On the threshold of the future
"We can slow down the mechanisms of aging"
Academician Sergey Lukyanov – about the medicines of the future and the state of modern biomedicine in Russia.
Maria Nedyuk, Izvestia
– [...] What are the most advanced developments of the university that are already close to the implementation stage?
– Reconstruction of the preclinical research center is being completed. It will develop, test and produce experimental batches of new drugs, new cell technologies, biomedical cell products for regenerative medicine and much more. Prototypes of new medical equipment will also be created there.
Now we are at the stage of obtaining a permit and introducing the latest rehabilitation complexes connected with the brain-computer interface into the clinic. If paralysis of the hand occurs as a result of a stroke or injury, mobility is restored using an exoskeleton controlled from an interface that, using an encephalograph, catches signals directly from the brain. Full-fledged preclinical and clinical studies have been conducted. Soon this system will be implemented in the clinic.
– And if we talk about cellular products, what exactly are you developing?
– The most interesting project is related to learning how to restore the function of insulin generation in diabetes mellitus. We have learned how to transform the cells of the patient himself so that they become able not only to produce insulin, but also to respond to changes in blood sugar levels. No, even slowly dissolving, artificially injected insulin can replace a natural source.
There are works to restore the urethra due to reprogrammed stem cells. Such operations are now possible and will be implemented soon. The law on cellular products has just been released, by-laws are being finalized now. Our country, I think, will soon enter the era of cellular technologies, and we will be among the leaders.
– What other developments that are in the greatest readiness, would you pay attention to?
– For us, the most interesting is the treatment of autoimmune diseases – when the immune system suddenly begins to work against the body. Here we are creating fundamentally new technologies based on the specific effect of monoclonal antibodies on autoimmune cells. This leads to long-term remissions in a number of autoimmune diseases due to the destruction of inflammation-inducing cells.
In the field of oncology, we focus on early diagnosis and plan to create liquid biopsy technologies. They will allow you to detect the tumor when it is not yet visible. The mutation with this technique will be calculated at an early stage by a blood test – trace amounts of tumor DNA remain in it. Such gene mutations can be found by sequencing (determining the sequence of nucleotides in the genome).
We are also working in the field of gene editing. This topic is very complicated legally. Nevertheless, we are doing it, because there are mutations that lead to absolutely tragic consequences. For example, there is such a disease as Duchenne muscular dystrophy, when children at the age of 5 begin to lose muscle mass and are doomed to die in 10-15 years. Making a change in the DNA of such children may lead to the fact that they will be able to survive. There are developments on gene editing of embryos, but today, of course, this is done only on animals.
– How do you see the foreseeable future of our medicine? And will all these technologies that you are talking about be implemented in our lifetime?
– There will be changes in medicine. The future is comfortable clinics and workplaces. This is digital medicine when we are not running around with endless pieces of paper. The patient's card with all the information should be available to any doctor.
If we talk about scientific successes, we are already seeing them. Look at the life expectancy in the world: a person aspires to 80+, in all developed countries this has already been achieved. When did people live so much more? The life expectancy curve for the last two hundred years is going up. And this is the merit of medicine. Cardiovascular diseases were mowed down before everyone from 40 to 60 years old, and now people live peacefully.
– Is it possible to create a medicine that will allow you not to age at all?
– We are trying to uncover the molecular mechanisms of aging. There is a point of view that during life mutations and harmful substances accumulate in the body, as a result of which we age. This is all true, but why are they accumulating? We know organisms whose life expectancy is very sharply different. There are mice that live for two years, and there are mice that live for 20 years. We are trying to figure out why this is so.
Man is no longer an object of biological evolution – it is an object of social evolution. Therefore, we can afford to live longer, better, and also uncover the mechanisms of aging and, possibly, break them. I think this is a task for the next century. We can slow down the mechanisms of aging.
One of the most striking signs of aging are changes in the thymus (thymus gland). This organ produces immune system cells that protect us. The diversity and richness of these cells decreases with age, and in old people it is very low, and they are not able to protect themselves from the new flu. But if you take 100-110-year-old people with whom our gerontology center works, they have the same diversity of these cells as a 40-year-old person. This means that they have some kind of peculiarity, and it has led to such a life expectancy. What if we find this feature and keep the thymus function longer? We conduct such studies. It is to increase life expectancy.
You need to understand that a person should not be eternal, because after a while only adults and old ones will remain. If the environmental conditions change, the old ones will die out, and the entire population will disappear. Therefore, we are working on prolonging life, but we do not touch the problem of immortality.
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