According to Einstein’s theory, time is relative and can be made to move slower by increasing the speed of the observer. In the famous twin paradox, this slowing of time enables one identical twin to live longer than the other. Animals treated with rapamycin, an inhibitor of mTOR, also live longer [1-5]. Of course, that does not mean that rapamycin slows time in the Einsteinian sense. Instead, it figuratively slows biological time by slowing seemingly opposite processes. On the one hand, rapamycin (and other mTOR inhibitors) retards cell proliferation, while on the other hand, it retards loss of proliferative potential [6, 7]. In other words, rapamycin decelerates proliferation while preserving the potential to proliferate. In that way, rapamycin suppresses both cell growth and geroconversion (conversion to senescence). It has been calculated that rapamycin slows geroconversion by approximately 3-fold [6]. By doing so, rapamycin slows development and aging, reproduction and menopause, and hyperfunction and functional decline [8]. This is because in each case one process is a continuation of the other (Figure 1, 2). For example, aging is a continuation of developmental growth (Figure 1), and functional decline (loss of function, Figure 2) results from earlier hyperfunction [8].
Figure 1. Rapamycin slows aging.
A. Cell culture. In proliferating cells, rapamycin (RAPA) slows growth. When the cell is arrested, then rapamycin slows down geroconversion to senescence. Geroconversion is a continuation of growth in non-dividing (arrested) cells. B. The organism. When development is completed, then mTOR drives aging and age-related diseases. Thus, aging and its diseases are quasi-programmed (a continuation of developmental growth). RAPA slows aging and delays diseases.
Figure 2. Rapamycin decreases hyper-functions, a key feature of aging, thus preventing functional decline.
The slowing of biological time entails “suppression plus preservation.” For example, by suppressing beta-cell function, rapamycin preserves beta-cell function in the long run [9-11]; or by suppressing reproduction, it preserves the oocytes, thereby delaying menopause [12-14]. In theory, a woman who wants to have children later in life could postpone reproduction using rapamycin. This can be seen as “freezing the ovaries” until later in life. Rapamycin suppresses cellular hyperfunction and thus delays all diseases of aging, from cancer to Alzheimer’s [8]. Pathological processes such as age-related diseases are continuations (or exacerbations) of physiological processes. Geroconversion is a continuation of growth (Figure 1), hyperfunction is a continuation of tissue-specific cellular function (Figure 2), age-related hypertension and presbyopia are continuations of developmental trends (see Figure 3 in ref. 15). Therefore, aging is both hyperfunctional and quasi-programmed [8, 16, 17]. (A quasi-program is a purposeless continuation of a developmental program.) Hyperfunction eventually leads to organ damage and functional decline [8, 15]. By suppressing hyperfunction, rapamycin delays organ damage (e.g., infarction) and loss of organ function [8, 15]. In addition to their therapeutic effects, the side effects of rapalogs are also consequences of slowing down time. For example, by slowing cell proliferation, high doses of rapamycin induce reversible anemia, mucositis and skin rash.
So why does rapamycin do all that? Rapamycin is produced by the bacterium Streptomyces hygroscopicus, which lives in the soil of Easter island [18]. This wonderful microbe had no intention of slowing time on its mysterious island; instead, it sought to slow down the growth of fungi, its natural enemy. But since rapamycin slows growth, it should also slow aging if aging is a continuation of growth. In fact, it does just that; rapamycin prolongs the lifespan of yeast [19].
Rapalogs (rapamycin, everolimus, temsirolimus and deforolimus) are allosteric inhibitors of mTOR complex 1, a central regulator of RNA translation and cellular growth and metabolism [20-23]. mTOR enhances translation of TOP and TOP-like mRNAs [22, 23]. Rapamycin and, especially, the pan-mTOR inhibitor Torin1 slow this translation [22, 23]. This raises the question, is slowing translation equivalent to slowing time and, if so, can biological time be measured based on the speed of translation?
The answer to that question is, not entirely. Although mTOR inhibitors may in principle “slow time” by slowing rapamycin-sensitive translation from mRNA to protein, this does not completely explain the gerosuppressive effects of rapamycin or pan-mTOR inhibitors. In fact, inhibitors of S6 kinase slightly exhibit gerosuppressive activities [24], even though S6 kinase is not crucial for RNA translation [23]. So, mTOR inhibitors may affect the speed of aging by suppressing geroconversion (Figure 1) and cellular function and hyperfunction (Figure 2) independently of TOP mRNA translation. In addition, rapamycin also slows age-related methylation, or the epigenetic clock [25-29].
Another intriguing possibility is that rapamycin slows time by slowing the circadian clock. mTOR inhibition slows the circadian clock and dampens clock oscillations, whereas mTOR activation accelerates the clock and enhances clock oscillations at the level of cells, tissues and mice [30]. Conversely, circadian clock mediators affect the mTOR pathway and aging [31]. Because mTOR activity is itself part of the circadian clock, its sensitivity to rapamycin can vary widely depending on the time of the day and the phase of the clock [32]. This should be taken into account when comparing the numerous studies in mouse models. It should also be taken into account when designing rapamycin-based therapies for aging.
Rapamycin has been combined with several life-extending drugs in the “Koschei” formula [5]. This rapamycin-based drug combination has been successfully used as an anti-aging therapy at the Alan Green clinic https://rapamycintherapy.com
The older we become, the faster time flies. It is initially measured in days, then in weeks, the four seasons, and finally “Winter-Summer” cycles. Of course, this is an illusion, but an annoying one. Would treatment with rapamycin enable us to notice Spring again?
Footnotes
REFERENCES
- 1.Johnson SC, Kaeberlein M. Rapamycin in aging and disease: maximizing efficacy while minimizing side effects. Oncotarget. 2016;7:44876–44878. doi: 10.18632/oncotarget.10381. https://doi.org/10.18632/oncotarget.10381. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Christy B, Demaria M, Campisi J, Huang J, Jones D, Dodds SG, Williams C, Hubbard G, Livi CB, Gao X, Weintraub S, Curiel T, Sharp ZD, Hasty P. p53 and rapamycin are additive. Oncotarget. 2015;6:15802–13. doi: 10.18632/oncotarget.4602. https://doi.org/10.18632/oncotarget.4602. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Kaeberlein M. The Biology of Aging: Citizen Scientists and Their Pets as a Bridge Between Research on Model Organisms and Human Subjects. Vet Pathol. 2016;53:291–8. doi: 10.1177/0300985815591082. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Kaeberlein M, Kennedy BK. Ageing: A midlife longevity drug? Nature. 2009;460:331–2. doi: 10.1038/460331a. [DOI] [PubMed] [Google Scholar]
- 5.Blagosklonny MV. From rapalogs to anti-aging formula. Oncotarget. 2017;8:35492–35507. doi: 10.18632/oncotarget.18033. https://doi.org/10.18632/oncotarget.18033. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Demidenko ZN, Zubova SG, Bukreeva EI, Pospelov VA, Pospelova TV, Blagosklonny MV. Rapamycin decelerates cellular senescence. Cell Cycle. 2009;8:1888–95. doi: 10.4161/cc.8.12.8606. [DOI] [PubMed] [Google Scholar]
- 7.Leontieva OV, Blagosklonny MV. Gerosuppression by pan-mTOR inhibitors. Aging (Albany NY) 2016;8:3535–3551. doi: 10.18632/aging.101155. https://doi.org/10.18632/aging.101155. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Blagosklonny MV. Aging and immortality: quasi-programmed senescence and its pharmacologic inhibition. Cell Cycle. 2006;5:2087–102. doi: 10.4161/cc.5.18.3288. [DOI] [PubMed] [Google Scholar]
- 9.Blagosklonny MV. TOR-centric view on insulin resistance and diabetic complications: perspective for endocrinologists and gerontologists. Cell Death Dis. 2013;4:e964. doi: 10.1038/cddis.2013.506. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Reifsnyder PC, Flurkey K, Te A, Harrison DE. Rapamycin treatment benefits glucose metabolism in mouse models of type 2 diabetes. Aging (Albany NY) 2016;8:3120–3130. doi: 10.18632/aging.101117. https://doi.org/10.18632/aging.101117. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Ardestani A, Lupse B, Kido Y, Leibowitz G, Maedler K. mTORC1 Signaling: A Double-Edged Sword in Diabetic β Cells. Cell Metab. 2018;27:314–331. doi: 10.1016/j.cmet.2017.11.004. [DOI] [PubMed] [Google Scholar]
- 12.Blagosklonny MV. Why men age faster but reproduce longer than women: mTOR and evolutionary perspectives. Aging (Albany NY) 2010;2:265–73. doi: 10.18632/aging.100149. https://doi.org/10.18632/aging.100149. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Dou X, Sun Y, Li J, Zhang J, Hao D, Liu W, Wu R, Kong F, Peng X, Li J. Short-term rapamycin treatment increases ovarian lifespan in young and middle-aged female mice. Aging Cell. 2017;16:825–836. doi: 10.1111/acel.12617. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Luo LL, Xu JJ, Fu YC. Rapamycin prolongs female reproductive lifespan. Cell Cycle. 2013;12:3353–4. doi: 10.4161/cc.26578. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.Blagosklonny MV. Answering the ultimate question “what is the proximal cause of aging?”. Aging (Albany NY) 2012;4:861–77. doi: 10.18632/aging.100525. https://doi.org/10.18632/aging.100525. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16.Gems D, de la Guardia Y. Alternative Perspectives on Aging in Caenorhabditis elegans: Reactive Oxygen Species or Hyperfunction? Antioxid Redox Signal. 2013;19:321–9. doi: 10.1089/ars.2012.4840. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17.Wang H, Zhao Y, Ezcurra M, Benedetto A, Gilliat AF, Hellberg J, Ren Z, Galimov ER, Athigapanich T, Girstmair J, Telford MJ, Dolphin CT, Zhang Z, Gems D. A parthenogenetic quasi-program causes teratoma-like tumors during aging in wild-type C. elegans. NPJ Aging Mech Dis. 2018;13:4–6. doi: 10.1038/s41514-018-0025-3. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Stipp D. A new path to longevity. Sci Am. 2012;306:32–9. doi: 10.1038/scientificamerican0112-32. [DOI] [PubMed] [Google Scholar]
- 19.Longo VD, Shadel GS, Kaeberlein M, Kennedy B. Replicative and chronological aging in Saccharomyces cerevisiae. Cell Metab. 2012;16:18–31. doi: 10.1016/j.cmet.2012.06.002. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20.Hall MN. An Amazing Turn of Events. Cell. 2017;171:18–22. doi: 10.1016/j.cell.2017.08.021. [DOI] [PubMed] [Google Scholar]
- 21.Hall MN. TOR and paradigm change: cell growth is controlled. Mol Biol Cell. 2016;27:2804–6. doi: 10.1091/mbc.E15-05-0311. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 22.Thoreen CC, Chantranupong L, Keys HR, Wang T, Gray NS, Sabatini DM. A unifying model for mTORC1-mediated regulation of mRNA translation. Nature. 2012;485:109–13. doi: 10.1038/nature11083. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 23.Thoreen CC, Kang SA, Chang JW, Liu Q, Zhang J, Gao Y, Reichling LJ, Sim T, Sabatini DM, Gray NS. An ATP-competitive mammalian target of rapamycin inhibitor reveals rapamycin-resistant functions of mTORC1. J Biol Chem. 2009;284:8023–32. doi: 10.1074/jbc.M900301200. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 24.Leontieva OV, Demidenko ZN, Blagosklonny MV. S6K in geroconversion. Cell Cycle. 2013;12:3249–52. doi: 10.4161/cc.26248. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 25.Epigenetic aging signatures in mice livers are slowed by dwarfism, calorie restriction and rapamycin treatment. Wang T, Tsui B, Kreisberg JF, Robertson NA, Gross AM, Yu MK, Carter H, Brown-Borg HM, Adams PD, Ideker T. Genome Biol. 2017;18:57. doi: 10.1186/s13059-017-1186-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 26.Cole JJ, Robertson NA, Rather MI, Thomson JP, McBryan T, Sproul D, Wang T, Brock C, Clark W, Ideker T, Meehan RR, Miller RA, Brown-Borg HM, Adams PD. Diverse interventions that extend mouse lifespan suppress shared age-associated epigenetic changes at critical gene regulatory regions. Genome Biol. 2017;18:58. doi: 10.1186/s13059-017-1185-3. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 27.Karunadharma PP, Basisty N, Dai DF, Chiao YA, Quarles EK, Hsieh EJ, Crispin D, Bielas JH, Ericson NG, Beyer RP, MacKay VL, MacCoss MJ, Rabinovitch PS. Subacute calorie restriction and rapamycin discordantly alter mouse liver proteome homeostasis and reverse aging effects. Aging Cell. 2015;14:547–57. doi: 10.1111/acel.12317. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 28.Pellegrini C, Columbaro M, Capanni C, D’Apice MR, Cavallo C, Murdocca M, Lattanzi G, Squarzoni S. All-trans retinoic acid and rapamycin normalize Hutchinson Gilford progeria fibroblast phenotype. Oncotarget. 2015;6:29914–28. doi: 10.18632/oncotarget.4939. https://doi.org/10.18632/oncotarget.4939. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 29.Gong H, Qian H, Ertl R, Astle CM, Wang GG, Harrison DE, Xu X. Histone modifications change with age, dietary restriction and rapamycin treatment in mouse brain. Oncotarget. 2015;6:15882–90. doi: 10.18632/oncotarget.4137. https://doi.org/10.18632/oncotarget.4137. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 30.Ramanathan C, Kathale ND, Liu D, Lee C, Freeman DA, Hogenesch JB, Cao R, Liu AC. mTOR signaling regulates central and peripheral circadian clock function. PLoS Genet. 2018;14:e1007369. doi: 10.1371/journal.pgen.1007369. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 31.Khapre RV, Kondratova AA, Patel S, Dubrovsky Y, Wrobel M, Antoch MP, Kondratov RV. BMAL1-dependent regulation of the mTOR signaling pathway delays aging. Aging (Albany NY) 2014;6:48–57. doi: 10.18632/aging.100633. https://doi.org/10.18632/aging.100633. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 32.Zhang Y, Giacchetti S, Parouchev A, Hadadi E, Li X, Dallmann R, Xandri-Monje H, Portier L, Adam R, Lévi F, Dulong S, Chang Y. Dosing time dependent in vitro pharmacodynamics of Everolimus despite a defective circadian clock. Cell Cycle. 2018;17:33–42. doi: 10.1080/15384101.2017.1387695. [DOI] [PMC free article] [PubMed] [Google Scholar]