The pharmaceutical industry has experienced tremendous growth in the cell and gene therapy field. Newly approved therapies have completely shifted the treatment landscape, with the hope of curing genetic diseases and cancers previously deemed incurable. These developments have no doubt pioneered a new shift in pharma, while ushering in new conservations about affordability and value of high-cost treatments. Alongside these developments, there has also been tremendous advancement in the field of longevity and anti-aging. Billionaires are investing in research that could prevent and possibly reverse the aging process. Jeff Bezos, for example, is one of the top investors in Altos Labs, a biotech startup pursuing biological reprogramming to rejuvenate living cells. Anti-aging research is primarily focused on treating age-related diseases, such as cardiovascular disease and cancer, to effectively reverse the aging process and extend the human life lifespan. Aging is now being viewed by many scientists as a disease itself, a disease that we could possibly cure in the very near future.

Although testing has only been done in animals, researchers using new anti-aging techniques have successfully restored lost eyesight and reversed the aging process in middle-aged and elderly mice¹. A number of new anti-aging biotech startups have launched in recent years, all interested in finding ways to turn back the clock. The majority of research in still in the beginning phases, but this field could usher in an entirely new era in the pharmaceutical industry.

There are several anti-aging techniques and therapies currently being tested by biotech companies, including:

• Longevity drugs, such as resveratrol and nicotinamide adenine dinucleotide (NAD+), which aim to ameliorate oxidative stress, improve mitochondrial function, and sustain youthful cell function

• Senolytic agents, which boost a key protein in the body that may protect older people against aspects of aging and a range of diseases²

• Telomerase activation, to slow, stop or possibly reverse telomere shortening that happens as you age. Short telomere length is associated with aging-related diseases, including cardiovascular diseases, stroke and dementia ³

• Cell reprogramming; the process of reverting mature, specialized cells into induced pluripotent stem cells, also known as iPS cells. This strategy has the capacity to reverse cellular phenotypes associated with the aging process ⁴

• Stem cell rejuvenation (i.e. stem cell transplant for aging), for improving immune system regulation, strength and mobility, and overall quality of life

The anti-aging industry has huge commercial value, and anti-aging science will inevitably grow in the coming years. The global anti-aging market is predicted to rise from around $191.5 billion currently to $421.4 billion by 2030.⁵ However, this new industry is not without some challenges.⁶ First, there is no consensus among scientists regarding the underlying causes of aging; second, humans are not mice: findings from animals may not be relevant to human beings; third, aging is an extremely complex, multifactorial process, manipulated by a number of factors (e.g., genetic, dietary and pharmacological intervention); fourth, aging is a long process, and long-term clinical trials are extremely costly. Another challenge is the Food and Drug Administration, which adheres to a “one disease, one drug” model of approval, and does not considering aging a disease. This may make it difficult to get a drug approved for anti-aging, or for a new use for an "anti-aging indication".

There are still other concerns that will undoubtedly arise in the near future as the technology advances; specifically, who will pay for this and how costly will these treatments be? How will we value a therapy that can extend life by 15 or 20 years? Will only the wealthiest be able to afford anti-aging therapies, or over time, will these treatments be made accessible to the general public? Also, what will the societal impact be if individuals are living past 100? Could this place an added burden on the health care system, Social Security, and other finite resources? It will be interesting to see what transpires over the next few decades, how these questions and concerns will be addressed, and if aging can really be considered a curable disease.   

References

1. Cellular Rejuvenation Therapy Safely Reverses Signs of Aging in Mice. March 7, 2022. https://www.salk.edu/news-release/cellular-rejuvenation-therapy-safely-reverses-signs-of-aging-in-mice/

2. Senolytic drugs boost key protective protein. Mayo Clinic. March 15, 2022. https://newsnetwork.mayoclinic.org/discussion/senolytic-drugs-boost-key-protective-protein/#:~:text=%E2%80%94%20Mayo%20Clinic%20researchers%20say%20senolytic,in%20mice%20and%20human%20studies

3. Tsoukalas D, Fragkiadaki P, Docea AO, Alegakis AK, Sarandi E, Thanasoula M, Spandidos DA, Tsatsakis A, Razgonova MP, Calina D. Discovery of potent telomerase activators: Unfolding new therapeutic and anti-aging perspectives. Mol Med Rep. 2019 Oct;20(4):3701-3708. doi: 10.3892/mmr.2019.10614.

4. Ocampo, Alejandro, Pradeep Reddy, and Juan Carlos Izpisua Belmonte. "Anti-aging strategies based on cellular reprogramming." Trends in molecular medicine 22.8 (2016): 725-738.

5. Jimenez, Darcy. Billionaires are betting on anti-ageing research, but can ageing really be cured? September 16, 2021. https://www.pharmaceutical-technology.com/analysis/billionaires-anti-ageing-research/

6. De Magalhães, João Pedro, Michael Stevens, and Daniel Thornton. "The business of anti-aging science." Trends in biotechnology 35.11 (2017): 1062-1073.