العلم (وليس الخيال) حول الشيخوخة: مقدمة

I initially wrote about Anti-Ageing in 2023, will there ever be a cure to ageing?

Over the coming months I will expand my thoughts in this area, specifically regarding the various medications and supplements used in this rapidly evolving science.

This will not be about skin creams, retinols, sun protection, botulinum toxin and dermal fillers.

I will look at products that I am familiar with in my clinical practice, some of my observations and commentary may not necessarily concur with all current research (which extensively exists).

I’ll talk about Metformin, following on with (in no order but please say if you would like one) the GLP-1 and GIP Peptides, Statins, Vitamins D, K and Bs, Fish Oils, Oestrogen, Testosterone, DHEA, NMN, Resveratrol, Acarbose, Quercetin, Spermidine and Rapamycin. This list is not exhaustive and will continue to expand as new research emerges.

Hopefully I can answer questions I get asked daily. ‘What should or could I take? Where do I get it from and how much do I take?’

The most important things in maintaining our health and lifespan remain things we all know already. To sleep well and exercise regularly focusing not only on aerobic activity but muscle strength. To remember that our mental health is as much as important as our physical health. It’s maintaining a healthy diet including periods of dietary restriction, keeping your weight and visceral fat low.

First a bit about some of the science and terms around ageing.

The risk of death roughly doubles every 8 years. Illness essentially occurs the further we get from our date of birth. Our genetic code is programmed into DNA and DNA damage is a natural consequence of ageing.

Telomeres are repetitive DNA sequences at the end of chromosomes to protect the chromosomes from becoming frayed or tangled, each time a cell divides the layers shorten. They are essential in protecting the integrity of chromosomes and organismal ageing.

Specific cells that divide many times have an enzyme called ‘telomerase’ which helps to add the telomeres back to the chromosomes.

Senescent cells are effectively old or run-down cells that have reached the end of their lives or have been damaged beyond repair. They produce a mixture of cytokines, chemokines, growth factors and extracellular matrix proteases which spread inflammation and are harmful to neighbouring cells.

في مرحلة الشباب، يستطيع جهاز المناعة لدينا التخلص منها بنفسه، ولكن مع تقدمنا في العمر، تقل فعالية الجسم في القيام بذلك، مما يؤدي إلى تراكمها وإلحاق الضرر بالخلايا الأخرى. وقد تم ربط وجود أعداد كبيرة من الخلايا المتقادمة بأمراض مرتبطة بالشيخوخة مثل السكري والسرطان.

There are currently in excess of 20 different clinical trials of drugs that combat senescent cells (known as senolytics), targeting several different age-related conditions from Alzheimer’s to Osteoarthritis and beyond. Whilst more data is needed, the hope is that senolytics could be the key to slowing down (not just progression) of specific diseases and ageing more generally.

تُعد «سينومورفيكس» فئة أخرى من الأدوية قيد الدراسة. فهذه الأدوية، بدلاً من قتل الخلايا المتقادمة، تعمل على جعلها أقل عدوانية.

كما يُشار غالبًا إلى الخلل الوظيفي في الميتوكوندريا. تنتج الميتوكوندريا في الخلايا الطاقة، فهي بمثابة «محطات طاقة» صغيرة، ومع تقدم العمر تنخفض كفاءتها، مما يؤدي إلى انخفاض إنتاجها للطاقة وإفرازها لمواد كيميائية تسبب تلف الخلايا. ويساهم ذلك في حدوث ما يُعرف بالإجهاد التأكسدي، حيث تنخفض دفاعات الجسم المضادة للأكسدة.

Chronic Inflammation in the body as we age can also reduce antioxidant defences and reduce immune responses and contributes to many age-related diseases.

تلعب البروتينات دورًا حيويًا في الجسم. وقد تتراكم البروتينات التالفة في الخلايا مما يؤدي إلى موت الخلايا.

الأميلويد هو نوع معين من البروتينات المطوية غير القابلة للذوبان. وهو مرتبط بأمراض تنكسية مثل مرض الزهايمر ومرض باركنسون.

Autophagy is the process by which damaged protein is removed from cells to prevent toxicity. Dysregulation of autophagy is also implied in age related diseases.

تُركز علم التخلق بشكل أساسي على كيفية تأثير العوامل البيئية الخارجية وأنماط الحياة على طريقة تعبير الجينات دون تغيير تسلسل الحمض النووي. وله دور في العديد من الأمراض التنكسية.

تشير «نظرية حاجز الأمعاء » المتعلقة بالشيخوخة إلى أن التغيرات التي تطرأ على الكائنات الحية الدقيقة في الأمعاء ووظيفة الحاجز، من بين أمور أخرى، تساهم في إثارة الالتهاب من خلال زيادة السموم والسماح للميكروبات بالدخول إلى مجرى الدم.

Our Preventative Health Assessments address lifestyle and identify individual risk factors that contribute to diseases such as those affecting the heart , brain and early cancers. By checking markers including those that specifically predispose to heart disease, identifying visceral fat, elevated lipids, inflammatory markers, deficiencies in vitamins, minerals and hormones (including insulin), cortisol and sex hormones, individual risk factors can be addressed to improve healthspan.

Anti-ageing medicine to extend lifespan takes this one step further by further focusing on the biological mechanisms I have mentioned to reduce inflammation, oxidative stress, DNA and protein damage.

In my mind there is no happy long life without health. Many of the drugs and supplements we already use in conventional clinical practice are being shown to address both.  Diabetic drugs like metformin and acarbose improve insulin sensitivity and have senomorphic properties. The GLP-1 diabetic/weight loss injection (semaglutide) increases insulin production and improves longevity by more than just improvement in diabetes and reduction in cardiovascular illness.

To find out more about our Anti-Ageing treatments and Preventative Health Assessments, you can book a preliminary consultation with me here or alternatively call 020 7935 4357.