Читать книгу The Principles and Practice of Antiaging Medicine for the Clinical Physician - Dr. Vincent C. Giampapa - Страница 20

After a review of all these theories of aging, it becomes obvious that there are many different concepts, which can affect aging and many overlaps among these theories.

The new theory which I have conceptualized over the last decade and which I now describe focuses on a combination of these theories. This theory stresses that the basis of control for the aging process in cells lies in the accurate reproduction of DNA and its resulting essential products—stem cells. DNA is essential for life, because it is directly responsible for every molecular change occurring within the body. Damage is inflicted on DNA every day by the environment, diet and both physical and emotional stress that humans endure. This damage is the primary cause of aging and diseased states. As bodies age, people become more susceptible to many serious diseases. The most common age-related diseases today in the United States that cause death are heart disease, stroke, cancer and Alzheimer’s disease. But what causes these diseases and how do they start? In essence, they can all be traced back to the initial breakdown of, and damage to, DNA.

In this theory, both the rate and quality of DNA damage most likely triggers key genetic control processes like methylation and therefore are responsible for changing gene profiles as we advance from fetus through childhood, adolescence, adulthood and old age.

The importance of a healthy state of DNA cannot be overemphasized. Within each human body, there are an estimated 100 trillion cells. Within each of these cells is approximately 5 feet of DNA. That means there are billions of miles of DNA within each human body. Just improving a small percentage of this extraordinary and vast amount of genetic material can make a major difference in the quality of health, well-being and how a person ages.

In essence, DNA is “life’s blueprint,” or, in more focused terms of this discussion, “aging software.” An individual code for health and life expectancy is genetically passed on to each person. It is inherited by each person from his or her parents, grandparents and so forth. New research has documented that life spans in both animals and humans are directly correlated with DNA repair rates.^6,9

Throughout life, DNA reproduces and replaces itself continually. In optimal conditions, DNA copies itself over and over again, making perfect reproductions. This is very close to the state that people are in when they are young and healthy. As people age, however, their DNA is damaged continually through ongoing bombardment by excess free radicals, environmental effects and radiation. The DNA begins to reproduce poorly and ultimately stops reproducing completely, which results in cell death.

Think of it as making a photocopy. If a well-maintained machine is used to copy the original document, it produces an excellent copy. But if the machine is poorly maintained, it will ultimately produce poor copies. Furthermore, if the machine continues to make poor copies of poor copies, the degradation becomes worse and worse with each successive copying cycle until eventually the copies are illegible. In essence, the same thing happens with DNA. If the body cannot produce clean and accurate copies of its DNA, health and longevity are directly affected. Therefore, the key to optimal health is to keep DNA clean and healthy so that it produces ideal, clean copies of itself. Currently, this can be done by helping the body neutralize excess free radicals and, at the same time, strengthen and nourish cells and the building blocks for DNA.

New literature has documented that even in old people, the telomeres (the sequence of base pairs at the end of our chromosomes) that seem to control the number of cell divisions have still not reached their terminal positions, which should signal final cell death.¹⁰ In essence, humans have not reached their full genetic potential, which is stored in each cell.

According to this new theory, humans are not irreversibly programmed to age and die, as is currently thought; in contrast, humans are programmed for self-repair and longevity. The key to optimal health, therefore, is the ability to keep DNA healthy in order to produce, ultimately, as clean a cell copy as is possible. This new theory is referred to as the unified DNA damage theory of aging (UDDTA).

The essential concepts in this new theory emphasize the ability to improve the ratio of DNA repair to DNA damage. This ratio of repair to damage is much higher early in life, when DNA repair can easily neutralize the damage sustained by DNA. In both nonprimate mammals and primates, it has been shown that the greater the DNA repair levels are, the longer the life span is.⁶ As animals age, this ratio becomes inverse, and the damage rates overcome the DNA repair capabilities. This inversion of the ratio of DNA repair to damage is linked directly to a number of key processes that are encoded within genes (see Diagram II-1). These processes, as mentioned in Chapter I, are glycation, inflammation, oxidation and methylation. The origin of these chemical processes lies within the genetic blueprints, the DNA. During the aging process, they slowly become uncontrolled, and each reaction contributes to further damage produced by the others. In essence, the loss of balance in this aging equation is responsible for altering the ratio of DNA repair to DNA damage. The loss of the subsequent accurate copies of DNA and the damage to the enzymes responsible for the DNA repair are the causes of the age-related changes that are seen in the form of both the microscopic and macroscopic effects on the body.

Furthermore, the damage to DNA has a direct impact on another key component that is responsible for aging: stem cell pool reserves. Adult stem cells have been shown to be present in many different body tissues, including adipose tissue, neuronal tissue, immune tissue and gastrointestinal tissue. Adult stem cells have the potential to redifferentiate and restore the aging and nonfunctioning tissues that are damaged by the many aspects of aging itself. With continued damage and poor repair of DNA, the genetic machinery in the DNA of stem cells is also injured, and its regenerative and restorative capacities are therefore lost over time¹⁰ (Diagram II-3).

In summary, the key goal of anti-aging therapy should be to accomplish the following:

1. Improve the ratio of DNA repair over DNA damage. This will result in fewer cell mutations and more accurate cell copies during cell replication, will preserve the stem cell pool and, ultimately, will optimize the aging process within all the key organs.

2. Improve the function of what has been called the aging equation (see Diagrams II-1, II-3); that is, control the processes of glycation, inflammation, oxidation and methylation. All of these components directly affect DNA function, DNA repair and DNA damage.

3. Control and optimize the environmental factors that also have a direct impact on DNA. These factors include diet regimens, exercise regimens and mind state. By reducing toxic elements such as pollution and radiation, the negative environmental effects of aging can be markedly decreased as well.

In summary, for the cosmetic surgeon, focusing on and improving the ultimate source of aging itself, DNA, is the most important and effective goal of an anti-aging program. We clarify in later chapters how this can be done and how new breakthroughs in laboratory testing can document, for both cosmetic physicians and their patients, the efficacy of anti-aging therapy and age-management “programs.