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What is a medicine?

Butler and colleagues (1) report on a closed consensus workshop about existing and possible future interventions that can slow, stop, or reverse aging. They review the effects of several antiaging interventions and conclude that there is no convincing evidence that administration of any specific compound, natural or artificial, can globally slow aging in people—or even in mice and rats. Different conclusions were reached during the 3rd European Congress of Biogerontology (Florence and Montecatini Terme, November 8–11, 2002). It is well known that autophagy is the only mechanism for housekeeping of cell membranes and organelles (2), the only potentially antiaging cell repair mechanism (3) to be regulated by nutrition via plasma insulin levels (4). Presentations showed that the effects of caloric restriction on membrane maintenance are mediated by the stimulation of autophagy and that a once-a-week life-long pharmacological stimulation of autophagy (as described in references 5 and 6) dramatically intensifies the antiaging effects of a very mild (10%) caloric restriction, making them maximal. The Pharmacological Intensification of Suppression of Aging (PISA) treatment [the name of the treatment was kindly suggested by Dr. George Martin] makes use of drugs already licensed for human use, at a much lower dose. From a practical point of view, the PISA treatment might open up a way to make people more likely to adhere to an antiaging regimen of dietary restriction otherwise too intensive to be endurable over their lifetime (7).