Welcome to the future!

This is how a host at the Longevity Leaders Virtual Congress opened up one of the panel discussions! Anti-ageing research (yes, this is real science!) is very much in its infancy. It isn’t mainstream science yet, but it will be in a few years’ time. The field has progressed a lot in the last five years, but there’s so much more we need to learn. Almost everyone in the ageing science field agrees we’re just scratching the surface and there’s so much more in the biology of ageing we’re still to understand. 

The virtual congress was a great place to explore the latest developments in the ageing science and to get to know how the great minds in the field think. I wanted to share a few of those thoughts with you.

Themes and trends

An idea which was echoed in a few talks is the way we need to change perceptions around how we develop treatments for ageing in the future.  It’s well-established now that ageing is the main risk factor for all age-related diseases. Take cancer, dementia, heart disease, kidney disease, strokes, pneumonia and diabetes. The risk of developing such diseases increases exponentially as we get older. So, what if we could prevent all age-related diseases rather than wait for them to appear and then treat them one by one? Rather than the traditional targeting of a single disease, we would be thinking about developing therapies for preventing a whole host of diseases. It’s a new mindset we need to develop! This concept was extensively covered in David Sinclair’s book ‘Lifespan’. But there are still some challenges to achieving this (I will come to these a little later).

A tiny mouse can live up to three years, whilst humans can live more than 100 years. And yet, we share around 97% of our working DNA. 

One of the most interesting sessions was the keynote panel: ageing science, healthspan and potential change. It was chaired by Nir Barzilai and attended by biotech leaders developing therapies for ageing-related diseases. Nathaniel (Ned) David president of Unity Biotechnology has highlighted how our reality and that of our children will be profoundly different from our current lives. As the same time, he acknowledged that the work that everyone is doing in the field in term of understanding the fundamentals around the biology of ageing and its translation into medicines will happen over a very long time – may be over few decades rather than the next one to five years. His company Unity is working on senolytic medicines and have one medicine currently in phase 2 clinical trials for the treatment of osteoarthritis. Senolytic medicines target senescent cells, also called “zombie cells”. These are the different faulty cells which stop dividing as we age and emit chemicals which can cause inflammation, cancer and turn other healthy cells into zombie cells.

“The cool stuff that’s going to happen in ageing biology won’t be a medicine, in the next 10 years, but there will be something we don’t even have a name for yet, some mechanism that’s going to be one of those…oh my gosh moments, that will get discovered in the next 10 years and I eagerly await to see what that is.” Nathaniel David

Joan Mannick, the Chief Medical officer of resTORbio – a company targeting the mTOR pathway which regulates the process of ageing and ageing-related diseases- said they’re working on targeting ageing of the immune system. We know that our immune system becomes less efficient as we age. That’s the reason older people are more at risk of infections like the flu or COVID-19. This is also why this age group responds less well to vaccinations compared to younger individuals. By targeting the biological mechanisms which contribute to the ageing of the different body functions, including the immune system, resTORbio aims to help protect older people from infectious diseases by making their immune system more robust. Joan recognised that developing therapies in the ageing field is unchartered territory, but added that the current community of ageing scientists will be the pioneers who will pave the way for the development of future anti-ageing therapies. 

Challenges

One of the main barriers to the clinical translation of ageing science into therapies, discussed, is that the regulators still need to buy into the idea of developing anti-ageing medicines. And this would open the door to trials which would have seemed impossible in the past.  

The Food and Drugs Administration (FDA) still doesn’t recognise ageing as an indication, for which treatments can be developed. In the medical world, an indication means a particular medical condition for which a drug or certain drugs can be used. In fact, Barzilai has been struggling to get his TAME (Targeting Aging with Metformin) study off the ground, as he’s still trying to get the FDA to approve ageing as an indication. 

There’s some progress though, with the World Health Organisation (WHO) creating a new classification for age-related diseases. This could pave the way to the recognition of ageing as an indication which could be targeted by treatment. 

Misconceptions

Perhaps one of the most common misconceptions around the field of ageing research, discussed in the conference, is the intention to live forever! Although a handful of scientists do think defeating death is possible! The aim of the longevity science is to target ageing with the aim to eliminate disease. The aim is to enhance our quality of life, to improve our healthspan, the time we’re healthy, active and disease-free.

The main idea is to improve healthspan but if lifespan is extended as a result, then that’s a bonus!

The future

In terms of predicting the next five to 10 years and what they hold within longevity therapeutics, Nathaniel David has nominated a few candidates as potential front runners in the field. He predicts that targeting mTOR is the way to disrupt ageing biologically. He mentioned the senolytics area, which his team is working on and hoped someone in the field was going to be successful. He also mentioned the area of treatment with youth factors and predicted there will be a circulating youth factor treatment either in clinical trials, or an approved therapy within the next 10 years. 

The most exciting thing Ned said is that he sees that “the cool stuff that’s going to happen in ageing biology won’t be a medicine, in the next 10 years, but there will be something we don’t even have a name for yet, some mechanism that’s going to be one of those…oh my gosh moments, that will get discovered in the next 10 years and I eagerly await to see what that is”

In short, this is just the beginning! There’s a lot we still don’t understand about the biology of ageing. Take the lifespan of the different species for example, one of the biggest mysteries in the field. A tiny mouse can live up to three years, whilst humans can live more than 100 years. And yet, we share around 97% of our working DNA. 

The more we understand about the mechanisms of ageing at the cellular levels, the more we’ll be able to identify the knobs we need to dial up or down to delay ageing and to transform our lives in ways we can’t even begin to imagine!

There were so many other players and companies attending the conference, that it would be difficult to do them all justice in a single article. But I’m keeping my monocle eye on all of them and we’ll keep you posted!

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