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The Elixir of Life – In a Poisoned Chalice?
Posted: 07 Jul 2014 11:47 AM PDT Is life extension science an astonishing promise or an astonishing threat? Or both? It was once a myth, now it’s dream; soon it will become an expectation. Suddenly the science of life extension is producing some remarkable results. New papers hint at the possibility of treatments that could radically increase human longevity(1,2,3,4). So much is happening that it’s hard to know where to begin. But I’ll pick just two of the gathering developments. The first concerns a class of enzymes called sirtuins. This month’s Trends in Genetics states that the question of whether these enzymes could increase longevity in mammals “has now been settled decidedly in the affirmative”(5). Last month a new paper in the journal Aging Cell showed how synthetic small molecules (in other words, potential drugs) can stimulate the production of sirtuins in mice(6). This both extends their lifespan and improves their health. These results show, the paper says, that it’s “possible to design a small molecule that can slow aging and delay multiple age-related diseases in mammals, supporting the therapeutic potential … in humans.” The second development I’ve plucked from the tumult of extraordinary new science concerns an external hormone (a pheromone) secreted by nematode worms, called daumone. A new paper reports that when daumone is fed to elderly mice, it reduced the risk of death by 48% across five months(7). “Daumone could be developed as an anti-aging compound.” There are still plenty of missing steps, not least clinical trials and drug development, but there’s a strong sense that we stand at an extraordinary moment. Who would not want this? To cheat the gods and mock the reaper? The benefits are so obvious that one recent article insists political leaders who fail to provide sufficient funding for life extension science should be charged with manslaughter(8). It’s thrilling, dazzling, awe-inspiring. And rather alarming. The most visible champion of life extension science, Aubrey de Grey, contends that “a lot of people alive today are going to live to 1,000 or more”. He lists four common concerns, that he rejects as “unbelievable excuses … for aging”, “ridiculous” and “completely crazy, when you actually remember your sense of proportion.”(9) On the first count – “wouldn’t it be crushingly boring?” – he’s right. Life, if you have a degree of economic choice, is as exciting as we choose to make it. If it becomes too dull, well, you can just stop taking your medicine. The other concerns are not so easily dismissed. “How would we pay the pensions?” is the second question he ridicules. I would rephrase it: “how would the very old support themselves without crushing the young?”. Even today, there are major distributional problems in countries like the UK. Wealthy elderly people, enjoying the compound interest from investments accumulated across decades, preside over a rentier economy that’s devastating to the young and poor, as house prices and rents become unaffordable(10). The inequality and the potential for exploitation that would emerge if people lived twice, not to mention ten times, as long can only be boggled at. This takes us to another concern he dismisses: “dictators would rule forever”. Is this proposition (if not taken literally) ridiculous? They hang on long enough already, with the help of the best healthcare their stolen billions can buy. Match the political power longevity offers with the economic power, and it’s not impossible to see how a thousand-year life could lead to a thousand-year reich. de Grey’s mockery becomes most offensive when invoked by his fourth rhetorical question: “what about starving Africans?”. Yes, what about them? What if, beyond a certain point, longevity becomes a zero-sum game? What if every year of life extension for those who can afford the treatment becomes a year or more of life reduction for those who can’t? Already, on this planet of finite resources, rich and poor are locked into unacknowledged conflict, as hyperconsumption reduces the planet’s capacity to sustain life. Grain is used to produce meat rather than feeding people directly; the safe operating space for humanity is narrowed by greenhouse gases, industrial pollutants, freshwater depletion and soil erosion(11). It’s hard, after a while, to see how this could produce any outcome other than a direct competition for the means of life, which some must win and others must lose. Perhaps the rich must die so that the poor can live. It’s true that the price of possible longevity treatments, which will be astronomical at first, would soon start to plummet. But this is a world in which many can’t afford even antiseptic ointment; a world in which, even in the rich countries, universal access to healthcare is being slowly throttled by a selfish elite; in which a new era of personalised medicine coincides, by unhappy accident, with a new era of crushing inequality. The idea that everyone would soon have access to these therapies looks unfeasible. It’s possible, as an article in Aeon magazine speculates(12), that two classes of people – the treated and the untreated – could pull inexorably apart, the first living ever longer, the second dying even younger than they do today. I don’t know the answers to these questions, and I’m far from being able to propose solutions. It’s all unknown from now on. But I do know that it’s foolish to dismiss them. Life extension science could invoke a sunlit, miraculous world of freedom from fear and long-term thinking. Or a gerontocratic tyranny. If it’s the latter, I hope I don’t live long enough to see it. References: 1. See for example (among thousands of possibilities): Alexey A Moskalev et al, June 2014. Genetics and epigenetics of aging and longevity. Cell Cycle 13:7, 1063–1077. http://dx.doi.org/10.4161/cc.28433 2. Akiko Satoh and Shin-ichiro Imai, 26 June 2014. Systemic regulation of mammalian ageing and longevity by brain sirtuins. Nature Communications, 5, #4211. doi:10.1038/ncomms5211. http://www.nature.com/ncomms/2014/140626/ncomms5211/full/ncomms5211.html 3. Dena B. Dubal et al, May 2014. Life Extension Factor Klotho Enhances Cognition. Cell Reports, Volume 7, Issue 4, p1065–1076. http://dx.doi.org/10.1016/j.celrep.2014.03.076 5. William Giblin, Mary E. Skinner, and David B. Lombard, July 2014. Sirtuins: guardians of mammalian healthspan. Trends in Genetics, Vol. 30, No. 7, pp271-286. doi: 10.1016/j.tig.2014.04.007 6. Evi M. Mercken et al, 16 June 2014. SRT2104 extends survival of male mice on a standard diet and preserves bone and muscle mass. Aging Cell, doi: 10.1111/acel.12220. http://onlinelibrary.wiley.com/doi/10.1111/acel.12220/pdf 7. Jong Hee Park, 6th May 2014. Daumone fed late in life improves survival and reduces hepatic inflammation and fibrosis in mice. Aging Cell, doi: 10.1111/acel.12224 9. http://www.ted.com/talks/aubrey_de_grey_says_we_can_avoid_aging#t-174230 11. See http://www.kateraworth.com/doughnut/ 12. http://aeon.co/magazine/being-human/will-new-drugs-mean-the-rich-live-to-120-and-the-poor-die-at-60/ |