Key Moments

#112 – Ned David, Ph.D.: How cellular senescence influences aging, and what we can do about it

Peter Attia MDPeter Attia MD
People & Blogs3 min read136 min video
Jul 8, 2020|13,325 views|205|18
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TL;DR

Cellular senescence drives aging and disease. Senolytics selectively kill senescent cells, offering potential treatments.

Key Insights

1

Aging is a flexible process influenced by biological 'control knobs' that can be manipulated.

2

Cellular senescence is a state where cells stop dividing due to stress and accumulate with age.

3

Senescent cells secrete factors (SASP) that promote inflammation and tissue damage.

4

Eliminating senescent cells in mice extended lifespan and reduced aging features without increasing cancer.

5

Senolytics, molecules targeting senescent cells, show promise in treating age-related diseases like osteoarthritis.

6

Targeting senescent cells may offer treatments for conditions like osteoarthritis, cardiovascular disease, and neurodegenerative diseases.

THE FLEXIBILITY OF AGING AND ITS CONTROL KNOBS

Aging is not a fixed, inevitable decline but a malleable process that nature has shaped throughout evolution. This malleability is controlled by specific biological 'knobs,' biochemical systems that can be modulated. Understanding these systems allows us to explore interventions to influence the aging process and extend healthspan. Examples range from genetic pathways like IGF-1 signaling and genes like daf-2 and daf-16, to lifestyle interventions like caloric restriction, and the widely studied mTOR pathway targeted by rapamycin.

CELLULAR SENESCENCE: A HALLMARK OF AGING

Cellular senescence is a state induced when cells encounter irreparable stress, causing them to permanently stop dividing. While this acts as a crucial anti-cancer mechanism in youth, these cells accumulate with age. Initially conceptualized by Leonard Hayflick in the 1960s as a limit to cell division in culture, it's now understood that senescent cells persist in tissues and contribute to aging. Children naturally eliminate these cells, but adults retain them, leading to a growing burden over time.

THE SENESCENCE-ASSOCIATED SECRETORY PHENOTYPE (SASP)

Senescent cells are not inert; they actively secrete a cocktail of factors known as the Senescence-Associated Secretory Phenotype (SASP). These factors, including inflammatory molecules like TNF-alpha and growth factors like VEGF-alpha, are secreted into the surrounding tissue microenvironment. This SASP creates a pro-inflammatory and pro-fibrotic environment, distorting tissue function and contributing to both the general features of aging and specific age-related diseases. The SASP can recruit immune cells and promote tissue damage, explaining how a small percentage of senescent cells can impact a larger tissue mass.

SENOLYTICS: TARGETING AND ELIMINATING SENESCENT CELLS

Senolytics are a class of drugs designed to selectively target and eliminate senescent cells. The concept was validated by experiments where genetically engineered mice lacking senescent cells showed significantly extended healthspan and lifespan. Unity Biotechnology, co-founded by Ned David, is developing senolytic medicines. The core idea is that by removing these detrimental cells, one can treat or even reverse age-related conditions, offering a paradigm shift from managing symptoms to addressing a root cause of aging.

CLINICAL TRIALS AND THE PROMISE IN OSTEOARTHRITIS

Early research demonstrated that eliminating senescent cells in animal models could reverse features of aging and disease. Critically, a Phase 1 clinical trial in humans with osteoarthritis showed that a single injection of a senolytic drug dramatically reduced knee pain and improved function for at least three months. This suggests that senescent cells contribute significantly to the pain experienced in osteoarthritis and that their elimination can provide durable relief, potentially offering a treatment for the primary reason many older people experience pain.

BROADER IMPLICATIONS AND FUTURE DIRECTIONS

The success in osteoarthritis suggests senolytics could address a wide range of age-related diseases characterized by senescent cell accumulation. Research is exploring applications in cardiovascular disease, neurodegenerative disorders like Alzheimer's, and even certain cancers. While challenges remain, particularly in identifying senescent cells in vivo and understanding their diverse roles, the development of senolytics represents a significant step forward in tackling the fundamental biology of aging and improving healthspan.

Common Questions

Ned David defines longevity as living without the indignities associated with aging, drawing examples from personal experiences with family members suffering from degenerative disc disease and Alzheimer's. He believes science and biology can change how we live to be free of these issues.

Topics

Mentioned in this video

Concepts
mTOR

A complex that acts as a master decision-maker in cells, influencing whether they divide or enter a state of resource conservation, inhibited by Rapamycin and caloric restriction.

Daf-2

A gene discovered in Cynthia Kenyon's screen, associated with the IGF-1 receptor signaling pathway, manipulated to extend lifespan in C. elegans.

Yamanaka factors

Four specific gene products that, when expressed in cells, can artificially induce a reset cellular state, similar to an embryonic state, with implications for youthful biology.

TNF-alpha

A pro-inflammatory SASP factor that is the target of successful drugs like Humira, indicating its role in bad biology.

IGF-1 Receptor Signaling Pathway

A biochemical pathway whose attenuation has been shown to extend lifespan in various organisms, including C. elegans and, to a lesser extent, mammals.

Senolytic molecules

A class of molecules designed to selectively eliminate senescent cells from living creatures, offering a potentially safer and less frequent dosing regimen.

VEGF alpha

A SASP factor that is the target of multi-billion dollar drugs like Lucentis and Eylea, used for eye diseases and cancer.

Bcl-2 protein family

A family of proteins that regulate apoptosis, targeted by Unity Biotechnology's molecules to selectively inhibit apoptosis inhibitors, thereby causing senescent cells to die.

C. Elegans

A millimeter-sized worm used in Cynthia Kenyon's groundbreaking research where knockdown of a single gene doubled its lifespan.

Daf-16

A gene discovered in Cynthia Kenyon's screen, a transcription factor associated with the IGF-1 receptor signaling pathway, manipulated to extend lifespan in C. elegans.

Mdm2

A ubiquitin ligase that marks proteins, including p53, for destruction. Inhibiting Mdm2-p53 interaction can selectively kill senescent cells.

Senescence-Associated Secretory Phenotype

A collection of over a hundred factors secreted by senescent cells that distort tissue function and contribute to features of natural aging and age-related diseases.

p53

A tumor suppressor protein whose concentration increases in senescent cells when its interaction with Mdm2 is inhibited, leading to selective cell death.

People
Leonard Hayflick

Scientist who, in the early 1960s, challenged the dogma that mammalian cells had infinite division capacity, coining the term 'senescent cells' and prophetically linking them to aging.

Cynthia Kenyon

Scientist whose paper on C. elegans showed that knocking down a single gene could double the animal's lifespan, opening up the field of aging research.

David Sabatini

Scientist whose work linked calorie restriction to Rapamycin, identifying mTOR as a common control knob for longevity.

Bob Nelson

A visionary investor from ARCH Venture Partners who supported Ned David's early efforts to fund Unity Biotechnology.

Jan van Deursen

Co-founder of Unity Biotechnology and collaborator from the Mayo Clinic, whose lab genetically engineered mice to eliminate senescent cells, providing proof-of-concept for their role in aging.

Ned David

Guest on the podcast and co-founder/President of Unity Biotechnology. He is a serial entrepreneur in biotechnology and a prolific innovator.

Judy Campisi

Co-founder of Unity Biotechnology and a collaborator, who discovered the first biomarker for senescent cells in vivo (1995) and the Senescence-Associated Secretory Phenotype (SASP) in 2008.

Alexis Carrel

Nobel laureate who famously believed that cells from mammals had infinite capacity to divide, a belief later overturned by Leonard Hayflick's work.

Ben Childs

A young scientist who collaborated with Jan van Deursen, publishing a paper in Science demonstrating the accumulation of senescent cells in atherosclerotic plaques in rodents.

Shinya Yamanaka

Nobel Prize-winning scientist who identified the four factors capable of reprogramming adult cells into induced pluripotent stem cells (iPSCs).

Jennifer Elisseeff

A professor of bioengineering at Johns Hopkins who collaborated with Unity Biotechnology on developing an osteoarthritis model and testing senolytic molecules.

Ned Sharpless

A scientist who has been searching for over a decade for a universal external marker of senescence cells.

Keith Leonard

Ned David's long-term business partner and CEO at Unity Biotechnology, who was also involved in founding Kythera.

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