I offer my apologies to all of our readers. Work has kept me from keeping up with the next blogs on the biology of aging, specifically those on human disease. My priority is to work to cure disease than update my blog on curing disease, so the blog has moved to the back burner as […]
An analogy: going back in time
I offer my apologies to all of our readers. Work has kept me from keeping up with the next blogs on the biology of aging, specifically those on human disease. My priority is to work to cure disease than update my blog on curing disease, so the blog has moved to the back burner as we move ahead toward FDA human trials.
However, a recent set of emails prompted me to explain the conceptual problem that faces us as we try to cure and prevent age-related disease. As has always been true historically, the major innovations are not technical or incremental, but conceptual and innovative. Major advances in medicine (and other disciplines) hinge upon our ability to open our minds and dispassionately reexamine our assumptions, which are often wrong. Assumptions are usually reasonable, but based on limited knowledge. Looking around us, the world might be flat. Watching the sun, stars, and planets, the universe might revolve around the earth. When we look a little further, however, the world becomes a sphere and the Earth is no longer the center of the universe. The same is true of aging: when we look a little further, we find surprises and a deeper understanding. Too often, we remain content with what might be true, to rarely do we look more deeply to find the truth.
A recent email suggested that even if telomerase gene therapy worked, wouldn’t we still need to consider using “concurrent stem cell therapy, endogenous stem cell boosting therapy, senolytic and NAD+ therapies, caloric restriction, low dose rapamycin, and acarbose “?
The problem is deeper than the question suggests, so I’ll try offering up an analogy.
A time-traveling 21st century physician goes back to 15th century Europe, approximately 6 months before a major smallpox epidemic is due to wipe out most of the population of the local towns. The physician knows that infection (and death) can be reliably prevented by vaccination with cowpox (literally, since the word derives from “vacca”, the Latin word for cow). Specifically, if the physician takes the fluid from the cowpox lesion of (for example) a milkmaid who has active cowpox and smears it on a dermal scratch of a potential smallpox victim, they can prevent smallpox. In short, it’s easy to prevent the epidemic, but only IF we understand understand the pathology.
However, the 21st century physician has become friends with the local 15th century healers, who have a deep knowledge of local herbal medicine. These local herbalists are remarkably observant, keenly intelligent, and have lifetime knowledge and experience with herbs, roots, flowers, bark, etc. They are profoundly competent within their framework, but have no understanding of microbes, vaccinations, or the immune response.
Now imagine an honest and well-intentioned conversation between the local professional herbalist and the 21st century physician and assume that they both respect each other’s knowledge (although the healer still can’t get over their limited assumptions about how to treat disease and cannot understand or believe in microbial disease). Even after the 21st century physician suggests that vaccination would effectively and easily prevent smallpox deaths, the 15th century herbalist persists in suggesting that “yes, that might work, but you still need to use herbs, prayer, incense, and specially made tisanes” to prevent smallpox.
Or to update our analogy, the modern age-researcher is profoundly competent within their framework, but have no understanding of how aging actually occurs at the cellular and epigenetic level. Even after 21st century data suggests that telomerase gene therapy would effectively and easily prevent age-related disease, the modern researcher persists in suggesting that “yes, telomerase therapy might work, but you still need to use concurrent stem cell therapy, endogenous stem cell boosting therapy, senolytic and NAD+ therapies, caloric restriction, low dose rapamycin, and acarbose “ to treat age-related disease.
For my part, I prefer the 21st century.