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Sight restored by turning back the epigenetic clock (nature.com)
310 points by evo_9 on Dec 4, 2020 | hide | past | favorite | 114 comments


I am not trying to diminish the work being reported on here. I just want to comment that I see these kinds of articles posted frequently, and they always leave me feeling like

Experimental "foo" results in NN% improvement in "quux" in new study. Possible human trials scheduled for "someday far far away" and could "one day" lead to rainbow colored pet unicorns for all humans.

Basically, some amazing thing may happen someday and I'll never hear about it and will likely be dead and gone well before it bears fruit.

It would be wonderful if there was a site that summarized these kinds of breakthrough research projects in a way that was practical for laypeople. E.g. disease, research being done, possible treatment/cure, stage of testing, availability to general public / how to get it or become part of trial group, cost, risks etc. E.g. I'd love to be able to star & watch this like a Github repo and be notified of progress...


I feel this way too, but I often find those circulating articles are in mainstream media by people who don't understand what they're reporting on or in "science will cure everything" blogs. However, this is a summary posted on one of the most respected journals in the world's website. The article/study it is summarizing was peer reviewed and developed by scientists at some of the world's top institutions. Sure, we shouldn't get caught up in reputation as a marker of quality, but at the same time it does count for something... this is not the same as most of the breathless articles that I see circulate on social media.


I didn't feel like the comment was arguing about the quality of the articles, but more the notion of how reading an article about some point in time progress of some early thing feels useless: what you want is to follow the thing. It is like if you hear about some new piece of software when it is just some proof of concept and it won't be a "real thing" for three years but you want to follow it so you can keep learning about it and watch its progress... so you watch its git repository or subscribe to its mailing list or whatever, and you can do that; but with science, the process--which at the milestones of publishing feels very open--is usually some weird closed competitive process.



I assume that foundation was started by David A. Sinclair? Same author of this book?

https://www.amazon.com/Lifespan-audiobook/dp/B07QGH1Q43/ref=...

Very interesting research in that book but honestly, very little actionable paths for the reader. We aren't yet to a point where it's possible to just pop a pill and live another 100 years. Probably the most effective thing you can do right now is caloric restriction, but that can kind of suck. The holy grail would be some way to eat normally, and slow the aging process.


There are several ideas about why caloric restriction might be working. There was one study that implicated human growth hormone in combination with zinc, dhea, vitamin d, and burberine in telomeres lengthening. Human growth hormone is produced in response to ghrelin, which is released when we are hungry. So it might be that it is the hunger, not the lack of food that slows aging.


If that is true, then it infers that simply being hungry could extend life.

Some compounds promote hunger, notably THC found in marijuana. Yet, as far as I know, chronic marijuana users are not living substantially longer lives? Then again, the hunger effect probably also diminishes as ones tolerance increases.


Intermittent fasting with a total calorie intake that is breakeven is probably the safest way to boost hgh, some weightlifters do this already. Others use ibutemoren which is a sectagogue for ghrelin to indirectly boost hgh


Skip meals, live in a calorie deficit, take resveratrol, try to reduce inflammation, exercise, sort sleep, are the ones I can remember off my head. Also eat a massive amount of broccoli sprouts.


Yes, these are the steps. I'll expand on one as well:

> try to reduce inflammation

Avoid the obvious things (alcohol, drugs) but also your diet has a huge effect on systemic inflammation. It's one theory as to why caloric restriction works. Simply eating less, means less inflammation.

But WHAT you eat also matters. As it turns out, SUGAR is highly inflammatory. To a lesser extent, complex carbohydrates are too.

So if you're really interested in longevity consider not just eating less, but eating less sugar (and by extension, carbohydrates).

If you ask me that sucks. Part of living life, is enjoying good food. And as it happens, a lot of good food is full of fat and sugar. I moderate and I don't eat a lot of it, but to think I would need to basically cut all of it out just to live another frail 10 years doesn't seem worth it to me.


Wasn't blood transfusion from a young another effective method? Though it is a Pandora's box of ethical problems


Interestingly, they had similar results with just giving mice saline mixture with albumin.

https://www.sciencedaily.com/releases/2020/06/200615115724.h...

Which sort of indicates that it is not young blood per se that plays the important role, but dilution and removal of "something" that accumulates with age.

Albumin is expensive, at least so far, no one thought about an industrial method to produce large quantities, because there was no demand for them. Aside from price, no ethical problems there.

Also, frequent blood donors tend to be much more healthy. A study from Kuopio, Finland, showed that they are almost immune to heart attacks:

https://pubmed.ncbi.nlm.nih.gov/9737556/

Ofc, the question of causality is strong here, no doubt. But maybe - if the body of a blood donor is forced to produce new blood frequently, might this new blood be "healthier" or "younger" in some sense.


There is a hypothesis that excess iron is a risk factor for heart attack, and that periodic blood loss clears it out. This could be why pre-menopausal women have lower rates of heart attack than men and post-menopausal women, even after adjusting for age and other factors.


A good occasion to remind everyone to consider donating blood, especially now - most places are pretty low on blood transfusions currently because of the pandemic. Varies by country of course but if you are healthy and it's possible where you live you can help a lot!


Even if one wanted to donate right now, aren't we supposed to be limiting our exposure to other people as COVID surges?

I'm probably too cautious of a person but I tend to not trust other people to exercise appropriate caution themselves. Intimate proximity to a nurse taking blood, seems like a bad idea right now.


This is a good message, but every time I’ve sought out to give blood they had way more than enough. Is there anywhere actually requesting blood now?


For men and postmenopausal women that could just be dumping excess iron to avoid organ damage. If the albumin had similar results for regular blood donors and premenopausal women, maybe we need albumin.


Is it? You can sell plasma right now, so it seems straightforward to let people sell blood every 2 months if they want to.


I have a relative that went blind due to double corneal tear. Every time one of these articles comes up, they forward me the link and ask whether that's something they could use. Of course, I always have to be the one giving the bad news.

I rarely see any of those articles materialize in a way where I could say "yes, this is something I can get right now". The only one I remember actually making it is the Argus II, and even then there is no way I could afford the $150K price.


I agree with the sentiment, but I don't think it's actually as gloomy as that. Those kinds of articles help keep science in the news, which in turn keeps people interested in science, which hopefully leads to people considering careers in science.

Maybe these things bear fruit, maybe they don't, but at least now we know about them, and maybe it'll inspire someone somewhere.


Closest you can get are probably podcasts with those researches, for example https://peterattiamd.com/podcast/


Sounds like battery research.


is this why big–pharma harvest blue bloods? i'm not sure i believe this hoopla about the tree of life.

but i'm interested in the biomedical applications from obscure species that feature bioluminescence, magic pheromones and how to test the quality of Eel I just put on back order.

i loved your italicized block. don't down vote this one.


Look how large a collaboration effort:

Affiliations Department of Genetics, Blavatnik Institute, Paul F. Glenn Center for Biology of Aging Research, Harvard Medical School, Boston, MA, USA Yuancheng Lu, Xiao Tian, Daniel L. Vera, Qiurui Zeng, Doudou Yu, Michael S. Bonkowski, Jae-Hyun Yang, Michael B. Schultz, Alice E. Kane, Karolina Chwalek, Luis A. Rajman & David A. Sinclair

Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA Benedikt Brommer, Chen Wang, Songlin Zhou & Zhigang He

Department of Ophthalmology, Harvard Medical School, Boston, MA, USA Benedikt Brommer, Anitha Krishnan, Chen Wang, Songlin Zhou, Emma M. Hoffmann, Margarete M. Karg, Ekaterina Korobkina, Meredith S. Gregory-Ksander, Bruce R. Ksander & Zhigang He

Schepens Eye Research Institute of Mass Eye and Ear, Harvard Medical School, Boston, MA, USA Anitha Krishnan, Emma M. Hoffmann, Margarete M. Karg, Ekaterina Korobkina, Meredith S. Gregory-Ksander & Bruce R. Ksander

Division of Genetics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA Margarita Meer & Vadim N. Gladyshev

Department of Pathology, Yale School of Medicine, New Haven, CT, USA Margarita Meer & Morgan E. Levine

Department of Genetics, Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA Noah Davidsohn & George M. Church

Department of Molecular Biology, Cancer Center and Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA Konrad Hochedlinger

Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA Steve Horvath

Laboratory for Ageing Research, Department of Pharmacology, School of Medical Sciences, The University of New South Wales, Sydney, New South Wales, Australia David A. Sinclair


I would love something like this. Over the past 5 years I have experienced my eyesight degrade since reaching 40 years old. I always use to quietly brag to myself about having such good vision. And then suddenly it gets a little bit of challenge to read, so you get a weak strain of reading glasses and from their you continue up in strengh ratings until you realise the person over the road from you has a blurred face and you have gone from needing reading glasses to needing glasses all of the time.


Since we're commiserating: the vergence of my eyes is failing and I'm not even 40. My actual vision is perfect; better than ever. But apparently my eyes don't converge so well anymore, giving me horrific headaches if I look at any kind of screen for more than a few minutes :( Really sucks. Doc gave me prism lens so I can use a computer again, but they're exhausting to use. Hoping I can find a specialist after the pandemic is over and figure out a better option; really don't want this to get worse.

Kind of sick joke, considering I spent almost a decade of my career doing computational imaging and computer vision work.

2020 :/


I had something like that and doing a few minutes a day of magic eye / 3d stereograms sessions helped me a lot. That consisted of learninng how to see them then learning to hold the image up in 3D (feels like starring behind the image) then rotating the eyes around while holding the stereogram in focus (looking at all parts of the image not just center). This helped strenghten my eye muscles and tension/headaches went away.


That's good to know, thank you!

I printed out a Presbyopia chart (http://www.robert-silverman.net/presbeninst.htm) that was linked on HN awhile back and started using a Brock string. Figured I'd do those until the pandemic is over and I can get some professional vision therapy.

Guess I'll pick up a magic eye poster too. At least it'll be more fun than staring at a string for five minutes.


There are tons of magic eye available as images online. Not all magic eye images are equal and beware they all have different depths and some are more visible and pop up faster than others. Some are particularly pleasant to stare at.

Btw, there is even a magic eye tetris out there. Playable only when one is proficient at seeing magic eye images.


Contact this guy. It looks like a non-surgical solution may be possible :

  https://media.ccc.de/v/35c3-9370-hacking_how_we_see
Essentially, they use a VR headset to offset the shifted vision, and then gradually correct the difference in therapeutic sessions. Pretty ingenious.


Very interesting presentation, thank you for the link. I'll have to look and see if they've made progress since then; something I can try at home perhaps.


Looks like the project has been silent since May. Hopefully they'll resurface after the dust from the pandemic settles.


Wonder if a VR headset with a custom interpupillary distance (IPD) would work for you? eg set it to a distance that's not physically correct, but er... more correct for how your eyes operate.

If it's works, you'd be able to read text again. You'd just need to do it from inside VR. ;)


Look into IIH, 5th or sixth nerve is affected, causes double vision.

Diamox fixes my double vision. Before that I was using prism glasses.


6th cranial nerve palsy is what got my vision. Unknown cause. I chanced it with strabismus surgery and it has really paid off for me.


How did you know it was that? I've had a quite sudden change in vision (I used to be able to read without glasses or function daily without glasses, and in a matter of weeks or months I suddenly needed glasses all day, I'm 37) and it seems my astigmatism progressed, but not that much since before.

I also had quite bad posture during the confinement and wonder if I could have pinched a nerve?


Hard to say. Sudden Eye strain caM weaken the eyes. In my early 20s I tried to focus on something really hard. Then “owe” I couldn’t focus at all.

Apparently I had needed glasss for years, and that was the final straw.


I'll definitely have my doctor take a look. Thank you. It's so hard to find information about possible causes for convergence insufficiency. All my Google diggings have come up with the usual information about treating it in children :/


I was referred to a child eye doctor, as apparently no one bothers with adults. Never made it due to covid.

Diamox was almost an over night fix. That’s when I put it together. I had to dig like crazy to learn about cranial pressure and sixth nerve.

Eye doctors were all clueless on it. Even Neurlogist mostly were.


Cellular clocks may not be so useful with this.

Your eye has "extra flexibility" to focus at birth (that is, it can focus beyond infinity and nearer than is useful), but it slowly hardens and becomes less flexible. Around age 40-50 is when you really start to notice the loss in range, assuming you had something close to a normal balance between distance and near vision to begin with.


Anecdote with N == 1 as usual.

I am 42 and I started experimenting with NMN, NR and resveratrol in January.

My eyesight measurably improved, by about 1,25 dp, within weeks (I am shortsighted since childhood.) I no longer notice any eye strain even after looking into screens for hours. My very, very mild presbyopia disappeared. Also, I believe that I can see colors much more brightly, but this is something that cannot be measured easily, if at all.


Hi, could you give me more information about what NMN and NR are?



Any way to maintain flexibility through diet and exercise?


I don't believe so. It's my understanding that the protein structures that make the lens so flexible-- mostly alpha-crystallin --- are created during the development of the eye and slowly lost over time.

Later, transparency is lost in the cornea for similar reasons and we get cataracts.

Then with cataract surgery you can choose your preferred focal length for your new stiff artificial lens.


Fuck man, this sucks. How come some people manage to still not need glasses past 50 then? What did they do different?


I'm in that category - I've noticed is that me and other mountain climbers and hikers seem to age better.

Could be selection bias - the unhealthy with poor eyesight could have quit or fallen off a ledge.


I doubt that that's a key factor. There's a lot of luck on initial refractive error, etc.

I don't need reading glasses. One reason is I have one eye with a slightly near refractive error and one with a slightly far refractive error. They're also both pretty close to nominal, so losing a bit of range on focusing doesn't hurt as much as if I'd been biased one way or another.

I do notice that I prefer slightly larger text than before. I bet if I tried reading glasses that I'd find that they lend some benefit.


I notice that after a long hike in the mountains, I can see a bit better. The effect stays for several hours.

Probably the eyes need some training too, refocusing onto near and far objects frequently. We live in a computer screen world, this is very unnatural for our eyes.


Maybe it’s from focusing to infinity for a long period of time.


Is there an incentive to perform peer-reviewed, triple-blind, controlled studies on people to see if diet and exercise helps? Then there's no way to know.


*quadruple blind. The subjects in this study are blind as well.


Vision loss + tinnitus: something that makes getting up in the morning hard to do!

The thrill of being able to restore these two things alone would be indescribable.


Hopefully your optometrist has warned you that it just gets worse and there's nothing they can do.


Precisely same here most noticeable on screens and in morning. My wife passed me her glasses and my screen became sharper than ever. My fear is using them too much might then mess up my non glasses vision.


Probably not. Age-related near vision loss is due to the lens of your eye losing flexibility with age, and not being able to change shape as much to focus on near things, and not any kind of baseline refractive error.


Same experience, aging sucks.


David Sinclair talks about this work in his book Lifespan, in case you are interested in the current state of anti-aging treatments.

It's very exciting that we are beginning to unravel a general mechanism that drives aging across species.


[flagged]


He already looks like the Madame Toussaud’s statue of himself. Whatever he’s doing is not working, at all.

In a decade that boy is going to look like Christopher Walken. In two, Willem Defoe. By the time he’s 65 he’s going to look like Nosferatu.


how can you tell if: 1) he is doing something? 2) it is not working?


He’s doing something. It’s impossible to do nothing.

And I think “it’s not working” is more of an opinion, so...


I disagree. I understand that it’s your opinion that he’s doing something, but without something concrete to back it up, it’s just an opinion.


It’s not an opinion. It’s impossible to do “nothing”. That’s as concrete as it gets.


Nobody I’ve met is aging the way Mark is aging. He looks... weird. Either he is a potential medical paper, or he’s doing something. Or he’s been replaced by a robot.


the reptilians have replaced him


Not imortal, but probably billionaires will be the first to get longer lifespans (250 years). Imagine how much powerful someone can become. There is a very nice book called Pandora’s Star where people live for a very long time and this causes a lot of interesting developments in society.


Will be old enough to see Facebooks decline


Or watch Ad Vitam (it's on Netflix).


That book feels so much like Atlas Shrugged in a sci-fi universe. It’s dreadfully exciting to read.


Ehh, they'll have fun living out those decades in hiding from the populace if so


Imagine an immortal Henry Kissinger


Lost much of my vision. Was restored by blood thinners and Diamox.

Not what the drugs were intended to treat. But a surprisingly effect.

2 dozen doctors had not been able to help me.


What made you consider those drugs for your eyesight?


Didn’t consider drugs for vision. Spent like 20k on glasses and eye doctors to little success.

Have increased cranial pressure. Makes eyes want go double. 5th or sixth nerve gets weak.

Diamox lowers pressure. Nerves work better, double vision goes away. Prism glasses help if I’m having a bad time.

Other issue was black disc / hallucinations in vision.

Doctors found I had a genetic clotting disorder. Only found due to clots showing up elsewhere in body.

Blood thinners are standard treatment. Aside from double vision all my eye Problems went away in a few days. So basically eye mini strokes.

Everything comes back whenever I try and go off meds.


That's interesting ... I've had vision problems (been partially blind out of one eye for years, and my vision often wants to go double), and no one's been able to pin point a cause. Keep getting hand-wavey responses like "it's just your migraines".

How did you discover you had increased cranial pressure?


Had a spinal tap to check pressure. It was high.

They removed some fluid to Lower pressure. Massive difference in symptoms. Lasted about a year. Diamox lowers pressure now.

Reddit has /r/iih a good place for learning.


What kind of blood thinners are you using?


Pradaxa. I don’t like it, but 3 days without and my right side goes numb. Then vision starts going weird.


Any hints to the mechanism of action for your case? How old are you btw, if you don't mind sharing?


40.


You saw 25 doctors?


He only saw the last doctor.


He saw 12 doctors but had double vision until the end...


clearly.


Hey, let's focus.


Probably about 15. Most multiple times.

Now I may have had less problems if I had taken the baby aspirin like I was supposed to. As that is a mild blood thinner.


Doesn't seem particularly weird to me, I've seen more than that myself for an issue.


Tricky things get dismissed out of hand. Treated as depression.

Oh you have anxiety. Take some anti-depressants.

Umm doctor my entire right side is completely numb.

Doctor: see a neurologist. Umm that’s a 3 month wait.

Neurologist. Take this pill call me in six months. We got about 10 meds to get through before I can start on the good ones.


Several research groups and companies are working on in vivo applications of cellular reprogramming. Since its discovery, reprogramming has been used to produce induced pluripotent stem cells from any other type of cell. That process has been found to reverse age-related changes in epigenetic patterns and mitochondrial function characteristic of cells in old tissues.

Introducing the factors capable of reprogramming cells into a living animal may produce effects akin to stem cell therapy by converting a small number of cells into induced pluripotent stem cells, followed by stem cell signaling that beneficially affects tissue health more broadly. Alternatively, many cells may have their epigenetic markers reset to a more youthful state without losing their identity to become induced pluripotent stem cells. Or both. Beyond this, there is certainly the threat of cancer or structural damage to tissue through the conversion of too many cells, and this class of therapy will require careful development to ensure safety, even as the mouse data continues to look quite interesting.

David Sinclair has been pushing an epigenetic-centric view of aging of late, with analogies to information systems and computing. The most interesting part of the the supporting work suggests that DNA repair of double strand breaks has the side-effect of driving alteration of the epigenome in characteristic ways with age. That will be an important connection between stochastic nuclear DNA damage and deterministic global effects throughout the body, should the evidence continue to hold up.

As this illustrates, however, epigenetic change is a downstream issue in aging, a reaction to events and a changing environment, not a first cause. Fixing it may or may not turn out to be particularly useful in the broader picture of aging, depending on exactly where it sits in the web of cause and consequence. As a comparable example, hypertension is a major downstream issue in aging. It is far removed from root causes such as cross-link formation and inflammation, but is also a proximate cause of many forms of further dysfunction, such as pressure damage to delicate tissues in the brain. Controlling hypertension without addressing its causes is both possible and beneficial - but the benefits are limited by the fact that those root causes are still there, chewing away at the body in a thousand other ways.


The eye was selected as the area for this research because it is self-contained in multiple ways. Viruses used to insert the OSK genes in they eye will stay in the eye, so there is less concern about possible effects elsewhere in the body. That provides an easier path towards translating and getting regulatory approval in humans.

But the very cool thing is there is no reason to believe that this technique couldn't eventually be used throughout the whole body.


In other news, they're also close to releasing eyedrops to help with presbyopia: https://modernod.com/articles/2020-sept/coming-soon-presbyop...

UNR844-Cl claims to restore flexibility to the aging lens by breaking the disulfide bonds that form between proteins in the lens. It's a really simple molecule too, composed of common supplements(lipoic acid and choline), so it looks like the risk is fairly low.


I've been following this drug's development process since back when it was named EV06.

Currently people with presbyopia who get laser eye surgery have one eye corrected for looking at nearby objects and the other for those which are far away - this works, but is not ideal.

With UNR844 one could potentially have the same typeof correction in both eyes.


I was just listening to some techniques on YouTube on how to fix presbyopia by switching to older prescriptions from current prescriptions to bring back the elasticity. Apparently focusing on reading or a computer screen too much can create the lens from returning to it's original condition/state as it remains locked/seized up. Might be bullshit but these eye drops would be amazing. I wonder if this is what David Sinclair was talking about when he said they will be able to fix bad vision soon.


Is this Active Focus?


I was confused at first because your link is about a different approach, using drugs that temporarily constrict the pupil. The drug that fixes the lens is in human trials too, and would also just be an eye drop. Here's an article:

https://www.healio.com/news/optometry/20201012/further-study...


The link mentions both approaches. The lens constricting drugs are listed first.


I've been watching this one for a while. If it works out, it will be fantastic (well, not for optometrists)


There is also some drugs being tested for some types of tinnitus and hearing loss. One of them is FX-322 by Frequency Therapeutics.

https://www.biospace.com/article/releases/frequency-therapeu...


I think one of the guys who founded Moderna originally wanted to inject mRNA to induce pluripotent stem cells. It would be great if that can somehow work for this. Instead of using an adenovirus to insert the genes, we can inject mRNA to induce expression of the transcription factors long enough for it to take effect.


This stuff could be BIG deal. Currently, most of therapies involve taking the cells out to reprogram them back to ipsc and trying to stuff them back again. IF this is viable in humans - adenoviruses work for us, too - or nanolipid vesicles. So, it should. Source: wife epigenetics postdoc in ipsc therapy


I am a glaucoma patient for 2 years and I'm 30. I hope there will be a cure before I lose my sight.


I previously posted this: https://www.nature.com/articles/s41586-020-2975-4

Maybe because I included (in mice) in the title, it didn't get upvoted as much as this post.


Looking at both, your link seems to go to a much less readable version of the article?


IN MICE.


in mice


I’m really starting to hate this trope, I think everyone should just assume “in mice” unless the title states “in humans” as that is a much rarer event for research papers to be at that stage than mice or other mammals.


People will assume what they will. I'd prefer a more explicit title.


I just don’t think commenting with “in mice” on every biology papers adds to and informs the discussion. Maybe headline wars could be on a separate thread for each article?


"In mice" isn't the whole story here.

"The authors found that OSK expression enhanced axon regrowth and cell survival in human neurons in vitro."

Granted, that's not actually restoring sight to an in vivo human patient just yet, but neither is it "in mice".


I'd like to see what happens if all the youth renewal strategies done on laboratory mice are applied to older, wild-caught mice of whatever variety is closest to lab mice.

I've heard the claim when calorie limiting applied to wild mice, they ... just die - they already have limited calories.

But just that leap might be a decent lesson.


Right? Can we get the title updated?


I previously posted this: https://www.nature.com/articles/s41586-020-2975-4

Maybe because I included (in mice) in the title, it didn't get upvoted as much as this post.


In mice.


> They infected RGCs in mice with adeno-associated viruses.

In Mice

https://mobile.twitter.com/justsaysinmice




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