The Fountain of YOUTH?

“The afternoon knows what the morning never suspected.” – Robert Frost

After my paediatric rotation, I appreciate more that infants aren’t just pint-sized versions of adults: they’re actually quite different physiologically. This triggered ruminations about exactly what these differences are – especially in those at the other end of the spectrum – the elderly. This took me beyond the normal maturation changes that makes us “adults” into what causes “ageing”.
I often have these extraneous thoughts when exams are upon me, and then feel compelled to follow them through! Another form of procrastination?
What I discovered is that a “cure” for ageing has been a quest of mankind down the ages. Efforts long preceded Ponce de Leon’s search for a “Fountain of Youth’ in Florida in 1513, when the average lifespan at birth averaged about 35 – the same it would remain until 1900. Now, this didn’t mean that most persons died by 35, but that, with so many infants dying, this pulled down the AVERAGE lifespan. Most persons who survived to 21 would be expected to live another quarter of a century or so.
But even without any fountains or elixirs, lifespans did double to around 70+ years today. This has been due primarily to better diet, exercise and, yes – the medical sciences through interventions starting from the birth of the child – paediatrics. Historically, medicine developed by treating diseased organs of the body — either from non-communicable or communicable agents — and not the entire body. Medicine can better be described as “sick-care,” rather than “health-care”! But with the increased lifespans, there was now an explosion in what came to be seen as “diseases” of ageing: Alzheimer’s, Parkinson’s disease, macular degeneration, osteoarthritis, heart attacks, strokes, some cancers.
This revealed that “ageing” actually occurred at the level of the cells from which all of us are made. Changes occur in the cells via a complex interplay between genes and environment, and after time, these manifest as the diseases mentioned above. In the search for a cure for those diseases, we are glimpsing, if not a “cure” for old age, at least a way for slowing it down.
However, in general, the medical establishment still considers anti-ageing medicine as a “crackpot” idea, and the regulatory bodies don’t recognise ageing as a treatable “disease”. It’s like when people were called “witches” for curing diseases in medieval times!
But the dream of extending lifespans has been given a shot in the arm by a confluence of two circumstances:   the rise of a group of super-wealthy individuals who’re willing to fund the research (like the co-founder of Google and the founder of PayPal) and the US-planned manned mission to Mars. In space flights, exposure to cosmic rays would destroy the DNA of at least 5% of the astronauts’ cells – an unacceptable level, almost like “old people”.
At this time, there are three prospects in the anti-ageing sweepstakes that are taken seriously. Firstly, Australian scientists have discovered a vitamin, nicotinamide mononucleotide (NMN), which helps cells repair DNA damage and makes them “young” again. This came out of research on the molecule resveratrol found in red wine, also claimed to extend life. NASA has taken an interest in this effort – the vitamin, not the wine!
A second is from the pharma giant Novartis. Working on an anti-cancer drug derived from the substance rapamycin, scientists noticed that while it had an effect on the immune system, it also lengthened the lives of flies, worms, and rodents too, by 25%. It recently sold the rights to its drug called everolimus/Afinitor to a start-up “resTORbio” which will now check if it rejuvenates aged immune cells of the elderly.
Lastly, there’s research on the effects of metformin – which has been used for 60 years as a treatment for diabetes, and this is closest to overcoming the taboo on anti-ageing medicine. There’s in progress right now one study being conducted by the Albert Einstein College of Medicine in NY – Targeting Ageing with Metformin (TAME). If successful, TAME would mark a paradigm shift, moving from treating each specific medical condition to targeting ageing per se.
Medicine won’t ever be the same! Now, back to my paediatrics exam tomorrow!