I have not found comprehensive data on startups in anti-aging medicine, so this survey is incomplete and biased according to my own familiarity with the companies and their programs.\u00a0 And the more important disclaimer: I have strong ideas about what the end of aging will look like, and this has colored the view I present of each company below. If you know of companies that you think should be on this list, please make suggestions in the Comments below.<\/span><\/p>\n Partial List:<\/b><\/p>\n Mature drugs<\/strong><\/p>\n Geron<\/b><\/a> is ancient by present standards, founded in Silicon Valley in 1990 by Michael West, who was already an advocate of telomerase therapies.\u00a0 They are long established, with market cap of $260 million but only 15 full-time employees. Clearly, their mission is research rather than production. Over the years, they have turned their telomerase expertise into drugs that block telomerase, useful as a cancer treatment, since most tumors cannot continue to grow without telomerase.<\/span>GRN163L (Imetelstat), is a drug under development that targets telomerase.\u00a0 They apparently made the decision years ago, when they sold the IP for their best telomerase promoter to Noel Patton<\/a> that telomerase was too dangerous to let out of the cage.\u00a0 I wonder if even now they realize that was a mistake.<\/span><\/p>\n Elysium Health<\/b><\/a> is Len Guarente\u2019s company selling a formula of NR and pterostilbene.\u00a0 Pterostilbene is a \u201cbetter resveratrol\u201d. Interest in both resveratrol and the NADH pathway grew out of Guarente\u2019s long-time study of sirtuins.\u00a0 I believe that modest health benefits have been established from this approach, but NADH is so well studied that if there were dramatic results, we would have seen them by now.\u00a0 And NR treatment is not without risks<\/a>.<\/span><\/p>\n Telomere therapies<\/strong><\/p>\n Sierra Sciences<\/b><\/a> (Bill Andrews) is focused on small molecules that promote expression of telomerase, lengthening telomeres and preventing cell senescence.\u00a0 Screening hundreds of thousands of chemicals <\/span>in vitro<\/span><\/i> for telomerase activity, they came up with TAM 818, which is now <\/span>for sale in New Zealand as a skin cream<\/span><\/a>.\u00a0 In an unrelated approach, they are offering a <\/span>clinical trial<\/span><\/a> (in a South Pacific island where regulatory agencies permit) using gene therapy to add copies of telomerase.\u00a0 My personal opinion: <\/span>Several years ago<\/span><\/a>, I believed that telomere shortening was an aging clock of primary importance, but then a <\/span>large Danish study<\/span><\/a> demonstrated that the scatter in telomere length is greater than the consistent drift toward shorter telomeres with age.\u00a0 I still think elongation of the shortest telomeres is an anti-aging strategy, but no longer regard it as centrally important.<\/span><\/p>\n Telocyte<\/b><\/a> (Michael Fossel) is experimenting with telomere elongation to prevent Alzheimer\u2019s disease and even to restore neurological function.\u00a0 Fossel understood aging and had the vision to appreciate the role of telomere erosion more than 20 years ago, and I have the highest respect for him, but from what I know, AD as a target seems to be mismatched to the biology of telomeres.\u00a0 Telocyte has recently announced a strategic partnership with Maria Blasco, a Spanish researcher whose lab has produced most of the biggest milestones in telomerase therapy.<\/span><\/p>\n Gene therapy<\/strong><\/p>\n Rejuvenate Bio<\/b><\/a> The Harvard laboratory of George Church was early in recognizing the potential for CRISPR technology to bring gene therapy into mainstream medicine.\u00a0 Rejuvenate Bio is offering a gene therapy program to dogs who are at genetic risk for mitral valve disease, a congenital heart disorder. It\u2019s cheaper than human trials, with less liability when something goes wrong, and it\u2019s a viable lab for gaining experience and honing technique. [Writeup at <\/span>FightAging!<\/span><\/a>]<\/span><\/p>\n Stem cell therapy<\/strong><\/p>\n Stem cells are among the most promising technologies we have for regenerative\u00a0 medicine.\u00a0 I’m surprised not to find more companies doing basic research, but there are lots of companies bringing the present (hit-and-miss) state of the art to patients.\u00a0 Advanced Cell Technologies<\/b><\/a>, a leader in the field, is now a part of Astella Therapeutics.\u00a0<\/span>Apceth Biopharma<\/b><\/a> delivers stem cell technologies in the health marketplace but doesn’t seem to do much research.\u00a0 <\/span>Pluristem Therapeutics<\/a> <\/b>and Brainstorm Cell<\/a> <\/b>claim to have active research programs.\u00a0 I have found no companies focused on the potential of stem cell therapies for extending lifespan.<\/p>\n Clinics and personalized medicine<\/strong><\/p>\n AHNP<\/b><\/a> (Apollo) acquired MPI, which was Dale Bredesen\u2019s vehicle for bringing his Alzheimer\u2019s protocol to the medical public.\u00a0 I give AHNP special mention because I believe that Bredesen\u2019s program is not only the first credible treatment for bringing brains back from AD; further, I think that Bredesen\u2019s Alzheimer\u2019s preventative program doubles as a comprehensive program to slow aging.\u00a0 With individualized programs based on a battery of diagnostic tools, it\u2019s a new model for how to do preventive medicine. I believe the program has transformative potential, but translation to the clinic has led to<\/span> growing pains at AHNP. They can\u2019t train new staff fast enough, and they\u2019ve <\/span>fallen behind explosive demand from new patients. Their software interface is buggy and there\u2019s a backlog of requests for personal support, but they\u2019re aware of the problems and building capacity as fast as they can.<\/span><\/p>\n Leucadia Theraputics<\/b><\/a> has a diagnostic and treatment model for Alzheimer\u2019s Disease based on drainage of amyloids from the brain, and physical blockage of the drainage pathway.<\/span><\/p>\n L-Nutra<\/b><\/a> is Valter Longo\u2019s company, offering programmed, packaged meals that provide some of the benefits of fasting with less of the hunger and deprivation.<\/p>\n Data Mining<\/strong><\/p>\n Human Longevity<\/b><\/a> is mining hospital records and genomic data to look for correlations. They offer testing and counseling to customers, then base their study on their customer base.<\/p>\n ASDERA<\/b><\/a> is Knut Wittkowski\u2019s small but important New York think tank.\u00a0 Like other math geek operationss, they are using computers to mine data for patterns that lead to new drugs.\u00a0 But unlike the others, they are not relying on the black box approach of neural networks. Wittkowski is an old-school statistician, familiar with an arsenal of classical statistical tests, choosing with judgment and expertise applied to the caseat hand.\u00a0 Both approaches are computationally intensive. The difference is whether computations are guided by expertise and experience or by an algorithm that directs its own search toward a human-defined goal. Think of it as Artificial Intelligence vs Human intelligence, if you like.\u00a0 Supervised learning vs a purely algorithmic search. Time will tell which approach yields more leads to actual treatments. I\u2019m rooting as usual for the underdog, the classical against the avant garde<\/i>.\u00a0 Neural networks may yield a prescription, but you don\u2019t know if it\u2019s a fragile artifact of the particular data you used or a robust new truth about biochemistry, and the computer can\u2019t tell you what it\u2019s thinking.\u00a0 With more human participation in the process comes more understanding of where the result comes from and (at least) a guess as to what it probably means.<\/p>\n \u00a0<\/b>Acturx<\/b><\/a> is another data mining project, headed by Edouard Debonneuil.\u00a0 Debonneuil\u2019s background is in actuarial science for insurance companies, and he is mining insurance records of millions of patients.\u00a0 By correlating prescription records with health outcomes, they look for unknown benefits from known drugs.<\/p>\n Senolytics<\/strong><\/p>\n Everon Biosciences<\/b><\/a> was founded in 2010 by Andre Gudkov<\/a>, with awareness of programmed aging built into their strategy. Gudkov believes that endogenous DNA damage in somatic cells is a primary clock driving diverse aging phenotypes.\u00a0 A prominent kind of DNA damage is the duplication of regions of DNA that contain no genes (retrotransposons<\/a>, including LINEs and SINEs).\u00a0 NRT1 is a drug in development that inhibits the enzyme that makes the copies.\u00a0 Another locus of research is senescent cells as emitters of signals that drive inflammaging<\/a>. \u00a0 But while other companies are racing to find agents that selectively kill senescent cells (leaving normal cells undamaged), Everon has focused on the innate immune system, including neutrophils and macrophages.\u00a0 Their hypothesis is that the innate immune system takes care of senescent cells when we are young, but the system has a fixed lifetime capacity, and once its limit is reached, senescent cells accumulate and the vicious cycle of increased inflammation begins.\u00a0 EBS3899 is a molecule they are testing for its ability to sensitize macrophages to senescent cells, and it seems to work better in vitro<\/i> than in vivo<\/i>.<\/p>\n Unity Biotechnology<\/b><\/a> works on one molecule at a time, exploring their potential to relieve arthritis or degeneration of the eye or age-related disease in lungs, liver, kidneys and the CNS.\u00a0 UBX0101<\/a> is their arthritis drug, in trials.\u00a0 Other drugs<\/a> at earlier stages of development target senescent cells and cognitive decline.<\/p>\n Oisin Biotechnologies<\/b><\/a> is searching senolytic drugs, joining a crowded race to minimize toxicity to normal cells while efficiently eliminating senescent cells.<\/p>\n Biomarkers and Age Clocks<\/strong><\/p>\n Spring Discovery<\/b><\/a> and InSilico Medicine<\/b><\/a>. In order to study anti-aging interventions, we need to evaluate them, and the traditional measure \u2014 waiting for experimental subjects to die \u2014 is too slow. This is the reason the Horvath clocks are so important.\u00a0 His algorithms based solely on methylation profiles are the best measures of human biological age we have so far. Spring and InSilico are both trying to improve on that, combining other measures along with methylation, and using neural network analysis — the black box of AI \u2014 to look for patterns that evade human brains. These two companies are unrelated and working on opposite coasts, but if there\u2019s a difference between their goals or methods, I have yet to understand what it might be.\u00a0 [ScienceBlog article<\/a> on InSilico]<\/p>\n Signal Molecules in Blood Plasma<\/strong><\/p>\n [Background<\/a> in my blog from 2 years ago.]<\/p>\n Jesse Karmazin\u2019s Ambrosia<\/b><\/a>\u00a0 was an ambitious start-up, turned to object lesson in hazards of the fast track.\u00a0 The basic premise is sound \u2014 that blood factors from the young are able to set back the clock of the older animal (or person) in whom they are introduced.\u00a0 But which blood factors? And how much is needed? And how many treatments would be needed before the body would set its own clock back, and start producing the youthful factors by itself?\u00a0 Karmazin\u2019s plan was to ask these questions with clinical trials funded by his subjects, people willing to pay thousands of dollars for two transfused pints of blood from a young person. This past winter, the FDA stopped him in his tracks.<\/p>\n Tony Wyss-Coray\u2019s Alkahest<\/b><\/a> has taken the same promising premise and followed with more care toward a promising future.\u00a0 In the early 2000s, Wyss-Coray was one of the Stanford pioneers of parabiosis. Originally, Alkahest seemed to be headed in the same direction as Ambrosia, offering small quantities of young blood to wealthy clients afflicted with Alzheimer\u2019s.\u00a0 But now they\u2019ve made some important discoveries about the active ingredients that give young blood its rejuvenating power. They are well aware that it\u2019s all about dosage–that some plasma components need to be downregulated and some upregulated to turn old blood to young (and perhaps turn old bodies to young\u2026).\u00a0 They\u2019ve coined the term \u201cchronokines\u201d, key proteins that increase or decrease with age, and they\u2019ve identified a few of these and launched clinical trials for macular degeneration and, Parkinson\u2019s, and dementia. I\u2019m impressed. My only suggestion is that they should be alert to the possibility that the interaction among these chronokines might be non-linear and, perhaps, surprisingly complex.<\/p>\n Other approaches<\/strong><\/p>\n Google CALICO<\/b><\/a> is well funded, but their relevance to progress in the field is hard to assess.\u00a0 We might guess that their research direction follows the intersts of Cynthia Kenyon<\/a> and David Botstein<\/a>, i.e., understanding the genetic contributors to aging in worms and yeast cells.\u00a0 They are partnering with Harvard\u2019s Broad Institute and California\u2019s Buck Institute in basic research.\u00a0 They are in it for the long haul, building biochemical knowledge from the ground up. If someone doesn\u2019t get there first, we may be very glad for their industry in another 10 years.<\/p>\n Google has also invested in shorter-term drug development through Verily Life Sciences<\/b><\/a>, with partnerships that include GlaxoSmithKline. Personal note: I see a danger here, in which the company that we trust to direct us to the best information sources is allied with an industry that has done so much to promote its products with disinformation about health.<\/p>\n Lyceum<\/b><\/a> is Michael Rose\u2019s effort to commercialize research he\u2019s done on the genetics of aging in fruitflies.\u00a0 The web site claims a systems approach, which sounds right to me, but no details are offered at this early stage.<\/p>\n resTORbio<\/b><\/a> is developing variants of rapamycin<\/a>, which is perhaps the most credible anti-aging drug commercially available.\u00a0 Rapamycin is not patentable, the main reason we see more research on variants and less on rapamycin itself.<\/p>\n CHAI = California Healthy Aging Initiative Activists in California are gathering support for a ballot initiative to provide $12B in state funding for anti-aging research over the next 12 years.\u00a0 CA is one of the states in which the people can create legislation directly with their votes; and in 2004, this process was used to appropriate $4B for stem cell research.\u00a0 Promoters of CHAI are trying to build on this precedent. But they face a dilemma. Gathering signatures and educating the public is an expensive proposition. They will need a broad coalition of research interests in the field to get their measure off the ground.\u00a0 But of course, these organizations will want to write the text in such a way as to direct future funding to themselves. The grass-roots activists who are energizing this initiative believe that adding incrementally to institutions that are already well-funded is less likely to generate disruptive technologies than <\/span>many small grants to individuals and start-ups with idiosyncratic theories of aging.\u00a0 <\/b>I like the idea of supporting small people with big ideas, perhaps because I are one.\u00a0 This is a science still in its exploratory phase, where we do not have a definite idea what will work, and there are competing theoretical frameworks to guide us.\u00a0 Once the proof-of-concept is complete, it\u2019s appropriate to pursue the \u201cD\u201d part of \u201cR&D\u201d, and for that, industrial-scale research is the most efficient course.<\/span><\/p>\n My perspective on the state of research<\/strong><\/p>\n I believe that aging is regulated under epigenetic control, but that the biochemical language of epigenetics is complicated, and it will be a slow road indeed if we persist in studying one intervention at a time.\u00a0 The time is right for open science, open communications, interdiciplinary collaboration, and the testing of treatments in sets of 2 and 3 and 4. (If we study only treatments in isolation, we miss the boat; but if we try to study 5-way and 12-way interactions, the number of combinations will overwhelm our neural networks–both silicon and wetware.)<\/span><\/p>\n![](\"https:\/\/cdn-images-1.medium.com\/max\/1200\/1*y6sLMHC-8RHv_aAlQKNugg.jpeg\")
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\nGame-changer on the horizon<\/b><\/p>\n