genetics at Harvard Medical School
