What are the ethics of using young blood to reverse the effects of aging?

Oct 8, 2015 /

In June, Stanford biologist Tony Wyss-Coray took the TED stage to describe no less than “an absolutely amazing development in aging research” (How young blood might help reverse aging. Yes, really). His research has shown that proteins found in the blood of younger mice can dramatically reverse the effects of aging when given to older mice. The implications are huge, perhaps ushering in a new era for the treatment of diseases like Alzheimer’s and maybe — just maybe — providing a way to treat aging itself.

But the same research has also triggered some hand-wringing, and it’s not hard to guess why. If turning back the clock on our bodies is as simple as infusing ourselves with “young blood,” won’t young blood become a commodity? And if it does, what will that mean for the world’s most vulnerable children? “I am petrified to think of the industry this would create,” wrote Todd L. in response to Wyss-Coray’s talk. “Think of how third-world children are treated now for inexpensive electronics and clothes. They would be treated like cattle to have their plasma harvested.”

How founded are fears about a black market in young blood? Here are three factors to consider:

1. It’s still very early days for this research.

Scientists have not yet identified the specific factors in young plasma that are responsible for Wyss-Coray’s results. And once they do, that’s still just a first step. Then they’d likely need to figure out how to inject those factors at much greater concentrations than they naturally occur, and how best to mix them with other ingredients, such as synthetic antibodies designed to counteract the pro-aging factors found in older blood. It is also still possible that activating stem cells — as young plasma is believed to do — will prove carcinogenic and thus too risky for humans.

The first, very limited human trial has just begun, so we don’t yet know if the transfer of blood between young and old would even work in humans, or how well. Humans live much longer than rodents, and in infinitely more complicated environments. What works for mice does not always work for men.

2. Giving blood is nothing like donating a kidney.

Let’s say for the sake of argument that transfusions of young blood do have a positive effect on humans, that young blood proves adept at combating not only neurodegenerative diseases like Alzheimer’s but also the ravages of aging itself.  What then?

It’s important to understand that blood is not the same thing as a kidney or a slice of liver. In fact, plasma differs from organs that tend to be criminally trafficked in several significant ways — the first being that it’s not illegal to sell.

The National Organ Transplant Act (NOTA), which outlaws the sale of soft tissue organs, excludes plasma. In fact, in the United States, donors can and do earn up to $200 a month for plasma donations. Several companies — and several hundred donation centers — collect tens of thousands of such donations every single day. Those donations are routinely used in a wide spectrum of pharmaceutical products, including treatments for blood disorders like hemophilia.

Donors are for the most part little taxed by this process because — and here’s the second big difference between blood and soft-tissue organs — the body can regenerate the lost plasma in about a week’s time. In fact, an average person can donate plasma about twice a week without any appreciable risk to his or her own health.

That’s not to say that there aren’t issues here. If rich or desperate would-be patients are determined enough, a black market could emerge, while critics of the current system argue that even the legal market might not be as safe as we think it is. But if blood plasma does prove to have anti-aging powers, the hope would be that the legal market would raise its donation rates, recruit harder — and work on ways to synthesize those useful factors to prevent exploitation.

3. More than likely, this technology won’t end up being about reversing or aging at all. It’ll be about helping people to heal faster.

To have any lasting effect, blood plasma would have to be administered to a patient at regular intervals. (Compare this with a kidney transplant, which, however complicated and risky it might be, still involves only a single operation for both the donor and the recipient.) Anyone seeking to benefit from young blood — be it to treat Alzheimer’s or to stave off the ravages of aging itself — would need weekly, or even daily, transfusions. That calculus changes the picture considerably, and makes it far less likely that a bloody black market would be viable. “It’s far more involved than a single surgery or even a few transfusions,” Wyss-Coray says. “The patient’s loved ones would have to be willing to subject them to untested blood, over and over again.”

That’s one of the reasons why, for now, researchers have more modest aims in mind, thinking more about using young blood to heal rather than reverse aging. For instance, it might be that short-term infusions help elderly patients heal faster from surgeries or falls. “It wouldn’t necessarily be about making them young again,” Wyss-Coray says. “It would be more about making them healthier.”

Wyss-Coray’s corporate affiliates have launched a small-scale human trial (just 18 or so subjects) to test the efficacy of young plasma in early and mid-stage Alzheimer’s patients, but that trial will proceed slowly and we won’t see results for many months yet.

Of course, neither black markets nor prospective patients will necessarily wait that long. Already, Wyss-Coray says, his inbox is flooded with notes from Alzheimer’s patients and aging billionaires alike, all of them seeking some form of consultation or treatment. But that’s not a reason to stop the research. What it means is that we should proceed with open but cautious minds. Public dialogue — predicated on facts, not misinformation — will go a long way towards dispelling some of the worries that are likely to creep up around “young blood” science. And people armed with facts will be far less likely to subject themselves or others to undue risks.

Tony Wyss-Coray_clickable

Illustration by iStock.