Anti-aging Science: The Emergence, Maintenance, And Enhancement Of A Discipline Part 1

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Abstract

Through archival analysis, this article traces the emergence, maintenance, and enhancement of biogerontology as a scientific discipline in the United States. At first, biogerontologists' attempts to control human aging were regarded as a questionable pursuit due to: perceptions that their efforts were associated with the long history of charlatanic, anti-aging medical practices; the idea that anti-aging is a "forbidden science" ethically and scientifically; and the perception that the field was scientifically bereft of rigor and scientific innovation. cistanche salsa extract The hard-fought establishment of the National Institute on Aging, scientific advancements in genetics and biotechnology, and consistent "boundary work" by scientists, have allowed biogerontology to flourish and gain substantial legitimacy with other scientists and funding agencies, and in the public imagination. In particular, research on genetics and aging has enhanced the stature and promise of the discipline by setting it on a research trajectory in which explanations of the aging process, rather than mere descriptions, have become a central focus. Moreover, if biogerontologists' efforts to control the processes of human aging are successful, this trajectory has profound implications for how we conceive of aging, and for the future of many of our social institutions.

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Ambitions and attempts to control aging have been part of human culture since early civilizations(Gruman, 2003). An obsession with immortality is a central theme in a Babylonian legend about the king Gilgamesh who ruled southern Mesopotamia in about 3000 B.C. In the third century B.C., adherents of the Taoist religion in China developed a systematic program aimed at prolonging life(Olshansky & Carnes, 2001). cistanche stem Through the centuries, a variety of anti-aging approaches have recurred. Among them have been alchemy, the use of precious metals (e.g., as eating utensils)that have been transmuted from baser minerals; "shamanism" or"gloomy"(cavorting with young girls); grafts(or injected extracts) from the testicles, ovaries, or glands of various animal species; cell injections from the tissues of newborn or feral animals; consumption of elixirs, ointments, drugs, hormones, dietary supplements, and specific foods; cryonics; and rejuvenation from devices and exposure to various substances such as mineral and thermal springs(Gruman 2003; Hayflick, 1994).

Cistanche can anti-aging

Anti-aging aspirations and efforts flourish today, perhaps more than ever, in the forms of (1)commercial and clinical enterprises that offer anti-aging products, regimens, and treatments; and (2)research and development efforts of biogerontologists-scientists who study the biology of aging. Indeed, anti-aging has been identified as one of the specific topics to be considered at the 19th World Congress of Gerontology and Geriatrics in Paris in 2009(International Association of Gerontology and Geriatrics, 2007). Many biogerontologists also seek to achieve what historian Gerald Gruman(2003)has termed "pro-longevity" -a significant extension of average human life expectancy and/or maximum life span without extending suffering and infirmity.

Although not universally true, one thing that characterizes both contemporary and previous anti-aging endeavors is their public perception as something simultaneously seductive and desirable yet also transgressive, suspicious, and even dangerous. As such, contemporary anti-aging research is a type of"forbidden knowledge"(Kempner, Perlis, & Merz,2005)-an area of research that is, in some ways, considered off-limits for various, often moralistic, reasons. However, the field of anti-aging research is not only tinged with questions about the moral transgressions of interfering with the "natural" process of aging, but it also has emerged from a tainted history where the science itself was considered marginal and without much merit. This history has conflated questions about whether we should pursue anti-aging interventions and whether we can control aging (Moody,2001/2). Because of these

questions, the field is still somewhat mired by its historically marginal and forbidden status, despite its recognition by large funding agencies and others as a now reputable and cutting-edge area of research.

At first, scientists' attempts to control human aging were regarded as a questionable pursuit due to: perceptions that their efforts were associated with the long history of charlatanic, anti-aging medical practices; the idea that anti-aging is a "forbidden science" ethically and scientifically; and the perception that the field was scientifically bereft of rigor and scientific innovation. The hard-fought establishment of the National Institutes on Aging, scientific advancements in genetics and biotechnology, and consistent "boundary work" by scientists, have allowed biogerontology to flourish and gain substantial legitimacy with other scientists and funding agencies, and in the public imagination. However, scientists in this field are vigilant about protecting the scientific status and credibility of biogerontology, which is still somewhat fragile.

This article traces the emergence, maintenance, and enhancement of biogerontology as a scientific discipline that is dedicated to understanding the biology of the aging process. Our data comes from secondary sources on the history of(bio)gerontology, primary materials documenting the establishment of the National Institute of Aging, and an exhaustive review of biogerontologists' publications on the history and state of the discipline. The archival analysis led us to consider theoretical insights from the social studies of science to describe biogerontologists' activities and intentions as they work to establish and bolster their legitimacy as scientists, and moreover as scientists worthy of research funding and public support. Using an inductive process, we toggled back and forth between data and theory to form our analysis of the emergence of biogerontology. cistanche tubulosa benefits and side effects At the end of the paper, we consider the significance of the emergence of biogerontology in shaping our cultural and scientific understanding of the aging process and its potential social implications for the future.

The emergence of biogerontology as a scientific discipline

The history of biomedical research on aging in the United States is a classic story of a new scientific discipline's struggle for legitimacy and funding. Scholars in the social studies of science have long been interested in the emergence of new scientific disciplines (Hedgecoe, 2003). The premise of this scholarship is that disciplinary building is a social, political, and cultural endeavor [see e.g. (Abir-Am,1985; Bud, 1993; Gieryn,1983)]. A new discipline may in fact develop around a new set of scientific discoveries, new methodologies, or new objects of inquiry. However, these scientific"facts" alone are not enough to constitute a new discipline. Individuals, groups, and institutions need to work towards legitimation within the larger scientific and social arena, through garnering political support, allying themselves with credible and respected scientists and other elite members of society, and convincing those around them (often through rhetorical strategies) that their discipline is indeed worthy of scientific inquiry(Abir-Am,1985; Fujimura,1996; Hedgecoe,2003; van Lente & Rip 1998). The history of biogerontology's emergence is one that follows this pattern as members in the field tried to establish their work as a legitimate scientific discipline. This story is particularly significant given the legacy of ill-repute that anti-aging/longevity efforts garnered in the many years prior to the establishment of the field. This perception of anti-aging research as not only scientifically inferior but also as an area of"forbidden knowledge"(Kempner et al.,2005)made the fight to establish the discipline all the more difficult.

Once the discipline was established, biogerontologists sought (and still seek) to maintain and enhance the discipline. This requires work to preserve their hard hard-fought status through other claims-making activities-"boundary work"-wherein members of the new discipline attempt to distinguish themselves from other groups in the same social arena (Gieryn, 1983), particularly those with less credibility and stature than themselves. In the case of biogerontologists, their boundary work activities aim to do two things: 1)weaken the boundaries between themselves and genetic researchers in other areas of the biosciences and 2)strengthen the boundaries between themselves and anti-aging practitioners and

entrepreneurs. Mere association with these latter groups was thought by biogerontologists to threaten their own scientific credibility, whereas the association with genetic researchers was to bolster their professional standing and support for their research. This hard-won legitimacy, achieved in part through biogerontology's affiliation with genetics, shapes contemporary and future(anti-)aging research, setting it on a trajectory that highlights a molecular understanding of aging and its potential interventions.

Modern biogerontology: the early years In his monograph on the history of ideas about "longevity" Gruman observed that the subject tends to be: relegated to a limbo reserved for impractical projects or eccentric whims not quite worthy of serious scientific or philosophic consideration. One reason for this neglect is that there is, in philosophy, science, and religion, a long tradition of apologism, the belief that the prolongation of life is neither possible nor desirable... Another reason is the fact that there are few subjects that have been more misleading to the uncritical and more profitable to the unscrupulous; the exploitation of this topic by the sensational press and by medical quacks and charlatans is well known. (2003, pp.6)

In her history of the development of U.S. government support for research on aging, published several decades ago, political scientist Betty Lockett(1983)observed: “Those who would study aging in order to retard or halt the process have been considered on the fringe of biomedical research, looking for the: fountain of youth... a marginal area... with so little backing from the scientific community"(p.5).

As Achenbaum (1995), Hayflick(1994), and Lockett(1983)detail, the early development of the modern research enterprise in the biology of aging in the United States, and in geriatrics as well, was to a significant degree stimulated by the Josiah Macy Foundation. During the late 1930s, it supported surveys on aging and commissioned a seminal volume on Problems of Aging: Biological and Medical Aspects(Cowdry,1939)that reviewed research

knowledge and issues regarding how to prolong human life and how to reduce disabilities and chronic diseases in old age. The foundation also funded a series of professional conferences that brought together researchers from a variety of disciplines and professions who formed a Club for Research on Aging which eventually became the Gerontological Society of America.

In 1940, the U.S.Surgeon General, who had attended a meeting of the Club, took the lead in establishing a small intramural research program in gerontology under the auspices of the U.S. National Institutes of Health (NIH). However, despite the substantial growth in the broad field of gerontology over the next three decades, the development of the biomedical research enterprise in gerontology stagnated. The NIH intramural research program on aging barely got off the ground during World War II as it was diverted by research devoted to the war effort. In 1948 it was designated as the Gerontology Branch of the National Heart Institute, was given a line-item budget, and conducted physiological research on elderly men.

Although an NIH Gerontological Study Section for reviewing extramural research applications was created in 1946, it was abolished three years later. In the 1950s and 1960s, extramural research on aging gained little ground at NIH. During this period, in response to pressures from Congress, five regional multidisciplinary centers for aging research and training were funded through NIH's program project mechanism. However, only one of these centers (at Duke University)ultimately survived, and an internal NIH evaluation of the work of these centers was pointedly uncomplimentary concerning the quality of their gerontological research (Lockett, 1983). Meanwhile, a Senate Subcommittee on Problems of the Aging and Aged issued a report "disparaging the quality of gerontologic research"(Achenbaum, 1995, p. 200).

When the National Institute of Child Health and Human Development (NICHD) was established in 1963, NIH programs on aging became part of NICHD's Adult Development and Aging Branch. Although the branch had an external peer review committee comprising a multidisciplinary roster of gerontological researchers, it only reviewed applications for program projects and training and career development grants, not research grants. Over the next ten years, gerontologists expressed their disappointment with the NICHD arrangement, especially the low proportion of that institute's funds earmarked for research on aging (see, e.g., Eisdorfer,1968).

The institutionalization of research on aging

By the late 1960s, frustrated by NIH's lack of funding for research on the basic mechanisms of aging, biogerontologists set in motion the forces that ultimately led to the establishment of a separate National Institute on Aging in order to ensure that earmarked funds for gerontological research would be adequate. cistanche tubulosa extract They drafted a bill in 1968 that called for a new NIH Institute with a five-year research plan" to promote intensive coordinated research on the biological origins of aging"(Lockett, 1983,p.85).In order to gain the support of the Gerontological Society of America, however, the bill was quickly broadened to include the medical, behavioral, and social sciences (Binstock, 2003).

During the subsequent political processes that finally led to the establishment of NIA in 1974, themes suggesting the marginal status of biogerontology persistently emerged. For example, the key political actor in the successful lobbying effort, Florence Mahoney, was an ardent pursuer of anti-aging interventions. She was very interested in rejuvenation therapies offered by an institute in Bucharest, Romania, and accustomed to taking serum treatments that were purported to slow or prevent aging. Mahoney was also a powerful Washington "insider" with politically elite connections, a long-time behind-the-scenes effective advocate for expanded government support for biomedical research. As noted in her biography, however, Mahoney's "accuracy in separating real science from charlatan [sic] science was not precise; she occasionally backed a rejuvenation expert who had mastered promotion and mystique"(Robinson 2001,p.237). Because of Mahoney's personal interest in anti-aging interventions, her crucial political support in establishing the NIA may have further aligned perceptions of biogerontologists' work with seemingly charlatanic medicine.

Throughout the protracted legislative history of NIA's establishment, from 1969 through 1974, various opponents of such an institute were quite candid regarding their negative view of the quality and promise of gerontological research. At a Senate hearing in 1971, for instance, an assistant secretary in the Department of Health, Education, and Welfare argued that the field of aging was not ripe for the injection of major new resources because it lacked "a substantial body of interested and competent research investigators, plus enough research leads, or promising ideas within the field to challenge the researchers to productive endeavors"(Lockett,1983,p.98). Similarly, in a House of Representatives hearing in 1972, the president of the Association of American Medical Colleges asserted that"there is a paucity of trained researchers and valid ideas in the field of aging research"(Lockett,1983, p.22). And when one version of the bill passed in 1972, a memo from the Office of Management and Budget to President Nixon urged him to veto it-which he ultimately did because an NIA"could raise false expectations that the aging process can somehow be controlled and managed through biomedical research"(Lockett, 1983, p. 139). Despite Nixon's veto-and consistent opposition from high-level NIH officials who apparently did not want to have a new institute carving out its own share of NIH appropriations(Lockett, 1983; U.S.Senate Subcommittee on Aging, 1973)-Mahoney, a cadre of gerontologists, and several key members of Congress persisted in their efforts. In 1974, in the midst of calls for his impeachment, Nixon signed the legislation creating NIA (Research on Aging Act of 1974,1974).

The establishment of NIA provided for biogerontology the kind of institutionalization that confers scientific stature and power(Cozzens, 1990). It began a process that legitimated research on aging both as more of a "mainstream" subject for biomedical research than the broader scientific community had regarded it, and as an appropriate area in which to invest sizeable amounts of public funds. Since NIA began operation, a number of important scientific frontiers have been opened up in research on the fundamental biological process of aging (see Masoro & Austad, 2006). Moreover, the overall NIA budget, which was only about $20 million in its first year of operation (Lockett,1983), grew substantially during the next 30 years to reach over $1 billion by the fiscal year 2007 (National Institute on Aging, 2007.

Although there are, of course, a number of distinguished European biogerontologists, nothing comparable to the NIA has been established in Europe. Some of them look to the U.S.NIA for research support and often succeed. But, as Warner(2007)reports, other than in Belgium and Denmark there have been no sustained initiatives by European governments or the European Union to fund biogerontological research on aging.

The struggle to maintain legitimacy and status

Parallel to the modern emergence of biogerontology as a scientific discipline has been the development of anti-aging medicine. Mykytyn (2006a) characterizes anti-aging medicine as a social movement in the sense that it involves a group of people bound together under a particular mission in opposition to the "mainstream" with, in this instance, mainstream referring primarily to both mainstream biogerontology and clinical medicine.

However, unlike other health social movements which are often characterized by a resistance to biomedicine from that outside of it-e.g, patients, activists, and grassroots organizations (see e.g, Epstein,1996; Brown & Zavetoski 2004;Landzelius,2006)-the anti-aging medicine social movement has its roots in large part from within biomedicine if perhaps a marginal wing of biomedicine. Aging, a cluster of human conditions and experiences previously considered to be nonpathological, has become medicalized like many other features of the human condition(Clarke, Shim, Mamo, Fosket, & Fishman, 203). This phenomenon has been specifically noted in the field of gerontology as the "biomedicalization of aging" (Estes & Binney,1989) and chronicled with respect to the sociopolitical transformation of cognitive senility into Alzheimer's disease (Fox,1989). At the same time, contemporary interest in anti-aging medicine is fueled by the promises and predictions of cutting-edge biomedical and scientific research, such as stem cell research, nanotechnology, and gene therapy (Mykytyn,2006b). Anti-aging medicine is thought to be feasible because of its reliance on the rhetoric of scientific breakthroughs. Biogerontologists, too, have benefited from the promises of cutting-edge biotechnology and have thereby made a number of recent scientific discoveries that seemingly have relevance for breakthroughs in slowing the rate of aging in human beings (see Masoro & Austad, 2006). As we will document, it is the promise of biotechnological advances that is at the heart of the boundary work in which biogerontologists engage. On one hand, they attempt to downplay their relationship with anti-aging medicine and extravagant anti-aging claims. On the other hand, they work to codify their relationship with biotechnology research in order to maintain their still fragile scientific status as a discipline.

The modern anti-aging movement

The modern anti-aging medicine movement was spear-headed in the 1960s and 1970s in Europe. A Romanian biologist and physician, Anna Aslan, established an institute in Bucharest that offered rejuvenation therapies and an elixir called Gerovital (Robinson,2001)which is still widely marketed. Members of the European and Asian elite, including Nikita Kruschev, visited the institute for treatments, and the Soviet Union established its own institute to study Gerovital and other potential anti-aging interventions. Today, a substantial German-speaking anti-aging movement is headed by Johannes Huber, an Austrian scientist, physician, and theologian who develops applies, and sells hormone treatments, dietary supplements, and predictive gene testing (Spindler in this issue). And various academies and centers on anti-aging medicine can also be found in France, Belgium, and Japan, along with European-wide and Asian/Pacific organizations of this ilk(Robert,2004).

At the same time that Gerovital was marketed throughout Europe, Geritol ——a similar product——was aggressively marketed in the United States. Although there has always been a strong interest in anti-aging products, it was not until several decades later that the market really took off. The use of anti-aging products, particularly dietary supplements, soared especially in the years following the enactment of the Dietary Supplement Health and Education Act of 1994 which relaxed regulation of such products (U.S.GAO,2001). From the late 1990s to the present day, hundreds of popular anti-aging books have been published, such as You: Staying Young: The Owner's Manual for Extending Your Warranty (Roizen &Oz,2007). The authors, prominent physicians in the United States, often appear on the Oprah television show and their book was the 23rd bestselling book on Amazon. com's website within three months of its release(Amazon. com,2008). A refereed scientific publication, the Journal of Anti-Aging Medicine(subsequently renamed Rejuvenation Research), began publishing in 1998 and several non-refereed publications with similar-sounding names also appeared. Hundreds of websites like "Youngevity: The Anti-Aging Company" have marketed products such as "The Vilcabamba Mineral Essence" to enable people to live their lives" in a state of youthfulness"(Youngevity, 2003).

There are no hard statistics on the size of the overall anti-aging market in the United States but some estimates are available. A research report prepared by the Business Communications Company, Inc. (2005)estimates that the anti-aging market in the United States alone will reach about $72 billion by 2009. It defines the market in terms of three categories(excluding exercise and physical therapy): appearance products and services; drugs and supplements targeting diseases of aging; and products based on "advanced technologies."Whatever the magnitude of the market, it seems highly likely to grow further given the intensity and prevalence of mass-marketing advertising campaigns.

One particular element of the anti-aging movement that has directly challenged the established gerontological community is the American Academy of Anti-Aging Medicine (A4M)which despite its name, is international in scope. Founded in 1993, the organization claims it has 20,000 members from 90 countries(Klatz,2007). The latest publicly available income tax returns show that it had accumulated net assets of$5.9 million by 2005 and had $2 million in income that year(Guidestar, 2007).

Although A4M is not recognized by the American Medical Association or the American Board of Medical Specialties, it has established certification programs under its auspices for physicians, chiropractors, dentists, naturopaths, podiatrists, pharmacists, registered nurses, nurse practitioners, physician assistants, nutritionists, dieticians, sports trainers and fitness consultants, and "medical spa facilities"(A4M, 2008). The organization puts on three annual anti-aging conferences in the United States, as well as conferences in nations throughout the world. cistanche tubulosa reviews Its first "World Congress" of anti-aging medicine outside the United States was held in Paris in 2003 in partnership with French, German, Japanese, European, and Asian-Pacific anti-aging societies and organizations(Robert,2004).In fact, in 2008 alone, the A4M scheduled 12 conferences in nine different countries. A4M's conferences have been so financially successful that in 2007 the organization sold an 80% stake in its conference business for $49 million to a London-based international media firm, Tarsus Group (Wilson, 2007. A4M states that it does not sell or endorse any commercial product or promote or endorse any specific treatment. But it actively solicits and displays numerous advertisements on its website for products and services (such as cosmetics, alternative medicines, and therapies), anti-aging clinics, pharmacies, and anti-aging physicians and practitioners, most of them listing certification by A4M.

What A4M terms"the traditional, antiquated gerontological establishment"(Arumainathan, 2001)may disagree with many of the organization's messages and the measures it promotes. Yet, most elements of A4M's broadly-stated goals are basically the same as those of many biomedical researchers and practitioners in gerontology and geriatrics, as we will demonstrate later in this article. The stated mission of A4M is:

the advancement of technology to detect, prevent, and treat aging-related disease and to promote research into methods to retard and optimize the human aging process....A4M believes that the disabilities associated with normal aging are caused by physiological dysfunction which in many cases are ameliorable |sic to medical treatment, such that the human life span can be increased, and the quality of one's life improved as one grows chronologically older(A4M, 2005)

This A4M mission is, in fact, very similar to a portion of the NSA's mission. For instance, an important research goal in an official NIA strategic plan is "Unlocking the Secrets of Aging, Health, and Longevity"; the plan declares that "The ultimate goal of this effort is to develop interventions to reduce or delay age-related degenerative processes in humans"(National Institute on Aging, 2001).

This article is extracted from J Aging Stud. 2008 December 1; 22(4): 295–303.