Can science make us live healthier for longer?

The main thrust for now is not necessarily to live longer but to live better; to decrease the period of bad health and frailty to a minimum amount. Biologist Oliver Bischof

29 March 2017
By Oliver Rowland

In the 19th century people mostly died from infectious diseases like pneumonia, tuberculosis and gastro-intestinal infections – not old age. Thanks to improvements in healthcare, including Louis Pasteur’s work on germs and vaccines, average lifespan has since doubled, meaning most people live long enough to die from illnesses associated with old age, like heart disease and cancer…
The usual approach is to treat the symptoms of these illnesses. Now the Institut Pasteur, whose resear­chers have won ten Nobel prizes for medicine, is among the world’s pioneers of a new approach – tackling them at their root by acting against the ageing process.
Researcher Oliver Bischof is part of its multi-disciplinary working group on anti-ageing at the Insitut in Paris and is organising a conference next month on cell senescence, one of the promising avenues. It in­cludes a free public session about anti-ageing research on
May 19 (which you can register for at: tinyurl.com/ageing-seine) with short talks in French and a question session with a panel of experts. This can include questions in English.
‘Senescence’ refers to damage to our bodies linked to the time passing, that is ‘physical’ ageing, as opposed to merely ‘chronological’ ageing (having been alive for an extended period of time). Senes­cent cells are age-damaged ones and clearing them from the body is now a major area of research.
You now have a whole group of researchers at the institute, looking at different aspects of ageing...
We’ve brought together all the people on the campus who are interested in ageing research, to speed things up on this topic. We started having regular meetings last year. This fits with the Horizon 2020 goals of the EU, which puts a lot of emphasis on finding ways of dealing with the ageing population. All around the world, more is being done to better understand ageing and age-related illnesses.
Do you agree whereas people used to die from infectious diseases – which the Institute is famous for – now it is diseases of old age?
Yes, we’re getting older so age-related diseases and ageing itself… it’s the most important risk factor for dying.
Is it quite a new idea to look at the causes of ageing itself?
Right now we’ve been treating diseases as single entities and trying to find a drug against disease X or one for disease Y. Now we’re trying to find fundamental underlying mechanisms that are common to many if not all age-related diseases and in finding these we would maybe be able to intervene in them and target a whole bunch of diseases with a single treatment, instead of treating them individually. We are far from that at present, but we are getting a better understanding of at least some of the mechanisms that are at work in the ageing process, one of them being cellular senescence.
Is it because this is an especially promising avenue that you are devoting a conference to it?
One reason is that I’m a committee member of the International Cell Senescence Association (ICSA) and this conference [icsa2017-senescence-on-the-seine.org] will tie in with our annual meeting. We started in 2012 but there is now more demand and diversity within the field, so it’s important to try to bring together people from different angles – biologists, clinicians and theoretical computer biologists, to find better ways to tackle the problem.
It’s also important to bring it to the campus here and to France, so this is being pushed everywhere possible and people become aware of it.
That’s also why we will have the public session, to explain to people what we can do for their health and to answer their questions. Readers who would like to come should register, then they will get badges when they arrive. Afterwards there may be a chance to mingle with the scientists.
The public session will be the last session of the last day, for an hour-and-a-half. We have plenty of space, so anyone interested can spread the word.
Please explain senescent cells
In general as we see it now there are two aspects to senescent cells. On the one hand there are indications that they help suppress tumours and can help in regeneration of tissues and wound-healing, so that’s positive. But the detrimental aspect is the accumulation of senescent cells with age, which is linked to decreasing health.
In the USA in the Mayo Clinic and at the Campisi labs they genetically-engineered mice where scientists can eliminate senescent cells from their body at will with a drug, and there was a clear positive effect on health and maximum lifespan – they lived up to 25% longer. Now we need to find drugs which may have the same effects on us, and there are some that have been found to kill senescent cells and to have positive effects. It’s early days, but there are companies that are getting on with
it, such as Unity Biotechnologies or Google’s anti-ageing institute Calico.
There’s a lot of enthusiasm, but we mustn’t overstate things. We know little about the different types of senescent cells and why some accumulate and others get eliminated by the immune system. Currently we are only eliminating a certain type. We think those that accumulate and cause trouble are different from those that have beneficial effects. In fact there is potential to use senescent cells as a cancer therapy.
Companies are testing many molecules, and more people are getting involved in understanding the impacts of senescence, so it’s great and it will help open new treatment avenues, but it’s early days and we can’t yet say we’ve found the Holy Grail of our health.
Can you guess how long it will take to have treatments available?
I wish I could. It looks very promising but it’s hard to put a timeline on it – drug development is a lengthy process.
One promising approach is re-purposing drugs that were developed for something else, because they have already been approved.
Another thing to be worked out is how to give the drugs – do we give a short course to clear the cells in two weeks, or keep them on a low concentration for a long time? It all needs to be tested for side effects.
Is the aim for people to live as long as possible?
The main thrust for now is not necessarily to live long but to live better; to decrease the period of bad health and frailty to a minimum amount, which will have a positive impact on health costs and on the way that people finish their lives. It’s a win-win situation.
So now, we are really trying to understand biological rather than chronological ageing. You can find people in their 80s with the biology of a 50 or 60-year-old, and vice versa.
The thing is to find biomarkers as quickly as we can – effective ways to identify the biological age of a person – so we can intervene at all levels, including nutrition and lifestyle.
There are likely to be societal impacts too – people may work longer and there may be a shift in the way people live their lives and how older people are perceived. Now most people retire at 60-65 and you’re out of the game, but it might be 70-75 because people will want to stay active and involved.
The oldest-ever person was French – Jeanne Calment, who lived to 122. Will we see more ‘Jeannes’?
It’s very hard to say if we will get more and more centenarians, it may be the case. But cell senescence is only part of the pie when it comes to ageing – an important part, but not all of it.
It’s exciting though – that more is being done in this area...
Here in France there is also a big push from the national health institute Inserm, which set up a consortium to work on these questions, bringing together different experts
to work on the ageing process.
So France is becoming a major player
in this field?
Yes, we’re going
the right way. The main players in sen­escent cell research are in Europe, though it was identified in the US.
n In parallel with the work under way in Paris, the Institut Pasteur de Lille, founded separately by Pasteur, is also taking a major interest in this field. Its first conference on healthy ageing in 2016 will be followed by another in December this year (longevitylille.fr).

...and some say  the future holds more, or is such thinking dangerous?

While scientists such as Oliver Bischof (above) are cautiously optimistic about prospects for longer life in good health, a growing fringe of activists claim that coming decades may see dramatic changes thanks to a combination of medical breakthroughs and advances in areas
like artificial intelligence and nanotechnology.

 Many such ‘transhumanists’ hope that accelerating progress will allow humans to repair and enhance their bodies to maintain youthful health indefinitely. High-profile names associated with the movement in France include former education minister Luc Ferry, who has said “it bets on the fact that man is perfectible”, and surgeon and founder of the Doctissimo site, Laurent Alexandre, who wrote a book called The Death of Death.

One activist group seeking to help bring about such changes is Association Française Transhu­maniste, whose vice-president Didier Coeurnelle joined a former French health minister and a
philosopher in a recent debate on the subject: Transhumanism – what hopes, what limits organised by the Catholic diocese of Monaco.

Mr Coeurnelle said: “We want to no longer die from age-related illnesses; to repair ourselves so we can live without limitation of time. Medicine has always had the aim of making people live longer, so this is a continuation, not a rupture.”
However, former health minister Jean-François Mattei said while major life extension might be possible it could be many years away and was not a priority. “To give an example, the first theorists in artificial intelligence held a meeting in 1956 and predicted A.I. superior to humans in less than a generation. It was supposed to happen over 40 years ago, and still has not.” He added: “I am for progress, for technology, but we must remain
masters of it and not let it run away with us.”

Prof Mattei said many transhumanists were atheists and some even thought humans would one day upload their minds to a digital format and replace their bodies with artificial ones. “When there’s no more God and no more man, there’s nothing left. Transhumanism is nihilistic and tota­litarian, because it imposes the law of technology.”

Mr Coeurnelle said: “The aim is not to oblige people, but to permit those who want to, to live much longer than now in good health. I think that there is an arrogance to think we are already perfect as we are and not to accept change – but in reality we have always accepted it.”
He said transhumanism included varied stances and some transhumanists were also religious.
“In fact the Bible presents patriarchs as having lived hundreds of years and it’s seen as a positive thing. And the rule to love your neighbour as yourself includes solidarity – and that includes help to those in danger. Today those in danger are the 90% of humans in a country like France who die from age-related illnesses.

“And in the view of transhumanists, the human being is more than just our physical envelope and if we can make modifications to allow our minds to go on, this also fits with some religious ideas.”
Philosopher Jean-Michel Besnier said: “My view is simple – when you are a human being life cannot just be reduced to survival. So when transhumanists say we must do everything possible to go on living, it seems regressive to me.
“Also, transhumanists never speak about how illness can help foster our personal growth – yes, it can kill us, but we can grow from it too.

“If life is too perfect there’s no more desire, just boredom or we’re just reduced to animals or machines. They forget the symbolic dimension of human life.”

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