Friday, August 14, 2009

Can regenerative medicine defeat aging?

The relevance of nearly all biogerontology research to combating aging is restricted to the potential for slowing down the accumulation of molecular and cellular damage that eventually leads to age-related ill-health. Meanwhile, regenerative medicine has been progressing rapidly and is nearing clinical applicability to a wide range of specific conditions. My view is that we are approaching the point where regenerative medicine can be used against aging. This would entail not retarding but actually reversing the accumulation of damage. If successful, this would obviously be a far more valuable technology than mere slowing of aging. However, in order to be successful it must be comprehensive, and some aspects of aging may seem impossible to address in this way. In fact, however, it seems that all types of molecular and cellular damage which contribute to age-related ill-health are realistic targets of regenerative interventions.

The human body is, ultimately, a machine - an astronomically complex machine, of whose workings we remain pitifully ignorant - but still a machine. Like any machine, it accumulates ‘damage’ as a side-effect of its normal operation: molecular and cellular changes that occur throughout life are initially harmless, but eventually (when too abundant) increasingly impede the normal operation of the machine and eventually cause it to fail altogether. Conceptually, there are three strategies to postpone a machine’s demise beyond its ‘warranty period’. First, we can treat it really well throughout its life, thereby slowing down the accumulation of damage: but that can never stop the accumulation altogether, because to do so would require not operating the machine at all, and anyway it cannot address damage that has already occurred. Alternatively, we can combat the late-life symptoms, the dysfunction that eventually emerges: but that too is only a short-term approach, because the underlying damage that causes the dysfunction is still accumulating and making the dysfunction harder and harder to address. This is why the way in which machines that people love are in fact kept in good shape is the third strategy: repair and maintenance, in which we let the damage be created, but repair it before it becomes so severe as to cause dysfunction. In the case of the human body, this means using regenerative medicine against aging.

So… can it work? Are all the types of damage that contributed to age-related ill-health amenable to repair?

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