Intimations of Immortality

ANYONE FAMILIAR WITH longevity research cannot not know Bryan Johnson, the subject of the 2025 Netflix documentary Don’t Die: The Man Who Wants to Live Forever. Once a heavily built man born into a family of humble means, becoming a billionaire saw him embark on an ambitious mis­sion several years ago not only to lose weight and flaunt his taut physique but also to beat ageing.

With the help of doctors and scientists, he developed a health protocol involving a strict diet, exercises, therapies, and more—he consumes close to 100 supplements or medicines a day. That pro­tocol, named Blueprint, is now a company that sells supplements and food. Some experts look down on Johnson’s eccentricities: his daily routine is quixotic—it includes 12 minutes of exposure to infrared rays with the intention of accelerating healing, high-frequency electromagnetic stimulation on the abdomen that is considered the equivalent of 20,000 sit-ups, besides putting on a cap that has 312 laser diodes on his head for hair growth.

 Although a controversial figure in longevity research, on October 28, Johnson, the 48-year-old American biohacker who claims to be as young as an 18-year-old physically, received $60 million in investments for his anti-ageing startup Blueprint. The company plans more offerings, including prescriptions for GLP-1 (glucagon-like peptide-1 receptor) drugs and advanced therapies to extend lifespan, signalling the popularity and growth of an industry focused on fighting ageing through regenerative medicines and technology.

GLP-1 drugs, also called GLP-1 agonists, are terms used by clinicians for weight loss drugs like Ozempic and Trulicity that mimic the GLP-1 hormone and suppress food cravings. They are also categorised by a section of scientists as longevity drugs—a lineup that includes senolytics like dasatinib and quercetin; anti-diabetes medicines that include metformin; immunosuppres­sants like rapamycin and others; anti-hypertensives (telmisartan and others); and antioxidant resveratrol, among others that fight off inflammations and organ dysfunctions.

This quest for beating death is nothing new. From the Mayan civilisation to ancient Asia, including in India and China, immortality has been a recurring theme in literature. The texts of yore are proof of the attraction of the human race for eternal youth. For instance, in Indian mythology, amrit is the nectar of immortality, obtained after the churning of Kshira Sagara (ocean of milk). Yayati borrowed youthful vigour from his son Puru for a thousand years, a testament to how far imaginative narrators could go in their fascination for eternal youth.

Anti-ageing is a buzzword even as life expectancy continues to rise worldwide. From being considered a scientific backwater until some decades ago, regenerative medicine has now gone mainstream. With breakthroughs such as cell therapy, gene therapy, tissue engineering and various similar technologies playing the catalyst, the global regenerative medicine market is projected to be valued at $154.05 billion by 2033, with a CAGR of 18 per cent during the period of 2024 to 2033, according to Precedence Research, which adds that the market is driven by the rising prevalence of disorders and demand for pre­cision medicines.

I had interviewed Dr Aubrey de Grey in 2010 at a time he was iconised as the “prophet of immortality”, an epithet he said he didn’t like. Formerly chief science officer for UK-based SENS Foundation, Grey is now president and chief science officer of the Lon­gevity Escape Velocity (LEV) Foundation. Asked about the change over the last 15 years in regenerative medicine, he tells Open, “It’s beyond description.” Of course, regenerative medicine goes beyond the longevity ap­plication and the most valuable things that have happened are in fact applicable across the board, he emphasises. The obvious ones, Grey points out, are induced pluripotent stem cells and CRISPR. The result has been a burgeoning private sector in the area, which is vital, not least because investors tend to write bigger cheques than donors, he adds.

UCLA researchers explain what induced pluripotent stem cells (iPSCs) are. They are “derived from skin or blood cells that have been reprogrammed back into an embryonic-like pluripotent state that enables the development of an unlimited source of any type of human cell needed for therapeutic purposes”. According to the US-based National Library of Medicine, “Since their discovery, iPSCs have been used in many research and clinical studies includ­ing disease modelling, regenerative medicine, and drug discovery/drug cytotoxicity studies... Similarly, iPSCs are widely utilised for the regeneration of tissue-specific cells for the transplantation to patients of various injuries or degenerative diseases. Studies like drug discovery, which implies screening of small molecules, test­ing of toxicity for assessment of safety, have successfully exploited iPSCs based technique.” In fact, iPSCs taken from patients can be used to test the effectiveness and potential toxicity of new drugs on human cells before they are tested in humans.

ACCORDING TO MARYLAND-headquartered National Genome Research Institute, CRISPR stands for “clustered regularly interspaced short palindromic repeats”—a technology that research scientists use to selectively modify the DNA of living organisms. CRISPR was adapted for use in the laboratory from naturally occurring genome editing sys­tems found in bacteria. The technology offers a lot of promise in medical research and cure. Recently, a child diagnosed with a rare genetic disorder was treated with customised CRISPR gene edit­ing therapy in Philadelphia, according to reports in the US media.

In India, too, the regenerative medicine market is growing at a fast clip, thanks to many reasons, including a rise in unex­pected deaths among the young and an increase in the old-age population and concomitant growth of diseases. Currently valued at  ₹7,641 crore, it is expected by market research company IMARC to grow to  ₹4.3 lakh crore by 2033. Besides, the gov­ernment is funding research in the sector. For instance, the Indian Council of Medical Research (ICMR) and various other insti­tutes support both basic and clinical stem cell research and have been investing in cell therapies to treat cancer.

Dr Able Lawrence, professor of clini­cal immunology and rheumatology at Lucknow’s Sanjay Gandhi Post Graduate Institute of Medical Sciences, who has a special interest in the area, says that senescence, or the biological process of ageing, which starts in the blood vessels before it affects the organs, has generated great attention in recent years in In­dia. More importantly, doctors themselves are sensing that drugs such as metformin and telmisartan are effective in combating in­flammation and therefore ageing. Lawrence is excited about the effectiveness of senolytics, a class of drugs designed to selectively kill senescent cells, meaning damaged cells that cause inflam­mation and age-related diseases. Senolytics, he says, help delay osteoarthritis, Alzheimer’s disease and certain other age-related ailments. They are after all anti-cancer drugs, repurposed to kill se­nescent cells selectively. Although he hastens to add that research into the efficacy of many medicines is inconclusive, Lawrence sees the prospects of quicker technology adoption and medical development to target ageing. His scepticism stems from certain beliefs that people have, including the benefit of blood transfu­sion from younger people—it is also called “vampire therapy”. He cautions that benefits often come with side effects, too.

For all their insistence on more evidence in longevity research, several scientists and doctors Open spoke to are nonetheless hap­py that it focuses on debilitating ailments and also prevention.

Talking about the hype around weight loss medicines, met­formin, rapamycin and so on, Grey tells Open that he would defi­nitely not put the GLP-1 receptor agonists in the same bucket as metformin and rapamycin. “The latter are (in different ways) calorie-restriction mimetics, that is, drugs that trick the body into thinking it’s in a famine even though it isn’t. The GLP-1s are appetite suppressants (of a new kind). They have the potential to make more of a difference to age-related chronic conditions than calorie-restriction mimetics. However, I don’t think either of them will really repair damaged cells, though both of them may prevent/delay inflammation,” he says.

Grey believes that gene engineering and stem cell therapy will be absolutely central to the medical defeat of ageing. “Both areas are progressing really fast right now, and that’s my main reason for optimism concerning timeframes for reaching longevity es­cape velocity,” avers the 62-year-old.

As with the watershed research he was part of, Grey adds, “I’d say that the biggest one was the ‘RMR1’ study that we performed over the past three years, taking 1,000 mice and showing that we could extend their lives more by a combination of damage-repair treatments than by one such treatment on its own. This opens the door to getting much larger lifespans (initially only in mice) by combining more treatments, which is what our next study will do.”

Some doctors meanwhile highlight a 2020 experiment with a polypill (containing 40mg of simvastatin, 100mg of atenolol, 25mg of hydrochlorothiazide, and 10mg of ramipril) and aspirin in people without any cardiovascular disease to say that anti-ageing research outcomes can be cost-effective, too. As it happens, low-income and middle-income countries account for more than 80 per cent of car­diovascular diseases each year worldwide, according to Lancet.

Among the drugs that a section of researchers say delay ageing are SGLT2 inhibitors (which stop the kidneys from reabsorbing sugar) and bisphosphonates, besides supplements such as resve­ratrol and Coenzyme Q10 that protect against oxidative stress and promote heart health. Evidently, based on sales data, the consump­tion of supplements has gone up globally, including in India.

Meanwhile, a University of East Anglia (UEA) research, in collaboration with the University of Glasgow, is gung-ho about rapamycin. A recent report on the university’s website said ra­pamycin has the same life-extending effect as eating less. The report quoted co-lead researcher Dr Zahida Sultanova, from the UEA’s School of Biological Sciences, as saying, “Dietary restric­tion—for example through intermittent fasting or reduced calo­rie intake—has been the gold standard for living longer. But it’s difficult for most of us to maintain [it] long-term.”

Despite being viewed with suspicion for its costly treatments and limited scientific evidence, the longevity movement, which weight loss drugs are part of, has succeeded in promoting a greater awareness of the need to age well and live longer.