the US—specifically in San Francisco’s Bay Area. By both the number of companies and levels of capital investment, the US far out- strips fellow longevity enthusiasts, China and the UK. But other centres in Europe and Asia are forming. In Singapore, for instance, the former president of the Buck Institute, Brian Kennedy, has set up a new centre for ageing attached to the National University of Singapore. This is still early days for green-

field foreign direct investment, but fDi Markets trackedone greenfield longev- ityannouncement froma longevity company:HongKong-based biotech company InsilicoMedicine, which applies technologies such as genomics andbig data to the development of newdrugs andresearch into the reuse of agingdrugs, plans to establisha researchanddevelopment facility in Taiwan’sNankang Software Park. Mergers and acquisitions have

pepped up too. In 2020, Hong Kong- based Regent Pacific, an investment firm specialising in healthcare and late-stage life sciences, acquired Insilico’s spin-out Deep Longevity. Spanish pharmaceutical company Grifols bought out its remaining stake in Stanford University start-up Alkahest for Grifols for a sum total of $146m. Jim Mellon, serial investor and

co-founder of London-based Juvenescence, a shareholder in Insilico, likens these early stages of longevity investments to the “dial-up phase of the internet”. “We are sure that something is

going to work,” he says.“We, like eve- ryone else, are not sure what’s going to work, [but] we do knowthat sev- eral key pathways of ageing have been identified.” Juvenescence, also co-founded by

Greg Bailey and Declan Doogan, is expected to go public this year, potentially taking the form of a Spac deal. Following some of the failures

of longevity companies, such as the plummeting stock price of RestoreBio, Juvenescence has spread its bets in 20 projects across 12 com- panies, ranging fromorgan regener- ation to senolytic therapies. Sergey Young, founder of

Longevity Vision Fund, with $100m of capital, likes to keep the term lon- gevity intentionally broad and has invested in 15 such companies, four ofwhich have gone public and three are due to go public this year. Since he set up the venture capi-

tal fund two years ago, his focus has been on “bringing affordable and accessible versions of longevity” to as many people as he can. ”I’m not a fan of immortality because if you take out death from human life, you don’t have life. But Iama big fan of adding 10, 20, 25 healthy and happy years,” MrYoung says. He points to the exam- ple of the cancer treatment market, which has grown exponentially over the past decade and is nowestimated to be worth more than $100bn. A similar net increase could occur with longevity drugs, he says, if there is a defined regulatory model to follow.

Regulatoryrags to riches Much of the future of longevity rests in the hands of the regulators. Should the regulatory framework bend in favour of longevity and approve the first clinical anti-ageing drug, it will be a watershed moment to help extricate the fiction from the science fiction still associated with longevity, researchers and investors say. When that day comes, longevity

—the longstanding “orphan of the investment and health worlds”— will become a “Cinderella” of the health sector, Mr Young remarks. The US Food and Drug

Administration (FDA) does not con- sider ageing a disease which, to an extent, has impeded longevity or age- ing treatments fromgoing into clini-

cal trials. The Targeting Aging with Metformin (Tame) trial might shore up the case for age-based drugs. Tameis a clinical trial looking at

the anti-ageing or ‘gerotherapeutic’ properties of diabetes drugmet- formin, specifically to see whether those taking diabetes drugmet- formin experience delayed develop- ment or progression of age-related chronic diseases, such as heart dis- ease, cancer and dementia. Led by Nir Barzilai, director of

NewYork-based Institute for Aging Research at the Albert Einstein College of Medicine, and funded by the American Federation for Aging Research, the trial involves 3000 peo- ple between the ages of 65 and 80, and aims to prove that an already approved drug can target ageing. Mr Barzilai hopes that this could

provide a template for other FDA- approved drugs to be repurposed and, eventually, for new drugs. “One of themajor things that

we’re going to do in this trial is to see the biomarkers of ageing,” he says— biomarkers being measurements of a biological state. Mr Barzialai explains that “we have biomarkers that tell us your biological age or chronological age, but we want to see which biomarkers change when you give a patient the drug”.

Ageing science San Francisco-based Bioage, a clini- cal stage biotech companywhich has built amap of different pathways related to ageing, uses biobank sam- ples fromup to 50 years ago to see what differentiates the ‘healthy agers’ and ‘unhealthy agers’ at a molecular level and investigate which existing drugs might have anti-ageing properties. Much like the Tame trial, Bioage

— which recently raised $90m in a series C funding round — has looked to repurpose two drugs, his- torically used for kidney disease


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