The Spanish firm Grifols helped set off a kerfuffle last year when it, along with other firms, offered nearly double the going price for blood donations for a COVID-19 treatment trial. Brigham Young University in Idaho had to threaten some enterprising students with suspension to keep them from intentionally trying to contract COVID-19. The trial failed, however, and now the Barcelona-based firm is hoping to extract something far more valuable from the plasma of young volunteers: a set of microscopic molecules that could reverse the process of aging itself.
Earlier this year, Grifols closed on a $146 million-deal to buy Alkahest, a company founded by Stanford University neuroscientist Tony Wyss-Coray, who, along with Saul Villeda, revealed in scientific papers published in 2011 and 2014 that the blood from young mice had seemingly miraculous restorative effects on the brains of elderly mice. The discovery adds to a hot area of inquiry called geroscience that focuses on identifying beneficial elements of blood that dissipate as we age and others that accumulate and cause damage. In the last six years, Alkahest has identified more than 8,000 proteins in the blood that show potential promise as therapies. Its efforts and those of Grifols have resulted in at least six phase 2 trials completed or underway to treat a wide range of age-related diseases, including Alzheimer’s and Parkinson’s.
Alkahest and a growing number of other geroscience health startups signal a change in thinking about some of the most intractable diseases facing humankind. Rather than focusing solely on the etiology of individual diseases like heart disease, cancer, Alzheimer’s and arthritis—or, for that matter, COVID-19—geroscientists are trying to understand how these diseases relate to the single largest risk factor of all: human aging. Their goal is to hack the process of aging itself and, in the process, delay or stave off the onset of many of the diseases most associated with growing old.
The idea that aging and illness go hand and hand is, of course, nothing new. What’s new is the newfound confidence of scientists that “aging” can be measured, reverse-engineered and controlled.
Until recently, “people working on diseases did not think that aging was modifiable,” says Felipe Sierra, who recently retired as director of the Division of Aging Biology, part of the National Institutes of Health. “That is actually what many medical books say: The main risk factor for cardiovascular disease is aging, but we cannot change aging so let’s talk about cholesterol and obesity. For Alzheimer’s, aging is the main risk factor—but let’s talk about the buildup in the brain of beta-amyloid proteins. Now that is beginning to change.”
The result is a flood of investment money, an explosion of research into what precisely goes wrong in our bodies as we get old and the promise of clinical results down the road.
In the months before the pandemic, investors ponied up billions of dollars to fund biotechs aimed at commercializing the new science. Some biotech firms are developing drugs and infusions designed to clean up zombie-like cells and metabolic junk that accumulate with age. Others hope to infuse new vigor into flagging cellular components, such as stem cells, or spur the body into beneficial actions by adding obscure hormones or proteins, that decrease as we get older. The NIA, under its director, Richard Hodes, recently announced plans to spend about $100 million over the next five years on basic research aimed at understanding “cellular senescence.”
“You have no idea how many people are interested to investing money in longevity,” said Nir Barzilai, the founding director of the Institute for Aging Research at Albert Einstein College of Medicine of Yeshiva University, and the founder of a company aimed at mitochondrial health. “There are billions of dollars.”
Although the vast majority of these efforts remain in preclinical development, several have recently entered FDA trials and could potentially hit the market in a few years. Some are already appearing on the gray market, raising concerns that hucksters are peddling anti-aging snake oil. Others, meanwhile, worry what might happen if these drugs actually do deliver on their promise: Will poor young people be coerced into selling their blood to elderly billionaires? Will magical anti-aging pills become the province of the Park Avenue and Hollywood rich, like facelifts, hair plugs and botox injections? Will the rest of us senile peasants be forced to watch them age backwards as we are left to wither and die?
Hacking Old Age
Getting old usually doesn’t end well. Despite massive gains in human life expectancy—over the last 150 years, it has almost doubled in many developed nations, though it dipped in the past year due to the pandemic—we still haven’t found a way to halt the relentless toll time takes on our bodies.