Tuesday, September 24, 2013

Telomeres: size may matter



I guess just about everyone in the world has heard of DNA.  I presume everyone knows that DNA is what genes are made of.  And I suppose everyone knows what genes are.  I suspect, however, that many people don’t know what a “chromosome” is. 

Simply put, a chromosome is a combination of DNA and protein, and under a microscope it looks like a rod.  Humans have 46.  Chimpanzees have 48.  Corn has 20.  And so on.  You might think of a chromosome as a “carrier” for DNA. 

When I studied genetics about 40 years ago, all we knew about telomeres was that they are the tips found on either end of each rod-like chromosome, but we didn’t know WHY they are there.  Scientists now know a whole lot more, of course, and in 2009 there was even a Nobel Prize awarded for a discovery having to do with telomeres.

Today it is known that telomeres serve essentially the same function as an “aglet”, that little plastic sleeve at the end of a shoelace.  Both telomeres and aglets protect the ends of things from degradation, and what telomeres protect are chromosomes.  What happens is that every time a cell divides, the chromosomes divide too—along with the DNA that makes up the chromosomes.  Because of the way DNA is replicated, the ends of each DNA strand get chopped off with each cell division, which results in the loss of some DNA .   So a telomere is essentially some “disposable” DNA that is added as a buffer to the end of each DNA strand so that non-essential DNA gets chopped off rather than the critical DNA that makes up the main part of the strand.  And then, to complete the process, there is an enzyme called telomerase that adds this buffer-DNA back on to the end of the telomere.

But unfortunately this system isn’t perfect, and eventually telomeres get shortened to the point that critical DNA is no longer protected.  When this happens, the critical DNA is said to be “exposed,” and it can combine randomly with DNA from other chromosomes.  This leads to chromosomal abnormalities and is the reason ALL cells eventually die:  they can no longer divide properly.  In fact, current theories about the aging process assume there is a finite limit to the number of times a cell can divide.

A small percentage of cancers (5-10%) have the ability to activate telomerase and thus add DNA to the end of their chromosomes.  This continual “rejuvenation” can make cancerous cells immortal—that is, they do not die.  Cell aging, therefore, represents a critical balance between keeping cells dividing properly, using telomeres, but NOT allowing them to continue dividing if they become defective (cancerous)

So basically, a lot of human-telomere biology can be summed up as follows:  long telomeres are good, short telomeres are bad.  This is because long telomeres allow cells to divide more times than cells with short telomeres. 

It is not surprising, therefore, that short telomere length has been correlated with many age-related disease conditions: cardiovascular disease, hypertension, arthrosclerosis, Alzheimer’s, Parkinson’s, dementia, diabetes, osteoporosis, and cancer.  In fact, the literature supporting these associations is very extensive.

Further, some pretty incredible results have been obtained by lengthening telomeres in mice, actually reversing some of the characteristics associated with the aging process.  The mice used in these studies are strains that don’t produce telomerase, so their telomeres are very short.  They show tissue atrophy, reduced testis size, deteriorated spleens and intestines, reduced fertility, diminished sense of smell, smaller brain size, and a lifespan only about half as long as that of normal mice.  But guess what—a 2011 study showed that after these mice were injected with 4-OHT (a drug that induces production of telomerase, which in turn results in elongated telomeres), indications of aging actually REVERSED:  testes grew, fertility increased, brains became larger. 

It seemed to be the fountain of youth . . .  at least until it was reported in 2012 that mice receiving the 4-OHT injections had higher rates of cancer.  This result is consistent with observations in many other studies correlating longer telomeres with increased cancer.  Apparently the researchers had reversed aging, but in the process, they had raised cancer rates.  (Some scientists think that inhibiting telomerase is a viable way to treat cancer—the theory being that if you can shorten telomeres, the cancer cells will die.)

And then (of course), there are telomere studies with results that are truly puzzling.  For example, 1,091 Scots born in 1936 (548 men and 543 women) were examined in 1947 at age 11 then again in 2006 at age 70.  The subjects were given cognitive tests, a physical examination, and their telomeres were examined.  As reported in 2012, telomeres were statistically longer in men than women, and longer telomeres were associated (in women only) with higher cognitive scores and lower levels of C-reactive protein, a molecule associated with inflammation.  Telomere length was not associated with any other measures of aging.

And then in 2011, a paper that reported on 60 mammalian species showed an INVERSE relationship between telomere length and lifespan—in other words, species with the longest telomeres had the shortest lifespans.  Moreover, the longest lifespans were not correlated with telomerase activity.

So what’s going on?

Well, there have been over 16,000 publications relating to telomeres and aging, and there are bound to be inconsistencies.  And, of course, what’s going on with mice may not relate to what’s going on with humans.  And what’s going on with most mammalian species may not have anything to do with humans.  But even so, these studies do seem to contradict everything we think we know about the relationship between telomeres and aging.

In spite of these findings, at least one of the three winners of the 2009 Nobel Prize, Elizabeth Blackburn, thinks that telomeres “are an integrative indicator of health.” She has been involved in the formation of Telome Health in San Francisco, which will measure telomere length of your white blood cells (if requested by a researcher).    The Telome Health website (http://www.telomehealth.com/index.html) asserts that telomere length is an indicator of aging and health and believes that telomeres can serve as biomarkers that would be useful to pharmaceutical companies in assessing drug response.  The company’s website lists 155 publications supporting their claims.  (And, near and dear to my heart, their foundational patents were licensed from the University of Utah.  A great example of University technology leading to the formation of a new company!)

However, as is often the case with emerging scientific disciplines, not everybody agrees that measuring one’s telomere length is useful.  Carol Greider, who shared the Nobel Prize with Blackburn in 2009, was quoted in 2011 as saying that telomere length is not particularly helpful in assessing health and well-being because telomere length is so variable.  “Do I think it is useful to have a bunch of companies offering to measure telomere length so people can find out how old they are?  No.”

In 2010, another telomere researcher, Maria Blasco of the Spanish National Cancer Centre in Madrid, Spain, founded a company called Life Length that also measures telomeres.  Well, actually, it reports the percentage of short telomeres, a metric that  Blasco apparently thinks is a better indicator of health than “average telomere length,” which is the metric used by Telome Health.  Life Length’s website (http://www.lifelength.com/index-eng2.html) is exceedingly thorough, and like Telome Health, it makes a compelling case for telomere analysis.

As an indication of how small the world of telomere science really is, Calvin Hartley from Telome Health has collaborated with Maria Blasco of Life Length.  In a 2011 paper, they reported on a telomerase activator called TA-65 that is purified from the root of Astragalus membranaceus.  They showed that in mice with short telomeres, injections of TA-65 resulted in increased telomere length and improved glucose tolerance, bone density, and skin fitness—and best of all, the rate of cancer did not increase.   A similar study using human cells that was published in 2013 also reported that TA-65 increased telomere length.

It turns out you can actually buy TA-65—it is sold, for example, by Telomerase Activation Sciences, Rev Genetics, and Life Meds, to name just a few.  Apparently TA-65 was discovered by Geron Corporation, a California company that was an early pioneer in stem cell commercialization.  It is sold as a “neutraceutical” and thus has NOT been subjected to the kind of testing that is mandated by the FDA for pharmaceuticals.  In other words, there have been no large scale clinical trials, efficacy has not been proven, and no one has determined the optimal dose.

Interestingly, a class-action lawsuit was filed in 2012 against Telomerase Activation Sciences by one of its former employees, who claims that he got prostate cancer while taking TA-65.  (Unfortunately, I haven’t been able to find out anything else about this case.)

Although the current research results are intriguing, at this point I’d look at telomere testing the same way you might look at getting your cholesterol or your blood pressure checked.   It is just another test that MAY be an important indicator of your health.  But I’d shy away from chemicals purporting to make your telomeres longer until we have results from large-scale clinical trials indicating that that these compounds are safe and effective—and won’t give you cancer.

All this is making me want to talk about neutraceuticals, natural product claims, the role of the FDA, statistical tests, clinical trials, and how we know if something is “true,” but I’ll leave that for another time.


Useful references:

http://www.nature.com/nature/journal/v469/n7328/full/nature09603.html
http://www.mdpi.com/2073-4409/2/1/57           
http://www.nature.com/news/lawsuit-challenges-anti-ageing-claims-1.11090



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