The Science Behind Aging (Not Just Behind Wrinkles)

Knowledge of the cellular mechanisms behind aging has contributed, first to understanding how environment, habits, and lifestyle help slow aging, then to studying new drugs targeting specific mechanisms that can slow cellular aging, and finally to finding truly effective therapies to block and slow tissue aging.

We discuss this with Professor Carlo Tremolada, Researcher and Director of IMAGE REGENERATIVE CLINIC.

Supplements and Off-Label Drugs

Supplements that increase NAD (nicotinamide adenine dinucleotide) levels are the primary candidates for anti-aging therapies. NAD is an important substance for cellular metabolism and longevity, whose studies began as early as 1997, when a young David Sinclair, professor of genetics at Harvard Medical School, discovered that NAD can help regulate a family of proteins called sirtuins, which improve epigenetic health and increase longevity in yeast. This sparked interest in resveratrol, a polyphenol present in red wine and used in many supplements, to activate sirtuins, leading to a recent study (Cell Metabolism, 2024) on the most promising supplements and off-label drugs, meaning those used for purposes other than their registered indications, to slow aging (Metformin, a drug primarily used for treating type 2 diabetes, NAD precursors, Glucagon-like peptide-1 (GLP-1) receptor antagonists, an intestinal hormone that stimulates insulin production and reduces blood glucose, TORC1 inhibitors involved in growth and aging, Spermidine, a molecule that may have beneficial effects on health and longevity, Senolytics, substances that eliminate senescent cells, Probiotics, Anti-inflammatories).

However, their effectiveness on aging and longevity is still a topic of discussion in the scientific community. Supplements and off-label drugs are indeed a controversial topic, with much debate about what works and what is useless.

Cellular Reprogramming

Caloric Restriction

The effects of caloric restriction on longevity (in laboratory animals) have been discussed since the 1990s, but only since 2007 has a major multi-year clinical study called the Calerie Study analyzed the effects of caloric restriction in humans. Only recently, however, has it been possible to demonstrate that subjects on a lower-calorie diet showed reduced inflammation and greater production of immune system T cells and energy-producing mitochondria. From here, studies on intermittent fasting or time-restricted feeding in mice suggest that a similar routine could suppress genes involved in inflammation and improve protein production, even in old age.

Infiltrative Therapies with Mesenchymal Stem Cells

Different from therapies with stem cells from umbilical cord or bone marrow, still under study and debate, infiltrative therapies with mesenchymal stem cells are already part of clinical practice for treating many pathologies. Among these, the Lipogems® regenerative system, patented by Professor Carlo Tremolada, has been widely used for years by physicians worldwide for treating cellular aging and chronic conditions such as osteoarthritis. Lipogems® is a minimally invasive regenerative procedure that uses autologous adipose tissue, rich in mesenchymal stem cells and growth factors, to promote tissue regeneration. The procedure maintains the perivascular niche of adipose tissue intact, ensuring the survival and effectiveness of mesenchymal stem cells in the regenerative process.