To Die or Not to Die: The Billionaire's Dilemma
Is living longer the solution to all of our health problems?
Since the start of time, humankind has yearned to live longer and defeat death. The search for the elixir of youth can be traced back to ancient times where Egyptians employed a host of various methods to live longer. Even Caesar was obsessed with eternal youth, erecting "youthful" statues of himself regardless of how he truly looked. 2000 years later, we still don’t have the answer to this, but we've come closer to solving this issue than ever before, with the help of a few billionaires bankrolling these efforts.
What is Longevity?
As our understanding of the human body increases over time, the Healthcare industry has slowly migrated from finding cures to diseases and ailments to developing interventions for these diseases. From here, the next stage is to develop preventative treatments. Longevity encompasses both intervention and prevention.
Laura Deming sums up longevity or the study of ageing as follows:
"trying to figure out what kinds of damage accumulate with age, how to reverse that accumulation, and the search for switches that we could flip in human biology to increase lifespan."
Rather than actually slowing down ageing or staying youthful forever, scientists involved with longevity actually look at it from the perspective of increasing our healthspan, which is the amount of time that we live healthy. Moreover, experts in the field argue that if we were able to solve for maximising our healthspan, this would actually be able to either prevent chronic age related diseases, or at least delay the onset of these diseases for as long as possible.
Longevity tech is multi-faceted with many research areas that experts are pursuing. Some of the more esoteric ones include:
Parabiosis: In the 70s scientists found that by surgically linking old and young mice together and sharing their bloodstream, they were able to increase their lifespan. More recently, similar experiments such as injecting young blood into old mice has shown better cognitive ability and improved health.
Senescence: As you age, your cells also get older but in a disproportionate manner. Some cells get older quicker or are damaged. Normally, in our DNA we have an enzyme called Telomerase. This enzyme ensures that our cells can divide and replicate in order to stay healthy. If one of our cells runs out of Telomerase, the cell may continue to persist and refuse to die. In this state, it starts secreting toxic factors that are bad for neighbouring cells and thus becomes a Senescent cell. In 2016, a group of researchers found that removing the senescent cells from mice made them live a longer and healthier life.
Reproductive systems: Interestingly, a study has found Eunuchs (castrated men) live nearly 20 years longer than other men. They found that the average lifespan of a Korean eunuch was about 70 years, 14 to 19 years higher than non-castrated men of similar social standing. Three of the 81 eunuchs lived to be over 100 years old. The researchers calculated that the rate of centenarians among this group of eunuchs was at least 130 times higher than the current rate in developed countries.
Definitely a weird one, and not sure how statistically significant this really is.
As a note, current lab tests are conducted on Mice as they are an ideal mammalian model due to their lower lifespan and can be kept in controlled environments easily.
What are the drivers behind Longevity Tech?
One of the key tailwinds in Longevity Tech is greater access to medical data. As our health records start to migrate to the cloud, researchers are able to mine this data to find insights and hopefully uncover some hidden gems.
One such discovery is Metformin which is a drug that helps diabetics reduce their blood sugar levels and has also been shown to also provide unintended health benefits in the form of life extension. Researchers found this by accident after analysing the medical data from diabetics. It's hoped that future discoveries will be possible as more medical data is digitised.
Furthermore, with greater access to data, the BioTech industry is able to harness compute power and artificial intelligence. Researchers are now able to facilitate the discovery of drug compositions, anti-ageing interventions and longevity biomarkers to enhance the study of ageing. This combined with greater access to testing facilities such as CROs allow researchers to conduct more accurate testing and quicken their feedback loops to ensure continuous iterations of their approach.
Underpinning all of this is the abundance of capital in BioTech. Whilst still largely underfunded from a government perspective, Longevity Tech has long been a billionaire's playground. Peter Thiel has prominently invested in furthering life extension research and has had a strong connection to parabiosis. More recently, Jeff Bezos has also joined the party, investing in Altos Labs, an anti-ageing startup pursuing biological reprogramming. More capital is flowing in the space off the back of the COVID-19 pandemic, demonstrating the need to make our ageing population more resilient.
So what are some interesting startups playing in this space?
BioAge is led by CEO co-founder Kristen Fortney and funded by a16z, BioAge aims to identify key biomarkers in youthful blood by employing biochemical and data science techniques to uncover insights in this area.
One of the core challenges in solving the ageing problem is working through the issue of long feedback cycles during the experimentation phases. How else are you meant to measure living longer but waiting for years to pass?
By identifying key biomarkers, this can help speed up the process significantly. A biomarker is essentially a biological molecule that can be used to see how well the body responds to a treatment for a disease or condition. For example, to test heart disease treatments, scientists look at Cholesterol levels, a known biomarker that correlates with cardiovascular disease. By identifying this relationship, cholesterol has become a powerful tool for drug development and treatment. BioAge aims to do something similar to solve for longevity.
To date, BioAge has three drugs undergoing clinical trials at various phases, and another immune ageing focused drug still in its discovery phase.
Loyal is an animal pharmaceutical company with a focus on extending both lifespan and healthspan for dogs. Founded in 2019 by Celine Halioua, the goal is to better understand dog ageing and eventually migrate this R&D into products to prolong human life.
Dogs and Humans have shared environmental factors, can share the same diet and also develop the same ageing diseases like cardiac problems and cancer, making dogs a good model for human health. With substantial funding from Khosla Ventures, First Round Capital and The Longevity Fund, Loyal has been able to complete its first clinical study on 500 dogs. The aim of the study was to better understand various ageing biomarkers and how they may relate to dog size and age.
Unity Biotechnology (NASDAQ: UBX) is taking a senolytic approach towards developing therapeutics that may address the root causes of ageing. As mentioned earlier, Senescent cells can cause issues if left untreated by secreting large quantities of harmful proteins, which can cause inflammation, dysfunction, and tissue degradation.
So far Unity is conducting clinical trials for senolytic medicine targeted at treating eye disease. Unity found that there was increased senescent cell burden in tissues around the eye leading to age-related macular degeneration and diabetic macular edema. By removing these cells, the goal is to restore vasculature to a healthier state and improve patient's vision.
In line with the current trend to have a DAO for everything, VitaDao is aimed at funding early stage longevity research. Members can join VitaDAO by purchasing VITA tokens or earning them through contributions of work or Intellectual Property. VitaDAO will directly hold IP rights to the projects incubated through the collective and plan to grow their portfolio of assets by representing them as NFTs.
VitaDAO has funded 1 project so far, the Longevity Molecule, which will be led by Morten Scheibye Knudsen and carried out by the Scheibye-Knudsen Lab in Copenhagen. Using advanced machine learning technologies the project has analysed 1.04 billion prescriptions from 4.8 million individuals over 50 years in The Danish National Health Service Prescription Database and correlated this with the survival of individuals prescribed certain drugs. The project has identified 10 FDA-approved medications that appear to have a strong effect on lifespan following analysis. The next step is to optimise, repurpose and reformulate these drugs to find the strongest impact on the human lifespan.
Lastly, whilst still an emerging industry in Australia, there are a few support networks for founders and operators looking to enter the space. The Ageing Decelerator, founded by Kyall Walker, is an emerging network that hopes to support early stage founders and teams solving the challenges of Ageing and Longevity.
Future of longevity
The longevity tech industry is still very nascent and given long feedback loops when studying ageing, it may take 10-20 years to really prove whether the current methods actually work. As more medical data is digitised, researchers will be able to find new insights and biomarkers of ageing. Additionally, researchers are starting to dig deeper into the genetics of exceptional longevity by studying centenarians (100 years old) and super-centenarians (110 years old) and their family genetics.
Current experts have conservatively estimated that it would be possible to prolong our healthspan and lifespan by about 30%. Even if that doesn't materialise, the research into senescent cells and a myriad of other areas will surely aid in treating and hopefully eradicating some life threatening diseases.