Is there a cure for ageing? So far, the quest for immortality has been an unsuccessful one with no evidence or promising discoveries. Until now.
Rich Quelch, guest contributor, delves into the world of growing old, anti-ageing research and senotherapy.
Senotherapy is an emerging scientific field and based on recent estimates it could be widely available within the next decade. Approaching ageing from a cellular level, scientists the world over are investigating how to stop the process of senescence through medicinal means. But we’re still a long way off commercialisation and there are unanswered questions around what this means for the human race.
The longevity industry comes of age
Life expectancy is rising in most of the developed world, with people in England and Wales now living almost 25 years longer than they did a century ago. The ONS predicts the UK’s population of over-65-year-olds will increase by 8.6 million in the next 50 years.
How to help people age healthily and lessen the growing burden of old age on global healthcare systems and economies is one of the most pressing questions currently faced by civilisation.
The leading causes of death worldwide are age-related illnesses like cardiovascular diseases, cancer, and neurodegenerative diseases. If this trend can be reversed and people can live healthier for longer without the need for clinical care, the impact would be huge.
Technology has an especially important role to play here. So much so, “Agetech” is being met with the same level of excitement as fintech in the mid-2010s, with many Silicon Valley giants like Facebook and Alphabet investing billions. As an industry, it’s already estimated to be worth €179.91bn* globally.
The opportunities for pharma in tackling mortality and increasing the human lifespan are also not to be understated. However, the complex cellular and molecular processes that underlie age-related diseases have continued to elude us in their pathology. However, the tide seems to be turning and scientists may have just unlocked the key to slowing ageing.
Understanding the science behind senolytics
Enter senolytics, the next big thing in anti-ageing research. Cellular senescence, leading to tissue dysfunction, is widely accepted as contributing to ageing and the development of debilitating age-related diseases. This is because, as we get older, an increasing number of the body’s cells enter a state known as senescence which results in the loss of a cell’s power to divide and grow.
Surrounding cells then start to become affected and as more and more enter this state, the body’s ability to repair tissue, control inflammation and protect against the risk of age-related diseases is compromised. The more senescent cells a person accumulates, it seems the faster their biological clock ticks.
Increasingly, the scientific community is exploring whether the process of senescence can be therapeutically targeted to help to slow or even halt it. As the median age for cancer, Alzheimer’s, Parkinson’s and other age-related diseases are high (60+), understanding their pathology can reveal new insights into what mechanisms also cause ageing.
For example, neurodegenerative diseases (NDDs) share cellular and molecular mechanisms commonly seen in ageing cells such as inflammation, mitochondrial dysfunction and oxidation stress.
We recently had a first glimpse of what might be possible in senotherapy. In the first in-human trial of senolytics, the results were promising; these drugs were successful in removing senescent cells in the same way in people as in mice. Specifically, the administration of senolytics improved the physical function in patients with idiopathic pulmonary fibrosis (IPF), a fatal senescence-associated disease where the lungs become scarred and breathing becomes increasingly difficult.
The challenges of healthy ageing
By 2100, it’s estimated 25% of the world’s population will be aged 60 or above, so the potential of senolytics to transform geriatric medicine and help people to age “healthily” is immense.
But, it’s important to understand the multidimensional challenges senotherapy may present the pharma industry, healthcare systems, governments and individuals if, or indeed when, we reach the stage of commercialisation.
The longevity industry is highly complex; a space where many industries overlap and intersect, requiring synergy and collaboration between pharma, technology, finance, health and social care, government departments, bodies and agencies, and political parties.
In this diverse and dynamic field, creating concrete understanding amongst all partners and making accurate forecasts will be hugely challenging particularly given the rapid pace at which Agetech is evolving.
At present, there exists a severe shortage of geriatricians with the clinical understanding and experience to lead the first round of clinical trials to determine if these emerging interventions are effective and safe. Until this skills gap is closed, clinical geriatricians, scientists trained in the biology of ageing, and investigators with experience in early phase clinical trials and drug regulatory systems will need to join forces and work together to prove or disprove the effectiveness of senotherapy.
At this early stage, we are also unclear about the potential side effects of senolytic drugs or whether such observable changes at the cellular level are permanent. Only time will tell as larger-scale and more granular testing is carried out in a clinical setting on human patients.
On an ethical level, there are also important questions to consider and debate about intervening in one of life’s most fundamental and inevitable processes – death.
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*Estimated at the time of conversion
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