Sunday, July 8, 2018

Functionomics, your necessary back-up plan for a longer better life.

The first person to live up to 150 years has already been born.



That's what Steven Austad, David Sinclair and Stuart Kim think.

All three are Professors: 
Of Biology, of Genetics and of Developmental Biology respectively.
Sinclair at Harvard Medical School and Kim at Stanford University.
Just in case you thought I quote some nutcase science colleagues.


Now, imagine, you being that person living to 150.


You'd only enjoy the privilege if you could live fully functional 150 years.


That's quite the opposite of how we experience aging today: a gradual loss of function.
It typically leads to dementia, heart disease, cancer, diabetes, frailty, you name it.


Treat that loss of function before it has deteriorated into any of those chronic diseases, and you not only prevent the diseases but you also extend your fully functional lifespan.


Treatment of function means an extension of lifespan and freedom from disease.

No need to be a professor to get that point.

But you apparently need to be in medicine to NOT GET IT.


With its refusal to acknowledge aging as a medical condition, medicine is guilty of causing bodily harm:
By withholding the treatment for functional decline until this treatable condition has deteriorated into one or several incurable diseases.

These diseases are not called chronic for nothing.


That's why I am an advocate for treating aging like a disease.


That's why our professors are big fans of two cool strategies:
Strengthening the innate repair mechanisms and bio-engineering the necessary repair or replacement technologies.

Back to the question whether you will make it to 150.


Probably not.


Because by the time these new strategies will have found their way into the clinic, you'll be dead.
I am pretty sure I will be.



Initial exuberance about any new biomedical insight is rarely justified. Just check back at the decoding of the human genome. 
Genomics was then hyped as THE hack for personalized disease prediction and prevention. Ten years later the sobering realization: "The numerous genetic variants that mediate disease risk … are thus meager in their predictive power. " [1].


So, don't bet on getting any lifespan extension treatments within your lifetime.


UNLESS


… you start with a third strategy. It's called robustification against aging.

It simply means to slow down, stop or even reverse the functional decline that comes with age.

Now imagine, if we could quantify and measure your organism's robustness against all the things that can go wrong under the hood we can keep it robust.
The best part is, we do not need to know the myriad of things that eventually will go wrong under the hood.

Surprisingly, measuring function is something sorely neglected in medical science.


That's where functionomics enters the stage.


Let's take the cardiovascular system as an illustrative example.


This system's failure is the cause of roughly half of all deaths (which is one reason why I have made it my priority).


Its purpose is to deliver oxygen and nutrients to each and every cell of all organs.
And then to carry away all the cells' waste products that come from metabolizing these nutrients and oxygen.


It has a second purpose: to unburden the heart, by actively pumping the blood through its conduits (the arteries).


The cardiovascular system does its job as a purely hydraulic system. 
Therefore cardiovascular function can be fully described by the same physical parameters that engineers use to build hydraulic systems.


The tool to describe and quantify the cardiovascular hydraulics is cardiovascular functionomics.


It's a profile of all the functional parameters that together determine your system's functional capacity. Much like your genomic profile determines your inheritance.


Translate that functionomic profile into a correction factor of your calendar age, and we have two vital things.


First, we know how robust you are against threats to this system.

Second, we have a benchmark that can tell us how good we are in robustifying you, say, with a drug or exercise or diet.


We do not need to know what exactly it is that might be threatening YOUR system, as long as we know that YOU are robust enough to withstand anything that CAN happen.


What is the net effect of 'robustification the functionomics way'?


It buys you time.


It may be only a couple of years, say, a decade.


But 10 years of staying functionally fit may make a sizable difference, between on the one hand living long enough and in good enough health to benefit from future technologies of rejuvenation, and on the other hand missing that boat.


Because, even if our professors' exuberance may be a bit overboard, we are pretty close to some exciting new life and health extension technologies. 

And if it wasn't for medicine, we would be much further ahead on that path by now.


That's why I conceived of functionomics.


It may make you, and me, the first ones to make it to a healthy 150 after all.


Bibliography


[1]      J. P. Evans, E. M. Meslin, T. M. Marteau, and T. Caulfield, “Deflating the Genomic Bubble,” Science (80-. )., vol. 331, no. 6019, pp. 861–862, Feb. 2011.

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