A main part of Unity Biotechnology’s work isn’t focused on aging per se, but rather on designing drugs and treatments that can make a person functional and free of the diseases associated with aging for as long as possible. “We don’t need to invoke ideas about aging. We view it through the lens of specific diseases,” David, a molecular and cell biologist, said.
Osteoarthritis is the first disease Unity Biotechnology is tackling, and that one disease represents a huge opportunity: By 2026, the market for osteoarthritis drugs will be $2.6 billion in the U.S. alone. The company is currently in a phase 1, government-approved safety trial with about 40 patients in multiple sites across the U.S. The goal is to show that the drug Unity is developing — what’s called a senolytic agent — can be injected into the knee and tolerated by patients in gradually higher doses. Ultimately, the thinking is that such a drug can destroy senescent cells, effectively halting or reversing osteoarthritis in the knee. In the future the same drug might be effective in treating pain elsewhere in the body.
“Osteoarthritis standard of care begins with ibuprofen, then steroids, and then most people’s standard of care is just accepting it: You’re old, that sucks, and you’re now in pain for the rest of your life,” David said. “But we think there’s a better way, by looking through the lens of biological insight of why those diseases happen in the first place.”
Demographics fuels novel science
The desire to conquer aging is an old one. The National Institute on Aging was established by the National Institutes of Health in 1974. Nowadays it has a budget of about $2 billion. But that desire has grown stronger in the 21st century.
Some of the reason is out of necessity. The U.S. population is aging, and in about 10 years, all the Baby Boomers will be older than 65, according to the U.S. Census Bureau. By 2035, older people will outnumber people under 18 for the first time in American history. Another reason comes straight from Silicon Valley. Over the last decade the titans of the tech industry — including Google and Facebook — have dedicated money toward cutting-edge research focused on curing disease as well as slowing, delaying and, possibly one day, reversing the conditions of old age.
Campisi is a professor at the California-based Buck Institute, founded in 1999 as the country’s first independent aging-research center. “Organisms have evolved very different lifespans and we do not understand how that occurs. It could be that the evolution of longer lifespans might require tweaking hundreds of genes, a feat that humans may never achieve with a single intervention,” she said. “We really do not understand what the absolute limits to lifespan are, and so the search for the fountain of youth is not going to be around the corner.”
For that reason, while cellular senescence is an integral part of Unity Biotechnology’s work, its mission is more about “healthspan,” or the period of time when a person is functional and free of the diseases associated with old age, even if a person is, chronologically speaking, a senior citizen. The thinking is that the effective treatment of diseases, like osteoarthritis, can make a person healthier, longer.
Assuming Unity Biotechnology’s phase 1 trial goes smoothly, David said the next step will be further trials to determine what effects the company’s senolytic drugs have on senescent cells in patients. That might be through measuring signs and symptoms, such as inflammation in the knee, for example.
“The time has finally arrived that our knowledge of biology and our sophistication level is sufficient that we can attack some of these fundamental, underlying causes of aging,” he said. “And it’s not just Unity saying that.”
