Third in an occasional series    on how Harvard researchers are tackling the problematic issues    of aging.  
    If only, wrote an ancient Japanese poet, when one heard that    Old Age was coming one could bolt the door.  
    Science is working on it.  
    Aging is as much about the physical processes of repair and    regeneration  and their slow-motion failure  as it is the    passage of time. And scientists studying stem cell and    regenerative biology are making progress understanding those    processes, developing treatments for the many diseases whose    risks increase as we get older, while at times seeming to draw    close to a broader anti-aging breakthrough.  
    If stem cells offer potential solutions, theyre also part of    the problem. Stem cells, which can differentiate into many cell    types, are important parts of the bodys repair system, but    lose regenerative potency as we age. In addition, their    self-renewing ability allows the mutations that affect every    cell to accumulate across cellular generations, and some of    those mutations lead to disease.  
    We do think that stem cells are a key player in at least some    of the manifestations of age, said Professor of Stem Cell and    Regenerative Biology David    Scadden, co-director of the Harvard Stem Cell Institute.    The hypothesis is that stem cell function deteriorates with    age, driving events we know occur with aging, like our limited    ability to fully repair or regenerate healthy tissue following    injury.  
    When it comes to aging, certain tissue types seem to lead the    charge, according to Professor of Stem Cell and Regenerative    Biology Lee    Rubin, who directs the Harvard Stem Cell Institutes    Therapeutic Screening Center. Particular tissues  nerve cells    appear to be one  somehow signal to others that its time to    age. This raises the prospect, Rubin said, that aging might be    reversed by treating these key tissue categories, rather than    designing individual treatments for the myriad tissue types    that make up the body.  
    The process of aging involves all tissues in your body and,    while different things go wrong in each tissue, they go wrong    at basically the same rate, Rubin said. We can think of it as    a process that is somehow coordinated, or there are fundamental    processes in each tissue that play out.  
    In addition to key tissues, certain chemical pathways  like    insulin signaling seem to be able to control aging, said    Rubin, whose work has received backing from the National Institute of Neurological    Disorders and Stroke, as well as private foundations. The    insulin signaling pathway is a chemical chain reaction in which    the hormone insulin helps the body metabolize glucose. Reducing    it has been shown to greatly extend life span in flies and    worms, Rubin said. Also, signaling doesnt have to be reduced    in all tissues.  
    If you just reduce it in neurons, the whole fly or worm lives    longer, Rubin said. Certain key tissues in those organisms,    if you selectively manipulate those tissues, have a positive    effect on a number of processes in other tissues.  
    Because it circulates throughout the body, blood is an obvious    place to look for controlling or signaling molecules that    prompt or coordinate aging. A key carrier of oxygen and    nutrients, blood is also rich with other compounds, some of    which appear to play a role in decline linked to age.  
    Scadden described recent work done separately by Ben Ebert, a professor    of medicine working at Harvard-affiliated Brigham and Womens    Hospital, and Steve    McCarroll, the Dorothy and Milton Flier Associate Professor    of Biomedical Science and Genetics, that identified age-related    changes in the blood that can increase the risk of diseases we    dont typically think of as blood diseases.  
    Another tantalizing study, published in 2013, used the blood of    a young mouse to rejuvenate the organs of an older one. In    these parabiotic experiments, conducted by Professor of Stem    Cell and Regenerative Biology Richard    Lee and Forst Family Professor of Stem Cell and    Regenerative Biology Amy Wagers, the    circulatory systems of the two mice were joined, allowing the    blood of the young to flow through the older ones body. The    older mouse showed improvements in muscle tone and heart    function. Later, similar experiments done by Rubin also showed    improvements in neuronal health and brain functioning.  
    The young mouses fate depended on the age of the older mouse,    Rubin said. If the latter was middle-aged, the young mouse    appeared to be fine. If the older mouse was very old, however,    the young mouse did worse.  
    Rubin said the experiments suggest that blood contains both    positive and negative factors that influence aging. It may be,    he said, that both are always present, but that positive    factors outweigh negative in the young and that negative    factors increase as we age.  
    Researchers have identified but not yet confirmed candidate    blood factors for the rejuvenating effects. What seems not in    doubt is the overall effect of the young blood on the old    mouse. Interest is intense enough that a California company,    Alkahest, has begun experiments giving Alzheimers patients    plasma from young blood in hopes of improving cognition and    brain function.  
    Even if that approach works, Rubin said, there would be    practical hurdles to the widespread administration of young    peoples blood plasma to older patients. But with an active    compound identified, a drug could be made available to restore    at least some cognitive function in Alzheimers patients.  
    In addition to the overall process of aging, researchers at the    Harvard Stem Cell Institute, as well as across the University    and its affiliated institutions, are investigating an array of    diseases whose incidence increases  sometimes dramatically     with age.  
    The list includes several of the countrys top causes of death     heart disease, stroke, diabetes, and cancer  as well as    rarer conditions such as the lethal neurodegenerative disorder    amyotrophic lateral sclerosis (ALS).  
    Two decades ago, when stem cell research hit mainstream    consciousness, many thought its greatest promise would be in    stem cells ability to grow replacement parts: organs and    tissues for damage caused by trauma or disease.  
    The stem cell revolution is still developing, Scadden said, but    so far has taken a different form than many expected. The dream    of harnessing stem cells to grow replacement hearts, livers,    and kidneys remains, but potentially powerful uses have emerged    in modeling disease for drug discovery and in targeting    treatment for personalized medicine.  
      We thought stem cells would provide mostly replacement      parts. I think thats clearly changed very dramatically. Now      we think of them as contributing to our ability to make      disease models for drug discovery.    
       David Scadden    
    Researchers have taken from the sick easily accessible cells,    such as skin or blood, and reprogrammed them into the affected    tissue type  nerve cells in the case of ALS, which most    commonly strikes between 55 and 75, according to the National Institutes of Health (NIH).  
    These tissues are used as models to study the disease and test    interventions. Work on ALS in the lab of Professor of Stem Cell    and Regenerative Biology Kevin Eggan has    identified a drug approved for epilepsy that might be effective    against ALS. This application is now entering clinical trials,    in collaboration with Harvard-affiliated Massachusetts General    Hospital.  
    In the end, stem cells might have their greatest impact as a    drug-discovery tool, Scadden said.  
    Much of stem cell medicine is ultimately going to be    medicine, he said. Even here, we thought stem cells would    provide mostly replacement parts. I think thats clearly    changed very dramatically. Now we think of them as contributing    to our ability to make disease models for drug discovery.  
    Also evolving is knowledge of stem cell biology. Our previous    understanding was that once embryonic stem cells differentiated    into stem cells for muscle, blood, skin, and other tissue,    those stem cells remained flexible enough to further develop    into an array of different cells within the tissue, whenever    needed.  
    Recent work on blood stem cells, however, indicates that this    plasticity within a particular tissue type may be more limited    than previously thought, Scadden said. Instead of armies of    similarly plastic stem cells, it appears there is diversity    within populations, with different stem cells having different    capabilities.  
    If thats the case, Scadden said, problems might arise in part    from the loss of some of these stem cell subpopulations, a    scenario that could explain individual variation in aging.    Getting old may be something like the endgame in chess, he    said, when players are down to just a few pieces that dictate    their ability to defend and attack.  
    If were graced and happen to have a queen and couple of    bishops, were doing OK, said Scadden, whose work is largely    funded through the NIH. But if we are left with pawns, we may    lose resilience as we age.  
    Scaddens lab is using fluorescent tags to mark stem cells in    different laboratory animals and then following them to see    which ones do what work. It might be possible to boost    populations of particularly potent players  the queens  to    fight disease.  
    Were just at the beginning of this, Scadden said. I think    that our sense of stem cells as this highly adaptable cell type    may or may not be true. What we observe when we look at a    population may not be the case with individuals.  
    The replacement parts scenario for stem cells hasnt gone    away. One example is in the work of Harvard Stem Cell Institute    co-director and Xander University Professor Douglas    Melton, who has made significant progress growing    replacement insulin-producing beta cells for treatment of    diabetes.  
    Another is in Lees research. With support from the NIH, Lee is    working to make heart muscle cells that can be used to repair    damaged hearts.  
    Trials in this area have already begun, though with cells not    genetically matched to the patient. In France, researchers are    placing partially differentiated embryonic stem cells on the    outside of the heart as a temporary aid to healing. Another    trial, planned by researchers in Seattle, would inject fully    differentiated heart muscle cells into a patient after a heart    attack as a kind of very localized heart transplant.  
    Lees approach will take longer to develop. He wants to exploit    the potential of stem cell biology to grow cells that are    genetically matched to the patient. Researchers would reprogram    cells taken from the patient into heart cells and, as in the    Seattle experiment, inject them into damaged parts of the    heart. The advantage of Lees approach is that because the    cells would be genetically identical to the patient, he or she    could avoid antirejection drugs for life.  
    What were thinking about is longer-term but more ambitious,    Lee said. Avoiding immune suppression could change the way we    think about things, because it opens the door to many decades    of potential benefit.  
    Change has been a constant in Lees career, and he says theres    no reason to think that will slow. Patient populations are    older and more complex, disease profiles are changing, and the    tools physicians have at their disposal are more powerful and    more targeted.  
    Many of our patients today wouldnt be alive if not for the    benefit of research advances, he said. Cardiology has    completely changed in the last 25 years. If you think its not    going to change even more in the next 25 years, youre probably    wrong.  
    When Lee envisions the full potential of stem cell science, he    sees treatments and replacement organs with the power to    transform how we develop and grow old.  
    It may not be there for you and me, but for our children or    their children, ultimately, regenerative biology and stem cell    biology have that kind of potential, he said. We imagine a    world where it doesnt matter what mutations or other things    youre born with, because we can give you a good life.  
    Lees not guessing at future longevity. Hes not even sure    extending life span beyond the current record, 122, is    possible. Instead, he cites surveys that suggest that most    Americans target 90 as their expectation for a long, healthy    life.  
    Thats about a decade more than we get now in America, Lee    said. We have work to do.  
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Researchers study secrets of aging via stem cells - Harvard Gazette