Joan Mannick, M.D. & Nir Barzilai, M.D.: Rapamycin and metformin—longevity, immune enhancement, and COVID-19

**Peter Attia** (0:11)
Hey everyone, welcome to the Drive podcast. I'm your host, Peter Attia. This podcast, my website, and my weekly newsletter all focus on the goal of translating the science of longevity into something accessible for everyone. Our goal is to provide the best content in health and wellness, full stop, and we've assembled a great team of analysts to make this happen. If you enjoy this podcast, we've created a membership program that brings you far more in-depth content if you want to take your knowledge of the space to the next level. At the end of this episode, I'll explain what those benefits are, or if you want to learn more now, head over to peterattiamd.com forward slash subscribe.
Now, without further delay, here's today's episode.
My guests this week are doctors Joan Mannick and Nir Barzilai. Joan is the co-founder and chief medical officer of Restore Bio, and that's a play on the word TOR, T-O-R, Targetive Rapamycin.
Before joining Restore Bio, she was the executive director in the New Indications Discovery Unit of Novartis, which we discuss early on in this podcast. She's an MD by training, or receiving her MD from Harvard Medical School, completing her residency in internal medicine and infectious diseases at the Brigham and Women's Hospital. Nir Barzilai is making his second appearance on the podcast, so that name may sound familiar to a number of you. He is the director of the Institute for Aging Research at Albert Einstein College of Medicine in New York. He has spearheaded one of the most impressive longevity gene projects, which basically looked at more than 500 healthy people aged 95 to north of 110, along with following their offspring, the centenarian studies and the centenarian offspring study. Nir also has a brand new book that just came out, oh, at the time of this recording, probably a week before, it's called Age Later, Healthspan, Lifespan, and the New Science of Longevity. We get into a couple of funny stories about that. Okay, this episode is one I've been looking forward to for a very long time, because we discuss the two drugs I get asked about more than all other drugs combined, namely metformin and rapamycin, or the category of analogs to rapamycin known as rapologs.
Now, the reason we decided to do this as a podcast with both Nir and Joan as guests was because of course there were many overlaps between rapamycin and metformin, not just in terms of longevity, but also of recent note, their potential for reducing the risk of SARS-CoV-2 infection or other infections, and of course COVID-19 morbidity. And we speculate on those things to a great deal. So basically the way this podcast goes is I wanna make sure everybody has the appropriate background information on metformin and rapamycin. So coming into this episode, you don't have to know anything about those two drugs. If you do, I think you'll follow it a little bit better. Because these are technical. And of course, the show notes will have all of the pictures and images and things that make it a little easier to follow this. But you can come into this not knowing a lot about them, though we have had many previous podcasts that discuss these things. And then we get into kind of the clinical indications that focus specifically around this issue of how would these drugs factor into the immune response, resilience and the amelioration of a hyperactive immune response in the presence of these diseases.
So without further delay, please enjoy my conversation today with Joan and Nir.
Joan, Nir, this is a first for me, and it is also very exciting. It's a first and it's the first time I have interviewed two people virtually simultaneously. It is also incredibly exciting because I am just such a fan of your work, Joan, and obviously yours, Nir. Nir, you've been a guest on this podcast before. And Joan, I have been eagerly looking forward to having you on for probably since the moment the podcast released. So I'm grateful to both of you for making the time. And then of course, to do this together is something that I've been a little nervous about for the past month because I've been thinking, how do I integrate the stories of rapamycin and metformin? How do I integrate the stories of these two incredible compounds that in their most native form came to us naturally? And then of course, we now have evolved elaborate synthetic versions of these things that have these sort of magical properties. So I have an idea for how these two can overlap, but before we do that, I think we should assume that maybe the listener is not familiar with you, Joan, and even you, Nir, though you've been on before. And maybe just help us understand a little bit about what you do, Joan. I know you're a physician by training, and you're also one of the world's experts on My Favorite Molecule. So help us understand how you got to be doing what you're doing.