The Future Of Aging: Bringing Hollywood To The Hospital
The first definition of anti-aging is “managing” the aging process, then “repairing” or treating age related disease, and the long-term definition is focused on “preventing” or maybe reversing the process of aging.
Ask anyone about their vision for anti-aging and you will likely be presented with a scene straight out of a Hollywood sci-fi movie with ageless humans and advanced regenerative tech—remember the movie Elysium with its Med-Bays that could cure disease as well as regenerate the human body, thereby offering eternal youth? While the dream of eternal youth has been around since Ponce de León supposedly went searching for the fountain of youth, modern science today offers anti-aging avenues through which this might just be possible. Well almost.
Quest for the Fountain of Youth: Navigating the Bumpy Ride to Human Immortality
Human beings are in need of such innovations today more than ever before. The world is rapidly aging. In 2015 the number of people aged 65 and above stood at an estimated 617 million—making up 8.5% of the global population—and this number is set to grow to 1 billion by 2030 for the first time ever, representing 12% of the global population. Furthermore, a person born in 2015 has a life expectancy of 71 years but life expectancy is predicted to improve significantly by 2030, with a number of countries including the U.S., Japan, South Korea, and leading European nations expected to cross the 80 years threshold. These figures highlight an unprecedented healthcare conundrum we are slowly heading towards: as we expect to live increasingly longer lives, the occurrence of disease, especially chronic age-related disorders, is rising rapidly. For example, nearly 81% of U.S. adults of 65 and above are likely to experience one or more chronic diseases.
This situation does not align well with the current widespread wellness-focused lifestyle trends we observe globally—based on the consumer’s obsession with looking, feeling, and staying young. As a result, we find that people across the globe, irrespective of gender, are seeking out and experimenting with anti-aging solutions that hold out the promise of extended youth—combining approaches such as dietary supplements, cosmetic solutions, and, of course, novel drugs promising eternal youth, and in the process creating a multibillion-dollar market opportunity.
So while commercial stakeholders—across the dietary supplement, pharmaceutical, and aesthetics industries—work on building well-defined anti-aging strategies to manage this global issue affecting us all, the actual path isn’t so simple. Aging is quite a complex and intricate process, the end result of interactions of multiple complex biological pathways and mechanisms within the human body that are difficult to understand, let alone manage.
Efforts to Prevent and Reverse Aging
Traditionally, the efforts of the anti-aging industry have been focused on repair, i.e. the treatment of various age-related disorders such as Alzheimer’s, osteoarthritis, osteoporosis, and age-related ocular diseases. However, Frost & Sullivan’s recent analysis of the anti-aging industry shows that this position is slowing changing. Anti-aging methodologies are increasingly focusing on preventing and better managing the aging process before the need for treatment or repair of age-related disorders arise.
Dietary Supplements: A Multi-billion Dollar Industry
One of the key tools used in the prevention and management of aging is dietary supplements. Supplements have been around for quite some time and already represent a multibillion-dollar industry. However, in order to target anti-aging applications, the industry has been forced to innovate and step up its game, developing products that critical scientific analysis suggests hold the promise of anti-aging benefits. Companies are conducting research on the use of product formulations with innovative ingredients, such as nicotinamide riboside (NR), Coenzyme Q-10, and alpha lipoic acid, to cater to this trend. For example, NR is a product that has received significant attention from the industry by showing promising improvements in cardiovascular and other physiological functions through promoting the levels of NAD+, an essential cellular building block crucial for energy production. Manufacturers who offer NR-based product have conducted pilot studies highlighting the ingredient’s possible health benefits. One such company is ChromaDex, which offers a nature-identical form of NR called NIAGEN, available to retail consumers under the brand name Tru Niagen. Another company offering an NR-based product is Elysium Health, with its consumer focused dietary supplement brand Basis offered via an online retail-based subscription model. Interestingly, both ChromaDex’s and Elysium Health’s advisory boards include Nobel laureates as well as research stalwarts from prominent academic research institutions such as Harvard, Stanford, and MIT—highlighting their (and the industry’s) R&D-focused positioning.
Short-term Diet without Long-term Problems
Another diet-based trend gaining popularity is short-term diets that lead to short-term calorific reduction, offering possible regenerative results that are generally associated with short-term starvation. California based L-NUTRA offers such a product, positioned as a Fasting Mimicking Diet, or FMD, commercially available to consumers under the brand name ProLon. Launched in collaboration with Valter Longo, a biogerontologist from USC Davis and a prominent researcher on the effects of starvation on cellular protection for aging and other diseases, the product is positioned as a periodic fasting regimen that may help encourage the human body into a rejuvenation mode.
Ageless Humans: Technology Disruptions to Conquer Aging
Fortunately, along with dietary supplements, pharmacological (or pharmaceutical) focused stakeholders in the anti-aging market have also upped the ante with novel innovations. One prominent approach focuses on cellular senescence. Normal human cells keep dividing throughout their life time, however for various reasons they sometimes stop dividing and start to accumulate in the human body. These “zombie” cells continue to move around in our bodies, as they are not naturally eliminated from the human body and keep on accumulating as we age. Research has shown that these senescent cells may lead to inflammation affecting human tissue and acting as a possible cause of a number of age-related disorders. Companies such as Unity Biotech and Oisín Biotechnologies are working on solutions that have shown promise in targeting and eliminating senescent cells and in the process help reduce the prevalence of age-related disorders. Some of the other areas that pharmacological approaches have focused on include the mitochondria (the powerhouse of the cell), telomeres (caps that protect the end of our DNA’s chromosomes but get shorter with age), mechanistic target of rapamycin or mTOR (a regulator of cell growth and proliferation), and blood transfusion.
In June 2018, Unity Biotech announced the kickoff of the first phase of clinical trials to evaluate UBX0101, its first “senolytic medicine” aimed at osteoarthritis, a prominent age-related health issue. Note that this product is for a specific disease and is not an overall anti-aging solution. The launch of drugs focused on a particular disease rather than a generic anti-aging clinical product is a strategy adopted by a number of companies in the pharmacological anti-aging space. This is because traditional regulatory processes are usually geared to assess products that aim to treat disease after they emerge, rather than evaluate methodologies that can help prevent and manage such age-relate diseases from occurring at the first place. Hence, such companies often produce a drug to treat a specific condition, and focus on wider anti-aging applications of the solution once efficacy and safety profiles have been established. A good example here is the Targeting Aging with Metformin (TAME) trials that aim to study the application of metformin—a widely used treatment for Type II diabetes with a well-established safety profile—in the treatment of aging-related conditions including heart disease, cancer, and Alzheimer’s.
Last but not the least, Regenerative Medicine (RM) offers the potential to resolve unmet treatment needs across multiple aging-related diseases. RM actually includes four separate approaches—cell therapy (using living cells to replace or augment damaged or diseased cells and tissues), gene therapy (altering the genetic code to treat a diseased state), tissue engineering (production and medical application of synthetic materials or biomaterials) and small molecules and biologics (chemical and cellular components that stimulate dormant cells for regenerative properties). Combinations of RM therapies (cell therapy + gene therapy) are gaining momentum—using gene-editing tools—in devising cures for aging-related issues such as neurodegenerative disease, cardiovascular disease, age-related ocular disease, osteoporosis, and arthritis.
Such diverse approaches to anti-aging may initially confuse stakeholders assessing anti-aging opportunities, but actually this variety clearly highlights the complex nature of the human aging process—one that demands a multipronged definition with multiple emphases. The first definition of anti-aging is “managing” the aging process (for example, using dietary supplements to extend general health and wellness into an advanced age)—and “repairing” or treating age-related disease (for example, using regenerative medicines to treat age-related diseases and aesthetic solutions for wrinkles and fine facial lines). The long-term definition of anti-aging is focused on “preventing” or maybe even reversing the process of aging (for example, using novel pharmacological approaches)—which, while currently being bleeding-edge and filled with uncertainty and roadblocks, may finally crack the anti-aging Gordian knot.
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This article was written with contributions from Neelotpal Goswami, Life Sciences Senior Industry Analyst, from Frost & Sullivan’s Transformational Health practice.