It’s Saturday afternoon and it’s perfect weather for a picnic at Dolores Park. I’m introduced to a mutual friend when they eventually ask, “what do you do for work?” and to this day I pause every time.
After two years working at a biotech startup, even some of my closest friends don’t understand exactly what I do between 8 to 8. So, every time someone asks me that question, during this ~2 sec pause I think about how many degrees away they are to the lab bench off some heuristics, and give an answer that’s usually some variation of:
“I work at a biotech startup (in San Francisco) as a biologist, trying to find cures for age-related diseases”.
In my final three-part series of my first-ever blog posts, I want to try to explain one of the most complex and mis-understood field in biology and popular culture: Longevity.
//TW: Topics about life and death
First
There’s only two rules on a first date: 1.) Don’t pull up on the Segway Ninebot MAX G30LP, and 2.) Don’t say you work in Longevity.
Longevity (biotech) has a marketing issue. Jeff Bezos invested an undisclosed amount to a $3B “startup” company that’s discovering therapies to reverse aging. Stitch together the blood vessels of an old mouse to that of a young mouse and the young blood plasma “rejuvenates” the old mouse. The field is plagued with misinformation that paints a very particular, first-world image of the science and the people that research and fund it.
That’s why I say I work on “age-related diseases” instead of “longevity,” because I don’t want to come off as a worshiper of eternal life and Bezos the all-mighty. I, like many other Scientists in this field, just want to help people by curing diseases. While there are Scientists that try to tackle “aging” as a disease itself to live longer. Others, like me, want to find ways to live healthier for longer.
But this field of Longevity, much like Gene Therapy, allows us to fundamentally change our preconceived notions of life and death. It’s certainly a biological challenge, but the social consequences carry greater weight.
And unfortunately, these complex biological stories are over-sensationalized by the media (blood boys, rapamycin, metformin, etc.). Today, I wanted to talk briefly about the modern-day efforts in Longevity; what’s possible, what’s being done, and who’s doing it. I’ll be explaining the objectives of the field, it’s progress, and what it means to me (and maybe you, too).
Longevity – Adding Life to our Years
When I first entered this field, I thought to myself: “why would I care if I lived longer? That’ll just mean I’ll rot in a hospital alone, pop Advil like candy and be riddled with bedsores until I finally take my last breath.” I don’t love the idea of dying, but if I’m going to be sick and frail in my old age I’d rather have those moments be quick. The last thing I want is my suffering to be drawn out because some “miracle drug” allowed me to “live” until 120. I don’t know about you, but that’s not exactly what I call living.
I’ve seen it all my life, just like you. My grandma has Heart Failure, and my grandpa almost definitely has Osteoarthritis. They can’t walk very fast or too far without discomfort/pain. My most distinct and early memory of growing up in Japan is of routine hospital visits to see my bed-ridden +95yr old great grandma who could barely recognize my face, let alone sit up by herself. So I thought: “What’s the point of living longer, if that’s how I’ll be spending the extra few years a longevity drug give me?”
When I entered the field, I realized quickly that Longevity was actually about adding healthy years to our lives. People called that healthspan, our total years spent as healthy as if you were ~20. Whereas lifespan, were our total years we lived. In the past ~century, advances in hygiene, vaccination, and healthcare have significantly increased our lifespan, where many of us now can expect to live past 80yrs old. But what hasn’t changed much in all of this is how we die. Our healthspan, and more specifically how we spend our final ~25% of our lives. That part hasn’t really changed.
We see it all around us. Our parents, grandparents, all of them, age.
And they become frail. Their quality-of-life plummets. They can’t clear the dining room table without bumping into it. Their knees become weak. They develop heart problems and need frequent breaks on the 10-minute walk to the train station.
But what if we can change that? What if we can find ways to sustain a healthy body for longer to live as healthy as a 18yr old, basically right until you die? That’s the main objective of the longevity field. And that, I can get behind.
The field of Longevity stems from gerontology, the study of old age and process of aging. It’s a broad field that has informed policy-making around health and elderly populations as well as basic research on how organisms age. They’re academics and scientific experts that have observed how we die for decades and sought ways to change it.
Over the past decade the field has intersected with cutting-edge technology from lots of different fields in molecular biology, gene editors, single cell transcriptomics, high-dimensional data analysis, enabling dozens of companies to find cures to age-related diseases and ways to extend lifespan.
Many of these companies operate under the gerontology (aka Longevity) hypothesis and is the foundation of these companies’ theses.
The Longevity Hypothesis
The gerontology hypothesis from Martin B. Jensen’s seminar on aging at 50Years.
In the past decade, the field has experienced a large push for longevity biotech. Yes, the majority of funding comes from large institutional investors, billionaires, Sam Altman and the likes. But no, the drugs that’re discovered are not just for them.
Because “longevity biotech” is actually a poorly phrased umbrella term for a huge array of companies that exist. These companies can range from tiny startups like Deciduous that at seed-stage with <$15M in funding, to huge ones like Calico, an Alphabet-backed company with bountiful of capital and resources. These longevity companies target different diseases, organs, and pathways of aging. But their theses are derived from the same central hypothesis that says:
If we can understand the biological pathways of aging as a series of chronological events, we can change the process of aging to prevent or cure age-related diseases and even aging itself.
It’s moonshot-y but hear me out.
Babies don’t get cancer. They don’t get Heart Failure, Osteoarthritis, dementia, diabetes, lung fibrosis, or non-alcoholic steatohepatitis. It’s only in later stages in life where we often see these diseases crash into us at full-speed, often a few at once. What if there’s something happening in our bodies as we age that is causing our bodies to slip, and the damage is exhibiting as “disease”?
What if aging is the cause, and the diseases are the symptoms?
This is the central hypothesis of longevity and the biotechs in the industry as a whole. The ambitious mission to allow us to live healthier for longer. Some companies like New Limit targets aging as the disease itself, and tries to find ways to slow, halt, or reverse that biological process. Others like Gordian target specific diseases that occur throughout the aging process (Heart Failure, Osteoarthritis, MASH, Pulmonary Fibrosis) and tries to find cures for those specific diseases.
Despite what you might hear on the news, many “longevity biotechs” are in the second category that want to add health years to our lives. No one wants you to just live longer in poor health.
Cuz I mean, what’s the point of that?
“I work in longevity”
Because I want to live healthier for longer, with the people I love.
I’ve always dreamed of curing a disease. Make a real difference. I work in longevity because I have a chance to give people a choice to live a healthier life for longer through medicine. Growing up, my mom would always say she wanted to die a quick and painless death. She doesn’t want her end to be drawn out like so many others: bed-ridden in a hospital or a retirement community.
Honestly, I want the same ending. And I think a part of me is a Drug Hunter because this is my way to make this dream come true. Not just bed-ridden in a hospital hooked onto a machine. I want to be able to play tennis whenever I want, walk to Tartine for a pastry in the morning, pick up some free Birite bread between 9-10pm on 18th & Guerrero. I just want live my life however I want right up to my final moment.
Our search for longevity is no Sisyphean quest, and it certainly won’t just be for the uber rich. These drugs that increase our healthspan will be for all of us.
And we’re going to see it in this century. In the next 10-20yrs we’ll see more and more drugs that fight age-related diseases in clinical trials. And in the next 30-50yrs, there will be drugs in the market that will give us the choice to make 70 the new 50.
We’ll be able to run along Embarcadero, finally hike Half Dome, have dinner in the Sunset at Mandalay… just the life we all know and love, for longer.
Final note: a letter from Investor (and now CEO!), Laura Demming, on Longevity.
Special thanks to Chiraag Hebbar for your feedback on my writing.
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