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In this episode of Longevity by Design, Dr. Gil Blander welcomes Dr. Eric Verdin, President and CEO of the Buck Institute for Research on Aging. Eric discusses the science behind therapeutic plasma exchange (TPE) and its potential to slow biological aging in humans. The conversation explores findings from a recent clinical trial, including measurable age reversal using epigenetic clocks.
Eric explains how removing and replacing plasma can dilute pro-aging factors in the blood, a concept inspired by earlier animal studies on parabiosis. He also describes why rigorous, placebo-controlled human trials are crucial for validating longevity interventions and distinguishing the field from hype-driven wellness trends.
The episode also highlights how omics data, such as metabolomics and proteomics, are shaping a new era of precision aging research. Eric emphasizes the value of lifestyle interventions as a foundation and sees future opportunities in combining TPE with personalized strategies to extend healthspan.
Guest-at-a-Glance
💡 Name: Dr. Eric Verdin
💡 What they do: President and CEO
💡 Company: Buck Institute for Research on Aging
💡 Noteworthy: Physician-scientist pioneering human aging research through epigenetics, metabolism, and translational science.
💡 Where to find him: LinkedIn
Episode highlights:
[00:00] Introduction to Longevity and Healthspan
[01:07] Meet Dr. Eric Verde: A Pioneer in Aging Research
[02:24] Exploring Therapeutic Plasma Exchange
[03:08] The Science Behind Heterochronic Parabiosis
[07:17] Clinical Trials and Methodologies
[12:58] The Role of Omics in Precision Medicine
[17:20] Epigenetic Clocks and Aging
[22:04] Therapeutic Plasma Exchange: Results and Implications
[26:22] Exploring Frequency and Efficacy of Treatments
[28:23] Biomarkers and Predictive Models
[31:33] Safety Profile and Side Effects
[33:28] Intrinsic Capacity and Aging Metrics
[36:58] Combining Treatments with Lifestyle Changes
[44:26] Future Directions and Recommendations
[49:08] Conclusion and Final Thoughts
Key Insights
Plasma Exchange May Shift the Aging Clock
Therapeutic plasma exchange (TPE) is more than a buzzword—it’s showing real promise as an intervention that can reverse biological age. Eric Verdin and his team conducted a placebo-controlled clinical trial and saw measurable changes across multiple epigenetic clocks, with some showing a 2.5-year reversal in biological age. The impact was most notable when plasma exchange was combined with immunoglobulin, a therapy designed to replenish key antibodies lost during the procedure. This suggests aging isn’t just about adding youthful elements, but removing harmful ones. While these findings are early, they offer a rare clinical signal in a field often filled with speculation. Instead of chasing unproven supplements, the trial highlights the power of well-designed studies in identifying what actually works to slow aging.
Biological Age Isn’t One Number, It’s a System of Signals
Chronological age is fixed, but biological age is dynamic, and tricky to measure. The episode explains how epigenetic clocks attempt to quantify aging using DNA methylation data, but each clock may capture different aspects of health. Eric emphasizes that no single clock holds all the answers, and results can vary widely for the same person depending on which clock is used. In their study, they didn't cherry-pick one model; they ran dozens to see which responded to the intervention. The takeaway? Measuring aging is still an evolving science. Clocks should be used to track changes over time, not as absolute scores. This nuanced view helps listeners understand why some people may show big improvements on one test and flatline on another, and why that doesn't invalidate the intervention.
Data-Rich Health Tracking Is the Future of Precision Aging
Today’s standard blood test measures around 18–20 biomarkers. But researchers now have tools to track thousands, transcripts, proteins, metabolites, and even wearable data. Eric believes this shift will redefine how we evaluate health and aging. Instead of waiting for disease, precision aging tracks biological shifts early and suggests personalized interventions. The Buck Institute is working with experts like Lee Hood and Nathan Price to build knowledge graphs that connect these complex data points. The aim isn’t more data, it’s better answers. What changes predict faster aging? What markers respond to treatment? Which combinations matter most? This approach could unlock targeted, efficient longevity interventions based on individual biology, not population averages.
Lifestyle Changes Still Outperform Most Longevity Hacks
Despite the excitement around plasma exchange and epigenetic clocks, Eric circles back to a core truth: most people can already add 20 healthy years to their lives with behavior change alone. Sleep, movement, social connection, stress reduction, and nutrition aren’t glamorous, but they work, and they’re underused. Eric warns against relying solely on medical interventions to fix what lifestyle can prevent. He sees TPE and other therapies not as substitutes, but as tools to extend gains for those already doing the basics well. This grounding message reinforces that the best path to longevity starts with what we already know, improving how we live now, not just how long we live later.
The Science Behind Plasma Exchange
Eric explains how early animal experiments in “heterochronic parabiosis”, connecting young and old mice, laid the foundation for human plasma exchange research. Scientists observed rejuvenation effects in older mice and hypothesized that removing harmful plasma factors could be just as important as adding youthful ones. This thinking inspired the use of therapeutic plasma exchange (TPE) in humans, where blood is processed to replace plasma while preserving cells. The goal: dilute pro-aging elements and reset biological systems. Eric outlines the procedure, its clinical legitimacy, and how it's already used to treat certain autoimmune conditions. The insight reframes plasma exchange from speculative biohacking to a plausible, regulated therapy with mechanistic support.
"This hypothesis—the idea that in the hybrid mouse, you were sort of diluting a series of negative factors in the old mouse, was not really paid enough attention at the beginning. Eventually, Irena Conboy and her colleagues at Berkeley conducted a simple experiment, which consisted of withdrawing blood from an old mouse and reinfusing the cells so there was no cytopenia. And they found that these mice benefited significantly in terms of their health span and lifespan."
Designing a Trial That Actually Measures Aging
Eric breaks down the rationale behind the trial's design. Instead of assuming benefit, the study aimed to prove or disprove TPE's effects using rigorous clinical tools. The trial featured multiple arms with varied frequency and combinations (e.g., TPE alone vs. TPE with immunoglobulin). Importantly, it included a placebo group, a rarity in this type of aging intervention. Eric also highlights the challenges: TPE is intensive, requiring several hours per session and specialized equipment. The team had to balance scientific ambition with practical feasibility. This section illustrates how serious longevity science must move beyond assumptions and measure outcomes under the same scrutiny applied to any other clinical intervention.
"Our goal here is not only to create a company [...]. Our goal was to understand how we can benefit those patients and what is the optimal, most cost-effective manner for this treatment to be administered with maximal results."
Predicting Who Responds—and Who Doesn’t
Not everyone responds the same to plasma exchange. So how do we know who should try it? Eric shares how the team used biomarker data, like glucose, liver enzymes, and bilirubin, to spot patterns. Some participants responded dramatically, while others saw minimal change. This discovery may help predict who benefits most, based on their baseline biology. The quote shows how Eric links these biomarkers to possible organ-specific aging, like liver function, and how future treatments might be personalized. This part of the conversation shows how longevity science is becoming smarter, not just broader.
"The question was: Among those markers identified early, before the interventions, which were the most predictive of a positive response? [...] I cannot tell you yet how this relates to the procedure or the biology. It could be that, for example, someone who shows one aspect of heterochronosis—which was not previously considered—as I mentioned at the beginning, the idea that an old mouse benefits from being stitched up to a young mouse because suddenly it has a new liver. So the fact that some liver enzymes might be correlated with this could indicate that perhaps those patients who had more liver aging benefited more."
From Biological Markers to Real-Life Outcomes
While molecular results are exciting, Eric reminds listeners of what really matters: how people feel and function. He references the World Health Organization’s “intrinsic capacity” model, a holistic measure that includes mental, physical, and emotional capability. Eric sees this as the true endpoint for longevity science. Instead of just showing shifts in methylation or proteins, the field needs to prove that interventions improve quality of life. He also mentions ongoing work to connect epigenetic clocks with real-world function, suggesting a path forward where aging markers aren’t just academic, they’re actionable. This segment grounds the science in human impact.
"It's one thing to measure aging in people by looking at parameters such as the omics and all this, it yields a lot of data, but it is meaningless to the patients. The WHO developed the concept of intrinsic capacity, a series of metrics that rely more on what you feel as you age. And obviously, our goal in fighting aging is to keep people in the highest state of emotional and physical capacity as they age."
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