A breakthrough in Alzheimer’s disease: the promising potential of klotho for brain health, cognitive decline, and as a therapeutic tool for Alzheimer's disease | Dena Dubal, M.D., Ph.D.

Peter Attia

May 27, 2024

Episode description

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Dena Dubal is a physician-scientist and professor of neurology at UCSF whose work focuses on mechanisms of longevity and brain resilience. In this episode, Dena delves into the intricacies of the longevity factor klotho: its formation and distribution in the body, the factors such as stress and exercise that impact its levels, and its profound impact on cognitive function and overall brain health. Dena shares insights from exciting research in animal models showing the potential of klotho in treating neurodegenerative diseases as well as its broader implications for organ health and disease prevention. She concludes with an optimistic outlook for future research in humans and the potential of klotho for the prevention and treatment of Alzheimer’s disease.

Disclosure: Peter is an investor in Jocasta Neuroscience, a company working to develop klotho as a therapy for people with Alzheimer’s disease.

We discuss:

  • Dena’s fascination with aging and how she came to study klotho [3:30];

  • Biological properties of klotho: production, regulation, decline with age, and factors influencing its levels [11:45];

  • Potential benefits of klotho on brain health [22:00];

  • The relationship between soluble klotho protein, platelet factors, and cognitive enhancement [33:45];

  • The role of platelet factor 4 (PF4) and it’s interaction with GluN2B in mediating cognitive enhancement [46:45];

  • Benefits of klotho observed in a mouse model of Parkinson’s disease [55:45];

  • Benefits of klotho observed in a mouse model of Alzheimer’s disease [1:03:00];

  • Promising results of klotho in primate models, and the importance of finding an appropriate therapeutic dose before moving to human trials [1:08:00];

  • Speculating why a single klotho injection has such long-lasting effects [1:25:30];

  • Potential cognitive benefits of klotho in humans, the impact of the KL-VS genetic variant on klotho levels, and the need for human trials to confirm these effects [1:27:45];

  • The interaction between the KL-VS genetic variant and APOE4 and how it impacts risk of Alzheimer’s disease [1:34:45];

  • The significance of klotho levels: studies linking lower levels to increased mortality and the broader i

Episode description

View the Show Notes Page for This Episode

Become a Member to Receive Exclusive Content

Sign Up to Receive Peter’s Weekly Newsletter

Dena Dubal is a physician-scientist and professor of neurology at UCSF whose work focuses on mechanisms of longevity and brain resilience. In this episode, Dena delves into the intricacies of the longevity factor klotho: its formation and distribution in the body, the factors such as stress and exercise that impact its levels, and its profound impact on cognitive function and overall brain health. Dena shares insights from exciting research in animal models showing the potential of klotho in treating neurodegenerative diseases as well as its broader implications for organ health and disease prevention. She concludes with an optimistic outlook for future research in humans and the potential of klotho for the prevention and treatment of Alzheimer’s disease.

Disclosure: Peter is an investor in Jocasta Neuroscience, a company working to develop klotho as a therapy for people with Alzheimer’s disease.

We discuss:

  • Dena’s fascination with aging and how she came to study klotho [3:30];

  • Biological properties of klotho: production, regulation, decline with age, and factors influencing its levels [11:45];

  • Potential benefits of klotho on brain health [22:00];

  • The relationship between soluble klotho protein, platelet factors, and cognitive enhancement [33:45];

  • The role of platelet factor 4 (PF4) and it’s interaction with GluN2B in mediating cognitive enhancement [46:45];

  • Benefits of klotho observed in a mouse model of Parkinson’s disease [55:45];

  • Benefits of klotho observed in a mouse model of Alzheimer’s disease [1:03:00];

  • Promising results of klotho in primate models, and the importance of finding an appropriate therapeutic dose before moving to human trials [1:08:00];

  • Speculating why a single klotho injection has such long-lasting effects [1:25:30];

  • Potential cognitive benefits of klotho in humans, the impact of the KL-VS genetic variant on klotho levels, and the need for human trials to confirm these effects [1:27:45];

  • The interaction between the KL-VS genetic variant and APOE4 and how it impacts risk of Alzheimer’s disease [1:34:45];

  • The significance of klotho levels: studies linking lower levels to increased mortality and the broader i

Mindsip insights from this episode:

Activate clotho to enhance brain function without crossing barriers

Clotho enhances brain function without crossing the blood-brain barrier, instead activating messengers like Platelet Factor 4 (PF4) in the blood, which then travel to the brain.

Monitor Clotho levels to reduce mortality risk

A large study of over 10,000 people found that having Clotho levels just below the average was associated with a 30% higher all-cause mortality risk over five years.

Leverage KL-VS gene variant to mitigate Alzheimer's risk

A large human study found that carrying a specific genetic variant of Clotho (KL-VS) effectively negated the increased risk of Alzheimer's disease associated with the APOE4 gene.

Reduce chronic stress to boost longevity protein levels

Studies on mothers under high chronic stress show they have significantly lower levels of the longevity protein Clotho, linking psychological stress to a molecular marker of aging.

Boost Clotho levels through robust exercise

One of the most robust interventions to increase Clotho is exercise, which after 12 weeks can raise levels by about 30%, and may even double them acutely after a single workout.

Boost cognition with a single low-dose Clotho injection

A single, low-dose injection of Clotho given to aging monkeys enhanced their cognitive function within four hours, with the effect lasting for at least three weeks.

Identify optimal Clotho dosage for cognitive enhancement

In primate studies, a low, physiologic dose of Clotho enhanced cognition, but surprisingly, much higher doses had no beneficial effect, suggesting a specific therapeutic window.

Utilize Clotho to protect cognition in Alzheimer's models

In mice genetically prone to Alzheimer's, high Clotho levels preserved normal cognition despite their brains being riddled with amyloid and tau, acting like a helmet for neurons.

Leverage Clotho, young blood, and exercise to boost brain health

Three independent lines of research on Clotho, young blood, and exercise all converged on the same discovery: they enhance brain health by releasing Platelet Factor 4 (PF4).

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