{"slug":"biological-ageing","tag":"biological-ageing","variants":["biological-ageing"],"description":"No description yet","count":9,"kinds":{"technology":6,"bottleneck":1,"idea":1,"trial":1},"related":[{"slug":"rejuvenation","tag":"rejuvenation","shared":9},{"slug":"survivorship","tag":"survivorship","shared":9},{"slug":"biomarker","tag":"biomarker","shared":3},{"slug":"open-problem","tag":"open-problem","shared":3},{"slug":"blood","tag":"blood","shared":1},{"slug":"childhood-cancer","tag":"childhood-cancer","shared":1},{"slug":"epigenetics","tag":"epigenetics","shared":1},{"slug":"exercise","tag":"exercise","shared":1},{"slug":"late-effects","tag":"late-effects","shared":1},{"slug":"objective","tag":"objective","shared":1},{"slug":"second-cancers","tag":"second-cancers","shared":1},{"slug":"senescence","tag":"senescence","shared":1}],"records":[{"id":"rejuv-age-epigenetic-clocks","kind":"technology","name":"Epigenetic age after cancer treatment","route":"/technologies/rejuv-age-epigenetic-clocks/","status":"emerging","tldr":"An epigenetic clock reads chemical marks on DNA and estimates how old the body looks, which is not always the age on a birth certificate. In survivors of childhood cancer the clock runs ahead of chronological age, and the gap is larger after radiotherapy and after certain chemotherapy drugs. What the gap means for any one person is not yet known, and the clocks do not agree with each other."},{"id":"rejuv-age-clonal-haematopoiesis-after-therapy","kind":"technology","name":"Clonal haematopoiesis after cancer treatment","route":"/technologies/rejuv-age-clonal-haematopoiesis-after-therapy/","status":"established","tldr":"Chemotherapy and radiotherapy do not select blood stem cells at random. They favour the ones carrying mutations in DNA-damage genes, which then expand. Most people with such a clone never develop a blood cancer, but the clone is a measurable mark of what treatment did, and in a minority it is the seed of a later leukaemia."},{"id":"rejuv-age-senescent-cells-after-treatment","kind":"technology","name":"Senescent cells and p16 after chemotherapy","route":"/technologies/rejuv-age-senescent-cells-after-treatment/","status":"emerging","tldr":"Chemotherapy pushes cells into senescence: they stop dividing but stay alive and keep releasing inflammatory signals. The usual marker, p16INK4a in blood T cells, rises sharply during treatment and is still raised a year later. In one study the rise matched about fifteen years of ordinary ageing, in another the gap in survivors was larger still."},{"id":"rejuv-age-frailty-and-late-effects","kind":"technology","name":"Frailty and late effects in survivors","route":"/technologies/rejuv-age-frailty-and-late-effects/","status":"established","tldr":"The clearest evidence that treatment ages people is not a laboratory marker, it is what happens to survivors decades later. In the St Jude Lifetime Cohort, one in eight women who had cancer as a child met the clinical definition of frailty at a mean age of 33, a rate usually seen after 65. Frailty predicted new chronic conditions and death."},{"id":"rejuv-age-telomere-length","kind":"technology","name":"Telomere length after treatment","route":"/technologies/rejuv-age-telomere-length/","status":"emerging","tldr":"Telomeres are the caps on chromosomes that shorten each time a cell divides. They are the oldest and best known measure of cellular ageing, and the one with the least to show for itself in cancer survivors so far: the measurements exist, the associations are inconsistent, and nothing follows from a result."},{"id":"rejuv-agenda-biological-age-as-an-untested-target","kind":"bottleneck","name":"Nobody has tested whether reversing measured biological ageing changes anything","route":"/bottlenecks/rejuv-agenda-biological-age-as-an-untested-target/","tldr":"Cancer treatment measurably accelerates several markers of biological ageing. No trial has ever asked whether moving one of those markers makes any difference to a person, and an entire retail industry rests on the assumption that it would."},{"id":"idea-rejuv-biological-age-as-a-randomised-endpoint","kind":"idea","name":"Put a biological-age marker in a trial that also measures something a person would notice","route":"/ideas/idea-rejuv-biological-age-as-a-randomised-endpoint/","tldr":"Epigenetic clocks and senescence markers run fast after cancer treatment, and nobody has shown that moving one matters. The way to find out is to make the clock a secondary endpoint in a trial whose primary endpoint is physical function."},{"id":"rejuv-trial-proffi","kind":"trial","name":"PROFFi: fisetin and exercise to prevent frailty in breast cancer survivors","route":"/trials/rejuv-trial-proffi/","status":"recruiting","tldr":"The first randomised trial to test a senolytic in people who have had cancer. Four arms crossing fisetin against placebo with tailored supervised exercise against a physical activity handout, and the primary endpoint is how far someone can walk in six minutes."},{"id":"rejuv-measure-consumer-biological-age-tests","kind":"technology","name":"The biological age test you can buy, and whether to buy one","route":"/technologies/rejuv-measure-consumer-biological-age-tests/","status":"emerging","tldr":"You can send saliva or blood to a company and be told your biological age. The underlying science is real and is described in the records on biological ageing after treatment; the test you can buy is not that science. Repeat measurements of the same sample can differ by years, no result changes any treatment, and nothing you can do in response has been shown to change what happens to you."}]}