Cheating death via regenerative medicine or stem cells?

How does one go about cheating death?

As I get older, fighting aging seems more relevant. Having battled a potentially fatal cancer also gave me a taste of mortality.

In biomedical research, it seems like living longer has become an obsession for some recently.

Could stem cells or other forms of regenerative medicine help people to meaningfully fight aging? Could this happen in the not-so-distant future?

Fighting aging and death

Recent headlines on new stem cell-related clinical developments might make you think that such anti-aging miracles are just around the corner.

It’s hard not to be drawn into such hype. In fact, this topic sparks more hype than almost anything else.

On the other hand, there are concrete future possibilities.

When it was early days after my diagnosis with aggressive prostate cancer in 2009 one of the many doctors said something that has stuck with me.

“Our goal is to help you die of something else besides prostate cancer!”

What this doctor said is perfectly right as a goal, but it stunned me a bit at the time.

I don’t want to die of prostate cancer, but I don’t want to die of anything. However, I will be dying of something eventually whether it is that or something else.

Something will eventually get you too. It’s just not fun to think about that reality.

Hype on cheating death

Instead it’s much more enjoyable to imagine escaping death. Maybe through some cutting edge, sci-fi-ish technology. Perhaps via stem cells.

In recent years there’ve been an unusually large number of papers and newspaper headlines about stem cell clinical developments on aging. As much as I hate to say it as an advocate for the stem cell field, many of these cases have been hyped.

Some media headlines suggest that cures for many bad things or even delaying death are about to happen tomorrow. There are some words and phrases that tend to crop up that can be clues to what is being hyped in the stem cell headlines: “miraculous”, “cure”, and “breakthrough”.  If you see those breathless kinds of words, paradoxically you should generally be less excited and more skeptical.

Three ideas: young blood, young CSF, or young cells

A hot idea in the last half-dozen or so years has been to give aging people some biological stuff from young people. The notion seems to be that young material, whether it is young blood, young cerebral spinal fluid (CSF), or young cells, might reverse aging in older folks.

The young blood idea even sparked a pay-for-play “trial” where you could shell out $8,000 to get some younger person’s blood transfused into you. That sparked a warning from the FDA. Parabiosis studies in mice were the main foundation for the young blood idea in people.

What about young CSF? More recently, I reviewed a paper on the use of young CSF in mice that reported some possible hints of reversing brain aging.

I’m somewhat skeptical. Of course, even if it did work in mice, that doesn’t mean it would do anything useful in people.

Where would you get enough young CSF to transfuse into older people’s cranial cavities?

Young cells to the rescue? Finally, we see attention given to the idea of “young cells.”

A lot of this is just B.S.

Stem cell clinics and even some biotechs claim that birth-related cells such as from amnion, placenta, or umbilical cord are “young” and so must have anti-aging properties. Show me the data.  Each of these perinatal tissues has cool cells in them and they may have useful clinical applications.

As usual, the tricky part is concretely proving it. With perinatal cells it is common for clinics to sell first to make money and then worry about data later, if ever.

Anti-aging research looking ahead including drugs

An attractive idea is that rather than giving aging people actual biological material from younger folks, this kind of regenerative research would discover drugs that could be taken to mimic the potential positive effects of cell therapies.

Such efforts could even include senolytics, where drugs of the future are supposed to remove senescent cells with great results.

Living longer would ideally be coupled to a better quality of life. If more people live to be centenarians but are miserable most of the last few decades then that’s a problem.

In the end, when thinking about this kind of research, I often end up circling back to a common sense reality. At a global scale, investing in basics like providing more of the world access to clean water and air, healthy foods, medical care including immunizations, and education is the best way to extend average life expectancy dramatically.

Still, I believe it also makes sense to do research on extending lifespan and improving quality of life.