Lifespan

Descended from gene B in M. superstes, sirtuins are enzymes that remove acetyl tags from histones and other proteins and, by doing so, change the packaging of the DNA, turning genes off and on when needed. These critical epigenetic regulators sit at the very top of cellular control systems, controlling our reproduction and our DNA repair. After a few billion years of advancement since the days of yeast, they have evolved to control our health, our fitness, and our very survival. They have also evolved to require a molecule called nicotinamide adenine dinucleotide, or NAD. As we will see later, the loss of NAD as we age, and the resulting decline in sirtuin activity, is thought to be a primary reason our bodies develop diseases when we are old but not when we are young.

Trading reproduction for repair, the sirtuins order our bodies to “buckle down” in times of stress and protect us against the major diseases of aging: diabetes and heart disease, Alzheimer’s disease and osteoporosis, even cancer. They mute the chronic, overactive inflammation that drives diseases such as atherosclerosis, metabolic disorders, ulcerative colitis, arthritis, and asthma. They prevent cell death and boost mitochondria, the power packs of the cell. They go to battle with muscle wasting, osteoporosis, and macular degeneration. In studies on mice, activating the sirtuins can improve DNA repair, boost memory, increase exercise endurance, and help the mice stay thin, regardless of what they eat. These are not wild guesses as to their power; scientists have established all of this in peer-reviewed studies published in journals such as Nature, Cell, and Science.

And in no small measure, because sirtuins do all of this based on a rather simple program—the wondrous gene B in the survival circuit—they’re turning out to be more amenable to manipulation than many other longevity genes. They are, it would appear, one of the first dominos in the magnificent Rube Goldberg machine of life, the key to understanding how our genetic material protects itself during times of adversity, allowing life to persist and thrive for billions of years.

Sirtuins aren’t the only longevity genes. Two other very well studied sets of genes perform similar roles, which also have been proven to be manipulable in ways that can offer longer and healthier lives.

One of these is called target of rapamycin, or TOR, a complex of proteins that regulates growth and metabolism. Like sirtuins, scientists have found TOR—called mTOR in mammals—in every organism in which they’ve looked for it. Like that of sirtuins, mTOR activity is exquisitely regulated by nutrients. And like the sirtuins, mTOR can signal cells in stress to hunker down and improve survival by boosting such activities as DNA repair, reducing inflammation caused by senescent cells, and, perhaps its most important function, digesting old proteins.[43 - Research by the authors showed that mTORC1 signaling in cancer cells increases survival by “suppressing endogenous DNA damage, and may control cell fate through the regulation of CHK1.” X. Zhou, W. Liu, X. Hu, et al., “Regulation of CHK1 by mTOR Contributes to the Evasion of DNA Damage Barrier of Cancer Cells,” Nature Scientific Reports, May 8, 2017, https://www.nature.com/articles/s41598-017-01729-w; D. M. Sabatini, “Twenty-five Years of mTOR: Uncovering the Link from Nutrients to Growth,” Proceedings of the National Academy of Sciences of the United States of America 114, no. 45 (November 7, 2017): 11818–25, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5692607/.]

When all is well and fine, TOR is a master driver of cell growth. It senses the amount of amino acids that is available and dictates how much protein is created in response. When it is inhibited, though, it forces cells to hunker down, dividing less and reusing old cellular components to maintain energy and extend survival—sort of like going to the junkyard to find parts with which to fix up an old car rather than buying a new one, a process called autophagy. When our ancestors were unsuccessful in bringing down a woolly mammoth and had to survive on meager rations of protein, it was the shutting down of mTOR that permitted them to survive.

The other pathway is a metabolic control enzyme known as AMPK, which evolved to respond to low energy levels. It has also been highly conserved among species and, as with sirtuins and TOR, we have learned a lot about how to control it.

These defense systems are all activated in response to biological stress. Clearly, some stresses are simply too great to overcome—step on a snail, and its days are over. Acute trauma and uncontrollable infections will kill an organism without aging that organism. Sometimes the stress inside a cell, such as a multitude of DNA breaks, is too much to handle. Even if the cell is able to repair the breaks in the short term without leaving mutations, there is information loss at the epigenetic level.

Here’s the important point: there are plenty of stressors that will activate longevity genes without damaging the cell, including certain types of exercise, intermittent fasting, low-protein diets, and exposure to hot and cold temperatures (I discuss this in chapter 4 (#x14_ch4)). That’s called hormesis.[44 - E. J. Calabrese, “Hormesis: A Fundamental Concept in Biology,” Microbial Cell 1, no. 5 (May 5, 2014): 145–49, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5354598/.] Hormesis is generally good for organisms, especially when it can be induced without causing any lasting damage. When hormesis happens, all is well. And, in fact, all is better than well, because the little bit of stress that occurs when the genes are activated prompts the rest of the system to hunker down, to conserve, to survive a little longer. That’s the start of longevity.

Complementing these approaches are hormesis-mimicking molecules. Drugs in development and at least two drugs on the market can turn on the body’s defenses without creating any damage. It’s like making a prank call to the Pentagon. The troops and the Army Corps of Engineers are sent out, but there’s no war. In this way, we can mimic the benefits of exercise and intermittent fasting with a single pill (I discuss this in chapter 5 (#litres_trial_promo)).

Our ability to control all of these genetic pathways will fundamentally transform medicine and the shape of our everyday lives. Indeed, it will change the way we define our species.

And yes, I realize how that sounds. So let me explain why.

TWO

THE DEMENTED PIANIST

ON APRIL 15, 2003, NEWSPAPERS, TELEVISION PROGRAMS, AND WEBSITES around the world carried the story: the mapping of the human genome was complete.

There was just one pesky problem: it really wasn’t. There were, in fact, huge gaps in the sequence.

This wasn’t a case of the mainstream news media blowing things out of proportion. Highly respected scientific journals such as Science and Nature told pretty much the same story. It also wasn’t a case of scientists overstating their work. The truth is simply that, at the time, most researchers involved in the thirteen-year, $1 billion project agreed that we’d come as close as we possibly could—given the technology of the time—to identifying each of the 3 billion base pairs in our DNA.

The parts of the genome that were missing, generally overlapping sections of repetitive nucleotides, were just not considered important. These were areas of the code of life that were once derided as “junk DNA” and that are now a little better respected but still generally disregarded as “noncoding.” From the perspective of many of the best minds in science at the time, those regions were little more than the ghosts of genomes past, mostly remnants of dead hitchhiking viruses that had integrated into the genome hundreds of thousands of years ago. The stuff that makes us who we are, it was thought, had largely been identified, and we had what we needed to propel forward our understanding of what makes us human.

Yet by some estimates, that genetic dark matter accounts for as much as 69 percent of the total genome,[45 - Up to 69 percent of the human genome may be repetitive or derived from endogenous viral DNA repeats, compared to previous estimates of around half. A. P. de Konig, W. Gu, T. A. Castoe, et al., “Repetitive Elements May Comprise over Two-thirds of the Human Genome,” PLOS Genetics 7, no. 12 (December 7, 2011), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228813/.] and even within the regions generally regarded as “coding,” some scientists believe, up to 10 percent has yet to be decoded, including regions that impact aging.[46 - Just what do we mean by the word finished when it comes to the sequencing of the human genome? Turns out, more than we thought back in the early 2000s. Regions of the genome previously thought of as nonfunctional are now emerging as playing potential roles in cancer, autism, and aging. S. Begley, “Psst, the Human Genome Was Never Completely Sequenced. Some Scientists Say It Should Be,” STAT, June 20, 2017, https://www.statnews.com/2017/06/20/human-genome-not-fully-sequenced/.]

In the relatively short time that has come and gone since 2003, we have come to find out that within the famous double helix, there were sequences that were not just unmapped but essential to our lives. Indeed, many thousands of sequences had gone undetected because the original algorithms to detect genes were written to disregard any gene less than 300 base pairs long. In fact, genes can be as short as 21 base pairs, and today we’re discovering hundreds of them all over the genome.

These genes tell our cells to create specific proteins, and these proteins are the building blocks of the processes and traits that constitute human biology and lived experiences. And as we get closer to identifying a complete sequence of our DNA, we’ve come closer to having a “map” of the genes that control so much of our existence.

Even once we have a complete code, though, there’s something we still won’t be able to find.

We won’t be able to find an aging gene.

We have found genes that impact the symptoms of aging. We’ve found longevity genes that control the body’s defenses against aging and thus offer a path to slowing aging through natural, pharmaceutical, and technological interventions. But unlike the oncogenes that were discovered in the 1970s and that have given us a good target for going to battle against cancer, we haven’t identified a singular gene that causes aging. And we won’t.

Because our genes did not evolve to cause aging.

YEAST OF EDEN

My journey toward formulating the Information Theory of Aging was a long one. And in no small part, it can be traced to the work of a scientist who toiled without fame but whose work helped set the stage for a lot of the longevity research being done around the world today.

His name was Robert Mortimer, and if there was one adjective that seemed to come up more than any other about him after he passed away, it was “kind.”

“Visionary” was another. “Brilliant,” “inquisitive,” and “hardworking,” too. But I’ve long been inspired by the example Mortimer set for his fellow scientists. Mortimer, who died in 2007, had played a tremendously important role in elevating Saccharomyces cerevisiae from a seemingly lowly, single-celled yeast with a sweet tooth (its name means “sugar-loving”) to its rightful place as one of the world’s most important research organisms.

Mortimer collected thousands of mutant yeast strains in his lab, many of which had been developed right there at the University of California, Berkeley. He could have paid for his research, and then some, by charging the thousands of scientists he supplied through the university’s Yeast Genetic Stock Center. But anyone, from impecunious undergraduates to tenured professors at the world’s best-funded research institutions, could browse the center’s catalog, request any strain, and have it promptly delivered for the cost of postage.[47 - Dating back to the 1960s, every three or four years the center has published a catalog of its strains of Saccharomyces cerevisiae. R. K. Mortimer, “Yeast Genetic Stock Center,” Grantome, 1998, http://grantome.com/grant/NIH/P40-RR004231-10S1.]

And because he made it so easy and so inexpensive, yeast research bloomed.

When Mortimer began working on S. cerevisiae alongside fellow biologist John Johnston[48 - Yeast researchers have interesting names. John Johnston and my adviser Dick Dickinson are just two of them.] in the 1950s, hardly anyone was interested in yeast. To most, it didn’t seem we could learn much about our complex selves by studying a tiny fungus. It was a struggle to convince the scientific community that yeast could be useful for something more than baking bread, brewing beer, and vinting wine.

What Mortimer and Johnston recognized, and what many others began to realize in the years to come, was that those tiny yeast cells are not so different from ourselves. For their size, their genetic and biochemical makeup is extraordinarily complex, making them an exceptionally good model for understanding the biological processes that sustain life and control lifespans in large complex organisms such as ourselves. If you are skeptical that a yeast cell can tell us anything about cancer, Alzheimer’s disease, rare diseases, or aging, consider that there have been five Nobel Prizes in Physiology or Medicine awarded for genetic studies in yeast, including the 2009 prize for discovering how cells counteract telomere shortening, one of the hallmarks of aging.[49 - In 2016, Dr. Yoshinori Ohsumi won the Nobel Prize in Physiology or Medicine for his work on autophagy in yeast. That’s when cells stave off extinction during hard times by digesting nonkey parts of themselves. B. Starr, “A Nobel Prize for Work in Yeast. Again!,” Stanford University, October 3, 2016, https://www.yeastgenome.org/blog/a-nobel-prize-for-work-in-yeast-again.]

The work Mortimer and Johnston did—and, in particular, a seminal paper in 1959 that demonstrated that mother and daughter yeast cells can have vastly different lifespans—would set the stage for a world-shattering change in the way we view the limits of life. And by the time of Mortimer’s death in 2007, there were some 10,000 researchers studying yeast around the globe.

Yes, humans are separated from yeast by a billion years of evolution, but we still have a lot in common. S. cerevisiae shares some 70 percent of our genes. And what it does with those genes isn’t so different from what we do with them. Like a whole lot of humans, yeast cells are almost always trying to do one of two things: either they’re trying to eat, or they’re trying to reproduce. They’re hungry or they’re horny. As they age, much like humans, they slow down and grow larger, rounder, and less fertile. But whereas humans go through this process over the course of many decades, yeast cells experience it in a week. That makes them a pretty good place to start in the quest to understand aging.

Indeed, the potential for a humble yeast to tell us so much about ourselves—and do so quite quickly relative to other research organisms—was a big part of the reason I decided to begin my career by studying S. cerevisiae. They also smell like fresh bread.

I met Mortimer in Vienna in 1992, when I was in my early 20s and attending the International Yeast Conference—yes, there is such a thing—with my two PhD supervisors, Professor Ian Dawes, a rule-avoiding Australian from the University of New South Wales,[50 - Dawes’s delightful tour of his experiences in the world of academe and cell biology research is a refreshingly direct and personal account of a remarkable journey into yeast research over four decades. I. Dawes, “Ian Dawes—the Third Pope—Lucky to Be a Researcher,” Fems Yeast Research 6, no. 4 (June 2016), https://academic.oup.com/femsyr/article/16/4/fow040/2680350.] and Professor Richard Dickinson, a rule-abiding Briton from the University of Cardiff, Wales.

Mortimer was in Vienna to discuss a momentous scientific endeavor: the sequencing of the yeast genome. I was there to be inspired. And I was.[51 - I also learned, the hard way, that I should not drink copious quantities of yeasty beer.] If I’d harbored any doubts about my decision to dedicate the opening years of my scientific career to a single-celled fungus, they all went away when I came face to face with people who were building great knowledge in a field that had hardly existed a few decades before.

It was shortly after that conference that one of the world’s top scientists in the yeast field, Leonard Guarente of the Massachusetts Institute of Technology, came to Sydney on holiday to visit Ian Dawes. Guarente and I ended up at a dinner together, and I made sure I was sitting opposite him.

I was then a graduate student using yeast to understand an inherited condition called maple syrup urine disease. As you might imagine from its name, the disease is not something most polite people discuss over dinner. Guarente, though, engaged me in a scientific discussion with a curiosity and enthusiasm that was nothing short of enchanting. The conversation soon turned to his latest project—he had begun studying aging in yeast the past few months—work that had its roots in the workable genetic map that Mortimer had completed in the mid-1970s.

That was it. I had a passion for understanding aging, and I knew something about wrangling a yeast cell with a microscope and micromanipulator. Those were essential skills needed to figure out why yeast age. That night, Guarente and I agreed on one thing: if we couldn’t solve the problem of aging in yeast, we had no chance in humans.

I didn’t just want to work with him. I had to work with him.

Dawes wrote him to tell him that I was keen to join his lab and I was “skilled at the bench.”

“It would be a pleasure to work with David,” he replied a few weeks later, the same way he probably did to so many other enthusiastic applicants. “But he’s got to come with his own funding.” Later I learned he had been excited only because he’d thought I was the other student he’d met at dinner.

I had a foot in the door, but my chances were slim. At the time, foreigners weren’t considered for prestigious postdoctoral awards in the United States, but I insisted I be interviewed and paid for a flight to Boston myself. I was interviewed by a giant in the stem cell field, Douglas Melton, for a Helen Hay Whitney Foundation Fellowship, which has been providing research support to postdoctoral biomedical students since 1947. After waiting in line outside his office with the other four candidates, I had my chance. This was my moment. I don’t remember being nervous. I figured I probably wouldn’t get the award anyway. So I went for it.

I told Melton about my lifelong quest to understand aging and find “life-giving genes,” then sketched out on his whiteboard how the genes work and what I’d be doing for the next three years if I got the money. To show my gratitude, I gave him a bottle of red wine that I’d brought from Australia.

Afterward, two things became clear. One, don’t bring wine to an interview because it can be seen as a bribe. And two, Melton must have liked what I said and how I said it, because I flew home, got the fellowship, and then got onto a plane back to Boston. It was, without a doubt, the most life-changing meeting of my life.[52 - For four years after that, I sent Professor Melton a bottle of red wine for New Year’s, just to say thanks for changing my life. He never acknowledged any of them or ever smiled at me, either because he didn’t think that’s what an awardee should do or because he’s a very private person. At least he knew I was grateful. The selection of red wine turned out to be ironic, as that foodstuff helped propel my career a second time nine years later.]

At the time of my arrival, in 1995, I had expected to build our understanding of aging by studying Werner syndrome, a terrible disease that occurs in less than 1 in 100,000 live births, with symptoms that include a loss of body strength, wrinkles, gray hair, hair loss, cataracts, osteoporosis, heart problems, and many other telltale signs of aging—not among folks in their 70s and 80s but rather among people in their 30s and 40s. Life expectancy for someone with Werner is 46 years.

Within two weeks of my arrival in the United States, though, a research team at the University of Washington, headed by the wise and supportive grandfather of aging research, George Martin, announced that they had found the gene that, when mutated, causes Werner syndrome.[53 - C. E. Yu, J. Oshima, Y. H. Fu, et al., “Positional Cloning of the Werner’s Syndrome Gene,” Science 27, no. 5259 (April 12, 1996): 258–62, https://www.ncbi.nlm.nih.gov/pubmed/8602509.] It was deflating at the time to have been “scooped,” but the discovery allowed me to take a bigger first step toward my ultimate objective. Indeed, it became the key to formulating the Information Theory of Aging.

Now that the Werner gene, known as WRN, had been identified in humans, the next step was to test if the similar gene in yeast had the same function. If so, we could use yeast to more rapidly determine the cause of Werner syndrome and perhaps help us better understand aging in general. I marched into Guarente’s office to tell him I was now studying Werner’s syndrome in yeast and that’s how we would solve aging.