Scientists at Harvard have discovered that over-expression of a simple molecule could prevent or even reverse parts of the ageing process. Is the science plausible, and at £30,000 a day, is this medical research truly in the best interests of everyone?
A world without cancer, Alzheimer’s, diabetes and cardiovascular disease only seems possible in science fiction. “We might take a little pill at breakfast, and this would wade off the diseases of ageing” smiles David Sinclair in his recent TED talk. Placed in Time Magazine’s 2014 list of the world’s most influential people, this eminent geneticist certainly has momentum behind his ‘anti-ageing cure’. Sinclair believes that it is engrained in society that we get old and die, so we don’t realise that we can fight against it. An easy cure for a multitude of diseases seems far-fetched, however evidence is mounting supporting these claims. Ageing is a complex process, but he feels there may be a single solution that will be available in our lifetimes, and it does not come cheap. Realistic estimations are at $50,000 a day.
So how does the molecule work?
You may remember NAD+ from A-level Biology; the oxidised molecule in the Krebs cycle can be used to produce energy in the mitochondria. This versatile coenzyme also regulates SIRT, a protein which helps the nuclear and mitochondrial genome communicate peacefully and clearly, by stabilising HIF-1 alpha (a molecule which is invaluable during hypoxia, but troublesome in excess). As we get older, this cross-talk becomes noisier as SIRT loses its ability to control HIF-1 alpha. This leads to mitochondrial dysfunction. Mitochondria are central to our cells well-being, and so their degeneration has catastrophic effects on our bodies.
As scientists elucidated this pathway, it became clear that SIRT under-expression might be easily fixed through NAD+ supplementation. By using animal models and finding they could make two year old mice appear six months old, Sinclair and Co. gained enough confidence in their findings to test on humans, with very positive preliminary results. As NAD+ is naturally produced, it is thought to be unlikely to have detrimental side effects.
Sinclair has faced criticism, however, from other members of the science community; disease is an umbrella term for a wide variety of ailments, and finding a single cure seems reductionist and absurd. He could be underestimating the complex gene interactions that underpin the ageing process, notably the role of telomeres. Telomeres protect the end of our chromosomes, but are depleted with each cell division. When they are too short, the cell cannot replicate DNA fully, so the cell becomes inactive. It is unclear if telomere length is a cause of or just correlates with ageing, but it does provide evidence of ageing being more than under-expression of a molecule.
What is interesting about this research is the hype surrounding the easily-administered nature of the drug. Research into preventing the ageing process has already discovered something that perhaps is inconvenient to admit and implement, lower calorie diets are better for us. Apart from the obvious that carrying excess fat is harmful, a mountain of research concludes that SIRT1 and other pathways regulate autophagy, the recycling of damaged cell components. Experiments show that lifespan in mice are increased when autophagy is activated during chronic calorie restriction. When we eat a large hamburger, this switches off the expression of SIRT. Does it say something about the western ethos that researchers feel we would rather try and self-medicate than to diet? Or perhaps they are simply catering to pharmaceutical demands?
In a society where we could effectively buy youth, what would the implications be? It is unlikely that this cutting-edge medicine would be subsidised. With a £2bn shortfall expected in 2015, it is hardly the golden age of the NHS. According to the 2014 Global AgeWatch Index, there is still considerable health inequality within the current generation of older people. If rich octogenarians weren’t just heinously advantaged in lifestyle, but also had the sharp mind and strength of a 25-year-old, would this just increase the gap between the rich and the poor? Sinclair seems to emphasise that by taking this pill, we could lead happier and more productive lives, as if happy and productive are synonymous or complementary terms. Scientific progress is affected by political and socio-economic motives and therefore the language around this ‘cure’ is laced with this productivity ideal, which may not truly have everyone’s best interests at heart.
In his TED talk, Sinclair says that the way we investigate disease is wrong – instead of looking at diseases on an individual level, we should take a holistic view of the body. As ‘ageing cures’ develop into real possibilities, it is also important to consider biomedical research in the wider context of our interconnected lives. Take Genetic engineering, for example, a contentious topic because of the obvious sinister connotations. It is vital that we examine all emerging science with the same scepticism, or we could really create a world we do not want. With these amazing cures, we need to critically think about what it could mean for every section of society. We can forget, that like our bodies, our society is not always immune to dangerous things.