Old age: a disease without treatment
Yulia Moiseeva, "Honest word" No. 3-2015
Aging is one of the most mysterious and not fully understood processes occurring with our body. However, according to geneticist Vladimir Maksimov, head of the laboratory of molecular genetic research of therapeutic Diseases of the Research Institute of Therapy and Preventive Medicine, today the world around us, despite the mass of accumulated knowledge of mankind, has become almost more of a mystery for us than before. It was with him that we talked about how genetics looks at the aging process, as well as whether it is possible today to invent a "time machine" for an aging body.
Aging begins at birth– Vladimir Nikolaevich, what is the role of heredity in the aging process, life expectancy and the development of life-threatening diseases?
– It is important to understand that there are no "bad" or "good" genes, they are bad or good depending on the situation. For example, there are certain genetic features that contribute to the formation of blood clots in the vessels. In ordinary life, this feature does not do anything good, especially if it got to a woman – during pregnancy it can lead to problems. But if a man got this feature, then in an extreme situation, in case of injury, for example, he will have a better chance of survival due to increased blood clotting. On the other hand, in ordinary life, he may not know about it. The same is the case with type 2 diabetes mellitus, which has become much more today. And why is there more of it? Because a person lives in prosperity for a short time when he has more food than he needs. And for most of its history, man lived when there was not enough food. In these conditions, a person had to store food in the form of fat deposits before the next hunt. Now, when we already have an excess of this very food, a person with certain genes inherited from distant ancestors continues to live with the ability to "store" food inside himself.
The older a person is, the less heredity affects him. At the same time, with age, it is more influenced by environmental factors. If we talk about serious hereditary diseases, then the more serious the hereditary disease, the earlier it makes itself felt. Something manifests itself in utero, something - in the first years of life, something later, but, nevertheless, the general trend is as follows. The hereditary contribution of centenarians in the family – moms, dads, grandparents – is present, but not great. That is, if you have long-livers in your family, there is no guarantee that you will live as long, and vice versa: if you did not have long-livers in your family, you cannot say that you will not become one. Yes, the probability of becoming a centenarian under the condition of heredity is somewhat higher, but not at times. More important is how a person lives his life. Someone worked in harmful production, someone was addicted to bad habits, and these factors accumulate over time and greatly affect life expectancy. People like to give examples like these: my uncle smoked and lived up to 90 years, and someone did not smoke and died of lung cancer. This also happens, but the exception only confirms the rule. And we identify the rule in large groups, and there is a clear relationship there: in groups where there is more smoking, there is more lung cancer.
– That is, in fact, we begin to age almost from birth?
– In a sense, yes. There are many theories of aging today, I like the theory of scientist Vladimir Mikhailovich Dilman. According to his theory, aging is connected in a certain sense with evolution. If we take into account Darwin's theory, natural selection participated in the development of living organisms, on which the adaptation of species is based. However, selection, in fact, works only at the initial stages of life, when you need to survive in order to leave offspring. When the offspring were born, it no longer matters for selection whether the parents will continue to live. Therefore, after a representative of the species has left offspring, the influence of selection becomes minimal. On the other hand, in order to live for a long time, you need the constancy of the internal environment of the body – homeostasis. But pregnancy is already a deviation from homeostasis. Growth, development is also a deviation from homeostasis. And in order for the body to grow, develop, so that pregnancy proceeds, certain mechanisms that disrupt the balance are activated in the body. Further, when these tasks are completed, in theory, such mechanisms should be turned off, but this does not happen, because nature does not need it. Therefore, the violation of homeostasis continues, which leads to aging of the body. Plus, a genetic component plays a role in the aging process: DNA damage accumulates in cells. DNA damage is constantly going on in our cells. Yes, we have repair systems, that is, systems that repair these damages, but this does not happen one hundred percent. All this creates the aging process. It turns out that we are actually starting to age from birth. Dielman's theory is confirmed by various facts. For example, changes in the brain, which are considered a substrate of Alzheimer's disease, first begin to appear at a young age. Shortening of telomeres – these are the ends of chromosomes with which the cell multiplies – occurs especially intensively in the first twenty years of life. Dilman considered aging as a normal disease, and since it is a disease, it must be treated. But science does not yet know how to do this.
– Tell us in more detail, how does the mutation in cells that causes the aging process occur?
– In the cell, during its vital activity, a normal metabolism occurs, which is accompanied by an exchange of energy. Some substances are synthesized, some disintegrate. Oxygen is involved in these processes, namely oxidation processes. Oxidation processes, on the one hand, are accompanied by the release of energy that we need, on the other hand, they are accompanied by damage to some cellular structures. In particular, they can lead to DNA damage. Some damages are eliminated by repair systems, and some do not have time to be eliminated. And then there are so-called somatic mutations, that is, mutations in the cells of the body. Over time, they accumulate, and we age.
The secret of longevity has not yet been revealed– Is it possible to say that the rate of aging and life expectancy have recently changed in one direction or another due to changes at the gene level?
– No, nothing like that is happening. The human genome, and other relatively long-lived organisms, does not change so quickly. Certain facts, of course, mislead us. For example, there is such a hereditary disease – long QT syndrome, it is detected when recording an ECG and can cause sudden cardiac death, especially with high physical exertion, for example, in athletes. When it began to be registered in the 70s, the number of cases of the disease was estimated in the United States as 50 per million. Forty years later, the same indicator was estimated as 350 cases per million. But this does not mean that the number of patients has increased over these forty years, they have simply learned how to diagnose this disease better. Such serious fluctuations do not occur in such short periods of time. At least, if this happens, it is not due to heredity, but to environmental factors. For example, take atopic dermatitis. Recently, this disease has become much more common. Why? Because in recent years, many substances have been synthesized that a person has never encountered before, and we have an allergy to them in the form of atopic dermatitis. And in order for something to change in genetics, a generational change is needed, while in order for something to really change, changes must occur in many generations.
– Is it impossible to predict life expectancy in the future or somehow influence it, even more so?
– Based on general biological concepts, it is believed that the life expectancy of a biological species is equal to the duration of puberty multiplied by five. That is, if a person has a puberty period of 20 years, then his life is conditionally equal to one hundred years. This also applies to other species. Let's say a cat has a puberty period of two years, multiply by five – we get ten years. This is some kind of convention, but we saw this pattern in many species. In order to break this pattern, we probably need some additional knowledge that we do not yet possess. All countries are working on this, but it is impossible to say that someone has achieved tremendous results. They say we have a period now when there is an accumulation of knowledge. Of course, we know a lot more than we knew ten or twenty years ago, but the amount of this knowledge does not grow into quality in any way. There is such a joke in the scientific community: the world is buried under a pile of information that many confuse with knowledge. Even more than that: the more we know, the more we realize how little we know. We need new approaches, which, apparently, we have not yet reached.
The whole world is working to establish the causes of longevity. Of course, such information was announced that life expectancy has been increased in certain countries. However, later it turned out that many centenarians in these countries spend the last years of their lives in the hospital. The question arises: is such a life expectancy necessary to spend the last years in a hospital bed?
– The Research Institute of Therapy and Preventive Medicine has been researching centenarians for a long time. What results have been obtained to date?
– There is a well-known joke: there are no healthy, there are poorly examined. Those who have lived to old age, moreover, have certain diseases, in this case diseases of the cardiovascular system predominate. But still, they lived to this age because these diseases proceeded favorably with them. Many centenarians have the same arterial hypertension, while it does not lead to standard complications that kill a significant part of the population – heart attacks, strokes. They have hypertension without lesions of the so-called target organs. Although, of course, most of these people take medications to lower blood pressure.
In fact, we are now launching a major project to study aging in Siberia, funded by the Russian Science Foundation. About six thousand people from the previously surveyed will take part in it. A number of indicators will be studied, including signs of atherosclerosis in the carotid arteries. The project is designed for three years, sufficient funding has been allocated for it, and we hope that we will complete the project in full and get interesting results regarding aging in the Siberian population, specifically in Novosibirsk. The first time we looked at the participants of the current project was in 2003-2004, then five years later. And now, in almost another five years, we will watch them again. Ten years ago, these were people 45-69 years old, that is, now the oldest of them are 79, they are approaching the age of centenarians. We will see who and why lived up to their years. The project will provide an opportunity to test some theories. For example, it is now believed that an increased amount of cholesterol leads to the development of heart attacks and strokes. But another opinion also appeared: the different ratio of cholesterol fractions is important. Now we can assess whether this is really the case. I think genetics will eventually answer many questions. Perhaps we will finally begin to understand how the human body actually functions.
Portal "Eternal youth" http://vechnayamolodost.ru21.01.2015