the future of health & longevity - singularity group · dr. kris verburgh, md 76 77. 11/14/2019 39...

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The futureof health & longevity

The 4th Industrial RevolutionInternet of Things

The Cloud

Artificial Intelligence (AI)

Robotics

Biotechnology

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Transform Medicine & Healthcare

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The 4th Industrial RevolutionINTERNET OF THINGS

The Cloud


Robotics

Biotechnology

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FU

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INTERNET OFTHINGS (IoT)

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Wearables & invisiblesMEASURE blood pressure, glucose levels, heart rhythm, body temperature, sweatcomposition, stress, mood, body weight, voice, eyemovements, sleep patterns, …

Monitoring MotivatingDiagnosing

Alerting

Having a heart attack in the future

Sends signalfor help

Image: TU Delft

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Smartphone ANALYZING VOICE to predict risk of heart disease, Parkinson’s disease, depression, …

Laitr Keiows Creative Commons Attribution-Share Alike 3.0 Unported

Tracking EYE MOVEMENTS to predict risk of cognitive decline

Tracking SWIPES to predict risk of psychiatric disorders and dementia

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Wearables• Blood pressure

• Temperature

• Sweat composition

• Heart rhythm

• Body weight

• Eye movements

• Sleep patterns

• Glucose levels

• Insulin levels

• (Micro)inflammation

• Size of cholesterol particles

• (tumor) DNA in blood

• Etc.

Insidables

AI-powered digital avatars and assistants tracking your health

Image: Medical Avatar

Image: Sensely

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The Cloud

Artificial Intelligence

Robotics

Biotechnology

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The Cloud

ARTIFICIAL INTELLIGENCE

Robotics

Biotechnology

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ARTIFICIAL INTELLIGENCE

Predict risk of death, suicide risk, disease risk, …

Diagnose disease and suggesttreatments

AI in medicine

AI could predict with close to 70% accuracy who would die within 5 yearsADA app

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AI identifies suicidal persons with >90% accuracy by analyzing brain scans

Image: M.A. Just and David Brent, Nature

AI & echocardiograms (ultrasound heart scans)

More accurate thanexperienced cardiologists

( > 90% accuracy)

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AI & human doctors work together in “One Minute Clinic” booths

Image: Pin Ang Good Doctor

NHS Online 111 app3 X more people directed to self-treatment instead of a human doctor

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The Cloud


Robotics

Biotechnology

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The Cloud


Robotics

BIOTECHNOLOGY

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BIOTECHNOLOGY

A child born today, has more than 50% chance of becoming 105 years old

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Gene editing tools(CRISPR-cas 9, TALEN, ZFN)

Tools to rewrite genes

CRISPR-cas 9 protein

Image: Cas9 wiki project, WikiCommons

CRISPR-Cas 9 protein

DNA

YourGenome, ShareAlike 2.0 Generic

• Cure genetic diseases

• Treat cancer

• Cure HIV

• Aging & longevity

• Modify embryos

• …

Image: DNA Lab, University of Michigan

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Price of editing a gene

▪ 1999 - Using viruses: hundreds of thousands of euros

▪ 2010 - Using ZFN (zinc finger nucleases): 5000 euros

▪ 2019 - Using CRISPR-Cas 9: 70 euros

Editing genes was never before so easy"These are monumental moments in the history of biomedical research. They don't happen every day.”

- Nobel prize winner David Baltimore on CRISPR gene editing

We will no longer be slaves of our own genesEvolution by natural selection =>

Evolution by human selection Image: YourGenome, ShareAlike 2.0 Generic

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DIY (Do It Yourself) biotechnology

27http://www.the-odin.com/gene-engineering-kits

London BiohackSpace

http://www.the-odin.com

Biohackers• Tristan Roberts: injected himself with plasmids coding

for HIV antibody N6 to treat his HIV infection.

• Josiah Zayner: claims to have injected himself with CRISPR-cas9 to erase the myostatin gene, enabling more muscle growth.

28screenshot Facebook Live video: Tristan Roberts/Ford Fischer

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Gene editing companies

ImmunotherapyTargeting cancer in a new way

Image: National Institute of Health

Cancer cell (white)attacked by immune cells (red)

White blood cellCancer

cell

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Stem cell therapiesiPSC: inducedPluripotent Stem Cells

Image: OpenStax College, WikiCommons

iPSC (stem cell)

Growing organs from stem cells

Image: courtesy of Doris A Taylor, PhD, FAHA, FACC, Director Regenerative Medicine Research, Texas Heart Institute

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Image: courtesy of University of Wollongong, Australia

3D (bio)printing

PARADIGMSHIFTS

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Paradigm ShiftBEYOND THE GENOME01

The genome (all your DNA)

Image: US National Library of Medicine

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Map your genome

Source: 23andme.com

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24 million people took a consumer DNA test

MIT Technology Review, 2018 & COMPANY REPORTS, LEAH LARKIN, ISOGG

Genetic testing for: skin health, athletic performance, aging, immunity, (predictive) wellness profiling, cancer risk profiling(oncogenes, …), toxin processing, …

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Nutrigenomics▪ Alcohol tolerance (ALDH2 gene)

▪ Bitter taste receptor genes

▪ Caffeine metabolism (CYP1A2 gene)

▪ Lactose intolerance (MCM6 gene)

▪ Fat metabolism (PPAR gene)

▪ Obesity (MC4R gene)

▪ Sweet tooth (SLC2A2 gene)

▪ Weight regain (ADIPOQ gene)

▪ Vitamin B12 (FUT2 gene)

▪ Vitamin B6 (NBPF3 gene)

▪ Etc.

The Epigenome

Images: freepsdfiles.net, WikiCommons

An on-offswitch for our genes

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The Transcriptome

Image: Kelvinsong, WikiCommons

A dimmerswitch for our genes

Integration of all ‘-omes’

Genome (DNA)

Epigenome

Transcriptome

Microbiome (bacteria)

Metabolome

Proteome (proteins)

Exposome (environment)

PredictivePersonalPreventive

treatments

AI, cloud, …

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FU

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ADDRESSING AGING WILL TRANSFORM HEALTH(CARE)

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AgingCardiovascular disease (atherosclerosis, hypertension, heart failure, stroke), alzheimer’sdisease, type 2 diabetes, cancer, osteoarthritis, osteoporosis, eye diseases (macular degeneration, cataract), kidney diseases, sarcopenia (reduced muscle mass), infections (due to declining immune function), …

is86% of HealthcareCosts

Image: Shutterstock

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Professor David Gems,University College London

“One of the most remarkable discoveries one that surprisingly few people know about:

It is possible to slow aging in laboratory animals. In fact, it is easy.”

Images: Bob Goldstein, Rama (WikiCommons)

ImmortalityIn Nature

Hydra (freshwater polyp)

Turritopsis DohrniiImages: Proyecto Agua, Flickr

Hydra

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ImmortalityIn Our Body

Images: Felipepunctocl (WikiCommons), National Cancer Institute

Is it possible to slow down or reverse aging?

Picture: PixMac

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Reversing aging through Yamanaka factors (Oct4, Sox2, Klf4, Myc)

In Vivo Amelioration of Age-Associated Hallmarks by Partial Reprogramming, Cell, 2016

- 2 days activation of Oct4, Sox2, Klf4, Myc- 5 days deactivation=> epigenetic reprogramming

Picture: Salk Institute

Normal (old) mouse Rejuvenated mouse

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Destroying senescent cells rejuvenates old mice

Targeted Apoptosis of Senescent Cells Restores Tissue Homeostasis in Response to Chemotoxicity and Aging, Cell, 2017 Pictures: Peter de Keizer

“This work is the first glimmer that we could live for centuries.” - prof. David Sinclair, Harvard University

“Aging is something plastic that we can manipulate.” - prof. Jean Carlos Belmonte, Salk Institute

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Alphabet’s aim:

slowing down aging andextending healthy life span.

Companies focusing on aging mechanisms

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When will we see the first treatments to address aging?

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“The future of the longevity industry not only has the logical potential to become the wealthiest industry in all of history, but also represents the most ethical way of doing business.”

- Dmitry Kaminskiy, In Silico Medicine

Why investing in companies that target aging?

• Addressing the ROOT CAUSE of aging-related diseases, not a downstream little cogwheel in the very complex cellular machinery

• By addressing the root cause of a disease (aging), there is more likelihood the intervention will PERFORM SUCCESFULLY in clinical trials

• More likelihood of a SUBSTANTIAL EFFECT instead of only small improvements of symptoms (especially for interventions that reverse aging)

• By addressing aging, an intervention can work for MANY aging-related DISEASES SIMULTANEOUSLY (e.g. hypertension, Alzheimer’s, osteoarthritis, macular degeneration)

• BLUE OCEAN

• Most people WANT TO STAY YOUNG and healthy as long as possible

• Addressing the silver tsunami will be one of the most IMPORTANT CHALLENGES

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“I just hope to live long enough not todie.”Bill Maris,

founder Section 32 venture capital fund,

former President of Google Ventures

Image: Melahno, WikiCommons

“There will come an age when our average life expectancy will reach 200 years.”

- Masayoshi Son, CEO of SoftBank and Vision Fund

"Ageing research is clearly gaining momentum … bringing hope that at some time in the future we will be able to keep age-related diseases at bay by suppressing ageing itself.”

- Marie-Thérèse Heemels, editor Nature

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The future: ramifications

What if lifespan would be 150 - 200 years?

EducationJobsRetirementHealthcareInsurancePersonal finance

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The multistage portfolio life

MULTISTAGE LIFE▪ Education▪ Job ▪ Micro-retirement▪ Education ▪ Job▪ Micro-retirement▪ Etc

3 STAGE LIFE▪ Education

▪ Job

▪ Retirement

Making peopleresistant to HIV:

MEDICINE or HUMANENHANCEMENT?

Pablo Ramdohr, FLickr CC BY-NC 2.0

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“For the first time in history, economic inequality will be translated into biological inequality.”

- Yuval Noah Harari, historian and futurologist

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AI-based preimplantation genomic screening: “polygenic risk scores” selecting embryos for better traits?

▪ Diabetes, heart disease, …

▪ Height less than 147 cm, IQ lower than 70

▪ What’s next?

“Suppose I could tell you embryo four is going to be the tallest, embryo three is going to be the smartest, embryo two is going to be very antisocial […].

That is the near-term future that we as a civilization face. This is going to be here.”

- Stephen Hsu, founder Genomic Prediction

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The beginningof a new revolution?

Digital software(20th century)

Biological software(21st century)

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BIOTECH industry revenue is bigger than revenue from COMPUTER & ELECTRONICS industry

Number of top 10 best-selling drugs that are biotech drugs

MIT Technology Review, 2018 & COMPANY REPORTS, LEAH LARKIN, ISOGG

Why now?

1. Far more accurate therapies: sledgehammers ⇒ fine pincers (e.g. CRISPR proteins, immunotherapy, RNA drugs, optogenetics, …)

2. Artificial intelligence (AI), data and processing power will outperform limited human intelligence

3. Biotech from lab/hospital => home (at-home testing, quantified self, biohacking, digital assistants, …)

4. Addressing (solving) aging

5. Upgrading the healthy, instead of only curing the sick

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In most parts in the world, mankind got rid of famine, plague and war.

Now, mankind will focus on upgrading their bodies, tackling aging and striving for the best possible health and happiness.

THANK YOU FOR YOUR ATTENTION

Dr. Kris Verburgh, MD

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Statements & food for thought

• Do you think aging is a disease and should we try to slow down or reverse aging (make people younger)?

• Imagine we have a clock that can exactly measure your biological age (your risk of dying) and health. Should governments and insurers use it?

• Should humans be allowed to biologically upgrade themselves during their lifetime? (e.g. genetically improving intelligence, muscle mass or stamina)

• How can we make people eat and live healthily?

• What is health? Often, people are healthy in the sense they are not sick, but they suffer from suboptimal health and accelerated aging.

• Should parents during IVF treatment (fertilization of egg cells in the lab) be allowed to use AI-based polygenic screening to select the most intelligent embryo before implantation in the womb?

"Brilliant and important book.”

- Professor Hanno Pijl, Leiden Academic Medical Centre

“Dr. Verburgh tackles age-oldquestions and arrives at somestartling conclusions – with practical suggestions for how to slow down ourbiological clock.”

- Prof. Dr. David Ludwig, Harvard University

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the future of health & longevity - singularity group · dr. kris verburgh, md 76 77. 11/14/2019 39...

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