The 2012, Oxford University philosopher Bennett Foddy states

            The notion of extending the
“average” human lifespan is one that has fascinated our species, to the point
of obsession, since at least Ancient Egypt. Perhaps more so than longevity, the
idea of increasing the youthful, healthy portion of life is truly what seems to
infatuate humanity, evident from today’s multibillion-dollar cosmetic and health/fitness
industries. In the past few decades, advances in modern biological and medical
techniques have given rise to the field of biogerontology, bringing with it a
slew of information pertaining to the natural process of aging. Along with our
understanding of the complexities of gene expression, tackling the idea of
severely reducing aging (the segment of life referred to as senescence) has
become a major goal of the scientific community. How far can we realistically
take these aspirations? Is it possible that humanity will one day altogether be
“cured” of aging or are we currently approaching our maximal lifespan? What are
the best methods to arrive at an ideal balance of longevity and healthfulness?

            In order to fully understand the
various life extension techniques currently being researched, it would be
helpful to ponder the fact that we’ve doubled the average lifespan in developed
countries in the past century alone. In an EMBO
Reports article from 2005, entitled “Who Wants to Live Forever?”, Jayne C.
Lucke & Wayne Hall point out that “in Australia, for instance, life
expectancy at birth has increased from 57 at the beginning of the 1900’s to 80
in 2000.” Populations in the United States and Europe have followed similar
trends, most of which are attributable to better sanitation standards and wider
access to medicines and treatment. In an interview with The Atlantic in May 2012, Oxford University philosopher Bennett
Foddy states “it used to be that people would die of an infectious disease;
they’d be struck down when they were very young or when they were older and
their immune system was weak” (Andersen). As our quality of life and technology
has improved over the past century, more information concerning the biological
processes associated with aging has also come to light.

            Though aging itself currently lacks
a definitive definition, there is general consensus that it is the period in
which normal metabolic and cellular processes in the body begin to break down,
eventually leading to organ dysfunction and death. Thomas Rando, who is the
director of the Paul F. Glenn Center for the Biology of Aging at Stanford
University, conducted experiments on laboratory mice in 2005 and found that “an
elderly mouse whose bloodstream was surgically linked to a young mouse
recovered its youthful wound-healing powers” (Weintraub). The stem cells of the
elderly mouse somehow became more successful in synthesizing new tissue, most
likely because of the “sharing” of the younger mouse’s blood cells. Stem cells
can be considered “template” cells that act within the body to replace faulty
somatic cells. Although the experiment yielded informative results, it is
unlikely that we’d see youth blood therapy being employed on a large-scale
basis in humans.

            Another method being investigated is
the use of drugs to aid in the treatment of age-related diseases and ailments.
In 2014, researchers at Cardiff University reported that “patients with type 2
diabetes who took the drug metformin lived, on average, 15 percent longer than a
group of healthy people who did not suffer from the metabolic disorder but were
similar in nearly all other aspects” (Weintraub). The current hypothesis is
that metformin plays a role in slowing down glycation, which is a process that
leads to sugars bonding to proteins within the body, essentially altering the
protein’s structure and interfering with its function. In addition to
metformin, a compound known as everolimus that was given to 218 adults was
found to have positive correlation in improving the flu shot’s effectiveness in
patients older than 65. The patients that were given “everolimus had a higher
concentration of germ-fighting antibodies in their blood than their untreated
counterparts” (Weintraub). Unfortunately, everolimus caused adverse side
effects in the some of recipients, most notably through the formation of ulcers
inside the mouth. Everolimus, which is currently used as a cancer treatment
aid, is also prohibitively expensive; it “costs more than $7,000 a month at
doses appropriate for cancer” (Weintraub) and there is no consensus on how
much, if any, amount would be needed to combat the effects of aging. It’s worth
nothing that everolimus is structurally similar to rapamycin, a chemical used
in the prevention of kidney rejection in transplant procedures.

            Perhaps one of the simpler
anti-aging treatments being explored is the implementation of caloric
restriction. In laboratory tests, “restricting the consumption of calories was
long ago shown to help mice live longer” (Weintraub). There may be a human
connection to this, although obtaining conclusive findings in a human
population would be complicated, as many people don’t have the ability or
willingness to partake in the low-calorie diets required for the time (most
likely many decades) needed to establish a proper evaluation of the benefits of
caloric restriction.

            Although the scientific and medical
communities are only beginning to delve into clinically tested life extension
therapies, there is already a massive market in the developed world offering
alleged anti-aging treatments. Many of these treatments are based on hormone
therapies and are not supported by the wider medical community. These currently
offered treatments are a cause of public safety concern, so much so that in
2009, the American Medical Association’s Council on Science and Public Health held
a summit to address the questionable claims of many of these organizations. In
a piece for The Chicago Tribune,
writer Bruce Japsen summarizes the council’s report: “despite the widespread
promotion of hormones as anti-aging agents by for-profit Web sites, anti-aging
clinics, and compounding pharmacies, the scientific evidence to support these
claims is lacking.” One such anti-aging organization, BodyLogicMD, offers
hormone treatments to aging people and “headlines its medical services as ‘The
Time is Now,’ running a companion quote from the late actress Mae West that
reads: ‘You’re never too old to become younger” (Japsen). Despite these fairly
overt company taglines, according to BodyLogicMD’s chief medical officer, Dr.
Alicia Stanton, “I don’t tell my patients they can stay young with this stuff”
(Japsen). Clearly, there is a disconnect between the company’s public message
and what is purportedly offered by it. Despite the potential dangers of
utilizing non-medically approved anti-aging treatments, the AMA has estimated
that the industry is worth at least $50 billion in just the United States.

            What is the wider public opinion on
life extension therapies? It seems that gerontologists have taken off running
into radical life extension research without a general consensus of the
non-scientific community’s feelings toward the topic. As Lucke and Hall point
out in their EMBO Reports piece, “the
most pessimistic scenario foresees prolonged senescence as an unintended
consequence of our efforts to extend lifespan.” The idea of watching loved ones
suffer from independence stealing ailments for a longer-than-necessary period
is quite unpleasant, but there may be public misconception in terms of what is
meant by “life extension.” In a June 2010 interview for Life Extension Magazine, Dr. Michael West, CEO of BioTime, Inc.
defines regenerative medicine as a “collection of technologies that utilizes
embryonic pluripotent stem cells and their derivatives to regenerate tissues in
the body ravaged from disease, primarily degenerative disorders associated with
aging” (Fahy, Kent). Life extension therapy is founded upon the idea of
regeneration to a youthful state, not simply a prolonged lifespan.

            In his interview, Dr. West points
out that a main contributor in the biological processes of aging may be found
within the regions located on the caps of DNA chromosomes, called telomeres. In
1986, researcher Howard Cooke found that the telomeres located on reproductive
cells, those of the sperm and ova, are long and maintain their length;
oppositely, somatic (body) cells become shorter over time as the body ages. Russian
scientist Alexey Olovnikov thought this telomere shortening could be analogous
to a sort of “clock of cellular aging, similar to the way the length of a fuse
leading to a bomb can be a kind of clock—the longer it’s set, the longer it
will burn before the bomb goes off” (Fahy, Kent). Olovnikov suggested that an
“immortalizing” enzyme exists, which somehow becomes shut off in somatic cells.
In 1990, Dr. West founded “Geron, where we isolated and purified this
immortalizing enzyme, which we called telomerase” (Fahy, Kent). By the late
90’s, West and his research team successfully showed telomerase to have stopped
the aging process in skin cells and macular degeneration in retinal cells in
the eyes.

            In addition to the telomerase enzyme,
Dr. West discovered that much of the body’s regenerative capacity originates
from the aforementioned stem cells. Stem cells are responsible for the
accelerated healing properties associated with youth/healthfulness. Dr. West
elaborates that “unfortunately, not all cells and tissues of the body have
extensive regenerative capacity, and indeed, in the case of humans, adult stem
cells all appear to be mortal…they can regenerate tissue function, but only for
a finite period of time” (Fahy, Kent). The dysfunction associated with the
aging of stem cells has been connected with telomere length shortening. As
reproductive (called germ line) cells do not experience telomere shortening, it
has been postulated that if researchers can “isolate germ line cells from human
embryos and just propagate them in a laboratory dish” (Fahy, Kent), and then
introduce them into a person who is experiencing some level of biological
dysfunction related to aging, that these embryonic stem cells will regenerate
or even reverse the effects of senescence. Dr. West points out that these stem
cells could be a long term and crucial development in the prevention of aging:
“theoretically we could make an unlimited assembly line, making new young
tooth-forming cells, new young cells for the retina, for the cornea, for the
heart, for the kidneys, and so on” (Fahy, Kent). Unfortunately, there was a
notable public backlash to the idea of using embryonic stem cells, leading to
the focus of the research being shifted to the use of induced pluripotent stem
cells (iPS cells).

            iPS cells are manufactured through
the treatment of a small amount of genes to coax cells back to a state
resembling an embryo’s cells, without the use of actual embryonic cells. Using
computer aided technology to analyze embryonic cells in order to find portions
of the genome that are responsible for regenerative healing, Dr. West states
that “we found, at the top of the list, almost as if highlighted in glowing
bold letters, four transcription factors that are active in embryonic stem
cells and inactive in virtually all body cell types—Oct4, Sox2, Lin28, and Nanog” (Fahy, Kent). Dr. West has described
this group of genes as master regenerative regulators that when expressed, are
capable of transporting old somatic cells back to an “embryonic” state,
“rewinding the ‘clock’ of development whereby embryonic cells normally
differentiate into the specialized cells of the body, as well as the telomere
‘clock’ of cellular aging” (Fahy, Kent). As no embryos are involved in iPS cell
technology, the research can avoid the controversy surrounding the use of
embryonic stem cells without sacrificing any of the integrity for regeneration
associated with them.

            Dr. West and his team have developed
a copyrighted technology, dubbed ReCyte, that uses germ line genes isolated
from testicular cells to genetically engineer iPS cells with large amounts of Oct4, Sox2, and Lin28 to be “time machines” that transport body cells to an
embryonic state. “ReCyte is a technology designed specifically to increase the
efficiency of reprogramming, and to do so on a robotic, commercial scale”
(Fahy, Kent). Dr. West believes that, based off of this advanced technology,
his team of researchers will be able to produce iPS cells that not only halt
aging, but reset the biological “clock” of aging in a relatively inexpensive
and accessible manner. ReCyte is currently proprietary technology associated
with BioTime, Inc. (Dr. West’s company) and is based on several patents. Dr.
West points out “that what’s so striking about iPS cells is how similar they
are to human embryonic stem cells in every respect” (Fahy, Kent). There are
over 30,000 genes expressed in embryonic stem cells and iPS cells are nearly
indistinguishable from these stem cells. Despite these amazing advances in the
genetics of aging, funding for the research is still severely lacking and Dr.
West is not hesitant to point out that with our rapidly aging population, it is
time for Congress to being allotting public funds into legitimate anti-aging
treatment methods.

            It is unlikely there will be much
governmental action until public attitudes about life extension therapies have
been evaluated and termed to be favorable. So far, there are “only assumptions
that are not even based on sociological studies” (Hall, Lucke) that the public
will generally be in favor of these treatments, but solid consensus is lacking.
This is a cause for concern in the biogerontology; “Aubrey de Grey, a
biogerontologist at the University of Cambridge, UK, has called for an open
debate between scientists and the public to overcome public misconceptions
about anti-aging research and its social implications” (Hall, Lucke). Indeed,
there may be a need for the biomedical field to engage in a public discourse with
opponents of life extension.

An unfortunate scenario would be for
massive amounts of time, money, and effort put into this technology, only for
it to be rejected by those who would benefit the most from it. The situation
becomes contradictory, as “de Grey pointed to an apparent paradox: there is
huge public interest in and willingness to pay for cosmetic and other
interventions that delay at least the appearance of aging; however, many
bioethicists assume that the public will be reluctant to pursue life extension”
(Lucke, Hall). In his interview with Ross Andersen of The Atlantic, Bennett Foddy states that humans have already
radically altered average human lifespan in the past century. Foddy speculates
that “if, at the outset of this process, you asked people if we should develop
technologies that would make us live until we’re 80 on average instead of until
we’re 40, people might have expressed these same kind of misgivings you hear
today” (Andersen). Indeed, as de Grey has suggested, public discourse may be
required in order to ease perceptions of this new, and seemingly bizarre,
technology.

It’s no doubt that the prospect of life
extension is a multifaceted and intriguing one, to say the least. The
disconnect between the leaps and bounds being made with technology to achieve
extended youthfulness and public attitudes towards such work is one that will
define how far humanity can push the limits of mortality. Oftentimes, new and
novel ideas are met with some level of non-intellectual criticism and
skepticism, but if a dialogue were to be opened up between the researchers
pioneering the field and the public, it could immensely help to quell some of
the (often unfounded) concerns about life extension therapies. Many people are
willing to accept death as an inevitability, and while they may be correct in
that assumption, the error may be in our current understanding of how long we
really have the capacity to remain productively alive. The future will be
filled with an increasingly older human population, and extending health span
should be a priority for our species; disease and death are master thieves of
knowledge, wisdom, intelligence, and love.