July 14th, 2026
It seems a little early in the development of partial epigenetic reprogramming as a class of therapy to be thinking about which of the other approaches to aging it can best be combined with. Nonetheless, a proposal for therapeutic plasma exchange and partial epigenetic programming to go well together is the topic of today's open access paper. The argument is that these two classes of approach are addressing different layers of the dysfunction of aging, and should this do little to interfere with each other's benefits.
Until such time as someone comes up with a safe, viable small molecule reprogramming therapy, it seems likely that reprogramming will remain quite limited in scope because of the delivery challenges inherent in gene therapy. Very few delivery systems have any potential to deliver a payload well to the whole body (or even most of the body), and none of the established options are capable of this outcome. Even when delivery is good for a given tissue, the many different cell types making up that tissue likely vary widely when it comes to optimal dose and duration of reprogramming agents. It is a challenge.
On the therapeutic plasma exchange front, even the most basic, initial questions around dosing and efficacy remain to be answered. Because there is little profit in this type of therapy, no-one with deep pockets has any incentive to run the extensive trials that would be needed to provide definitive answers. As things stand, it seems likely that forms of therapeutic plasma exchange and plasma dilution will spread throughout the medical tourism space, but no firm data will emerge in the near future. This the case for numerous therapies adopted by clinics outside the US and Europe, but which do not bring in enough revenue for someone to sponsor formal clinical trials.
