life expectancy in top-performing countries has been increasing three months a year every year since the early 19th century. Throughout most of human history, you had about a 50-50 chance of making it to your twenties, mostly due to deaths from infectious diseases and accidents. Thanks to medical advances, little by little we have found ways to prevent 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, this has allowed one scourge to rise above all others to become the biggest killer in the world: aging.
Aging is now responsible for more than two-thirds of deaths worldwide – more than 100,000 people each day. This is because, as counterintuitive as it may seem, the main risk factor for most of the modern world’s top killers is the aging process itself: cancer, heart disease, dementia, and many other health problems. they become radically more common as we age. We all know that factors like smoking, lack of exercise, and poor diet can increase the risk of chronic disease, but these are relatively minor compared to aging. For example, having high blood pressure doubles your risk of having a heart attack; being 80 years old instead of 40 multiplies your risk by ten. As the world’s population ages, the magnitude of death and suffering caused by aging will only increase.
But this is not my prediction: apart from being depressing, extrapolating a trend of two centuries for another year is not innovative. What’s much more exciting is that, 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 speaking: 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 break down. misbehave due to disturbances. to its chemical structure. The most exciting thing is that we now have ideas on how to treat them.
By the end of 2023, one of these ideas will likely be shown to work in humans. One strong contender is “senolytics,” a class of treatments that target aging cells, which biologists call senescent cells, which accumulate in our bodies as we age. These cells seem to drive the aging process, from causing cancer to neurodegeneration, and, conversely, removing them seems 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 (an anticancer drug) and quercetin (a molecule found in colored fruits and vegetables), they not only lived longer, but also They also had a lower risk of disease. including cancer, they 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 littermates who didn’t get the drugs .
There are more than two dozen companies looking for safe and effective ways to get rid of these senescent cells in people. The largest is Unity Biotechnology, founded by the Mayo Clinic scientists behind that mouse experiment and with investors including Jeff Bezos, which is testing a variety of senolytic drugs against diseases such as macular degeneration (a cause of blindness) and pulmonary fibrosis. There are many approaches under investigation, including small proteins that target senescent cells, vaccines to encourage the immune system to kill them, and even gene therapy from a company called Oisín Biotechnologies, named after an Irish mythological character who travels to Tir na. nÓg, the land of eternal youth.
Senolytics aren’t the only contenders, either: Others currently in human trials include Proclara Biosciences’ GAIM protein, which removes sticky “amyloid” proteins, or Verve Therapeutics’ gene therapy to lower cholesterol by modifying a gene called PCSK9. . The first true anti-aging drug will most likely target a specific age-related disease driven by a particular hallmark, rather than aging in general. But the success of a drug targeting one aspect of aging in clinical trials will allow us to consider this higher goal in the not too distant future.
In 2023, the early success of these treatments could fuel the biggest revolution in medicine since the discovery of antibiotics. Instead of going to the doctor when we’re sick and eliminating age-related problems like cancer and dementia in their late stages when they’re too hard to fix, we’ll intervene preemptively to prevent people from getting sick in the first place. : And, by sticking to those treadmill-shredding mice, we’ll reduce frailty and other issues that don’t always prompt a medical diagnosis at the same time.