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The world’s elderly population is growing fast, especially in Asia. Photo: Alamy

Biotech boss backing gene therapy to solve ageing crisis seeks injection of urgency, but scientists preach patience

Experimenting on herself didn’t go down well with scientists, but Elizabeth Parrish is convinced gene therapy can increase the length and quality of our lives, and wants early approval for treatments to stem ‘planet’s biggest killer’

Wellness

Elizabeth Parrish is a proponent of controversial ideas. Rankled by barriers to trials on potential life-enhancing treatments, she used herself as a guinea pig and says the results have borne fruit – but she has irked the science community in the process.

The CEO of Seattle-based BioViva, a biotechnology company that focuses on developing gene therapies to slow the ageing process, revealed that in September 2015 she flew to Colombia and tried two experimental gene therapies on herself. Six months later, BioViva claimed the experiment was a success against ageing and that the treatment lowered the biological age of Parrish’s immune cells by 20 years.

Elizabeth Parrish, CEO of BioViva.
Parrish, then 44, took a myostatin inhibitor, a drug being tested as a treatment for muscle loss and a telomerase gene therapy which lengthens telomeres. Telomeres are located at the end of every chromosome, and they get shorter over time as the body ages.

Telomeres also allow the cell and its DNA to divide until it experiences cell death, which scientists believe contributes to ageing. This also shortens telomeres. The gene therapy that Parrish took encourages cells to produce telomerase, a protein that repairs them.

Parrish’s actions caused a stir within the industry, mainly because BioViva had not done the pre-clinical work needed to progress to human studies or testing. Neither did the US Food and Drug Administration authorise Parrish’s rogue experiment as “patient zero” (as she likes to call it) – hence the trip to Colombia. But Parrish denies her actions were reckless.

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“As a matter of fact, not intervening in one’s health is more reckless because we already know how we’ll die,” she told the Post at a conference about ageing and longevity in Hong Kong. “We can actually use this powerful technology to treat what we call complex disease, which is many of the diseases of childhood and ageing.”

The reference to childhood diseases is personal for Parrish. In 2013 her son was diagnosed with type 1 diabetes, and she could not understand why promising research she saw on gene therapy wasn’t making its way to hospitals to help dying children. The situation motivated her to launch her company BioViva and its campaign to bring gene therapies to humans, with her being the first.

“We studied a couple of gene therapies that had the most promise to treat not only adult diseases, but also childhood diseases, and I took them to prove they were safe to the world,” she said.

We can actually use this powerful technology to treat what we call complex disease, which is many of the diseases of childhood and ageing
Elizabeth Parrish, CEO BioViva

Parrish’s foray into longevity science began when she stumbled upon a SENS Research Foundation conference in Cambridge, UK, and discovered how gene modifications had extended the normal lifespan of worms up to 11 times and mice by five times. It was there she learned ageing ought to be classified as a disease, a collection of conditions including cancer, heart disease, stroke and dementia and that everyone will suffer. She wanted to tell the world and get people to put money behind finding a cure.

“[Ageing is] the biggest killer on the planet – by 2050 it will be the biggest killer in every small pocket of the world. To think that ageing is a problem of industrialised countries is just not correct. In countries that are developing right now we see most of the causes of death are associated with ageing – cancer, heart disease and various other things,” she said.

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Parrish’s point about the growing disease burden from ageing populations in developing countries is a grim reality across the Asia Pacific region. According to a 2016 report by Marsh McLennan Companies called “Advancing into the Golden Years, Cost of Healthcare for Asia Pacific’s Elderly”, between now and 2030, 200 million people in the region will become 65 years and above.

This translates to an increase of 71 per cent in the number of elderly people, compared to an increase of 55 per cent in North America and 31 per cent in Europe over the same period. What worries governments, though, is the extraordinary speed at which the region is ageing.

Parrish believes that gene therapy is a solution to the ageing problem, while other medical professionals think she is assuming too much and rushing into the unknown.

For example, in the 15 years from 2015-2030, China’s elderly population will rise from 11 per cent to 18 per cent, according to World Bank data. It took Germany 25 years to make that leap. South Korea’s elderly population will move from 13 per cent to 23 per cent, a rise that took Italy 40 years, and Singapore’s elderly population will rise from 11 per cent to 20 per cent over the same 15-year period – a shift which took France 49 years.

To pick out one key particular phenomenon of telomere length as a key determinant of ageing and to say if you’re going to lengthen telomeres you’re magically going to cure ageing, I think that is fanciful
Duncan Baird, professor of genetics

Hong Kong also has a rapidly growing elderly population. Between 1997, the year the city returned to Chinese sovereignty, and 2016 the percentage of residents aged 65 and over in the populatio rose from 10.3 per cent to 16 per cent. That number is expected to rise further to 24 per cent in 2025, meaning a quarter of the city’s population would be elderly. Hongkongers have the longest life expectancy in the world – 87 years for women and 81 years for men.

The Marsh McLennan report warns that the cost of elderly health care in Asia over the next 15 years will snowball to approximately US$20 trillion, which is unsustainable. Current health systems aren’t prepared to handle the wave of unmet demands that will occur from societal ageing – such as whether there will be enough doctors, specialists and hospital beds. It forces a focus on the future workforce – who will care for old people?, and infrastructural capacity – where will we care for them?

On the flip side, societal ageing leads to a greater number of people with non-communicable (or chronic) diseases, such as diabetes, heart diseases and cancer. The longer a person lives the greater their exposure to NCDs and greater the demand for health care services.

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Managing chronic illness is expensive and can place a significant financial burden on individuals and their families because many in Asia pay for health care services out of their own pockets. Diverting public funds into elderly care, the report states, can adversely impact economic growth.

Parrish believes science can play a vital role in averting an ageing crisis – by using an IV drip and a series of injections.

“Gene therapy or gene modulation is the only way we’ve extended lifespan, healthy lifespan in the past in science. They [worms, flies, mice] live longer and die in a shorter period of time at the end of their life … We can only learn that [for ourselves] through the application of these therapeutics in humans.

“What we’ll do is we’ll use them in humans and then we’ll look at these biomarkers and extrapolate how much that associates with a certain age group. We can consider how long that person might live in this healthier body. But that takes time, and the outcomes of that will be a little bit down the road,” she said.

BioViva’s website.
Since her personal experiment, Parrish says people have contacted her to ask if they can try her anti-ageing gene therapy. She admits this is not enough to expedite the official sanction for use of such therapies in humans. Instead, she is interested in asking countries to re-regulate.

While the “EU has passed through regulations for a couple of gene therapies and the US FDA is following suit”, Parrish wants to set up partnerships with governments, universities and paid-for trials (for those who can afford the hefty price tag), and has also got Hong Kong in her sights.

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“We are here to scope things out. We’re interested in Hong Kong for a prognostics and diagnostics clinic which helps [us to] follow patients’ data from today, throughout their life,” she said, and then give them access to gene therapy and other treatments to see what the outcomes are.

“Hong Kong has the longest lifespan right now on the planet … These are highly functioning bodies, which is actually really good news … These are great bodies to work with because they’re optimally ready for longevity in a sense,” she said.

Scientific rigour in Parrish’s work is the massive snag in her efforts to peddle gene therapies to the world. Many scientists, including those that are and have been a part of BioViva’s scientific advisory board, have told the media that bypassing preclinical studies and trials raises serious ethical questions about how quickly such treatments can be tested on people, and whether medical regulators can be dodged.

The Chinese character for longevity. Hongkongers have the longest lifespan in the world. Photo: Alamy
In an article in the MIT Technology Review published in October, 2015, one member, George Martin, a professor at the University of Washington and former scientific director of the American Federation of Aging Research, told the publication he was “upset” by Parrish’s trying of therapies on herself and urged “lots of preclinical studies”. He also said he had resigned from his role as an adviser to her.

Duncan Baird, a professor of cancer and genetics at Cardiff University’s School of Medicine, told The Guardian in a story on Parrish that he didn’t agree with her “impatient” approach, either.

“To pick out one key particular phenomenon of telomere length as a key determinant of ageing and to say if you’re going to lengthen telomeres you’re magically going to cure ageing, I think that is fanciful.”

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Parrish’s goal of bringing gene therapies to thousands of people could well be a pipe dream, but her sense of urgency about solving the world’s ageing crisis is real and governments around the world – including Hong Kong’s – need solutions now.

“By 2050 there’ll be 1,003 per cent more people living over the age of 100,” she said. “It’s fantastic news that we’re living longer, but we need to live healthy longer.

“Right now, if you’re running a drug through innovation through the FDA [US Food and Drug Administration] it’s 15-plus years and costs at least a billion dollars. It’s too slow. We lose 40 million people a year to ageing. All of those people may have been a part of spearheading new technologies.”

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