Live Long and Prosper

Ann Arbor’s Forever Labs builds a thriving business banking stem cells on the prospect of future cures and life extension // Illustrations by Blair Kelly
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Live Long and ProsperForever Labs, a self-described longevity company based in Ann Arbor, is nothing if not ambitious. “We’re seriously trying to extend human lifespan,” says company CEO Steven Clausnitzer. In the meantime, for a price, the company’s credentialed surgeons extract cells, including stem cells, from the bone marrow or fat tissue of healthy clients. Then, they freeze the cells and store them indefinitely at an Indiana biobank for later use if needed.

“How old are you?” asks Clausnitzer to open a promotional video on the homepage of Forever Labs’ website. “Your stem cells don’t have to get any older. You can preserve them in their youthful state, and access them later in life to help you.”

Clausnitzer, 41, in jeans and a sweatshirt, greets me in his downtown Ann Arbor office beneath a large poster that reads “Make Something People Want.” On his desk is Darren Hardy’s book, The Compound Effect: Jumpstart Your Income, Your Life, Your Success. Company co-founder Mark Katakowski, wearing jeans and knit hoodie, joins us. Apart from their tech industry-inspired casual work attire, the two co-founders are vastly different. Clausnitzer’s background is in sales and marketing, including several years at American Express, while Katakowski, 43, is very much the scientist. He worked for more than a dozen years in Detroit’s Henry Ford Hospital laboratory of physicist and neuroscientist Michael Chopp, studying the very stem cells his company now banks for its customers.

Chopp was Katakowski’s physics teacher when he was a student at Oakland University. “Very creative, and very careful,” is how Chopp describes Katakowski, a Rochester Hills native. “Great lab skills.” Chopp’s lab worked on mesenchymal stem cells, known as MSCs, which are very different from the ethically controversial embryonic stem cells, and from blood stem cells, which are used in bone marrow transplants. MSCs are relatively abundant but do not easily convert, or differentiate, into every tissue type, as do embryonic stem cells. MSCs commonly tend to form bone, fat, and connective tissue like cartilage. Chopp, though, has used MSCs to treat rodents with stroke and traumatic brain injury, with encouraging results. In 2012, Katakowski submitted a grant application to the National Institutes of Health, proposing to transplant young MSCs into older mice to extend their lifespan. He didn’t get the grant, but in the process, Katakowski learned of a research group based in Texas that had already done a similar mouse experiment — to treat osteoporosis — and ended up with longer-lived mice.

Above: Forever Labs co-founders Mark Katakowski (left) and Steven Clausnitzer bank on the day young stem cells have the ability to help improve human health. // Photograph by Matt Lavere

That was the antecedent that would eventually lead Katakowski and Clausnitzer to conceive Forever Labs. They met 13 years ago at Clausnitzer’s wedding. (Katakowski was a friend of the bride.) The two men became close friends, and nine years ago launched a website called hubski.com, a social media aggregator about science and technology. A few years later, during a phone call, Clausnitzer and Katakowski began having a discussion about banking their young stem cells for the future. “I’m bumming out because I want to store my own stem cells, and I can’t find anyone to do it for me,” Clausnitzer recalls.

A business plan quickly developed after the two men met with Brighton orthopedic surgeon Laith Farjo. Like many “orthopods,” Farjo often extracts bone marrow from the pelvis of patients and injects stem cells into the site of injury to promote healing. The FDA allows the practice but has not weighed in on how well it works. Realizing that surgeons were already routinely extracting patient bone marrow, Clausnitzer and Katakowski considered banking a logical extension, and Forever Labs launched in November 2015.

The company grew quickly. Today, it has now enlisted at least 25 doctors in nine states to collect stem cells from clients. Individuals banking bone marrow either pay $7,000 for lifetime storage, or $2,500 for extraction and freezing plus $250 a year to bank the cells for possible use later in life. The company even recently started banking MSCs from fat cells, obtained by plastic surgeons during liposuction. Forever Labs has also raised roughly $2 million from venture capitalists and other investors.

The company’s ultimate goal, though, is to delay aging or even reverse it with young MSCs. “We’re freezing youth so we have a leg up,” Katakowski told an audience at Google in 2017. “Worst case scenario, you’ve got young cells to treat age-related disease.” But someday, he imagined, taking a cue from the Texas mouse researchers, “we can take our young bone marrow stem cells and we can just give them IV [intravenously], like they did to the mice, to ourselves.” That injection of young stem cells, Katakowski says, could boost general health — what he calls “health maintenance.” He also raised the possibility of an increase in human lifespan. “If we could do maintenance on a cellular level, could we prevent the aging process in humans?”

Forever Labs intends to find out. The company is now injecting stem cells from young lab mice into genetically matched older mice, a procedure called “heterochronic transplantation,” on the theory that young MSCs can slow or reverse aging in these mice. (Chopp’s lab at Henry Ford Hospital is conducting these experiments, which are far more rigorous than the Texas research, under contract with Forever Labs.) Once proven, Clausnitzer says, “we want to bring forward heterochronic transplantation in humans.”

“If we could do maintenance on a cellular level, could we prevent the aging process in humans?”
— Mark Katakowski, Forever Labs Co-Founder

Altering the aging process is not as outlandish as it might sound. Researchers can now lengthen the normal lifespan of mammals, mainly rodents, using a variety of methods. These include manipulating genes and giving certain drugs, as well as drastically restricting calorie intake. Much has been learned about the biological pathways that influence aging, and well-funded companies like Longeveron, Unity Biotechnology, and Calico (which is backed by Google) are working on anti-aging interventions.

However, there’s little experimental evidence supporting any anti-aging effects using these MSCs. Katakowski cites the Texas paper and another from a Russian group that injected whole bone marrow into mice, which lived longer than control mice.

University of Michigan biogerontologist Richard Miller, one of the country’s top aging researchers, however, is dismissive. “The notion that sticking bone marrow into old folks will make them young again is a wish-fulfillment, a grotesque over-reading of some sparse sketchy current experiments, promoted to fact because it looks good on a website or Powerpoint slide,” he says in an email.

Katakowski, however, is careful not to claim rejuvenation effects for young human MSCs. “We’re not sure yet,” he says. “The health maintenance aspect of this is completely unwritten.” Katakowski says he’ll publish the results of the mouse longevity trial after all the mice have died, which should take another year or so.

Forever Labs’ main lure to clients right now is as a safe keeper of young cells for future stem cell transplants to treat diseases, if needed. “A lot of our clients are interested in banking their stem cells for the treatment of age-related disease,” for example heart failure, Katakowski says. “It’s very much like insurance.” That’s how Denise Edmund looks at it. The 39-year-old Brighton resident banked her bone marrow through Forever Labs’ installment plan last May, after helping care for a mother living with Alzheimer’s disease and a father battling cancer. “Having both parents ill at the same time got me thinking about my future,” says Edmund, who coordinates the University of Michigan’s robotics graduate program. “I want to have a fighting chance and have a tool that will hopefully help if I should someday become ill.”

While bone marrow and cord blood transplants are routinely used for blood disorders, there are no FDA-approved MSC therapies, despite scores of clinical trials. Many trials are now underway for medical emergencies such as stroke and heart attack, Katakowski says. But unqualified success isn’t likely anytime soon in the brain and the heart, given the obstacles, according to Mai Lam, a Wayne State University stem cell researcher. That’s mainly, she explains, because MSCs, once implanted, don’t differentiate into the necessary cell types that can help, and few end up lodging, or engrafting, in place. So they quickly disappear. “That these cells could be used for a multitude of diseases and applications, that’s kind of a stretch, especially given the data,” she says. Lam does think there is some potential for treating bone, blood, and connective tissue disorders, because those cell types are more closely related to bone marrow MSCs.

Katakowski argues MSCs will be used much more widely. He cites a recent scientific paper, from a Chinese group, assessing 23 MSC human transplantation trials for stroke, all conducted in Asian countries. The paper found the therapies overall improved brain and motor function as well as quality of life for MSC transplant patients in comparison to controls.

But even if MSC transplantation some day proves to be effective, other stem cell types could end up being used instead, says Shane Shapiro, medical director of the Regenerative Medicine Therapeutics Program at Mayo Clinic’s Jacksonville, Florida campus. For example, it is now possible to take an adult human skin cell, reprogram it into a stem cell, and then make it into virtually any cell type. These “induced pluripotent” stem cells, which earned their discoverers a Nobel Prize in 2012, are now in human trials. They have major obstacles to overcome, but “could very much be the wave of the future,” Shapiro says. “We wouldn’t necessarily need to have a large supply of our own banked cells to turn into medicines.” It is also possible that standardized MSC cell lines will be used. Many clinical trials are employing such cell lines instead of a patient’s own cells. Finally, drugs that mimic stem cell effects could win out.

Some of Shapiro’s patients in Florida seek his professional advice about banking their stem cells with Forever Labs. He tells them, “The future is unknown, and whether or not we’ll ever be able to use those cells is entirely unclear to me.”

Katakowski acknowledges the alternative stem cell futures, but still thinks individual MSCs will have more of an impact, because the body’s immune system is less likely to reject them. “We think banking your own is important,” he says. “It’s part of the toolkit you want to have.”

“Why wait until you get sick, when you could potentially take your cells, reintroduce them while you’re still healthy, to mitigate things like cardiovascular disease, stroke, Alzheimer’s?”
— Steven Clausnitzer, Forever Labs CEO

Wayne State’s Lam was asked if she would bank her mesenchymal stem cells with Forever Labs. “Being a scientist in the stem cell field, I would not,” she says. “Yes, if there was a therapy available for stem cells, or a high potential for it, I would do it now versus later, that is true. But because I don’t think that potential’s there, I wouldn’t do it, period — now or later.”

Even if therapies arrive, it’s not even clear that young stem cells would be entirely necessary. Older ones might do just fine. Although MSCs do decline in function and number as a person ages. “We’re all going to get older, and we’re going to have less MSCs, and the ones that remain are going to become more damaged than the ones you have in your body right now,” Clausnitzer says. That’s proven, Lam adds. “Their initial claim that young stem cells are better, that is true,” she says. “Your stem cells age and your stem cell compartment decreases as you age.”

But Shapiro says that may not necessarily make a practical difference. “Everybody in this space will grab onto what I call tokens of legitimacy,” he says. “Which is, you take something that does have scientific validity, and turn it into something much bigger. And so, yes, stem cells age … yet that doesn’t mean when we start using cells as treatment that we know definitively that the age of that cell matters.” For example, Shapiro says he once ran a clinical trial using an MSC treatment called bone marrow aspirate concentrate (BMAC) to treat osteoarthritis of the knee.

“We looked to see if the age of the patients mattered in terms of their response to treatment, and it did not,” Shapiro says. “We had many patients in their late 60s and early 70s that we treated with BMAC and they had a fantastic response.”

Katakowski, for his part, cites transplant trials in mice and rats — the latter which share more similarities to humans — showing young human MSCs may be more appropriate for wound healing and stroke recovery, respectively. He also notes another human trial in which older patients suffering from heart failure tended to do worse.

If there are limits to what MSCs will do, you wouldn’t know it from the Forever Labs website. “Why wait until you get sick, when you could potentially take your cells, reintroduce them while you’re still healthy, to mitigate things like cardiovascular disease, stroke, Alzheimer’s?” asks Clausnitzer in the company’s promotional video. More and more people are buying in. “Just in the last couple of months we’ve done hundreds, and next year it’ll be thousands,” Clausnitzer says.

Forever Labs is clearly giving people what they want, if not necessarily what they’ll need.

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