Is there anti-aging medicine? Yes, here are 3 types – but the effect has not been proven on humans yet

In the movie The Last Crusade must Indiana Jones choose one among many golden cups to find the Holy Grail.

Does he find the source of eternal life? Or does he choose wrong and die?

– There is only one way to find out, he says and steps forward towards the shelf with goblets.

Anti-ageing: – It’s the wild west

The market for anti-aging medicine may remind you of the scene with Harrison Ford in the mysterious cave. Not because the risk of choosing wrong is certain death. But everywhere on the internet you can find treatments with praise for a longer life, for which there is not very strong evidence.

– It’s the wild west, says Morten Scheibye-Knudsen about the selection of medicine and dietary supplements against ageing.

He is a doctor, and also takes some of the most talked about preparations himself on a daily basis. More on that later.

Not finished yet

Morten Scheibye-Knudsen researches aging and genetics at the Center for Healthy Aging at the University of Copenhagen.

Together with Kaare Christensen, head of the Danish Center for Aging Research at the University of Southern Denmark, he has agreed to assess the evidence behind the most talked about anti-ageing pills.

Both researchers emphasize to Videnskab.dk that there is actually some truth to some of the promising claims. But: It just doesn’t apply to experiments with humans. The optimism is based on experiments with fruit flies, mice, rats and worms.

– There are promising results from experiments with animals, says Kaare Christensen.

– But we are not there yet. We are still a long way from having effective anti-ageing medicine that meets the requirements that doctors usually set for medicine, he emphasizes.

But how far are we then? And what treatments are we talking about?

3 types of anti-aging medicine

If Indiana Jones, in his search for an elixir of life, faced a shelf of pill boxes, he would probably choose a box with one of these three names on it:

• Rapamycin
• Metformin
• Senolytic medicine

At least if he had read the news and followed the medical longevity– the debate, i.e. the anti-ageing debate.

Anti-aging pills fill the media image, and they have become particularly popular among men as part of the so-called longevity-the wave.

It is the wave of interest that has arisen in getting a longer life.

1. Rapamycin – from bacteria on Easter Island to darling on the internet

Rapamycin is one of the molecules that has received the most attention. It is a fabric that originally comes from Easter Island. Or Rapa Nui, as the island in the Pacific Ocean is also called. Hence the name of the medicine.

The substance is extracted from a bacterium. It was originally designated to combat fungal infections in organ transplants.

But now experiments have shown that rapamycin also has a special ability to affect a molecule called mTOR. It is a molecule that is central to the regulation of cell processes, including their growth, metabolism and lifespan.

– Rapamycin is the molecule that has shown the greatest potential in terms of delaying ageing, says Morten Scheibye-Knudsen. He is the lead author of a new scientific review of research into medicine to delay old age.

For example, a study published in Science has shown that rapamycin can increase the average lifespan of mice by ten percent. But that is only one of many studies, and other research has shown that the drug can increase the life expectancy of mice by up to 60 percent.

– A positive effect has been seen on many different animals and yeast cells. This suggests that rapamycin affects something fundamental in the breakdown of cells, explains Morten Scheibye-Knudsen.

Right now, around 20 human clinical trials with rapamycin are underway. We cannot yet know whether they will demonstrate the same effect as has been seen in the animals.

– But it would be strange if it didn’t also work to extend the lifespan of people, adds the aging researcher.

2. Metformin – from diabetes medicine to potential life extender

Kaare Christensen from the University of Southern Denmark emphasizes that he is not an expert on molecular mechanisms. But he is, among other things, a professor of epidemiology, a research field with a focus on diseases and health conditions in society, and he generally wonders about longevity– the wave among young, healthy people.

Especially when it comes to the next drug on the list, metformin.

Metformin is a drug that is already used, mainly for the treatment of type 2 diabetes.

The substance works primarily by improving blood sugar control. But some studies suggest that it can also delay the body’s aging process, among other things by acting as an anti-inflammatory.

It is not yet understood exactly how the drug works on healthy people. But some studies suggest that metformin, for example, can activate the enzyme AMP-activated protein kinase (AMPK). It can also regulate certain immune cells and reduce the release of certain cytokines. All of these are processes that can reduce inflammation in the body.

Experiments with animals, however, have also shown that the effect seems to depend on which genes one has. The genes can therefore be decisive for whether the treatment is either beneficial or harmful for the recipient.

It specifically suggests experiments with worms. The roundworm Caenorhabditis elegans is one of the most used model organisms in aging research. That is because they are relatively easy to breed and study. They also share several biological traits with humans.

A study from the journal Aging Cell shows that metformin increases the lifespan of some species of roundworms, while others are actually harmed by the drug and die earlier than expected.

And that is precisely why it is strange that metformin has become so popular, especially among young healthy men, Kaare Christensen believes.

– We are talking about healthy people, who take some medicine as if they were sick, without knowing for sure whether it has a positive or potentially harmful effect in the long term, he says and adds:

– I do not get it.

Morten Scheibye-Knudsen is one of those who take metformin without being ill. The aging researcher from the University of Copenhagen is currently 44 years old, and he has told several media outlets that he is taking the diabetes medicine in the hope of being able to extend his life.

– I have only been open about my habits, he says.

– But how do you relate to the fact that you, as an aging researcher, can help add credibility to a preparation that has not been proven to extend the lifespan of healthy people?

– I have never recommended others to do the same as me, and I have no financial interests in metformin. I have a family history of both Alzheimer’s and Parkinson’s, so I have my personal reasons for why I do what I do – I would like to avoid getting one of these brain diseases myself, says Scheibye-Knudsen.

Morten Scheibye-Knudsen says that as a doctor he can prescribe metformin for himself. It is a preparation that usually requires a diabetes diagnosis and a prescription. Others neither can nor should therefore try to do the same as him, he says. He emphasizes that his self-treatment is experimental, and that he may well die from it at some point.

Still, he continues. Why?

– Because of the preliminary results, he replies.

Several studies of patients with type 2 diabetes have shown that metformin has a potential effect against both Alzheimer’s (here) and Parkinson’s disease (here).

At the same time, both Morten Scheibye-Knudsen and Kaare Christensen point out that no major clinical trials have been conducted on healthy people that support the results.

3. Senolytic medicine – the body’s new waste disposal method

This also applies to the last form of treatment on the list, says Morten Scheibye-Knudsen.

Senolytic medicine is an approach to treatment rather than a specific preparation. The treatment involves the use of different molecules that have the ability to find and remove old and disturbing cells from the body.

Senescent cells, they are called. They occur naturally with age, and they tend to accumulate over time. The problem is that they can damage surrounding tissue and healthy cells, and therefore a treatment has been developed to cleanse the body of them.

A kind of new waste management method.

Senolytics have currently only been investigated in animals such as mice and rats, and the treatment has shown a potential effect in the fight against various age-related disorders such as cancer or heart and brain diseases.

– And there you have come relatively far, says Morten Scheibye-Knudsen.

– From animal experiments we know that if you remove the old cells with senolytic medicine, the animals seem to become healthier and live longer. Now we are waiting to find out how it will work in humans.

Right now there are about 40 ongoing trials with senolytics on humans. But there is still no solid evidence in the research for a positive effect. In general, the promising results for antiaging medicine come from experiments on animals.

Therefore, it would also be a bad idea for especially young healthy people to try something that has already become popular on the internet, for example rapamycin or metformin.

Kaare Christensen from the University of Southern Denmark thinks so.

– We are in a situation where it is difficult to justify anti-ageing medicine medically, based on an assumption that it can add more years of life.

– In addition, we still do not know enough about possible side effects from taking some of these pills, he adds.

In other words, Indiana Jones and his quest for an elixir of life would also be risky in reality. At least until further notice.

© Videnskab.dk. Translated by Aksel Kjær Vidnes for forskning.no. Read the original article at Videnskab.dk.