Ending Aging | Aubrey de Grey | Talks at Google

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I can't wait to see what this guy can do. He's a hero, and I don't say that about people.

👍︎︎ 13 👤︎︎ u/TJ11240 📅︎︎ Apr 12 2014 🗫︎ replies

A modern day warrior. A fighter OF and FOR humanity! http://en.wikipedia.org/wiki/Aubrey_de_Grey

👍︎︎ 7 👤︎︎ u/gripmyhand 📅︎︎ Apr 12 2014 🗫︎ replies

Once you get past the speech impediment (which is not hard, it's mild) this guy is extremely well spoken. Not in the emotionally compelling way many TED speakers are, but in a technically excellent and relatable way.

👍︎︎ 6 👤︎︎ u/[deleted] 📅︎︎ Apr 11 2014 🗫︎ replies

Good talk, although nothing really new.

So ... why has there been no research publication from SENS for over a year?

The research blog is just slowly publishing chapters of a report written mid-last year, describing research performed mainly the year before or earlier.

Is there just a research pipeline that is about to burst open? I can't imagine the research is going so poorly as to stall in dozens of different places all at once.

👍︎︎ 2 👤︎︎ u/rumblestiltsken 📅︎︎ Apr 14 2014 🗫︎ replies
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ROBBIE: It is my pleasure today to introduce Aubrey de Grey to Google for the third or fourth time I think. AUBREY: Fifth. ROBBIE : FIfth time that he's talked to Google, but the first time in Cambridge. Dr. de Grey has been for the last decade or so probably the leading proponent of anti-aging reasearch. Originally a computer scientist, he developed an interest in biology and combatting aging in the 1990s and went on to create the SENS Foundation which has the ambitious goal of defeating biological aging, or at least, radically extending healthy human life. So I think we have a sort of very interesting talk ahead of us. And I would like you to join me in welcoming Dr. de Grey. [APPLAUSE] AUBREY: All right, yes, thanks for coming. Yes, actually while Robbie was talking I realized I think this was the sixth one actually that I gave. I gave I think four in Mountain View. If there any people in Mountain View listening who were at the talk I gave last year, this talk will be slightly different. I constantly try to improve the presentation. And, of course, there are two ways in which that can happen. One is to talk about new data-- things that we have achieved over the recent times. And also, of course, to improve the persuasiveness of the argument that aging really is humanity's worst problem and something that is completely scandalous that so few people actually try to solve. So the title of my talk deserves a little bit of explanation. First of all, the word "rejuvenation," that is carefully chosen. I use that word very advisedly because I really mean that we are talking about reversing aging. In other words, turning back the biological clock, making people biologically younger both mentally and physically than they were before the intervention was begun. And as you'll see over the next 10 or 20 minutes, the first, let's say, half of my talk, I shall be explaining why this constitutes a kind of happy medium between two essentially impractical and implausible extremes that have been the major source of all the pessimism that surrounds the feasibility of doing anything about aging with medicine. So first of all, the nature of the problem. This is just a randomly chosen statistic. I've used American data here. And this is simply the proportion of the US population over the age of 65. The x-axis goes from 1950 through to a projection out to 2050. And in case you can't see the screen properly, the proportion in question goes up from 8% up to 22%. So it's pretty dramatic. And the first thing I want to make sure that you don't forget is that this is a cause for celebration. Ultimately the fact is that this is a result of the fact that we are no longer seeing all that many people dying prematurely in infancy, or in childbirth, or whatever. And that's wonderful. But we all know the downside. We all know that pension plans are creaking and in danger of collapsing and all matter of other difficulties are occurring as a result of this change. The thing, of course, that I want to focus on is the fact that it's not the result of the statistics shown here-- the proportion of the population over 65. Rather, it's a result of the fact that people over 65 tend to not be very well, and especially over the age of 75 or 85. And that is what I'm out to change. Ultimately this is a little bit of a paradox if you think about it. 200 years ago the life expectancy was very low. People used to die of other stuff. And mostly they died of communicable diseases-- tuberculosis and diphtheria. And we have become very good, at least in the developed world, actually to be honest quite good in the developing world, at stopping that from happening. Not just through medicine like vaccines antibiotics, but just through realizing that hygiene is a good idea and mosquito nets work. So you might think, well hang on, why haven't the diseases of old age been similarly susceptible to elimination or at least very great reduction from similar measures? And that's where I want to spend an amount of time. And I'm going to start by simply giving a definition. As computer scientists, you all know that precise definitions are rather important in getting anything done technologically. And medicine is no different. And this will do as a pretty good hardcore definition of aging. There are loads of definitions of aging out there. So it's quite important to actually fix on one for the purposes of discussion. This one is first of all mechanistic. It actually says what aging is in terms of cause and effect. But also in other ways it's good at orienting our thoughts around what might be necessary in order to do something about aging. So what I'm saying here is in a very simple nutshell-- aging is a side effect of being alive in the first place. It is very, very similar, in essence it's really no different in the human body than it is in a simple man-made machine like a car or whatever. Ultimately any machine with moving parts is going, a simple side effect of the laws of physics, forgot biology, to do damage to itself as a consequence of its normal operation. And that damage is going to accumulate progressively until eventually it exceeds the tolerance that the body, the machine, is set up to manage. And once that happens, the machine starts to work less well and eventually not work at all. So it's just the same in the human body as it is in a man-made machine. There is, of course, a big, big difference between the human body and a typical inorganic machine which is that the human body and indeed other living organisms have a fabulous array of built-in damage repair machinery-- machinery that eliminates damage as fast as it is created. But you got to remember what that means. It doesn't mean that we can't think of the body as a machine. What it means is that our job in extending the healthy longevity of the machine, in the case of the human body, is easier than it otherwise would be because we've got all this help from the machinery that the body has already has installed. The reason it's harder in aggregate is, of course, that the human body is vastly, vastly more complicated than a simple man-made machine or even the most complicated man-made machine. And, of course, also, we have the misfortune of not having the plans. So it's a bit tricky figuring out what to do. But it still means that we ought to be able to use the same kind of approaches against aging of the human body as we do against aging of a simple machine. Now the thing is that this is not very well understood. And there's a particular way in which it's very poorly understood by society that has had an enormous impact on the extent to which we have taken seriously the idea of doing anything about aging medically. Ultimately the misunderstanding, the misconception that exists, is that an arbitrary division is made between whatever aging itself might be defined to be as against the diseases and disabilities of old age-- the diseases in particular. Things like cancer and Alzheimer's and cardiovascular disease. These diseases of old age are, of course, enormously widespread and staggeringly costly now that we don't have much in the way of diseases of early life. But they are not like infectious diseases. First of all, they are universal. You will get Alzheimer's unless you die of something else first. You just will. And secondly, they are not medically curable in the strict sense. What I mean by that is simply that we cannot, even in principle, invent a therapy that can be applied once to the body and eliminate a disease like Alzheimer's from the body such that the person won't get it again unless they are reinfected in some way. We can't do that because aging is a side effect of being alive in the first place. And the diseases of old age are caused by aging. So you can't cure it in that way without curing being alive in the first place which would rather defeated the object really. So that makes it difficult. But it does not make it impossible to apply medicine to the disease of old age. They are still medical problems. And they are medically preventable in principle. We just have to start from a different point-- a different conceptual starting point. Putting it in another way, it's like this. This is the conventional way that we partition, that we classify, the various sources of ill health that humanity is susceptible to. We have communicable diseases. We have congenital diseases that occasionally people are born with because of mistakes in their DNA. And we have the diseases of old age-- the intrinsic, chronic, progressive things that predominantly affect people who were born a long time ago. And then completely separate from all these three, we think of this over here-- this miscellaneous, kind of diffuse, nonspecific phenomena like sarcopenia. That means lots of muscle mass. Or immunosenescence, the decline in function of the immune system, which we think of as part of aging itself. That is the way that most people think of ill health. But it's completely wrong. The correct way to think about it is to put that big black line there instead. That actually these are diseases in the sense that they can actually be cured, whether by a vaccine or whatever, or by some kind of gene therapy maybe. And these ones over here are parts of aging. The only difference between the third column and the fourth column is that these things over here are things that we've taken the trouble to give names to. That really is all it is. It's terminological, semantic. It's not a biological difference at all. And once we understand that, that the diseases of old age are part and parcel of aging, we have a chance of getting somewhere with both of them. This is the tragedy of not getting to grips with that concept. At the moment, if we start with my definition of aging down here, that metabolism in other words, being alive in the first place, the normal operation of the human body throughout life causes a variety of different molecular and cellular changes to occur in the body that eventually once they get a abundant enough, contribute to the ill health of old age. That definition leads to a variety of different potential approaches to postponing the ill health of old age. And pretty much everything we have in the clinic today consists of this up here-- geriatric medicine. That is a real tragedy because the whole idea underpinning geriatric medicine, in other words, the attacking the pathologies of old age, is to ignore everything that I just told you in the past few minutes. It is to pretend that the disease of old age can be cured just like an infection-- to bash away at the symptoms and hope for the best. And it's never going to work because the precursors of these pathologies, this damage done here, is obviously still continuing to accumulate while the person is still alive. And therefore the pressure against these therapies-- the pressure to make pathology happen anyway is increasing-- and the therapies are inevitably, inevitably going to get less and less effective as someone gets older and older. So of course geriatric medicine is better than nothing. I'm not saying it isn't . But it's only a little bit better than nothing, and it only ever will be a little bit better than nothing. Now, I'm not the first person to realize that by any means. For the best part of a century some people have been pointing this out and saying well, prevention is better than cure. Maybe we should try to intervene at an earlier stage in the chain of events because this definition of aging is perfectly uncontroversial. You know? I may be saying it in a slightly different way, but ultimately, this is what people-- people wouldn't have argued with that definition of aging even a century ago. So as people have said well, let's go in to up here. Let's call the problem the problem of metabolism. Let's try to clean up the way the body works and thereby slow down the rate at which it creates damage. It sounds like a fine idea. It would postpone the age at which the damage reaches this pathogenic threshold. And that unfortunately has not succeeded. No real medicine has emerged that substantially postpones the disease of old age by slowing down the accumulation of damage. Why not? There's a very simple reason. It's called complexity. Just as the pathologies of old age are rather complex. You don't have to read this slide. This is just a small subset of the things that go wrong with you late in life. Similarly, unfortunately, metabolism is also a rather complicated. This is a simplified diagram of a small subset of what we know about how the body works. And as you can tell, it's a bit of a mess really. And any software engineer can easily understand that this is like spaghetti code with no comments. There's no way that you're going to be able to go in and tweak this thing to make it not do the thing you don't want it to do, namely create damage in this case, without having side effects that do more harm than good. It's just not going to happen. The gerontology approach, as I am calling it, is not doomed in principle the way the geriatric approach is. But we would need to understand this massively complex network of processes almost infinitely-- astronomically better than we actually do today-- in order to have a prayer of implementing what I'm calling the gerontology approach. Of course I'm actually understating the problem. The problem is not really that this is a simplified diagram of a small subset of what we know about how the body works. The problem is that this is a simplified diagram of a small subset of what we know about how the body works which is completely dwarfed by the completely astronomical amount that we don't know about how the body works, even ignoring all the stuff that we don't even know that we don't know. So you know waste of time. Not going to happen any time soon. So that is in a nutshell why the world has become, when I say "the world" here I am not talking of course about people who have thought about biology and aging, has become so fatalistic and pessimistic about applying medicine to this problem. But luckily that's not the end of the story. Let me come back to cars for a minute. This, of course, is a success story. This car here is perhaps 100 years old. And it was definitely not designed to last 100 years. It was probably designed to last 10 or 20. So we must ask ourselves how has it succeeded in lasting so long. And we all know the answer. The answer is that it's been very, very, very well maintained. If you maintain your car only as well as the law requires, then sure enough it lasts only about as long as its manufacturer is expected to wait until they could sell you a new one. But this car, somehow or other its owners fell in love with it, and they did an unusually and necessarily comprehensive amount of maintenance on it, and that was the trick. Maintenance really works if it's comprehensive enough. And we don't have any 200-year-old cars. But the only reason for that is because cars had not been invented 200 years ago. We certainly will have 200-year-old cars. So if we come back and ask what that analogy means for the problem at hand, the human body. It mean this. It means that rather than trying to go in and slow down or eliminate this process whereby metabolism creates damage or go in and interfere with this process where damage creates pathology. Instead we just uncouple those processes from each other. We dive in and separate them by periodically repairing the damage that's been created already by the way the body works, and thereby, even though it's continuing to be created, preventing it from reaching this pathogenic threshold-- very simple idea. It's an idea whose proof of concept is all around us in well-maintained machines. It's the way that we're actually going to defeat aging. So what does that mean in practice. Of course you or I, anyway, certainly can't go out and keep a car going for 100 years because we don't have the expertise. So what I need to do is summarize now for you, and I realize, of course, that most of you will not very much biology. So I won't go into too much detail. What I need to summarized now for you is what it means in practice to actually do the maintenance approach. And the big first step in addressing a really complex problem like this is often, I am sure you agree, to break it down into sub-problems, preferably a manageable number of sub-problems. So that was the first step that I took back nearly 15 years ago now. These are the seven sub-problems-- seven types of damage-- changes in the body at the cellular or molecular level which continue throughout life as side effects of being alive-- side effects of the body's normal operation. And which eventually accumulate to a point where they contribute to one or another or more of the diseases and disabilities of old age. And as you can see, these are very clearly down to earth, concrete, biological phenomena. They are very broad categories, and that's a good thing because it means we don't need so many of them. But the point is that they are clearly defined and within each category-- this is the reason why this particular classification is useful-- within each category there is a generic therapy, a type of approach to implementing the maintenance concept that can be applied to every example within the category, not necessarily identically. Certain minor changes might be required. And we'll come to those things later on. But basically, there's one generic therapy, which means that this classification is useful. So lets go through it briefly. Cell loss-- what does that mean? It just means cells dying and not being automatically replaced by the division of other cells. Simple enough-- cells die, they are not replaced, the number of cells goes down, eventually the organ of which the cells were a part is going to not have enough cells to do its job. So you can understand that that would be a part of aging. You can have too many cells. It turns out that there are two very different ways in which you could have too many cells. And the reason they are different for my purposes is precisely because the way in which we would go about addressing the problem is different in the two cases. The first one is having too many cells because they are dividing when they're not supposed to, in other words, cancer. And the other one is having too many cells because they are not dying when they are supposed to. That's something that a lot of people ignore. But it's quite important, it turns out, in certain parts of aging. Possibly the most conspicuous is the immune system in which cell death and the-- and cell death is really important as a way of making room for rapid cell division later on. So those are the three that are related to the number of cells. Down here we've got things that the molecular level. Two of them inside cells and two of them outside. The ones that are inside-- the first one is mitochondrial mutation. So I guess most of you know what mitochondria are, but just to recap. They are the part of the cell that does the chemistry of breathing-- the combining of oxygen with nutrients to extract energy from the nutrients that is then used by the rest of the body. And unlike any other part of the cell, mitochondria have their own DNA-- a very small amount-- only encodes 13 proteins, but still very essential. And it just turns out that mitochondrial DNA accumulates mutations far far faster than the nuclear DNA. So that's really important. The second one is garbage-- waste products-- just waste products-- things that the cell makes as a side effect of was it's normally doing, but which for whatever reason, the cell does not have the machinery either to break down or to excrete. And so, of course, it accumulates. And just as your kitchen works every bit as well after a week's worth of garbage has accumulated in the garbage can as it did the moment you took the garbage out. Similarly, the cell works just as well with a manageable amount of garbage. But just as your kitchen doesn't work so well if you don't take the garbage out for a month, the cell doesn't work so well in old age because it's got too much of this stuff. The other two are things that's happen outside the cell in the spaces between cells and they're also really important. First one is, again, waste products. There's a question over there which I will take in a moment. Extracellular junk-- this is stuff like the amyloid that form plaques in Alzheimer's disease. And this is important in the same kind of way that molecular garbage inside the cell is important. But again I list it separately because the way we're going to address it is different than for the stuff inside. And finally then, molecular changes that are not garbage but rather changes of structure that cause loss of elasticity of the lattice of proteins that gives our tissue it's-- gives our tissues their shape and their stretchiness which is important in things like the major arteries. So the question was? AUDIENCE: You mentioned that-- AUBREY: I am sorry shout please. AUDIENCE: You mentioned the mutation rate in nuclear DNA is much lower than mitochondrial, and that makes sense. But there is still mutational damage to nuclear DNA. That eventually is going to be a problem, right? AUBREY: Right, so great question. I'll repeat it because it may not have been heard. So the question is OK, hang on, we've got mitochondrial mutations here. Even if nuclear mutations accumulate much more slowly than mitochondria, it's still non-zero rate, surely we're going to have to fix it. And I agree. We are going to have to fix it. The question really is are we going to have to fix it in anything like a currently normal lifetime. And it turns out that it looks as though we probably aren't going to have to except in one indirect way. So without going into too many details the essential answer is that there's one particular problem that mutations in the nucleus can cause that is so much more serious so much more quickly than any other that is the thing that has driven evolution to make the quality of our DNA repair machinery and made the machinery as good as it is. And that thing is cancer which is in my list in a different place that doesn't talk about DNA. So that's basically the answer to your question. We believe, or I believe anyway, that the effect of mutations which do not affect the cell cycle, do not actually cause cancer, is non-zero, but it is so rare as to be non-pathogenic until we have lived very much longer than we have any danger of living so far. All right so to go on. So these are the damage types. This is a great start, but of course, we need to know more. First of all, we need to know a little bit about how this type of damage translates into pathology. And here I want to stop for a moment and emphasize perhaps a philosophical point, a conceptual point, but a really, really important one that underpins the whole logic of what I'm saying here. We would like to know as much as we can about how metabolism creates these various types of damage. And we would like to know as much as we can about how these types of damage cause the various pathologies and diseases of old age. But we don't need to know all that much about those things. Really it's just a case of reassurance to know these things because at the end of the day given that metabolism causes damage and damage causes pathology, if we can actually implement the maintenance approach properly-- repair the damage-- in other words restore the molecular and cellular structure of the body to how it was at a younger age within a good approximation, then we have solved our problem. We do not need to know how it got that way, or how it's going to get worse. We just need to-- we can just rely on the fact that since the human body is a machine, its function is determined by its structure. So if we can restore the structure, we will restore the function, including the remaining longevity. This kind of side stepping of our ignorance is absolutely fundamental to why this whole approach feasible in the foreseeable future. One thing, however, that it is important to try to get a grip on is a reason why we can be reasonably confident that this classification is exhaustive-- that it really does cover everything. We haven't got number eight and nine hiding out there to be found. Now, I can make a biological argument for that. You can start by saying well OK, damage can only accumulate throughout life in structures that persist throughout life-- long-lived structures. If a cell, or indeed a molecule, is created and maybe gets damaged and then it's destroyed, then the damage is gone along with the molecule or the cell. So that's not accumulating. So we can say OK, what is long lived in the body? DNA-- certain types of protein that don't get destroyed-- cells that don't divide-- and so on. And that kind of-- kind of give you this list that way. But actually there's a quite persuasive circumstantial argument as well, a very simple circumstantial argument that says this list is probably complete. Here it is. It's been the same list for more than 30 years. All of these things have been major topics of study and discussion in gerontology since at least the 1980s and in many cases a lot longer. And you kind of would have expected that the list would have got longer by now. We've come a long way in biology in that time. Now one argument that might be considered a rebuttal of this is that well hang on, maybe people weren't looking for a classification. And that's kind of true, they weren't. But that argument is going away as well because the fact is I've been challenging people to extend this list for more than a decade now and I seem to be getting away with it. This seems-- this really does seem to be standing the test of time. So that's quite encouraging. And it gets progressively more encouraging as time goes on. All right, so now I do a little bit just to concentrate mind, so to speak, with how this translates into the initiation and progression of the various major diseases and disabilities of old age. This is something that-- especially people when I am talking to donors-- they really care about this. Someone's decided that they are predisposed to getting Parkinson's at an early age. You know who I am talking about. Someone may have found that their mother's got cancer or whatever. So they'll have specific things that they care about. They'll give eight-digit sums to the charity that is working on Parkinson's disease which they hadn't done the year before because they only were triggered to do so when they realize that they personally had a problem. This is a personal thing. I think that's a shame. I think it would be much better if the bulk of humanity cared more about each other. But I work with this. So let's look at those pathologies, the linkage between the damage and the pathology. Sometimes it's really simple. It's a one-to-one relationship here. Division obsessed cells-- cells that are dividing when they are not supposed to. That's basically the definition of cancer. Usually though, it's a lot more complicated. So there are a lot of things that can go wrong with the hear during old age. Atherosclerosis, the number one cause of death in the Western world-- the cause of heart attack-- the cause of strokes. That's this down here. It starts out with cells in the artery wall being poisoned by stuff that gets inside them that they can't process. And I'll talk more about that later because it happens to be something that we've had some good success on recently. Arteriosclerosis, stiffening of the arteries, which causes hypertension and of course, all the knock on effects like in kidney failure. That's this bottom one down here-- molecular bonds being formed between the proteins that make up the artery wall and that give it its elasticity. And those bonds just stiffen it, they make it less elastic, and that's what causes high blood pressure. Molecular garbage outside the cell-- there's something called senile cardiac amyloidosis which is now known to be the number one killer of people who get over the age of about 105. It seems to be the number one. It took a long time to figure that out simply because not many people that old have autopsies done on them. But now we've got enough data, it's pretty clear that that's the case. And then finally, there's cells in the heart called pacemaker cells which are responsible for actually responding to signals from the brain and causing the heart to actually beat. And those cells die, and they're not naturally replaced over time, not adequately anyway, so eventually we haven't got very many in the heart. And even though nothing else may be wrong with it, the heart just stops listening to the brain and it can't be bothered to beat anymore and you die. So that's this one up here. So heart disease is complicated. Alzheimer's is another really complicated one. This is a disease that was defined more than a century ago as the combination of these two things down here-- molecular garbage inside neurons called tangles-- molecular junk outside neurons called plaques. We now know that the sharp end of Alzheimer's is cell loss. Neurons dying initially in certain parts of the brain like the hippocampus-- and then more broadly-- and causing loss of cognitive function. So again we've got to fix all of these things in order to really get a cure for Alzheimer's. Frailty-- let me call just like non-specific decrepitude. This is pretty much everything. Maybe cancer doesn't come into that. But pretty much all the rest you can point to certain aspects of frailty that are driven by each of these types of damage. So you see the linkage is very clear. It's inextricable the linkage between damage and pathology-- the relationship between aging itself, whatever you mean by that, and the diseases of old age. And if society could just get that into its thick head, then there would be a very great deal more money spent on doing something about aging. And we wouldn't be making such slow progress. All right, let's get on to the solutions. We've only talked about the problem so far. So the maintenance approach breaks down itself into a variety of different strategies. They all begin with r-- replacement, removal, repair, and reinforcement. And that-- well they say it that way, but to be more specific, they work like this. So you all have heard of stem cell therapy, of course. Stem cell therapy is the maintenance approach to address this problem-- cell loss. That's what it's all about. We put cells into the body that can divide and differentiate to replace cells that the body is not replacing on its own when they die. And of course, stem cell therapy by and large has been developed to do things, to treat problems that are not related to aging, things like spinal cord trauma. But the fact is it is just as applicable to certain of the pathologies of old age. And it now increasingly in clinical trials being actually applied to such problems. Perhaps the most conspicuous and best example is, well, the simplest anyway, is Parkinson's disease, which has historically been treated in rather primitive ways by injecting compounds such as precursors of dopamine-- the chemical whose shortfall is the main driver of Parkinson's disease. But the holy grail of treatment for Parkinson's disease without the faintest doubt is the introduction of stem cells into the relevant part of the brain, to substantia nigra which will divide and differentiate into the type of neuron that makes dopamine. And we are now getting there. This was first tried about 15 years ago. And it was sometimes successful. Sometimes patients got better. Sometimes they didn't. When it did work, it worked spectacularly. There are people out there now who have not had any symptoms of Parkinson's disease for well over a decade. And despite having been treated once with stem cells and not had any other treatment since. That's how well it works when it works. But because it usually didn't work, there was an enormous amount of pessimism in the field. And it was pretty much given up on for a long time. Now if you think about that, you have to ask well, OK, was that actually the right decision or was it driven by short-termist, political, or other motivations? Ultimately, if you think about it, it's so obvious why it didn't work. I mean this was already known-- namely that they were just not quite good enough at getting the stem cells into the right states, the right type of stem cell, that it was a shame that they gave up. But they did give up. They were just not making dopaminergic neurons sometimes. And now that has finally-- the circle has finally closed, and clinical trials are now being pursued with great vigor. And I think that we're in a very, very strong position to have a proper cure for Parkinson's disease within 10 years. That's a strong statement I know. But I really think it's true because we're now good enough at getting stem cells into a state that is a dopaminergic precursor, as it's called, and thereby restoring dopaminergic capacity to the substantia nigra by stem cell therapy. So in one talk I don't have time to go through all of these in detail. If you go back into the Google Tech Talk archive, you'll find talks from me back in 2005, 2006 on three or four of these things just dedicated to each one of them. So that's where you want the detail from back then. If you want more detail, obviously go to our website or read the book that I gather we have plenty of copies of outside at the back which we'll give away later. But I'm going to just highlight a couple of these later on. First of all though, I want to emphasize what this means in terms of the sociology and the politics of medicine and medical research. At the moment, as I have probably already said a bit too often, the problem is that we are simply not addressing aging as the precursor of age-related disease in the way we should be. We have to reorganize medical research in recognition of the fact that there is no difference between treating aging and preventing age-related disease. Preventative medicine for the diseases of old age is the treatment aging-- it just is. Now this is beginning to change. For the longest time, I was basically the only person saying this and maybe I just wasn't saying it well enough. I don't know. But now I'm by no means the only one. There are mainstream people, especially influential people at the National Institutes of Health, who are beginning to get this message out. However, I'm not exactly holding my breath. The fact is it's the government. It doesn't tend to move very fast. There's an enormous amount of vested interest in the status quo in keeping things how they are. So I honestly don't know whether this is really going anywhere. I think that the progress that needs to occur is going to rely predominantly on people with independent means for quite a long time to come. We shall see. However, in the end what we're going to have is medicine that actually works against the disease and disabilities of old age. And they are going to be the medicines that dominate medical practice in the future. Medical practice is going to be all about what I'm calling here "preventative geriatrics" because ultimately that is the major threat that people in the developed world anyway, and increasingly in the developing world, face in terms of their health. And in the long term, it's very simple. Just as today nobody gets tuberculosis, nobody gets polio, it's going to be like this. Nobody will get Alzheimer's or heart attacks, or macular degeneration or all these other things. And there will be dramatic consequences for health. If we're not getting those, and we're also not getting tuberculosis and so on, then we're going to stay the way the people in this room are today however long we live. And that is a very, very different world. Now, I'll talk about life span a bit later on. But I want to emphasize that what we work on is not life span. We don't work on longevity. We work on health. Longevity is a side effect. It's a consequence of keeping people healthy. Now, in terms of credibility, I think it's important to emphasize that it's not just me saying this. I'm still, as Robbie mentioned at the beginning, probably the primary and most prominent, and most vocal advocate of all of this. But that's just because I've been doing it for a long time. There's quite a lot of people out there who have come very enthusiastically around to the point of view that I'm putting out to you today. This is just by way of illustration a research advisory board. There are 25 people here who are extreme luminaries, world leaders in their various research fields. Any of you know a bit of biology will probably have heard of some of these people. Here's George Church whom I actually had coffee with this morning. He's one of the pioneers of next-generation sequencing among other things. He's a really, really important guy. Let's see, this is Bill Haseltine who invented the term "regenerative medicine." This is Mike West who started Geron and then advanced cell technology. He is a really important guy. This is Maria Blasco who runs the Spanish equivalent of the NIH. Tanya Tyler who runs the world's biggest regenerative medicine institute. You know, these are quite important people. And they have signed up very, very unambiguously to a hard-hitting statement of endorsement of the approach that I've been describing to you today. So you might ask, well hang on, what role does a nonprofit have? If this is getting so credible, then surely it must be getting attention from the private sector. People must realize that there's a fair amount of money to be made in this area. And those of you who listen to the news probably know that this is indeed true. There is actually an increasing interest from the private sector in a very big way. Six or eight months ago Larry Page, in particular, and Google in general, announced that there was going to be a new company called Calico working on the problem of aging as a medical problem. And they hired one of the most successful biotech leaders of our time, Art Levinson, who ran Genentech for a long time, to run it. Now Art Levinson has the enormous advantage that he is not a card-carrying, lifelong gerontologist, so he is not in danger of being encumbered by conventional wisdom. He also has the enormous advantage of being extremely smart and a careful thinker, and he has the third extraordinary advantage of having a humongous budget courtesy of Google. So he is in a position to make an enormous difference. And I have very high hopes he will do so. Much more recently, just two weeks ago, the person who sequenced the human genome, Craig Venter, together with the person who founded the X Prize and Singularity University, Peter Diamandis, got together and announced a new company named Human Longevity Inc., which is working on the same problem in a rather narrow way, focusing on genome sequencing which is no surprise given Venter's involvement. But again, this shows that the credibility issue is beginning to go away, and it's about time too. However, the fact is that human longevity is working on low-hanging fruit and does not, honestly, claim to be working on the problem in a comprehensive manner. I'm hoping first for sure that Calico will be working on this problem in a comprehensive manner. But while their precise plans remain somewhat opaque, I'm not relying on it. Ultimately, I believe that for quite a while to come we're going to need a nonprofit participation in this that is essentially the guardian of the things that other people might be in danger of neglecting. And that's what SENS Research Foundation is. We don't work much on this top line-- on stem cell therapy. And the reason we don't is precisely what I just said. There's a lot of people out there doing exactly that already. And our money, our very limited budget of something in the region of $4 million or so dollars per year, is better spent making more of a difference elsewhere. All of these things down here are correspondingly much more neglected, especially the ones with two exclamation marks. Pretty much nobody else is working on them, and that is a tragedy. But it does mean that someone, namely us, needs to be around to do it. I am going to talk about this one for a little longer just to give you a proper feel for what we do. And make sure you understand that we aren't just talk, we actually get lab work done. This is the beginning of atherosclerosis when a white blood cell, a macrophage, in the artery wall becomes poisoned by contaminants, oxidized cholesterol to be precise, contaminants of the material that it is processing. It becomes this thing called a foam cell, a kind of undead, inflammatory thing. And it gets full of lipids as you can see. And this is something that progresses. These cells don't go away. More and more of them pile into the plaque and eventually the plaque gets big enough to burst. And that's when you get a heart attack and a stroke, and we don't want that. So what have we got now to do anything about that? What we've got is surgery-- stents and such like. That as you probably know doesn't really work very well and plus surgery is really invasive. Also we've got statins. Statins are preventative. It sounds good, doesn't it? But they are too preventative. They are an example of the, what I would call a moment ago, the gerontology approach. They attack the problem by attacking the aspects of our desirable metabolism that cause the problem. In other words, in this case they reduce the rate at which we synthesize cholesterol. Now cholesterol itself is an absolutely vital molecule. And it's only oxidized cholesterol that's bad for you. So that means that if we diminished oxidized cholesterol by diminishing cholesterol, we have a very serious therapeutic index problem. But there's only so far we can go before we start to do more harm than good. That's why statins ultimately are not the solution. What we're doing at SENS Research Foundation is attacking the oxidized cholesterol directly. In particular we're attacking a particular type of oxidized cholesterol, 7-Ketocholesterol, which has been well established by other people to be public enemy number one here-- the most toxic and the most abundant. First thing we did we found bacteria that were able to break it down. You do something called an enrichment culture. You take a bunch of different bacteria. You give them this stuff to eat. You don't give them anything else. The ones that can't eat it just sit there like lemons. The ones that can, grow. And of course, the stuff goes away. And that's very straightforward. Then rather than proposing to inject lots of bacteria into the body to eat the stuff, which would probably have side effects, we instead figure out the genetics. We figure out how they do this. We do mass spectrometry which is a way of identifying the breakdown products and inferring the enzymatic activity. We could also do expression analysis to figure out which genes are being activated by the thing that this thing is breaking down. And the result is quite some time ago back in 2008-- no 2009 maybe 2010-- we had got our hands on some genes and enzymes which were able to break down 7-Ketocholesterol. Then we started on the hard part which was to get those genes working in human cells. That's tough because bacteria are very different from human cells in lots of different ways. But we finally did it. And first of all, we had to make sure that our engineered gene-- engineered protein-- went to the right part of the cell. This just shows that we can do that. You have to go to the lysosome which is sustained by red. This is our engineered protein. This is overlap. But then we had to actually make it work. And this basically is what shows that we succeeded. If you have an absolutely supportable amount of 7-Ketocholesterol in the medium of cells that are trying to grow, then they die, whatever happens, but if you have a more modest amount than the fact that this bar on the right is always taller than the ones before it is an illustration that the engineered gene is protective. It's protective because it creates an enzyme that breaks down 7-Ketocholesterol and the enzyme is targeted to the right part of the cell. These various negative controls, either they don't have an enzyme, or they have the wrong enzyme, or the enzyme is not targeted to the lysosome. So this was a pretty impressive result. It's only about a year-and-a-half old. And we're now working to extend that to make it work in the cells that really necessary-- not macrophages. And then of course we'll move to mass models. AUDIENCE: Sorry just wanted to know which of those bars is control, ie, no change, it's the same. AUBREY: OK, so the sets of bars here. Right? So each of these sets is a different concentration of the toxin so-- AUDIENCE: I got that. And the one on the far right is with your enzyme. AUBREY: That's right. AUDIENCE: So what's the one that has nothing cutting the cells off? AUBREY: That's the black one. AUDIENCE: OK, thanks. AUBREY: Right, so let's go on to longevity for a minute. So the first question is how much extra life do we expect to get? And the first thing I want to mention of course is to reemphasize the fact that this will all be healthy life. We will be keeping alive only by keeping people healthy. That's really just an extension of what we have seen historically over the past, let's say, 50 years. The reason why life expectancy is now maybe 10 or 12 years greater than it was in the 1960s is because people aged, let's say, 70, are about as healthy as people work in the 1960s who were aged only 58. That is a really important thing to understand. But it's not the whole story. So the therapies that I've been outlining to you today I think have a good chance of getting about 30 years onto our life. They will add 30 years. And because they are rejuvenation therapies that repair damage. What that means is that we'll be taking people who already, let's say 60, and fixing them up well enough that they won't be biologically 60 again, either mentally or physically, until they are chronologically 90. So that's the key thing that we're doing. Not just slowing aging down, but reversing it. Now you may ask, well OK, why only 90? Why doesn't this work indefinitely? And the answer is because these therapies won't be perfect. They are pretty good. I think they're going to work on most of the types of damage that we've got. Certainly, they're going to work on most of the examples within each of the categories of damage. But they are still going to be stuff that is a little bit harder. They won't be perfect. So then what? Well the thing is that 30 years is a hell of a long time in technology, including medical technology. And essentially we've bought that time. So bearing in mind what I told you earlier about the very high likelihood that these categories are indeed an exhaustive classification, notwithstanding what the first question I mentioned about the possibility that in a very distant future we may have to worry about other effects of nuclear mutations. We're talking about a seriously interesting situation. We're talking about the possibility that by the time these people who are rejuvenated come back as 90-year-olds who are biologically 60, we will have improved these therapies enough, still not perfectly, but enough that we can re-rejuvenate them even though the problems of rejuvenation is a bit harder than it used to be so that they won't be biologically 60 for a third time until they are 150. And I don't know whether by the age of 500 we're going to be able to figure out how to solve the problem of nuclear mutations that don't lead to cancer well enough as well. But I certainly think it's quite likely. So we're talking about the possibility of kicking the ball up the road faster than time is passing pretty much as for as long as we like. That's what I've called longevity escape velocity-- the minimum rate at which we need to improve the comprehensiveness of the therapies in order to stay one step ahead of the problem. And I think we've got a very good chance of maintaining longevity escape velocity once we get that first generation set of therapies that give 30 years. That's quite an important thing to understand. So we're talking about very long longevity-- people just don't tend to die when they are healthy. So that's quite nice to know. The next question, therefore, which you're probably all thinking about now, is well how soon are these therapies, these first generation therapies, likely to arrive. And I want to answer that in two ways. First of all, I want to tell you a direct answer, and then I want to tell you the answer that matters. The direct answer is of course we don't know. Like any other pioneering technology, the time frame is extremely speculative. But I would say, going out on a limb, that we have a 50/50 chance of getting there within 20 or 25 years just so long as within the next 5 or 10 years the rate of progress is not seriously slowed down by lack of funding. I would say it is currently being slowed down by at least a factor of three. So we're in a bad way-- we're losing a lot of lives-- but the fact is that's a reasonable time frame. I think there's at least a 10% chance that it will take 100 years if we hit problems that we haven't thought of yet. But still you know a 50% chance is quite enough to be worth fighting for. So that's what I'm going for. But here's the answer that you need to be thinking about is this down here. Eventually, at some point before then, we're going to have sufficiently dramatic and impressive progress in the lab, typically with mice, to convince people that it's only a matter of time before we get this sort of thing happening. And that is when the shit is really going to hit the fan. It's going to be complete pandemonium. And you'd better be ready. I think the sooner that happens the better. And I believe that one thing I'm achieving by giving so much publicity to this research is softening the world up-- getting people to understand the feasibility and indeed the desirability of doing something serious about aging in the clinic and thereby diminishing how dramatic the progress in the lab needs to be to achieve this tipping point of public opinion. That's what I want to try and achieve. So I am just going to close in the last minute or two by highlighting the sociological implications-- the social context. I spend my entire life answering questions like this. Oh, dear where we put all the people? Won't it be only for the rich? Won't dictators live forever? Won't we just get bored? Wouldn't it be so boring not having Alzheimer's and being able to remember everything you did? And how will we pay the pensions? Now look, why do we pay people? Why do we pay people quite a lot of money to do nothing from the age of 65? Any ideas? I'll tell you why. It's because we're very sorry for them. And the reason we're very sorry for them is because there are about to get sick and die. And I'd prefer that not to be the case. You know it will be a whole new social contract, yes, but the fact is, it's the only reason. So these are not very good reasons, and I'm not even going to bother going any further with saying, why not? This is what we ought to be thinking about when we come to the sociological considerations. Not having ill health in old age is quite important. You know it was a massive, massive shock to me when I discovered in the age of about 30 that most people, certainly even most biologists, don't really regard aging as a particularly interesting or particularly important problem. And the reason it was a shock was because I had never considered that anyone could think any differently. It's like you don't consider the color of the sky. I mean it's so completely clear that ill health is the number one source of suffering in the world and that aging is the number one source of ill health. So obviously it's the world's biggest problem. Dear me. When it comes to the economics, obviously you have to consider the fact that the elderly will be able to contribute wealth to society rather than just consuming wealth. And that they won't get bored because they'll have the energy and vitality to explore novelty the way you and I do. And they can take-- they can retire temporarily for 20 years. And then go back and retrain and be a rock for the next 40 years. And above all, the thing that the elderly get the most scared of is that they will become a burden on their kids, on the people that they used to support. And they are really scared of that-- it's not going to happen anymore. So that's what we need to be thinking about. This is the book I mentioned. It was written in 2007 so you might think it might be a bit out of date. It isn't really out of date yet. And the reason it's not is not because there's been no progress. There has been masses of progress. The reason, the very heartening reason, is that the progress has overwhelmingly been the sort of progress that we said would happen. So again, this idea, this concept, this paradigm, is really standing the test of time. And I'll stop there. And I hope there's time for some questions. [APPLAUSE] AUBREY: Go ahead. Please. AUDIENCE: So one thought that occurs to me. We talked earlier about how this is easier because the body already has all these self-repair systems. But the question that comes to my mind for that is a little bit of a Pollyannish [INAUDIBLE] question. Is the synergy between the systems that you mentioned and whether or not recruitments in one of those systems would buy that synergy from the other systems. I specifically thinking of mitochondria producing mitochondria, but it's a general question. Do you think there's a possibility of that? Do you see that? AUBREY: So very interesting question-- so it's so interesting that I'm even going to take the trouble to repeat it. So the question is really supposing we just fixed one of these things really well. But we didn't actually fix anything else. Would that not have kind of knock-on secondary effects that would somewhat alleviate the pathologies that were being predominantly caused by the other types of problem, even if those other types of problems themselves were not being directly addressed? I'm absolutely sure that there would be such an effect. The thing that is much, much harder to ask is how much effect? And furthermore I think we can certainly say that if you fixed one of these things, the overall effect will certainly not be so substantial as to give let's say, a decade of life. I think we can certainly put pretty confident upper bounds. Now you mentioned mitochondria mutations at a particular candidate, and it's a great candidate to choose. I think that is the one about which the range of uncertainty is the greatest partly at the bottom end actually. The mitochondrial mutations are the one case where we can't point to any particular pathology of old age for which that type of damage is the major driver. But looking at it the other way around, what we can say is that if mitochondrial mutations matter at all, then they probably matter very ubiquitously. So actually, my very first book, which was purely for an academic audience back in 1999-- that was the book for which I got my Ph.D.-- that was written precisely about that and I said that maybe we've got a 10% chance of doubling a lifespan just like that. Any more? AUDIENCE: Do you still think that? AUBREY: Yeah, 10%. Good. AUDIENCE: So I suspect this is another one of your boring questions, but you didn't have it on your list. You say that aging is the biggest problem. How about hunger and poverty as things that cause a lot of suffering in the world today? AUBREY: Yeah, just do the numbers. How many people are hungry? How many people have the diseases and disabilities of old age? Just do the numbers. Yep. AUDIENCE: You may not be able to answer this, but if you were going to estimate. Say you wanted to get all this accomplished in the next 25 years, what do you think that it would cost in today's economics? AUBREY: The glorious news is that the money is ridiculously small. So we need to divide it in phases. The money certainly gets much bigger at later stages just as for any medical research when we get into clinical trials. But I don't even bother thinking about that because I know, as I mentioned in I think the second-to-last slide, that once we get sufficiently dramatic results in mice, game over. Money will be no object. People will just get it. And it will be straightforward to get money in the door. So the question then is how much is the money we need now to really get this done. When I say "we" here I am not just talking about SENS Research Foundation, of course, I'm talking about overall. I think we're talking about really small money like $100 million dollars per year for as little as 10 years would do it. And we're already up in the SENS Foundation itself like $4 or $5 million dollars. So It's only an order of magnitude we're talking about. It's pitifully small. And when we look back on how long it took for that money to be forthcoming, we are going to be very ashamed as a species. AUDIENCE: Are there parts of the body that are not really designed to be rejuvenated? Like teeth and [INAUDIBLE] maybe? AUBREY: The parts of the body that don't have very much in the way of intrinsic, built-in repair capacity are actually tending to be the easiest ones to fix because they're the ones that don't need repair very much. So teeth is a great example. Teeth have some repair. Some species have more than two sets of teeth in their life, and actually the work that's going on in that area is precisely along those lines, organizing for stem cells to regrow a new set of teeth. That is relatively on the simple side. Yep, in the back. AUDIENCE: At the beginning you said that damage was the main cause of aging, and yet we haven't had a lot of success moving out maximum life spans in different creatures, which makes it seem that maybe there are other mechanisms besides just damage. AUBREY: OK, so we've done pretty well with maximum life. First of all it depends how you define maximum. So the technical definition that is conventional within gerontology which can be used conveniently for populations like 7 billion or populations like 100 like you have with mice in the lab. They normally use the life span-- the number after which 5 or 10% of the population is still alive. So If we use that definition, then yes we've actually been pretty successful in moving things out. But not because of progress against aging. What has predominantly happened over the postwar period is that people seem to be benefiting from what are called cohort affects, which essentially means they were born younger, or at least they were-- they spent most of their lives younger. And we understand a bit about that. Prenatal nutrition has made an enormous difference to lifelong health. AUDIENCE: Actually I meant maximum as maximum. AUBREY: OK, so I was going to get onto that. AUDIENCE: So the model organism would be pushed out to the maximum. AUBREY: Right, so yeah, so in the case of model organisms, no question, we've actually got-- I mean the world record mouse lifespan is like five years and like 20 years ago it wasn't. It was like three years-- or three and a half. So that's happened, but that's small populations. So that's why I wanted to give that earlier answer. If we look at huge populations, like human race, then things get a bit more interesting. It is rather curious what's been happening there. The world record lifespan is 122, and the person who reached that age died in 1997 which is quite long time ago. In the time between then and now, the number of people who reached 100 has gone up worldwide by a factor of several, right? So it's bizarre that-- in fact no one is anywhere near this. The current world record living person is 116. Well, what's going on? That is a big paradox. Nobody has much idea. It could be cohort effect again. It could be that there were periods of particularly good nutrition and such like in the 1870s or whatever. But it's a major research topic. We really don't know the answer to that. Yep. AUDIENCE: Do you do anything with nanorobots and things like that. Do you think that's going to play in this? AUBREY: Will nanobots and such like play a big part? Well, my view in general-- let me answer a slightly more general question. My view in general is that non-biological solutions to medical problems which already play a minor role with things like cochlear implants, or indeed spectacles, right? They do actually have a very good prospect of playing an increasing role as time goes on. And certainly the miniaturization of non-biological solutions such as nanobots or things on the way to that-- millibots, microbots-- will accelerate that process. However, I'm pretty sure that they won't play a dominant role until well after we've got this stuff working well enough to get to longevity escape velocity. Yep. AUDIENCE: Do you think that on the whole our genes and genetic program are kind of indifferent to whether the elderly live longer. Or are there sort of mechanisms within the genetic code that are actively reducing life span because it would be adaptive to have non-reproducing organisms sort of not be taking it? AUBREY: So the three-word summary of your question is-- is aging programmed? That's the way it's normally stated. So the consensus answer to this in the field which I agree is that no aging is not programmed. A long time ago, however, in fact for probably 60 or 70 years starting in the 1880s it was firmly believed that aging is programmed because everything must be programmed because evolution is clever, right? And people came up with clever reasons why it would be programmed like it would improve the signal-to-noise ratio of natural selection by eliminating these useless, old organisms. At the beginning of the 1950s the people started to point out that very few organisms in the wild are actually old enough to suffer any real functional decline because predation, and starvation, and hypothermia, and so on take such a rapid toll that you've just got nothing left by that time. Now originally that argument was oversimplified. You do indeed need some non-negligible amount of death from aging in the wild in order to maintain selection for our antiaging machinery that I spoke about earlier. Otherwise that machinery will just degrade through spontaneous mutations in the germline from one generation to the next. But there isn't very much. And certainly when you look at questions like how rapidly does the rate of aging change in a population when you put them into a different environment where the selective pressure is sharply divergent from how it was, then it turns out that the rate of change is really slow, so slow that it can be ascribed only to selection from spontaneous mutations rather than any kind of changing in the input environmental parameters to any kind of program. AUDIENCE: Metabolism reduction is one of the things that people try to use for [INAUDIBLE] without-- it doesn't seem like it's very sure how it's going to work out. How does it lead to the degradation? AUBREY: OK, so first of all I want to make sure that everyone understands the way I'm using the word "metabolism." There's a phrase in biology, metabolic rate, which refers specifically to the rate of consumption of oxygen. So that's in other words, the rate of oxygen metabolism. But I am using the word metabolism in the way that biologists use it strictly which means everything that goes in the body-- all of the processes that keep us alive from one day to the next, whether they have oxygen involved or anything else. Now, your question refers to calorie restriction, essentially eating less, and it turns out, yes, it was discovered way back in the 1930s that if you feed a mouse or rat less than it wants then it lives a bit longer-- that's cool. Other than that it seems not to work very well for longer-lived species. It works much better, conversely, for really short-lived spaces like nematodes. You can get the nematodes to live three or four times longer than they otherwise would just by starving them at the right time in their life cycle. Why is this? Why it turns out to be fairly straightforward. It all comes down to the strength of natural selection. Long famines are less common than short famines and therefore the reason, the need, to live longer so-to-speak is less. So we have less good machinery, less efficient, less impressive machinery to respond to nutrient deprivation in this way than a short-lived organism does. Thank you very much. [APPLAUSE]
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Channel: Talks at Google
Views: 96,234
Rating: 4.8830409 out of 5
Keywords: talks at google, ted talks, inspirational talks, educational talks, Ending Aging, Aubrey de Grey, aubrey de grey ted talk, aubrey de grey immortality, aubrey de grey diet, aubrey de grey joe rogan
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Length: 65min 13sec (3913 seconds)
Published: Fri Apr 11 2014
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