Mitochondria have long been correlated with age-related disorders. When mitochondria reach a certain point in their “lives” they undergo a morphological change such that they transform from round and small to elongated and big. This change seems to result in loss of function, which makes sense since we know structure denotes function. Damaged mitochondria are usually degraded via a type of autophagy known as mitophagy which is specific for degradation of dysfunctional mitochondria. However, these elongated mitochondria are difficult to remove from the cell, because of their size and shape, so they tend to accumulate within the cell. This accumulation leads to cell toxicity and has been correlatively linked to age-related disorders.
Researchers at UCLA have discovered how to induce anti-aging characteristics (via promotion of healthier mitochondria) by increasing the levels of a protein that helps reduce the accumulation of dysfunctional mitochondria in cells (see image below). Typically, levels of this protein decrease with age and lead to the undesired changes in size and shape previously mentioned. Female flies lived 20% longer with this protein induction and male flies lived 12% longer than their counterparts that composed the control group. Control group flies were unable to remove damaged mitochondria efficiently after a certain age.
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| Images shown in a - c show the natural progression of aging mitochondria that change from small and round in youth to elongated and large in midlife (around 30 days). Image d shows the more youthful appearance of mid-aged mitochondria after protein induction (hence, anti-aging effects). Stark differences between c and d support anti-aging results since age is the same. The same results are observed with different imaging techniques, as shown in rows 2 and 3. |
Here the hope is to develop drug therapies that can mimic the actions of this protein and induce similar results (delaying onset of disorders and mortality) in humans.
If we can accomplish this and live longer, should we? Why or why not?
Maleficence – we do not know what kind of side effects could result from this type of anti-aging therapies, either to the individual or our entire society. If the potential harms could outweigh the potential benefits then this is not a road we should venture onto, which leads into justice. Who will be able to obtain access to these potential anti-aging and longevity-increasing therapies, and will this be fair to all? Typically, low SES populations will not be able to access these therapies since they will be expensive and most forms of public insurance will not cover this type of treatment.
Imagine an individual who will be the next: Albert Einstein or Barbara McClintock or Jonas Salk or Rosalind Franklin or Rosa Parks or Frida Kahlo or Amelia Earhart or Mahatma Ghandi; in other words, someone that makes accomplishments that better humankind.
This individual is unable to afford this treatment but will hopefully continue to be an outstanding contributing member of society if they had more time to do so by living longer. Society might deem this individual worthy of receiving the treatment for free (if they agreed to receiving it) or at a significantly reduced cost. However, would this opportunity be extended to another individual (same sex, age, and SES) who was a single-parent raising 3 young children who was also experiencing clear symptoms of early-onset Parkinson’s Disease?
Sources:
Rana, A., Oliveira, M.P., Khamoui, A.V., et al. Promoting Drp1-mediated mitochondrial fission in midlife prolongs healthy lifespan of Drosophila melanogaster. Nature Comm 8:448, 1-14 (2017). DOI: 10.1038/s41467-017-00525-4
What a great article, Beatrice. When you first introduced the idea of inducing anti-aging characteristics, I immediately thought of plastic surgery, and how frequently people get plastic surgery to make themselves look younger. Not only could this new treatment help people look younger, but it could also help them live longer. It would be interesting to compare the anti-aging effects of plastic surgery versus this new treatment.
ReplyDeleteFrom an ethics standpoint, I think you make a great argument regarding the justice of having this treatment only available to higher SES populations. Unfortunately, I think that many aspects of healthcare are like this in that higher SES populations have access to the best treatments, physicians, and facilities. Although it is unjust for lower SES populations to have limited access to advanced treatments such as this anti-aging mitochondrial treatment, I would argue that it is even more unjust to not let anyone have access to the treatment at all. We should be helping as many people as possible, so I think it is maleficent to limit this treatment from everyone simply because not everyone can afford it. For everyone to be able to afford every treatment available is an unrealistic goal. In medicine, I think it is important to realize that you might not be able to save or treat everyone, but you should help as many people as you can.
Hi Sara. Yes, it would be interesting to compare this therapy to plastic surgery. I did not mean that no one should have access to this therapy because it undermines the ethical principle of justice. I think it us unethical to go through with this kind of treatment primarily because the potential side effects are not known and it is dangerous to “play” with people’s lives in such a way. Regardless of whether or not they have the financial means to afford this treatment. I believe it is our duty to make sure our patients are safe and that we do nothing that could hurt them: beneficence. However, if the financially affluent patients want to go through with it anyways, then we must respect their autonomy and respect their wishes to take on that unknown risk. This happens all the time with controversial treatments that are usually not legal or approved here in this country. I just wouldn’t be the doctor in charge of their care. I’d do my best to inform them of their options and all the risks associated and then direct them to the people they wish to be in contact with.
ReplyDeleteI found this information very interesting thank you for sharing it. At first I didn't see the correlation between plastic surgery and an aging mitochondrial treatment. This is because I feel that plastic surgery, especially among the famous and wealthy, has such an artificial appearance of youth. Mitochondrial treatment however would presumably be a more realistic and natural way in which to reduce the effects of aging. Ultimately this would be beneficial to an individual but would it benefit the human race? Right know increasing populations size is limiting resources, devastating ecology, and threatening our very existence. By prolonging the lifespan of the entire population then these factors will only increase exponentially. Ultimately, I think that we should make this treatment very costly and only allow a certain amount of people to utilize it for several reasons. First, all the money can go into researching more inexpensive and effective ways to offer the treatment to the rest of the population. More importantly, the treatment can be tested on the "elitist" class and if there are any side affects then they will be identified in them similar to upper class people now with their rubbery plastic faces from cosmetic surgery. Once enough funding and research has been given to the protein therapy then it would be better suited to be given to general public. Lastly, this will hopefully allow us a better opportunity to accommodate for the global implications of an increase in human life expectancy.
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