Our bodies are more susceptible to diseases as we age.  Age is the greatest risk factor for nearly every major cause of death.  For over a decade, I have been the proponent of managing the process via Age Management Medicine principles which mitigate the effects of aging. My patients and I have greatly benefitted from that approach.

Reversing aging; now that’s a whole different level of transformation.  There are a variety of theories to explain aging that are collectively referred to as the Hallmarks of Aging, such as telomere shortening, epigenetic alterations, cellular senescence, mitochondrial dysfunction, stem cell exhaustion, to name a few. But most experts agree that it is not any single one of these processes that is responsible for aging, rather an intricate interplay among them that can differ substantially in any individual.

At Alternity Healthcare, I have been using telomere testing and more recently, epigenetic testing to gauge the effectiveness of the age management protocols we employ.  But recent discoveries have provided deeper insights into the mechanisms that underlie biological aging and, more importantly, potential interventions to delay aging and promote healthy longevity.

We are at the point at which rejuvenation therapy that directly targets an aging process is a reality.  To understand what this means, I am going to discuss what we can do about one of those hallmarks, namely cellular senescence.

As we get older, more and more of the cells in our bodies become dysfunctional and enter into a state known as senescence.  Senescence is primarily caused by telomere shortening and DNA damage. These senescent cells, or sometimes called zombie cells, no longer divide or support the tissues and organs of which they are part; instead they have markedly increased metabolic activity that secretes a range of harmful inflammatory chemical signals; that state is known as the senescence-associated secretory phenotype (SASP). Normally senescent cells dispose of themselves through a self-destruct program called apoptosis and are cleared away by our immune system.  Apoptosis is a natural safety mechanism that prevents damaged and precancerous cells from reproducing, so it fights cancer and promotes tissue repair. 

If they aren’t eliminated, senescent cells become problematic.  As some cells evade apoptosis and our immune system weakens with age, they accumulate.  The SASP also encourages neighboring cells to become senescent, compounding the problem. The accumulation of senescent cells is considered to be one of the reasons why we age and develop age-related diseases. 

Therapies that remove senescent cells are called senolytics.  Senolytics have been shown to increase lifespan and ameliorate age related diseases, such as cancer, heart disease, osteoporosis, arthritis and Alzheimer’s, in multiple species, and they are now in human trials.

The field of senolytics is booming with many biotech companies racing to develop them.  While there is no approved direct senolytic yet available, I am going to briefly discuss two FDA approved drugs that block mTOR,  a protein kinase crucial to regulating the cell cycle.  mTOR is involved in a variety of biological processes related to cell growth and energy production.  It is one of the principal chemical pathways involved in aging.  Drugs that inhibit mTOR therefore have very promising effects on longevity:  Rapamycin and Metformin.

Many people are familiar with Metformin as a drug to treat T2D.  It produces its glucose lowering effects, in part, by weakly inhibiting mTOR. diabetic patients taking metformin have reduced mortality compared with diabetic patients not receiving metformin, and they may live longer than nondiabetics not receiving metformin. The downside is that it also impairs mitochondrial function to some degree.  So used alone it may not be the best for everyone.

Rapamycin slows aging, extends life span and prevents age related diseases.  But it wasn’t developed for that.   It is an FDA approved drug used in high daily doses to prevent tissue rejection in transplant patients.  Rapamycin inhibits the SASP and strongly affects (mTOR) or the mechanistic target of rapamycin pathway.  mTOR is a key regulator of metabolic balance.  When activated, it promotes growth. Think of high mTOR activity being analogous to the phrase “Live fast, die young”, because too much activity is good for growth but bad for lifespan.

In a 2009 study rapamycin made headlines by significantly extended the lifespan of mice (by about 30%), and has extended lifespan in every species studied to date. Other studies in mice showed that the drug blocked the progression of Alzheimer’s disease, atherosclerosis, muscular dystrophy, and cancer. In 2018, a rapamycin human clinical trial using low, intermittent dosing in healthy adults was completed and reported the drug to be safe over the short-term when used for anti-aging purposes with minimal to no side effects.  Another study showed that inhibiting mTOR enhanced immune function and reduced incidence of viral infections in the elderly

This is just the tip of the iceberg for age reversal therapies.  I am very excited for the future. If you’d like to learn more about what you can do to slow or even reverse aging, just click the button above, or the link here, to schedule a free discovery call with me.