Rethinking Aging: the Moonshot

We need to rethink aging altogether.

Not from the prism of that which we think we know — the different concepts we have created to explain disease — but rather from biology. This would entail working from the biological changes that take place in a population as it ages, without paying attention to how we have previously labeled each of the individuals in that population. Only then can we determine who might benefit from one of the therapies currently gathering dust on the proverbial pharmacy shelf.

That is the moonshot. But it requires us to turn the tables around. Instead of starting from that which we think we know, such as asking what makes people with tremor different from people without, it behooves us to start from the more agnostic platform of biology. The type of question we would seek answers for is, for example, who are those with a given end of the spectrum of mitochondrial dysfunction about which we have specific therapies.

Thus, the future of clinical trials would not be based on targeting thousands of people sharing a clinical diagnosis but with many underlying (and unknown) biological abnormalities. Rather, clinical trials would be smaller, targeting fewer individuals at a time, but matched to a therapy or therapies with much greater odds of improving their specific biological abnormality – and slowing the progression of their disease.

That is the future the CCBP is helping to build.

– Prof. Alberto Espay

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