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The Biggest Breakthroughs in Science Happening Right Now

It’s our breakthroughs of the year episode, covering 2023’s biggest achievements in science and tech, including space technology, life extension, fusion, gene editing, vaccines, and, of course, GLP-1s


If you’re looking for a hopeful and mind-expanding conversation to round out the year, this one is for you.

It’s our breakthroughs of the year episode, covering 2023’s biggest achievements in science and tech, including space technology, life extension, fusion, gene editing, vaccines, and, of course, GLP-1s.

It has become a Plain English tradition—after weeks of stories that often take us into sad areas, like anxiety, depression, and war—to close the year with a nerdy conversation about the most important developments at the frontier of science and technology. Today’s frontier guide is Dr. Eric Topol. He is the founder and director of the Scripps Research Translational Institute and a bestselling author on the future of medicine.

If you have questions, observations, or ideas for future episodes, email us at

In the following excerpt, Derek and Eric Topol discuss a new breakthrough that can reveal the age of individual organs in the body.

Derek Thompson: So my goal for our next 40-ish minutes together is to give people an appropriately optimistic safari guide to the most important, the most interesting, the most wondrous breakthroughs happening right now in biotech. And I should begin by saying I am so very far from being an expert in these subjects, but for better or worse, this is the part of the world, this is the genre of news that I’ve become the most interested in in the last two years, probably since my conversations with you about the mRNA vaccine breakthroughs.

So I gave you a list of today’s topics just so you had a rough road map of the journey, but before we set off, I want you to tell me, of all the breakthroughs, the science reports, the AI research, the published papers, the cover stories in Science and Cell and Nature, I want to know what is Dr. Topol’s nomination as the most important or interesting breakthrough in science in the last year?

Eric Topol: Well, there are many ones that of course you can imagine are worthy to get special recognition, but the one that I found the most intriguing of all was the work from Stanford, Tony Wyss-Coray and his colleagues, on internal clocks. It was the cover of Nature just a couple of weeks ago, and it was the first time to be able to tell the age of 11 different organs of the body by different plasma proteins, such that this will really advance the science of aging and the ability to influence aging at an organ-specific level. And 20 percent of us have advanced, accelerated aging of one organ.

This was a breakthrough. This had not really been shown before, and it took really a monstrous effort of looking at thousands and thousands of proteins and figuring out if they were specific to an organ and then showing that these proteins were linked to outcomes like heart failure or Alzheimer’s or all the other organ-specific-type adverse things. So it was a big contribution among many that I highly regard.

Thompson: I had no idea you were going to say this. I know nothing about internal clocks, but I’ll tell you the first question that occurred to my mind when you said internal clocks and you kept talking was it’s interesting to think that when someone asks me, “How old are you?” I have one number I give them, 37. But I have been alive for 37 years. That is my external clock, so to speak. My liver, I drink maybe a little bit too much whiskey and scotch than I should. Maybe my liver is 45, maybe my heart is 23, maybe my brain is 34. Maybe my pancreas is 55. Tell me how in some, hopefully not science-fiction, but science-fact future, someone listening to this podcast could imagine getting a birth certificate for all of their organs. What kind of a test would it take to learn, “Well, you are a 37-year-old man, but your heart is this age, your pancreas is this age, and your liver is this age”? How would someone begin to get that information in the future?

Topol: Yeah. Well, it’s available today for your total body, the so-called epigenetic clock, Steve Horvath, where it looks at methylation markers, and it can tell you very accurately what’s your biologic age. So it could say, “Well, Derek, you’re 37, but your biological age is 42.” But that’s a total body, and that’s the best that we have right now for a clock.

Now, to be able to drill down into 11 most important organs is a new thing. And so this is going to very likely become available widely in a way to do checkups on people much better than we can today. We don’t want to have to always resort to MRI scans or CT scans or that sort of thing. And also, doing these liquid biopsies that are starting to get some traction in cancer, it isn’t clear that they’re going to be useful to prevent not only cancer, but other conditions as well. So that’s why this was a finding that really stands out. It’s not yet ready for daily, to give you a readout, like you said, is that whiskey hurting you, hurting your liver to some degree, but it will. This is where we’re headed.

Thompson: It’s really cool. One more follow-up question on this before we get into the meat of today’s episode. Do we know if these full-body biological clock tests are truly predictive? By which I mean, if there’s a 60-year-old who’s told that their body is the biological age of a 30-year-old and there’s a 30-year-old who’s told they have a biological age of 60, can we really expect that 60-year-old to live 30 years longer than the 30-year-old? I don’t know that my full math is right there, but is it predictive on that kind of life-span level?

Topol: Yeah. Actually, it turns out they’re pretty darn accurate, looked at in just tens of thousands, if not hundreds of thousands of people. The tricky part is, I kind of look at it, if you want to give it a very simplistic, reductionist description, it’s like the rusting of your body. Some people don’t rust very much and others do, but it’s very generalized and rudimentary. It doesn’t tell you where the problems lie. But the reason why this is a big deal also is because if we’re ever going to start to find ways to promote aging, the reduction of aging, decelerating our aging process, it’s important to have these kind of metrics because it’s unlikely that any particular intervention is going to have a quick whole-body effect, but it might on a particular organ. So that’s why this is especially promising. It’s a path towards a regulatory, towards approval someday of agents that promote healthy aging.

This excerpt was edited for clarity. Listen to the rest of the episode here and follow the Plain English feed on Spotify.

Host: Derek Thompson
Guest: Eric Topol
Producer: Devon Baroldi

Subscribe: Spotify