Episode 16: Can Rapamycin Reverse Skin Aging?

Welcome to Inside the Cure with Dr. Charles Moak from Allure Medical. Learn what it takes to cure diseases, not just manage their symptoms. Healthcare isn't going to save itself, so let's jump right in.

I want to talk to you about something very interested in which is anti aging and as it pertains to the skin. So over following podcasts, I'm going to talk about other anti anti aging drugs that are being studied and some that are maybe available right now or should be available in the near future, but also how it pertains to different parts of your body. So we're talking about a promising new anti aging drug that appears reverse aging of the skin. There's a lot of things we can do for the skin to slow down the effects of aging or certainly to reverse effects of aging. We can do laser treatments that brushes off the outer layer of the skin or penetrates deeply in the skin to damage cells so it regrow. That's something we do commonly. We can use sunblock to slow down aging and vitamin C topically and retinol, which is vitamin A topically to slow down brown spots and wrinkles and fine lines. But is there something we can do to really halt the aging process? So we're talking about rapamycin, R, A P A M Y C I N and its effect on a kinase or enzyme called mtor, which is called the mechanistic target of rapamycin or also referred to as mammalian target of rapamycin. So they actually have a kinase enzyme that's named after a drug. There's also a gene named after the same drug. So rapamycin was discovered on Easter island decades ago and it was found in yeast. And they studied it for years and they found that it actually inhibited organ transplant rejection, particularly kidney transplant rejection, and also treats a rare vascular deformity on people's faces that commonly occurs in children. So it's FDA approved for both this blood vessel tumor in kids and faces, as well as for preventing rejection or reducing rejection of kidney transplants. But rapamycin inhibits this enzyme called the mechanistic target of rapamycin, which is produced by the gene called mtor, mechanism targeted rapamycin. And this particular gene appears to substantially regulate aging. So when MTOR is turned on, cells grow. And we need that during development to go from an embryo into a child, a child to adult. We might want it to grow our muscles bigger, but also can grow into damaged cells such as cancer cells and senescent cells. Senescent cells is a hallmark of aging. This where cells that are triggered to grow, grow until they no longer function very well. They get kind of enlarged, they get less vacuoles in them and they won't die. So some people refer to them as like zombie cells. They're in your body and are leading to disease. And they put out this chemical called sasp. It's called senolytic associated secretory phenotype. The that signals other cells to also become old and inefficient in zombie cells. So we don't want those. We want to be able to turn MTOR off. So what turns MTOR off? What turns the mechanistic target rapid myosin off? Well, a few things. One thing is you could starve yourself. And when you starve, your body repairs itself and it actually kills off dead cells for energy and it starts repairing cells and cleaning out your cells. And that's really good. We want to periodically, maybe fast for two or three days so that we block MTOR and also is blocked by rapamycin. Rapamycin turns MTOR off. What turns MTOR on? Eating, particularly eating sugars or carbohydrates and eating proteins. Fat doesn't really turn it on so much. So there's got to be a balance between turning this on and off. We want to grow, we're building muscle or exercising. We also want to turn it off. We want to slow down aging. Now rapamycin, the drug, which is a pill again, is used for suppression of kidney transplant rejection in certain tumors that occur, benign tumors. But it also has been studied in many different creatures and has slowed down aging and extended their lifespan, and not only extended lifespan in mice and flies and worms and yeast, but it also made them younger and healthier and lived at longer, healthier life. Life. So this is very interesting. It's actually being studied in human beings right now as well as animals, particularly dogs, to see if they live longer and healthier lives and to see if humans get less age related disease. So these studies aren't quite out yet. There's been two studies in dogs, companion dogs, that did show benefit for dogs. And some people do give rapamycin to dogs. Some people take it for themselves because they believe that the science will prevail and it will extend life. We just don't know that yet. So I'm talking about a study they did on the skin. So rapamycin can be turned into a cream. And there's been numerous studies looking at using rapamycin into a cream for various benign tumor conditions, one called tuberous sclerosis. And these Vascular angiofibromas. They use it orally for that. But if they put it into a cream and make it work, that'd be better. So they did made it in a cream. And numerous investigators found that we can put it in a cream. It doesn't get much systemic absorption, meaning it stays in the skin. And it seems to work to reduce these benign tumors in the skin. So there's already a precedent for using rapamycin as a cream. Researchers at Drexel University College in Philadelphia, Pennsylvania recently did a study on skin of people older than 40 years old. Actually examined. They did it on their hands and they were supposed to put the rapamycin cream on one hand and put a placebo cream on the other hand. And they wouldn't know which container had the rapamycin or the drug. And they did biopsies of the skin, which is like a little punch biopsy. They take a little piece of skin before and then in follow up that went up to eight months. What they found was that markers of aging, markers of hand or skin aging were reduced in the rapamycin group. They actually got younger compared to the placebo side. And the skin was thicker, which we want thicker skin, thin skin looks wrinkly. There was less wrinkles, less photo damage on the rapamycin treated side. They looked less bony and less veiny on the treated side than the placebo side. And this was seen in about four months. The skin was brighter and the pigment was better. So that's something that is available now. It's not FDA approved for wrinkles, but it is FDA approved. It's called off label if your doctor prescribes it to you for other conditions. And I've seen it at you have to get it from compounding pharmacy. There's currently not a cream commercially available. There's a pilver commercially available. It's a cream can be made by your compounding pharmacist. These are pharmacists that really don't work at your typical pharmacy. They're the ones that make stuff specifically for doctors. A lot of times dermatologists use compounding pharmacists. A lot of anti aging doctors that want to make something for the patient doesn't exist. And I've seen it cost anywhere from $38 to $80 for a 30ml vial, which should last about four months because you take about a half of an ML every other day is probably enough, say for your face or for your hands. If you put on more body parts, you'd obviously use more than that when they did the studies they didn't see it significantly absorbing into the body. So you could probably put it on more than one area. And I'm not suggesting that you take rapamycin cream, something I've order for some of my patients to see if they would benefit like they did in the study. They should. We don't really know the outcome of that until months go by. But these are some of the things that we're seeing developing in the field of anti aging medicine. There's drugs that can turn the clock off or slow it down and we don't yet know. Will rapamycin as a pill slow down aging for humans? There's a lot of people, I believe it does, that have been using and prescribing it for several years for patients to see if they slow down aging. There's currently ongoing study that they're tracking markers of aging in people who are given rapamycin. They're usually taking it once a week, in some cases taking a lower dose every day. I think that's probably not appropriate. There's, there's actually different types of mtor and we really only want to inhibit one, which happens best when you just take it once in a while. It's got a very long half life, meaning it stays in your body for several days. So I don't think it's necessary to take it very often. That's really the reason why using it in your skin every other day is fine. Even every third day would be fine because it does seem to have a half life very long in the body systemically, probably has a long half life in the hand, but we don't really know that. So thanks for tuning in. I'm going to bring up other updates that are kind of tying into this whole concept of regenerative medicine. You know, healthcare. Right now we should think of healthcare as being sick care or disease care. Just like your car insurance covers your car when you get in an accident and your house insurance covers your house when it burns down. But they don't pay for the smoke detector, the filters, they don't pay for your car tire pressure. We have to realize that as humans, if we want to live a longer, healthier life and be in better shape as we get older, we've got to do things on our own, which certainly include lifestyle intervention, exercise, sleeping well, eliminating stress. There's other things that have been shown to probably prolong life, such as saunas and different really widely available therapies and sometimes drug therapy is a part of it. So thank you very much.

Thanks for listening to Inside the Cure with Dr. Charles Moak. See you next time.

Sam.