by Chip Walter
To anyone not checking beneath the surface, Health Nucleus might look like a money grab; an innovative way to rob as many members of the One Percent of their excess cash as possible. But the service was absolutely legitimate. It also promised that as new information emerged, participating customers would be updated on an ongoing basis.
Besides, Venter had to make some money. By July 2016, HLI had raised north of $300 million. But the investment had come from traditional investors who (because they didn’t include Larry Page and the generous people on the Alphabet board) required, if not profit, then at least revenue, some return on investment. This meant Venter had to generate income and get actual research done at the same time, and that sometimes made life a royal pain. After all, who wouldn’t prefer to do pure research and wrestle with the sublime mysteries of human biology without having investors breathing down one’s neck? But how had Mick Jagger once put it? “You can’t always get what you want.”
Not that it was in Venter’s nature to bide his time anyway. He relished concrete, preferably spectacular, results, just as he had with Celera during his battles over the Human Genome Project, his creation of the first synthetic life-form, and the Face Project. That was why it was so important to not simply tweak the medical arts, but to revolutionize them. Thus came HLI’s Health Nucleus, a doorway to reinvention.
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FOR ANYONE WHO WANTS to take advantage of HLI’s Health Nucleus service, there are certain protocols. They aren’t the Final Protocols, like the ones practiced at Alcor—the opposite, really—all about avoiding the requirements of Alcor’s Chill Chamber. Before arriving, each client is politely asked to fill out all manner of online questionnaires about their health, and to submit every bit of medical information possible to the assigned Health Nucleus physician: recent blood tests, brain scans or MRIs, histories of surgery or illness—as much phenotypic information as possible.
On the surface this seems reasonable enough, but occasionally the questionnaires could cause dark thoughts to arise in a patient’s mind. Take the section on magnetic resonance imaging (MRI). “The MRI…produces detailed pictures of organs, soft tissues, bones, and virtually all other internal body structures…[and helps] researchers quantify volumes of different parts of the brain…to understand your risk of certain neurological conditions that are associated with aging.”
When reading passages like this, the reasonable part of a client’s brain thinks, Well, sure, this makes sense. Why wouldn’t I want to know if I have a brain aneurysm waiting to happen, or that I’m losing neurons at an alarming rate, or my bones are brittle, or cancers that have not yet begun to reveal themselves are lurking within? Knowing these clearly gives me advanced warning, an upper hand.
But then, some of the more unreasonable parts of the brain kick in, like the amygdala, the little fear center lodged in the middle of the brain behind the eyes: But do I really have to know everything about the density of my bones? Or the total content of my body fat, or the discovery that soon my marbles will start trickling south?
When people balked at partaking in the Health Nucleus like this, it confounded Venter. Why wouldn’t they want to know that they had medical problems before they got out of hand, rather than die an early death like his father had? Venter told me about a woman who had read an article about him and the Health Nucleus in Forbes. She tweeted him to say he was evil because he wanted to use the tools to change God’s will. “So cheating death means you’re trying to cheat God?” Venter responded. “He wants you to die of prostate cancer so you better just get on with it?”
For those who partake in the Health Nucleus experience, the scrutiny begins even as the client rolls up to the facility to be greeted by Virgil, the security guard at HLI’s San Diego offices. He’s there with a big smile as patients are escorted into the futuristic confines of a suite. The service is entirely first class. No refrigerator-white walls, no gurneys or saline bags hanging from rolling poles, no beeping and gurgling machines as one waits interminably for the medical amenities. Here, the atmosphere is more spa-like, with bright and engaging staff who provide visitors with spiffy, loose clothing, healthy snacks, both breakfast and lunch to order, even selected reading—simply pick any book on the shelves in your suite, and peruse it while comfortably awaiting the next battery of tests. Take it home afterward, if you like.
Nevertheless, the day of testing itself lasts eight full hours. Shortly upon arrival, the phlebotomist siphons off 20 or so vials of blood. These are needed to entirely sequence the subject’s genome, all three billion base pairs. Companies like Ancestry.com and 23andMe might say they are analyzing your DNA, but the truth is they only look at snippets of it: the parts science already largely understands, like how much Neanderthal DNA you can claim, or what part of the world various members of your family hailed from, and, more recently, in 23andMe’s case, insights into whether you have the genes associated with heart disease or Parkinson’s or Alzheimer’s. These make up a few drops in the oceans of information contained in any human genome.
The Health Nucleus, on the other hand, sequences all the patients’ DNA. They may not understand much of what it means right now, but only by gathering the information in the first place can the great AI algorithms hope to unpeel their secrets. It’s part of the big biomedical feedback loop.
In addition to the genome, the service gathers two other “omes” as well: the metabolome and microbiome. Sampling the metabolome allows scientists to analyze the trillions upon trillions of small molecules roaming within and among the cells of the body that drive millions of yet unknown pathways within. One of the joys of sequencing the microbiome is that it requires a stool sample to get a look at what is going on in your gut.
If science still remains in the dark about the genome, the metabolome and microbiome are even more confounding, like strange hieroglyphs from an ancient culture: undeniably real, but mystifying beyond any sensible ciphering. The metabolome takes science into the wild world of proteins and the marvelous ways they fold, pucker, and build out the hardware that drives every one of the 100 trillion cells within your body. The microbiome is an altogether different system that includes the ranks of invisible symbiotic organisms, mostly bacteria, that live within each member of the human race—usually in the stomach and intestines, but in several other sectors too, including the skin, hair, and eyes.
Amazingly, the microbiome consists of 10 times the genetic information the human genome itself does, and is as much a part of what keeps us alive as our own DNA. It affects diet, health, disease—even emotion. But the details of how all these high-speed transactions take place remain almost entirely mysterious, because only recently did we really learn they existed or had meaning at all. The only sure thing any scientist can say right now is that, together, all of these “omes” somehow communicate with and profoundly affect each person’s life.
In addition to these tests, Health Nucleus patients spend an hour and a half having every centimeter of their brains and bodies scanned. HLI promises the highest resolution MRI scans in the world. Resolutions fine enough to pick out sticky beta-amyloids in the brain or signs of neuronal shrinkage, or cancer tumors the size of a pea. Later, electrocardiograms—movies of a subject’s heart as it goes about its quotidian labors (42 million beats a year)—are administered.
Next comes the DEXA bone density scan, which reveals not only how much muscle a subject has in comparison with body fat, but where the muscle and fat themselves reside—a key indicator of health, or lack of it. Gait tests also assess how subjects move. Telltale signs of a shaky gait can reveal the earliest signs of dementia.
Finally, cognitive tests end the day, monitoring how quickly the brain reacts, as well as how it handles logic, spatial problems, and decision making.
It is difficult to imagine the Health Nucleus running a more thorough examination of your “self,” and by 2016 it was working. Two years in, 500 brains and bodies had been run through HLI’s hardware, thoroughl
y analyzed and tabulated. Venter had found that fully 30 percent of the clients had discovered some serious problem that they had otherwise been unaware of. Venter was careful to point out that these were not people who had been heading to the hospital because their doctors had found something wrong with them, or because some symptom had made it clear they needed to be treated. These were people who had assumed they were perfectly healthy!
Revelations like that could be sobering. Research suggests that Health Nucleus has been able to detect diseases related to aging that were serious enough to warrant treatment within the next month in 8 percent of its 209 participants. In 2 percent of these participants, early stage cancers were detected.16
Venter told the story of one woman, just 27, who had her brain scanned by Health Nucleus. Deep inside, the doctors found an aneurism: a damaged vessel that looks like a bubble in a tire. Thanks to the discovery, she arranged immediately for a neurosurgeon to remove it. It is possible she could have lived a long life with the aneurism in there waiting to explode, said Venter. But chances are that one day, the vessel would have blown out. “Her first, and last, symptom would have been bleeding to death through her nose.”
Then there was the story of an older couple all prepared to go on an overseas vacation the day after their Health Nucleus visit. They were in good health, they thought, and figured the battery of tests would be a little something they could revisit after they returned. Except the machines found a cancer tumor beneath the breastbone of the husband that had been missed in previous exams. Not long after the surgery, the man contacted Venter to say the exam ruined their vacation, but saved his life. So, thanks.
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VENTER LOVED TO TELL STORIES like these. Not that he wanted anyone to be ill, but because the illnesses were discovered early. That was the point. They provided the most dramatic possible examples of the direction he felt medicine should take the human race. You thought you were okay, but you really weren’t. Your body found you out. But that’s a good thing, because now we have predicted the weather of your medical future. Now the trouble can be repaired. Maybe not every time, but far more than if you had remained clueless.
Venter admitted that for now, HLI was mostly using Health Nucleus’s scanners, MRIs, sound waves, and needles to make these discoveries. Maybe that was still a bit reactive in the old-fashioned way, but was that so bad? Already, Health Nucleus was uncovering cancers early enough to cure them. Once the omes—the genome, metabolome, and microbiome—got cranking and the artificial intelligence algorithms began making sense of all that data, then science could get down to creating a new kind of Precision Medicine. At least the current version of the Health Nucleus was a start.
Health Nucleus’s high costs were still a problem, though. After all, who but the wealthy could use such a service? But Venter was working on that, and like the cost of sequencing the genome itself, he was certain the prices would plummet. Brad Perkins, HLI’s chief medical officer, predicted that in 10 years everyone would have his genome sequenced. It would be as normal as checking your ears, and the cost would be zero. But first, gather the data and crunch the numbers. That was the ticket.
Well, one of them, anyhow.
25 | SUPER CELLS
In the summer of 2016, Bob Hariri was sitting in the Palo Alto offices of Human Longevity, Inc., listening to Riccardo Sabatini tell him all about the company’s Face Project. Hariri’s adolescent son was with him, and in about half an hour they would be hopping onto his Bombardier Challenger 604 jet before heading to San Diego, and then off to Asia for a couple of weeks of family R & R.
As an HLI founder, Hariri had heard of Sabatini’s work and was fascinated by it, but he also knew his role at HLI was soon likely to change. There was talk among the triumvirate—Hariri, Venter, and Diamandis—that it might be best to split off the stem cell work to create an entirely new business. It wasn’t that there was any ill will among the three. But Venter, as CEO, had pretty much focused HLI on genomics and Health Nucleus. Hariri’s investigations of stem cell therapy were undeniably interesting, and related to longevity and health span, but were a little out of the orbit of HLI’s current plans. For his part, Hariri really wanted to focus on placental stem cells, and felt he was making serious progress.
Sure enough, in early 2017, the stem cell side of HLI split off, and Hariri and Diamandis, with a fresh supply of Silicon Valley investors, formed a new company called Celularity, designed exclusively “to turn stem cells into medicine.” This did not diminish anyone’s belief that stem cell therapy could be a powerful ally in the fight against aging, not to mention a whole flock of other ailments. The shift merely meant the two operations could move forward faster and more independently. Later, when the time came, they could reconvene as collaborators. That was the plan anyhow.
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DURING THE COURSE of his long explorations at Celgene, HLI, and Celularity, Hariri had continued to develop some unusual views on aging. He saw three very good reasons to make the affliction go away: It robbed people of their health, mind, and looks. Clearly, the use of the brain and body were pretty useful, but looks? Wasn’t that egotistical, the stuff of Hollywood and those kind of people? No, said Hariri. He held that the older, more frail and haggard people appeared, the more society marginalized them. Aged faces and bodies became a signal for all to see that it was time to move on. So even if your brain and body were strong, if you looked old, you were ushered into the societal dust heap. But what if you had access to medicines created by placental stem cells? Those, at least theoretically, could solve all three problems: regenerating body, mind, and appearance.
This was not an entirely new idea. Before Diamandis and Hariri had begun brainstorming their longevity play, scientists outside the United States had undertaken stem cell research more aggressively than the FDA in the United States. Among them was the Karolinska Institutet in Stockholm, Sweden, unequivocally regarded as one of Europe’s best medical establishments. At Karolinska, scientists had injected stem cells into patients with blood, brain, eye, bone, and liver disorders, including cancer. The studies were ongoing, but so far the new treatments seemed to be working. Stem cells were simply injected into damaged organs and soon began to regenerate stronger, fresher cells. No petri dishes or complex pharmaceuticals required.
Stem cells were being put to novel uses elsewhere too. In 2016, researchers at another of Venter’s companies, Synthetic Genomics, began collaborating with Martine Rothblatt, founder of United Therapeutics (and before that, creator of Sirius XM Satellite Radio).17 In one project, the two companies genetically modified the hearts and lungs of pigs. Next, they planned to transplant those organs directly into humans who needed them: something called xenotransplantation.
Pig valves and other assorted porcine organs had been used for decades to bide time for people suffering from failing hearts, but using whole hearts and lungs from pigs creates huge problems because the body rejects them. Venter’s plan was to use genomic sequencers to compare the genomes of pigs and humans, precisely identify the genes that created rejection problems between the two species, use Crispr technology to snip out the offending genes, and then insert the edited versions into pluripotent pigs’ ovaries to create brand-new pigs carrying “humanized” lungs and hearts. It turns out the organs of the average pig are about the same size as the average human, and the genetics are remarkably similar too.
If transplants of this kind happen someday, they will essentially transform recipients into chimeras: part pig, part human. Of course, if the pig’s genes were changed too much, their stem cells might not survive. “It’s not like by changing a couple genes you’ve got it solved,” Venter said. Nevertheless, so far the experiments had been promising, if not perfect.
But maybe none of this would be necessary if placental cells could perform their magic. Imagine an aging baby boomer whose cells are giving out from all of the damage that his DNA hasn’t been repairing as well as it did bac
k at age 25. Sore knees or, worse, a heart or spine or pancreas or brain starting to sputter.
Now, rather than a heart transplant (pig or otherwise), or great buckets of drugs to keep the body clattering along, doctors could inject Hariri’s placental medicines. As the old stem cells give out, the pristine, new ones step in. Later, when another part of the body begins to run down, a new, fresh batch could be supplied, and so on, until boomers everywhere were being youthfully topped off and their cells reset—not only healthier, but actually younger, and therefore not marginalized! Ken Bloom, HLI’s president, had said himself that stem cells might someday find a way to push the length of human life beyond 120 years—maybe way past that.
But as compelling as placental stem cells might appear, they weren’t perfect. At least, not yet. For one thing, the fresh stem cells that one receives from their own body will always adhere to whatever genetic ailments that body’s DNA already carries. If someone is genetically prone to arthritis or heart problems, or even addictions or depression, those problems are going to reappear eventually. Cancer could also be an issue. Introducing new stem cells into the body of someone with a predisposition to various cancers might actually encourage tumors rather than eliminate them. In some ways, cancer cells were like pluripotent stem cells in that they can replicate indefinitely.
Down the road, Crispr technology might fix problems like these with a couple of nicks of the Crispr scissors. But Crispr had its own problems. It could easily change and swap cells, but once the DNA of a pluripotent stem cell is rearranged, that change remains forever and is even passed along to the next generation, just as if evolution and your own parents had provided the DNA. One would want to be very careful that there were no unintended consequences when swapping these genes.
