Immune Aging Biomarkers for Clinical Trials

Andrea Cipriano (Stanford) and Chiara Herzog (Cambridge Stem Cell Institute) join me to discuss "Immune aging biomarkers for clinical trials," published this July with co-author Jamie Justice, Executive Director of the $101M XPRIZE Healthspan competition. The problem the paper takes on: the immune system is central to how we age — infection risk, vaccine response, cancer surveillance, frailty — but there's no consensus on how to measure immune aging. Tools that work in a single research lab fall apart across multi-center trials. And you can't run a clinical trial, or award a prize, for improving something you can't measure the same way twice. Their answer is a five-criteria framework for evaluating whether an immune aging biomarker is actually fit for use, with XPRIZE Healthspan as the real-world test case. Immune function is one of the three domains that competition measures, which makes this paper the measurement backbone for a third of the largest prize in XPRIZE history. We get into which biomarkers hold up and which are overhyped — multidimensional immune metrics, inflammaging scores, functional assays, IMM-AGE, iAge — and where the human evidence on interventions actually stands versus where the enthusiasm is. But the theme that kept surfacing wasn't in my outline. Nearly every promising direction ran into the same need: more longitudinal data, across more people, measured consistently enough, to refine the predictors. That's a solvable problem, and it's worth asking who is positioned to solve it. CHAPTERS 0:00 Why the immune system sits at the center of aging 0:00 The measurement problem 0:00 The five criteria 0:00 Which biomarkers hold up, and which don't 0:00 Why a competition needs a common yardstick 0:00 Can we move the needle? Interventions and the evidence 0:00 Immune age, mortality, and what insurers would need 0:00 The gaps, and the next five years ── THE RESEARCH ── Cipriano A., Herzog C., Justice J. et al. "Immune aging biomarkers for clinical trials." Nature Medicine 32, 2368–2382 (2026). XPRIZE Healthspan: https://www.xprize.org/prizes/healthspan Here's the study by Raghav Sehgal et. al. proving the responsiveness of epigenetic predictors of biological age: Responsiveness of epigenetic aging biomarkers to longevity interventions in humans https://www.nature.com/articles/s41591-026-04562-9 And here's a link to our interview with Dr. Sehgal: https://youtu.be/zuf6Bw4hGCk ── GUESTS ── Andrea Cipriano — Stanford Stem Cell Institute and Department of Obstetrics and Gynecology. Immune aging mechanisms, T-cell dysfunction, and partial reprogramming to restore immune resilience. Chiara Herzog — Group leader, Cambridge Stem Cell Institute. Epigenetics and DNA methylation clocks, non-invasive biomarkers, lifestyle intervention studies. ── ABOUT THIS CHANNEL ── Tom Nodine is the founder of Human Life Expectancy and author of "Revolutionizing Insurance with Epigenetic Testing." This channel covers what is actually changing human life expectancy — biological age measurement, longevity interventions, and the economics of who pays for them. https://www.humanlifeexpectancy.com Subscribe for more conversations with the researchers doing this work. #longevity #immuneaging #biomarkers