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Young Blood, Revisited

Here’s an update on the state of those studies that showed that infusing blood of younger animals into olders ones reversed some effects of again. Human studies are underway – small, but worth keeping an eye on – from a startup out of Stanford called Alkahest. Their website isn’t really even running yet, but maybe they just have their priorities in order?

The Alkahest trial is small. (Sharon) Sha can enrol only 18 people aged 50 to 90 with mild to moderate Alzheimer’s disease. Each receives a unit of young human plasma or saline once a week for four weeks. They have the next six weeks off, then have four more weeks of infusions. Those who had plasma first time around get saline and vice versa. The process is blinded, so neither the patients, nor their carers, nor Sha herself, know who is receiving what. Throughout the trial, doctors will look for cognitive improvements. Only at the end of the trial, as soon as October this year, will Sha analyse the findings.

One sobering statistic from the article says that the world’s supply of plasma would be enough to treat about three per cent of the worldwide Alzheimer’s population. So if it turns out that young plasma really does make a difference, we’re going to have an immediate supply problem. I would assume that the plasma supply would shoot up, because young blood will immediately become more valuable, but even so. . .

Alkahest (and others) are thus searching for the active components in that plasma, and that (one hopes) will turn out to be the answer.

34 comments on “Young Blood, Revisited”

  1. johnnyboy says:

    uh uh – a one-month treatment, on 18 patients, to reverse cognitive signs of AD. How could that possibly fail ?
    If they wanted to lose all credibility for their approach, they couldn’t have chosen a better way than this: a short-term, under-powered trial in the most difficult disease known to man.

  2. MoBio says:

    It would be interesting for them to do a formal power analysis to determine how large an effect they would need to see (given the small N and likely high variability) for it to be statistically significant.

    This may be even more of a problem given the cross-over design.

  3. anonymous says:

    Shouldn’t a properly controlled experiment compare the infusion of young human plasma with that of old human plasma? Comparison vs. saline is comparing apples with oranges…

  4. The Aqueous Layer says:

    This can only lead to one thing: Cognitively deficient Geriatric Vampires.

    Don’t say I didn’t warn you.

  5. oldnuke says:

    “reversed some effects of again”

    I think you meant to say “aging”. Although some of these claims remind me of the movie “Groundhog Day”. 🙂

  6. matt says:

    Is six weeks enough time to see any difference? After all, they cannot take brain slices and count neurons, so the effect needed will be massively larger. And does swapping arms of the study after such a short time wipe out any controls for the experiment? How does that work?

    Maybe they will get exceedingly lucky…for an academic, it’s enough to get a result that suggests more research; for a business, the time and money are flowing out of the hourglass, and results have a definite deadline.

    “Sorry, sir, you are over twenty-five; we cannot take plasma donations from anyone over twenty-five. There’s no market, and frankly, it’s not healthy for the recipients.” Meanwhile your grade school and high school kids are making money like pro athletes… “Plasma cows” bred for overproduction of plasma… The stories write themselves.

  7. Vlad says:

    It is best when ingested directly from the brachiocephalic vein. After all, it’s worked for me for over 300 years….

  8. John Wayne says:

    I kinda hope this study works. This would create a situation wherein we could determine the market value of youth; most of the work in this area has been shoddy at best.*

    * Paraphrased from Kim Stanley Robinson’s ‘Red Mars’

  9. Anon says:

    Really baby-boomers? This?

  10. cancer_man says:

    just 7 posts and all the good Dracula jokes have alreaady been taken…

    1. anon says:

      Not sure I saw any GOOD Dracula jokes.

  11. chimist3 says:

    Something something Lady Bathory

  12. Sang sue sang regrets... says:

    Indeed, Frenchies are right: “Il faut que jeunesse se passe”

  13. Proteus says:

    I wonder if “young blood” has differing concentrations of peroxynitrites versus old blood…Lane? Are you there? Did you make the move?

  14. Noni Mausa says:

    Of course, the world supply of young plasma at present is not the potential world supply of young plasma. This could, if effective, be a new source of pin money for the healthy young people of the world, with the added pleasure of their providing something important for their elders. With a donation regime of 6-8 donations per month, many people would line up even unpaid for the benefit of their beloved elders. I know I would have.

    I suppose the bottleneck to the supply would be the equipment, which is more complex than the mere needle and bag of conventional blood donation.

  15. mp says:

    Has the original findings (that young blood rejuvenates old mice) been independently replicated by other groups?

    Have any primate experiments been performed?

    Those sorts of things take precedent, to me, before an underpowered short-term human trial…

  16. Lane Simonian says:

    I made the move, but don’t have a very good answer to your question. Levels of peroxynitrites increase in general with aging. This is the only semi-relevant study that I could find.

    http://www.ncbi.nlm.nih.gov/pubmed/17050374

  17. Jacob says:

    @mp Reports of rejuvenating effects from parabiosis have been replicated in at least five labs off the top of my head.

    Tony Wyss-Coray at Stanford
    Richard Lee at Harvard
    Lee Rubin at Harvard
    Saul Villeda (Wyss-Coray alumni) at UCSF
    Amy Wagers at Harvard

  18. tangent says:

    Today I learned the word “parabiosis”. It’s a good day.

  19. DanielT says:

    I am surprised that they could get such a poor study past their ethics committee. Don’t studies have to have a chance of success to be ethical? What possible benefit could come out of this for any participant?

  20. Slurpy says:

    DanielT, it’s a startup. Their ethics committee is composed of venture capitalists. The only surprise here is that they didn’t demand the young-blood suppliers be completely drained for the study.

  21. sgcox says:

    #Slurpy
    Why do you think they did’t ?

    p.s. I really miss the comments numbering. Otherwise a good new setup !

  22. Eric says:

    #MoBio
    The cross-over design should actually improve the statistical power. With this sort of study design each person serves as their own control helping to reduce variability. Your point is still valid – it’s almost certainly an underpowered trial but that’s not surprising at this stage of development.

    It should be viewed like a phase 1 trial of a new drug. The primary outcome is safety. If you can get a hint of efficacy that’s great, but that’s not really the goal. Most IRBs wouldn’t approve a long trial with a large number of patients at this stage. And most competent companies wouldn’t jump into a large trial either because there are too many unknowns (how much plasma to transfuse? how often? how young should the donors be?).

    If successful, this would be the first of many studies. And the end result won’t be known for quite some time. It would be great if it works – but if I were a VC guy I’d invest my money elsewhere.

  23. jbosch says:

    When you donate blood, plasma is replaced within a short period of time say 48h. If plasma from young people does have an effect on aging, there should be a good correlation between blood donation and less aging effects. Anybody knows of such a study ?

  24. Montgomery Burns says:

    Excellent! Bring me the Simpson boy!

  25. matt says:

    @Eric #above

    It improves the statistical power only if you can measure something in the six weeks before you swap, right? If the time frame for any benefit is beyond six weeks, then you see no difference and what’s more, you can’t extend the study, or down the road see some difference between controls and actives (because they’ve all been mixed).

    Forget benefit–what differences can you measure in mild, early-stage Alzheimer’s patients in the control group over six weeks?

    Not to mention the optimism seems to be based on mice sharing their entire circulatory system for significant periods of time–that’s a constant, complete, total transfusion ongoing for long periods of time. This study is almost homeopathic in its diminution of active material. 🙂

    Regarding safety, do we really need safety studies of plasma transfusions?

    Can’t fault their optimism, though.

  26. gippgig says:

    The worrisome side of this is that donating plasma could cause your blood to get “older” sooner accelerating aging. Has this been tested in animals?

  27. Morten G says:

    Eh, human data already exists. You just have to mine it. Donor age vs outcome on completed treatment. Donors are tracked in case a recipient develops a disease. Boom.

  28. Dave says:

    And, what are they going to do if the study shows that saline injections result in improvements?

    Dave

  29. Eric says:

    @matt
    Actually, it improves the statistical power regardless of whether you can measure improvement in six weeks or not. It’s just that it might only improve the power from horrible to poor 😉

    Is four weeks treatment enough to see an effect on cognition? I agree with you – it seems highly unlikely. I assume they are planning to look at some sort of biomarkers that they’ve identified in the mouse studies. If they are really only looking at cognition with no other useful data acquired in this trial – well, good luck with that.

    It’s easy to criticize this study design, but the reality is – the proper study is just not feasible at this stage. One could dose a thousand people for 2 years. That would certainly be better, but who wants to fund that without preliminary data?

  30. ScientistSailor says:

    It’s been shown that 18 months isn’t long enough to show an improvement in cognition as the control groups don’t deteriorate very much in that time-frame. Six weeks isn’t going to show anything.

  31. Anonymous BMS Researcher says:

    I like the previous comment on that typo “some effects of again!”

  32. Scott says:

    This isn’t an update on the experiment. This is an update for the website to increase traffic. Thanks for this highly un-informative “article.”

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