The man who wants to beat back aging

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The man who wants to beat back aging
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Saudi Arabia has reportedly offered to pay one-third the cost of a planned—but unlaunched—clinical trial testing whether the diabetes drug metformin can delay symptoms of aging. Read more into the controversy behind this trial. ⬇️

On a blazingly hot morning this past June, a half-dozen scientists convened in a hotel conference room in suburban Maryland for the dress rehearsal of what they saw as a landmark event in the history of aging research. In a few hours, the group would meet with officials at the U.S. Food and Drug Administration , a few kilometers away, to pitch an unprecedented clinical trial—nothing less than the first test of a drug to specifically target the process of human aging.

"I wouldn't dignify them by calling them 'treatments,'" added Michael Pollak, director of cancer prevention at McGill University in Montreal, Canada."They're products." The group's paranoia about the term"anti-aging" captured both the audacity of the proposed trial and the cultural challenge of venturing into medical territory historically associated with charlatans and quacks. The metformin initiative, which Barzilai is generally credited with spearheading, is unusual by almost any standard of drug development. The people pushing for the trial are all academics, none from industry .

Barzilai, who is quick to see the humor in any situation, leaned over to a colleague and muttered,"I hope it's not symbolic."Barzilai credits his military service with shaping his scientific temperament and administrative mettle."The most helpful years in my life were in the Israeli army," he says.

The study of the Bronx centenarians built on a surge of basic aging research in model organisms like yeast, fruit flies, and nematodes. By manipulating individual genes and measuring effects on life span, researchers could test the role of specific molecular pathways in aging.

Even a modest delay in aging could increase average life expectancy by 2.2 years, compress the period of morbidity at the end of life, and save perhaps $7.1 trillion in health care costs over a period of 50 years, Olshansky and colleagues estimated in a 2013 paper in the journalTo achieve those benefits,"we've got to act quickly," he argues."The numbers of people that are frail and disabled [are] rising fairly rapidly, and we're seeing an increase in unhealthy life span.

"It all starts in the Middle Ages," says McGill's Pollak."There were herbalists in Europe—and, independently, herbalists in China—who found plant extracts that were useful when people came in complaining of urinating too much." The extracts derived from a perennial herb known variously as goat's rue, French lilac, Spanish sainfoin and false indigo."It worked for some people," Pollak says.

Epidemiological studies have also suggested that metformin reduces cancer risk and mortality and preserves cognitive function. And in a big-data study that, although observational, got the attention of many aging researchers, British researchers reported late last year that in a retrospective analysis of 78,000 adult type 2 diabetics in their 60s, those who took metformin on average lived longer than healthy age-matched controls.

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