The biology of aging: looking to defuse the genetic time bomb

Each cell is functionally restricted by differentiation, which determines its complement of active and inactive genes. Various diseases then become manifest in each cell, depending on these specific gene combinations. Neoplasia, for example, is due to a multistep series of genetic mutations. It is common in continuous replicators such as bronchial epithelium, colon, and marrow but rare in intermittent replicators such as endothelial and smooth muscle cells. In contrast, these latter cell types are centrally involved in degenerative phenomena such as atherosclerosis. However, in both continuous and intermittent replicators, reduction of gratuitous cell turnover will be of great benefit. The nonreplicating adult neuron almost never undergoes tumorigenesis compared with glial cells but gives rise to a variety of age-related degenerative diseases such as Alzheimer's or Parkinson's disease. In the nonreplicating neuron, therefore, it is imperative that we promote strategies to preserve cell viability by minimizing oxidative damage. Natural antioxidants such as vitamin C and E and beta carotene, as well as an optimal caloric and protein intake, should be cornerstones of treatment and prevention for the aging patient. A place for pharmacologic intervention is also likely soon. Current research should soon identify the precise mechanisms responsible for programmed cellular senescence and oxidative cellular damage so as to illuminate additional means of rational treatment, and perhaps more importantly, prevention.