It has been nearly eight years since I last pondered the potential arrival of the first rejuvenation therapies, and it’s high time for an updated assessment! Over this span of time, it is plausible that the first rejuvenation therapies, albeit in a prototypical form, have emerged, showing promise in principle but not yet definitively proven. My outlook remains consistent: the initial rejuvenation therapies that show sufficient efficacy to warrant their classification as such will likely stem from the SENS vision. This theory posits that aging is primarily caused by a few types of accumulated cell and tissue damage, and biotechnologies designed to either repair or render this damage irrelevant will lead to rejuvenation.
The landscape of groups dedicated to developing these therapies has significantly expanded in the past eight years. A burgeoning longevity industry has taken root, with numerous biotech and pharmaceutical companies now focusing on aging research compared to just a handful a mere eight years ago. We find ourselves further along in the transformation occurring in the medical life sciences, where the treatment of aging is poised to become a predominant focus within the realm of medicine.
Age-related diseases are rooted in the same underlying mechanisms of damage responsible for aging itself. The distinctions between aging and disease lie mainly in the labels assigned to various sets of symptoms. Consequently, the frailty, illness, weakness, pain, and suffering associated with aging are outcomes of accumulated damage and subsequent dysfunction at the cellular and molecular levels. Embracing the objective of repairing this damage will pave the way for managing aging as a chronic condition, thwarting its harmful effects by periodically addressing and resolving the root causes before they manifest as symptoms and impairment.
The upcoming rejuvenation therapies will diverge significantly from traditional treatment methods. The forthcoming rejuvenation toolbox over the next few decades will encompass an array of treatments targeting distinct types of molecular damage within cells and tissues. Presented here is a speculative outline of potential (and existing!) rejuvenation therapies in a potential order of emergence.
1) Clearance of Senescent Cells
Various companies are currently developing an array of senolytic approaches aimed at selectively eliminating senescent cells to counteract degenerative aging processes. These interventions, which prompt apoptosis in senescent cells through diverse mechanisms, hold promising potential for rejuvenation. Studies in animal models have demonstrated rapid and extensive reversal of aging features and age-related diseases post-senolytic therapy. The most advanced senolytic therapies have progressed to phase 2 clinical trials, with multiple novel drugs expected to be approved for clinical use within the next decade. Notably, the dasatinib and quercetin combination, well-known for effectively removing senescent cells, is considered a legitimate rejuvenation therapy with accessible options for those seeking the treatment.
2) Restoration of a Youthful Gut Microbiome
Aging leads to detrimental changes in the composition of the gut microbiome, characterized by an increase in pro-inflammatory microbes and a decline in beneficial strains. Animal studies suggest that the gut microbiome’s status significantly impacts long-term health, akin to diet and exercise influences. Promising rejuvenation strategies to reverse age-related alterations in the gut microbiome include fecal microbiota transplants from young donors and immunization with flagellin to eliminate harmful microbes. While these interventions have shown favorable outcomes in animal models and limited human trials, their effects on human health and longevity await further exploration, leaving their practical rejuvenating potential unverified.
3) Clearance of Amyloid Deposits
Amyloid deposits, misfolded proteins that form solid accumulations in the body, contribute to age-related dysfunction in certain cases. Therapies designed to eliminate or impede the production of specific amyloid types, such as amyloid-β in Alzheimer’s disease and transthyretin amyloid associated with heart disease, have made notable strides. Immunotherapies targeting amyloid-β have exhibited success in removing brain amyloid deposits, albeit with suboptimal side effects. FDA-approved therapies for transthyretin amyloidosis have emerged, offering potential benefits to older individuals, although widespread adoption hinges on cost effectiveness. As research progresses, additional treatments targeting various amyloid forms may surface, potentially necessitating periodic administration for individuals aged over 40 to mitigate age-related complications.
4) A Comprehensive Cancer Cure
A decade ago, a universal cure for cancer seemed distant, but recent advances in telomere and telomerase research have reshaped this outlook. Telomeres play a crucial role in cancer progression, enabling cells to evade replicative limits. Ongoing investigations into telomere dynamics and related factors augur well for the development of robust cancer therapies. While a definitive cure for cancer remains a long-term prospect, the evolving landscape of cancer research presents hopeful possibilities for transformative treatments in the near future.
In summary, the domain of rejuvenation therapies is rapidly evolving, with emerging treatments showing promise in mitigating age-related damage and promoting healthier aging. The journey towards effectively managing aging as a modifiable condition is gaining momentum, underscoring the imperative of continued research and innovation in the pursuit of longevity and well-being.
