Summary
David Stewart of AGEIST interviews Dr. Sanjeev Goel about therapeutic plasma exchange and its remarkable potential for Alzheimer's prevention and treatment. Dr. Goel traces the science from Irina Conboy's 2005 heterochronic parabiosis study, which showed old mice rejuvenated when connected to young mouse blood, to the current understanding that dilution of old plasma rather than addition of young blood drives the rejuvenation effect. Dr. Goel explains three key mechanisms by which TPE combats aging: reducing cellular senescence and SASP molecules, rejuvenating the immune system, and decreasing systemic chronic inflammation. He discusses the AMBAR trial results showing mild Alzheimer's reversed and moderate Alzheimer's stabilized after a year of treatment. Dr. Goel also describes his own clinic's trial in Toronto testing TPE every three months in healthy people in their 50s and 60s, measuring DNA methylation age as a primary outcome, with preliminary results showing decreases in biological age.
Key Points
- Irina Conboy's 2005 parabiosis study launched the field; subsequent work showed dilution of old blood drives rejuvenation, not young blood transfusion
- TPE works through three mechanisms: reducing cellular senescence and SASP, rejuvenating the immune system, and decreasing chronic systemic inflammation
- The AMBAR trial showed mild Alzheimer's patients reversed and moderate patients stabilized after a year of TPE
- TPE reduces SASP molecules far more effectively than any senolytic supplement like fisetin or quercetin
- Dr. Goel is running a clinical trial in Toronto testing TPE every three months in healthy people aged 50-60, measuring DNA methylation age
- Preliminary results show decreases in DNA methylation age and protein composition shifting toward a younger profile
- Keith Richards reportedly had blood washing procedures in Switzerland decades ago, an early form of the concept
- The procedure uses a machine similar to dialysis, simultaneously removing blood from one arm and returning cells with saline and albumin through the other
Key Moments
From parabiosis to plasma exchange - the origin story
Dr. Goel traces the science from Irina Conboy's 2005 heterochronic parabiosis study, where connecting old and young mouse blood supplies caused the old mouse to visibly rejuvenate with brown hair, weight loss, and increased muscle strength.
"what they did was they connected the blood supply of an old mouse with the young mouse. So they basically just connected the two bodies of these mouse together. They're sharing the same blood supply. And it was really remarkable how the old mouse basically became younger."
Three mechanisms of TPE anti-aging action
Dr. Goel outlines the three proposed mechanisms by which TPE combats aging: reducing cellular senescence and SASP, rejuvenating the immune system, and decreasing chronic systemic inflammation.
"One is that, so as one of the, one of the things that therapeutic plasma exchange is reducing cell senescence. So that's one thing."
TPE outperforms senolytics at reducing SASP
Dr. Goel explains that TPE reduces SASP molecules far more effectively than any senolytic supplement like fisetin or quercetin, making it a uniquely powerful anti-aging intervention.
"TPE reduces SASP all across the board, way more than any stenolytic could do that."
