Active and Healthy Longevity – Glossary

Ilia Stambler

The discourse for the promotion of active and healthy longevity is expanding globally. Hopefully, the language of extending active and healthy longevity will become the common language around the world, in English and other national languages. It may help to recognize some key terms and concepts in this language. Below is an attempt to produce a short lexicon of some of the currently popular terms in longevity promotion. This short lexicon is of course very incomplete and is a work in progress. The readers are welcome to advise on improvements. See also: https://hpluspedia.org/wiki/Category:Life_extensionism

Active and healthy longevity (extending healthspan)

Increasing the average and maximal lifespan, accompanied by a reduction of morbidity. Synonym – extending healthspan (the healthy lifespan). The healthspan extension of the population is associated with increasing their activity and productivity and facilitates the development of all branches of economy. The advancement of active and healthy longevity requires the deployment of new approaches to health care management, such as precision medicine, early diagnosis, personalized and preventive therapy.

Biobanking

Procedures and services provided by biobanks, such as: collection, processing, storing, licensing and distribution of biological materials (cells, fluids, tissues) for their future therapeutic use, in particular in pharmacological research and regenerative medicine.

Bioinformatics

The application of methods of information processing for the solution of biological and medical problems and tasks, such as establishing diagnosis or selecting a treatment. Such tasks commonly require complex analysis of massive biological and medical data of various kinds (big data or multi-omics analysis) in order to obtain a comprehensive picture of biological processes, predicting the course of disease and evaluating the results of treatment. Bioinformatic analysis uses various methods of mathematical and computer modeling (including visualization and virtual simulation), biostatistics and information theory, artificial intelligence.

Biomarker of aging

Biological or physiological indicator of the aging process, allowing to describe and predict the process of aging and aging-related diseases, and the results of therapeutic interventions into these processes.

Cell therapy

Therapeutic use of cells and cell products to induce regeneration, improve function and other therapeutic effects.

Clinical trials

Experiments or observations done in clinical research on human subjects, to clarify the accuracy of diagnostic techniques, or benefits vs. risks of potential therapeutic interventions (such as drugs, medical devices or dietary supplements), establishing their efficacy and safety. Clinical trials in humans take place after extensive preclinical research establishing the feasibility of application and ethical committee approval establishing the desirability of testing in human subjects.

Epigenetic modulation

Induction of changes in gene function without changes in DNA sequence, including therapeutic and rejuvenating effects on cells and tissues. Examples of epigenetic modulators are methylation, small interfering RNAs, micro-nutrients.

Gene therapy

Therapy modifying the genetic information, with a change of DNA sequence, by activating or suppressing certain genes to achieve therapeutic effects, for example the production of proteins necessary for the organism, or elimination of pathogenic proteins. The modification of genetic information is often done by introduction into the organism of vectors-carriers of genetic information, such as retro-viruses or plasmids.

Geroprotecotrs (anti-aging medications)

Medications slowing down, stopping or potentially reversing aging processes, and as a result providing general prevention for aging-related diseases, such as dementia, cardio-vascular diseases, cancer, type 2 diabetes, obstructive lung diseases, etc. Potential geroprotective (anti-aging) substances under research and development include: anti-glycemic, hormone-modulating, mitochondria-modulating, immuno-modulating, probiotic, detoxifying and bio-regulating medications.

Induced Pluripotent Stem Cells (iPSCs)

The type of stem cells that could be produced (reprogrammed) from adult differentiated cells, using special chemical and biological factors (such as the Yamanaka factors), for further use in regenerative medicine. The main advantage of using such cells is the potential avoidance of immune rejection and solution of ethical problems, by using the patient’s own cells and tissues.

Monitoring

Observing the state of the organism, using various diagnostic technologies – either periodical or continuous, either mobile or stationary, either invasive or non-invasive. For example, monitoring technologies include such methods as ultrasound, magnetic resonance imaging (MRI), measurements of blood pressure, heart rate, gas exchange, EEG, ECG, etc. Data from monitoring are often collected in centralized databases (such as electronic medical records – EMR of the health system), or decentralized personal databases (in particular in different “quantified health” applications). The data from monitoring serve to prevent dangerous conditions and to improve therapeutic regimens based on individual patients data.

Multi-omics analysis

Combined analysis of information about the human organism, aimed to diagnose its condition and analyze the efficacy of specific types of treatment. The information is collected in a systemic way from different levels of biological organization (“omes”), including: genome – genetic information, as presented by DNA sequence; epigenome – the epigenetic markers of gene regulation; transcriptome – the collection of mRNA participating in the transcription of genetic information into proteins; proteome – information on the proteins present in the organism, or in specific cells or tissues; metabolome – information on products of the organism’s metabolism (metabolites); physiome – information on the physiological, such as energetic, parameters of the organism, etc. The information from the various levels (“omes”) is correlated with each other and with the clinical history (anamnesis) and therapeutic regimen to provide systemic, multi-faceted diagnosis and therapy.

Phases of clinical trials

Clinical trials, aimed to establish the treatment efficacy and safety in humans, proceed through several stages of phases: The preclinical stage: Testing the treatment (e.g. drug) in non-human models, e.g. in vitro testing (“in glass”) and in vivo testing (in model animals). After the preclinical experiments, ethical committee establishes the possibility and desirability of proceeding toward actual clinical trials in humans (Phases 0-4).

Phase 0 – Pharmacokinetics, particularly bioavailability and half-life of the drug (usually involving several human test subjects); Phase I – Testing of the drug on healthy volunteers or patients for dose-ranging and initial safety (usually tens of subjects); Phase II – Testing of the drug on patients to assess efficacy and side effects (usually a few hundreds of subjects); Phase III -Testing of the drug on patients to assess efficacy and adverse reactions (up to thousands of subjects); Phase IV – Postmarketing surveillance, i.e. observing the results of the drug use in the public, after its sales.

Precision medicine

An approach to disease prevention and treatment that takes into account precise individual differences in people’s biology and physiology, including genetics, environments and lifestyles, thereby giving the greatest chances of therapy success for the individual patients or specific groups of patients. This involves: Precise diagnosis – using extensive patients data to provide reliable and early indications of diseases and predict the response to treatments; Precise treatment – delivering treatments for individual patients and groups of patients that are most justified and effective for them, with the fewest side effects; Precise outcomes – thorough evaluation of the impact of the treatments on patients.

“4P” Medicine – Predictive, Preventive, Personalized and Participatory

Precision medicine is often associated with “4P Medicine” – i.e. medicine which is: Predictive (providing early preclinical indications of diseases), preventive (aimed for early prevention of diseases, before they take hardly manageable and costly forms), personalized (designed for specific patients, in accordance with their biology and environment) and participatory (empowering the individuals to take part in their physical evaluation and health management, under the expert supervision of the physician).

Regenerative medicine

A branch of translational medicine, including tissue engineering, cell therapy and molecular biology, which develops the processes of replacing, producing or regenerating human cells, tissues or organs, in order to restore or establish normal function of the organism.

Small molecules, biologics, nano-medicine

Substances with therapeutic properties, acting on various biochemical and molecular-genetic processes of the organism. Biologics – proteins and other biological molecules, used for therapeutic purposes (for example, vaccines or bio-regulators). Small molecules – chemical compounds, usually up to 100 nanometeres (1 nanometer = 1/1 bln meter). Nanomedicine – the use of nanoparticles and more complex nano-structures and nano-devices for diagnostic and therapeutic purposes (size up to several hundred nanometers).

Stem Cells (SC)

Non-differentiated cells, capable to differentiate into different types of specialized cells and tissues (e.g. muscle or nervous tissues). Stem cells are studied to be potentially used for regeneration or restoration of function of aging and diseased tissues and organs.

Testing – in vivo, in vitro, in situ, in silico

Conducting experiments on biological models, for example with the purpose of clarifying potential efficacy and safety of new medicines. The testing is possible: in vivo (in the living organism, e.g. in model animals), in vitro (“in glass” or “in a test tube”, i.e. outside the living organism, including “lab-on-a-chip” approaches), in situ (in the original condition or place, e.g. in the true conditions and place of a biological process), or in silico (using computer modeling of the behavior of experimental systems).

Tissue engineering

The application of a combination of cells, engineering and materials technologies, with suitable biochemical and physicochemical factors, to grow tissues for replacement or reconstruction, or to develop and test new pharmacological therapies. Examples of bioengineering systems include: bio-scaffolds, bio-reactors, 3D bio-printing, or tissue self-organization.

Translation (in medicine)

The process of translating scientific research to its application in clinical practice, including all the stages of research and development: from studies on cells and tissues, through animal studies and human trials, up to marketing, production and distribution. Methods are sought for the facilitation and optimization of this process.