Just putting this out there, I am a PharmD and this is totally real and the traditional medical establishment is really behind. It is positive effects are beyond doubt - the argument against it is usually "we don't know what the side effects if 100m+ went on it for 20+ years". (which is also 100% true, but that's where patient autonomy comes in). Also, there are some questions about how much are really the positive effects.
Anyway, I am tinkering with something in that space - feel free to reach out if you want explore being a co-founder. (email in about)
What makes me scared about this is that it's immunosuppressive. The immune system is a very important part of the human body, and I worry that taking it could have terrible health impact after years of acting on your body lines of defense.
Your concern is correct. Suppressing the immune system is a 2-edged sword - a little suppression in the right setting, is extremely beneficial, but go overboard and it is harmful. That's why in a perfect world, we would have large human trials with different dosages and iterate until we can get the maximum benefit and the least harm.
The problem is, no one wants to do those trials because rapamycin is cheap and generic. Why would Pharma spend money on something that they can't patent? Also, these kind of trials have to go on for 10+ years at a minimum - which is cost-prohibitive even if it is patentable (not to go in the weeds, but long trials count in the period of exclusivity given to pharma patents).
I believe the right approach is to use it off-label, be upfront about the potential risks, and collect lots of data so you can improve as you go. Practical anti-aging so to speak.
Another approach is through the NIH grant pathway, but that has a lot of road-blocks as well.
> The problem is, no one wants to do those trials because rapamycin is cheap and generic. Why would Pharma spend money on something that they can't patent?
Same issue with psychedelics. However, they are so useful that people in the medical/therapeutic/academic fields are doing tons of research anyway.
Apparently big pharma is also trying to create their own psychedelics (there was an article about it on the front page of HN recently).
So far, the business seems like it will be on the assisted therapy side and everything that it entails. So more like services instead of products.
> That's why in a perfect world, we would have large human trials with different dosages and iterate until we can get the maximum benefit and the least harm.
Off topic, but whenever I think about this, I find myself thinking that what the world really needs is next-level human/medicinal modeling. Imagine if human trials didn't have to happen in order to know the long-term effects (and in a fraction of the time)!
I'd imagine we'd have to have complete knowledge of the human body to completely replace human testing. There's a hell of a lot that we don't know, especially when it comes to why or how things work.
I'm sure. But it's data we don't even have right now. We don't even know every chemical that naturally occurs in the body, how are we supposed to predict how they could interact with novel chemicals? Some day, though, it may be possible. There was a point where people couldn't imagine these image generation AIs working
Yea, data collection is the key here. If we had unobstrusive sensors that people could wear and embed in their body, to continuously measure a multitide of biometrics, that would greatly empower bio-AI systems.
Why don't insurance companies fund some of this research? Honestly, I don't know.
Wouldn't they want to get treatment costs down? Large HMOs, especially, have motivation to control treatment costs, and access to the patients, data, etc... to make it work.
Delivering care counts toward their margins, regulated by the ACA. I forget the exact number, but it is 80 percent to be spent on care, something like that.
The key thing is more care = more dollars = more in the bank.
One response to that legislation was insurers buying care providers.
If you think about it, there are specific parts of our immune systems that are likely entirely maladaptive given modern civilization, where people are ~never exposed to parasites, animal venoms, etc.
We can turn those parts off, while leaving everything else on, and be better for it (no allergies, psoriatic arthritis, MS, Chron’s, etc.; and so none of the accelerated cellular senescence those conditions provoke in affected tissue.)
A lot of recent pharma is already focused on doing specific forms of this at low levels. Every other drug ad in the US is for an immune-receptor blocker of some kind. And the side effects of these drugs come down mostly to the fact that they’re too low-level — they stop these parts of the immune system from being called into action at affected sites, but they leave it active and “patrolling”, such that it attacks harder any tissues that don’t absorb the receptor-blocker well, and such that you get withdrawal effects of potential inflammatory crisis if/when it wears off.
Just deactivating the relevant parts of the immune system entirely, on the other hand, provides the same benefits these drugs do, but with none of the “now the rowdy enforcers have nothing better to do, so they go looking for trouble” drawbacks.
Deactivating parts of the immune system wouldn't be simpler than giving receptor blockers. Everything in the body is connected to one another, and whatever circulating immune signaling proteins are involved could have numerous other effects on other non-immune cells.
There's also no reason to think that the immune system is so easily split up between systems that respond to parasites, bacteria, and virii. While a human designer might think that way, in nature most things are messy and have tons of overlap. This is true of the immune system. For example you can measure C-Reactive Protein and use it as a thermometer for general systemic inflammation. But elevated levels could as likely be a cold as a particularly intense workout-- they'll both trigger strong immune reactions with lots of overlap in effect.
> There's also no reason to think that the immune system is so easily split up between systems that respond to parasites, bacteria, and virii.
Well, sure. We essentially have multiple "immune systems", with overlapping goals. (Sort of like having both an anti-virus and anti-spyware scanner installed, as well as a system integrity checker, secure-boot verification logic, etc.)
Some immune responses are good at stopping all sorts of things (e.g. xenoreactive antibodies, which attack both parasites, bacteria, and cancer cells.) I wouldn't suggest doing anything to these. Conveniently, these processes don't tend to cause many long-term health problems, save in edge cases (e.g. xenograft implantation.)
Other immune responses are more specialized. And — also conveniently — it's the reactions/systems that specialize in responding to things we see almost none of in "city living", that seem to do bad things for longevity.
Parasite-specialist immune cells (mast cells), for example, cause a lot of chronic inflammatory problems. We've been preventing mast cells from doing their jobs for a long time now — that's the point of taking antihistamines — with very little negative to show for it. I don't think it would be much of a stretch from there to a treatment for allergies that's just a siRNA that "NOPs out" the entire immune-response functionality of mast cells. (Or even a "permanent" treatment for allergies, via CRISPR gene edit to rub out the definition of mast-cell antigen recognition receptors from the body's vocabulary.)
And I would also say that it's not much of a stretch to hypothesize that people who had this done, would, under longitudinal studies, show increased longevity / QUALYs. "Never having an [even sub-clinical] allergic reaction" would do really good things for the body. At the cost of — for most people reading this — just having to avoid sashimi.
For the average human on Earth: sure, merely uncommon.
For the average person who lives in a city and rarely goes out into nature, and paranoid-ly avoids doing things like walking barefoot in dung or wearing shortsleeves in forests when they do: effectively never.
If you live within the malaria zone (and an awful lot of people do) being in a city isn't protection. And the main threat from short sleeves in the forest is things that want your blood, not parasite infection.
According to the abstract of the article, its effects, at least in that form of using it, were not immunosuppresive.
On the contrary, the protection of the intestine to aging effects was due to increased autophagy in the intestinal cells, which eliminated the defective cells, and by increased levels of antimicrobial lysozyme, and these effects persisted long after the initial treatment ended.
As someone already said - rapamycin literature is mostly in cancer and transplant patients and with relatively high-doses. The risks are real, but my clinical judgement would lead me to believe that for at least some people the benefits would far outweigh the risks
Anyway, I am tinkering with something in that space - feel free to reach out if you want explore being a co-founder. (email in about)