In 2009, the Nobel Prize in Physiology or Medicine was awarded to three scientists for the discover of how chromosomes are protected by telomeres and the enzyme telomerase. Today, telomeres, stretches of DNA at the ends of chromosomes, are used as part of a new, commercially available genetic test that helps individuals better understand how well they are aging. The test, TeloYears, was developed by Telomere Diagnostics (TDx), a molecular testing company begun in 2010. One of TDx’s founders, Dr. Elizabeth Blackburn, was one of the three Nobel Prize recipients and a trailblazer in molecular biology.
TeloYears is easy to use, requiring a blood sample to be sent to TDx’s laboratory where telomeres in white blood cells are evaluated and summarized in a report sent back to the test-taker. Unlike other genetic tests, TeloYears is based on a biomarker that changes over time, allowing an individual to make behavior and lifestyle changes based on their results. Additional services and coaches to help test-takers interpret their results and develop a plan of action are part of TDx’s offering. To learn more about the TeloYears technology and services, Medgadget had a chance to hear from TDx’s CEO, Jason Shelton.
Medgadget, Mike Batista: What are telomeres and how are they associated with aging?
Jason Shelton: Telomeres are the changing, protective caps on the ends of our DNA strands that tend to shorten and fray with age, and grow or shrink with positive or negative lifestyle factors. Imagine our DNA as a long spiral ladder with millions of rungs. Our telomeres are the last few thousand rungs on the ends of the ladder that keep it from “unzipping” as cells divide and thus protect our genes, which are made up of long stretches of rungs in the middle. Technically speaking, telomeres are repetitive stretches of the nucleotide base pair sequence TTAGGG at the ends of our chromosomes. When we are born, our telomeres are typically at their longest. However, throughout our lives the telomeres shorten. At every cell division, telomeres lose a bit of their DNA until, over time, the cell cannot replicate and becomes “senescent,” which is the cellular equivalent of aging. However, telomeres allow a real-time measurement that can be used to reinforce lifestyle changes that are associated with slowing and even reversing cellular aging. Telomere Diagnostics developed TeloYears, a simple DNA test that tracks cellular age based on telomere length. The test can be repeated over time to see how a patient’s lifestyle plans (e.g. diet, exercise and stress management) are working to improve functioning on a cellular level.
Medgadget: What led to the idea of developing a consumer product based on telomere length?
Shelton: An impressive range of studies in the published academic literature—undertaken by organizations ranging from the U.S. Department ofVeterans Affairs to the National Institutes of Health to NASA—have validated the measurement of telomere length as a gauge of a person’s cellular age. The 2009 Nobel Prize in Medicine, which was awarded for the discovery of how chromosomes are protected by telomeres and the enzyme telomerase, inspired a diagnostic test involving telomeres for the consumer market. The year after the Nobel was awarded, a molecular testing company, Telomere Diagnostics, was founded to harness the power of telomeres in an original way, and the recently launched TeloYears genetic test was the result.
Medgadget: How exactly does the TeloYears genetic test work from receipt of the kit to getting results?
Shelton: The TeloYears evaluation begins when a test-taker mails his or her blood sample (one drop of blood from a finger)—collected at home using a custom kit produced by the company—to Telomere Diagnostics’ CLIA-certified laboratory in Silicon Valley, California. There, the telomeres in the white blood cells are analyzed using a method that Telomere Diagnostics has published in a peer-reviewed journal, the only company to have done so. Specifically, the relative average telomere length in the white blood cells is measured using a proprietary technique called the quantitative polymerase chain reaction (PCR) assay, whose use has been spotlighted in academic literature. The evaluation conducted by the laboratory is summarized in a report mailed to the test-taker. There is also personalized support available from expert “TeloCoaches” for those who wish to understand better what their results mean for them and how to take action to improve by working with TeloCoaches to customize a Lifestyle Action Plan.
Medgadget: What is contained in the laboratory report summary that is mailed to the test-taker?
Shelton: The TeloYears test report provides the test-taker with his or her average telomere length expressed both numerically (as a T/S ratio, which is a unit measure commonly used in published literature) and also as an age and gender adjusted percentile score based on a comparison to a reference range that is statistically representative of the US population. The report also interprets that result in terms of providing the test-taker’s age in TeloYears, which is calculated as the actual age of a typical man or woman whose telomere length is similar to theirs. Additionally, if they have taken the test more than once, the report also shows how their results have changed over time. Furthermore, the TeloYears Blueprint for Aging Well, which is sent as part of the TeloYears test results, compiles and distills the decades of scientific evidence on the link between telomere length and aging into one simple, tabulated, and value-added resource for those who feel inspired to take action and get the most out of their results. This includes a detailed self-assessment to help identify areas for lifestyle improvement.
Medgadget: What options are available to test-takers who discover that their cellular age is much older than their actual age, as indicated by shorter telomeres?
Shelton: There are safeguards in place to help those who would like to better understand their results or may be surprised by them. There is personalized support available through a service called TeloCoach, which provides the test-taker with one-on-one advice from a certified TeloCoach who will help them better understand what their results really mean and what to do with them by providing a personalized Lifestyle Action Plan based on telomere science, their results, and lifestyle habits. We also facilitate discussions with a doctor or our Medical Director for those who wish to and/or if they have an unusual or extreme result.
It’s somewhat analogous to having your cholesterol checked and finding out it’s too high and then taking steps to improve your lifestyle. Likewise, it’s important to understand that telomere length can change. The rate of change of a person’s telomere length is very individual and can be affected, both positively and negatively, by many contributing factors including genetics, lifestyle, stress, and environment. In fact, the rate of change is not constant even within the same person’s lifetime. A test-taker may be able to slow the rate at which their telomeres shorten with lifestyle interventions. Telomeres can shorten more rapidly during periods of stress such as serious illness or infection. Likewise, during periods of good health, the telomeric rate of shortening can slow significantly. Finally, proper diet, exercise. and stress management have been shown to even increase telomere length. We recommend that a test-taker consult their doctor before engaging in any diet, exercise, or lifestyle modification program.
Medgadget: How users have responded to and taken advantage of the insights provided by the results of the TeloYears test?
Shelton: For more than two decades, telomere length has been well established in the clinical literature as an important biomarker of overall health. Only now is it being made broadly available to those who take a preventive approach to their health by tracking their health and fitness. But unlike step and trackers, telomere length is more personal, because it’s not just what a person does, it’s who they are at the level of their own DNA. And this part of their DNA can change. Therefore, we are committed to helping people learn about their telomere length and the body of knowledge around telomere biology in general. Through this important and integrative factor of overall health, we wish to help people find the inspiration to make healthier lifestyle choices through the personalized information about their own DNA. But if you don’t measure it, you can’t manage it—and we’re making it available at teloyears.com.
In recent years, the TeloYears technology has been spotlighted in various media reports highlighting test-takers. For example, a televised CBS News report profiled several TeloYears test-takers. Additional feedback from our customers is available on the reviews section of our website.
Medgadget: How does TeloYears compare to or differ from other genetic tests available to consumers such as 23andMe?
Shelton: TeloYears is much more actionable because your telomere length can change, whereas your ancestry or traits cannot. We have the world’s leading telomere measurement method and are the only company to publish the analytical validation of our method in peer review. The telomere is a unique part of human DNA that changes with lifestyle and also has more than 20,000 peer-reviewed papers supporting its links with a variety of age-related diseases and mortality in general. Because this part of the DNA can change, our test can be more actionable than other DNA tests that are more “one and done” measurements of a fixed aspect of your DNA. In this sense, it is akin to cholesterol testing, which is also actionable in that results can be influenced by positive lifestyle changes, in a way that other DNA tests are not. Telomere length measurement can be impactful in terms of wellness and disease prevention. Test-takers can use this biomarker as a motivational and monitoring tool to manage their health and make lifestyle changes to improve it.
Medgadget: Consumer-accessible genetic testing is a booming market. What challenges or gaps still exist when it comes to providing consumers with contextual, useful insight into their current or future health based on indicators in their genetic code?
Shelton: We want to increase awareness among consumers as well as among the medical community about the existence, importance, and potential benefits of telomere testing that can provide actionable information and inspiration as TeloYears does. There are perhaps more published data on telomere length and its usefulness, particularly in identifying risk of cardiovascular disease, the leading cause of death in the US, than some more commonly used biomarkers. Yet skeptics remain, which can create confusion in the market. Plus, until now, there has not been an accessible option for routine telomere measurement. Ideally, we would like physicians to encourage telomere length testing for their patients, just as they currently offer them the standard cholesterol test. And we would like patients to come to expect a test like TeloYears to be a standard part of their physical exam, knowing that they could use the information it provides to guide their lifestyle choices.
We also believe that continuing to integrate the types of information that can be delivered by these tests, such as telomere length, into personalized medicine will fundamentally change the way each patient is managed.
Medgadget: What can we expect next from TDx or the TeloYears product?
Shelton: We want to be the world’s leader in telomere length measurement. We are working on a more clinically focused intended use for identifying risk of coronary heart disease to be sold through physicians. In the not-too-distant future, our goal is that every time a doctor orders a cholesterol test for HDL and LDL, they will also order ATL (average telomere length) because telomere length has been shown to be associated with risk of heart disease independent of conventional vascular risk factors. Cardiovascular disease remains the leading cause of death in the US. We want to help fight that.