Longevity drugs, aging biomarkers, and updated findings from the Interventions Testing Program (ITP) | Rich Miller, M.D., Ph.D.

**Peter Attia** (0:11)
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My guest this week is Dr. Rich Miller. Rich was a previous guest from all the way back in February of 2021 And that was such a remarkable episode that I knew at that time we were gonna have to do another one. And I can tell you now, we're gonna do a part three at some point as well. Rich is a professor of pathology at the University of Michigan, where he is also the director of the university's Paul F. Glenn Center for Biology of Aging Research. He is also one of the principal architects of the Interventions Testing Program, or ITP, created to evaluate potential life-extending interventions in mice.
Rich received a bachelor's degree at Haverford College and then went on to earn an MD and PhD at Yale, followed by postdoctoral training at Harvard and Memorial Sloan Kettering. Now, you have no doubt heard me talk about the ITP, not only in the first episode with Rich, but it seems to come up all the time when we talk about Giroprotective molecules. Again, what does Giroprotective mean? Giroprotective means molecules that extend lifespan, but not through targeting a very specific disease process, but rather by targeting the hallmarks of aging. So in this episode, we talk about the ITP, not in as much detail as we did in the first episode, because if you really wanna understand that, you can go back and listen to it. But for those who don't remember or haven't listened to the first episode, we certainly cover enough here so you can understand it, what its purpose is, how its mouse model is significantly different and demonstrably better than all the other mouse models used out there, how the studies are conducted, what the metrics of interest are, how drugs are dosed, delivered and more.
We also talk about how the ITP looks at healthspan, not only lifespan.
We cover notable successes from the ITP, including rapamycin, 17-alpha-estradiol, acarbose, kanagaflozin and a few others of late.
We talk about some of the most recent successes, including one that absolutely blew my mind, meclazine, which is an over-the-counter drug used to treat seasickness. Additionally, we do a deep dive into the idea of biomarkers of aging and what we know about various aging rate indicators. I actually found this to be the most important and interesting part of the discussion for me personally, because I'm quite steeped already in some of the drug stuff. We end the discussion speaking about some of the most notable failures, including nicotinamide riboside, metformin, and resveratrol. So without further delay, please enjoy my conversation with Dr. Rich Miller. Hey, Rich, great to sit down with you again. I don't remember exactly when we did this before, but I know I enjoyed it thoroughly. And it's actually one of the few podcasts I've gone back and listened to. I don't often, for obvious reasons, go back and listen to podcasts that I've recorded, because I already heard them. But there was so much in that one that I've at times gone back and listened to parts of it. So excited to sit down and chat with you again. But assuming that maybe people who listened to us in the past, or maybe even aren't familiar with the ITP, I think it's always great to start with sort of an overview of what the Interventions Testing Program is. I certainly refer to it a lot in both podcasts and even in things I write.

**Richard Miller** (4:21)
Sure, it was developed by the National Aging Institute under the leadership of Huber Warner about 20 years ago. We are just now finishing our 20th year. We've sent in applications, so if the peer reviewers like it, we may get five more years of funding. It represents work being done by three different research laboratories, mine at the University of Michigan, Randy Strong's at the University of Texas Health Science Center at San Antonio, and a program at the Jackson Labs where David Harrison was in charge. David will be stepping down next April and he will be replaced by Ron Kostanja as the first new appointment for the ITP leadership at the Jackson Labs. What we try to do is quite simple. We try to find drugs that will slow aging and extend mouse lifespan.