The elixir of the gods is here. Or, it was. The tale of Ambrosia, LLC.

Disclaimer: We started writing this post back in January, right around when Ambrosia officially began operating in the US. Since then, Ambrosia has suspended its work following concerns from the FDA. Its former website domain, ambrosiaplasma.com, is no longer live. Simply put, Ambrosia seems to have disappeared. And though Ambrosia may be out of the picture, if we’ve learned anything whilst writing this piece, the quest for immortality has a long history. Ambrosia and its founder Jesse Karmazin are not the first and certainly won’t be the last to tout the transfusion of “young blood” to combat disease and aging. And with the scientific jury still out on whether or not this is even possible–let alone safe–the importance of this piece cannot be overstated. As a result, we have therefore decided to leave this piece in its original narrative form. We hope you enjoy reading.

Original Piece:

Humanity has been fantasizing about an elixir of youth since the Mesopotamian Epic of Gilgamesh. Have we finally found it in an obscure blood transfusion startup? Ambrosia, a company run by the Stanford-trained Jesse Karmazin, claims to have begun operations in 6 US cities. Its mission? To provide customers with the blood of young people. Its claims? To rejuvenate its customers through the use of this “blood drug.”

This, for the cool price of 8,000 USD for 1 litre or 12,000 USD for 2 litres. And while the word “ambrosia” may have its roots in the food or drink of the Greek gods conferring longevity and immortality, Ambrosia, LLC, is anything but.

What is Ambrosia?

Taking a tour of Ambrosia’s recently updated website, one is immediately reminded of other similar, Silicon Valley-esque sites. It’s aesthetically pleasing. It has pictures of hikers, lush fields, and tastefully decorated shelves–all of the things you want your company to stand for. What Ambrosia’s site doesn’t have is information. The entire site has just 160 words, including the “science” used to back up this treatment modality (more on that later). Towards the end of the site, visitors are directed to a PayPal payment menu with two options: 1 L or 2 L of young people’s blood. Even in our minimalist culture, this website seems to be a little bit sparse.

So, to learn more about what Ambrosia is, what it does, and how it started, we went straight to the source: Jesse Karmazin, a Stanford Medical School graduate (but, still without a medical license), founded Ambrosia in 2016. Since then, he’s kept a relatively sparse presence on the internet while building his company. Other than attracting the attention of the notorious Silicon Valley investor Peter Thiel, basic Google searches of Karmazin yield nothing more than articles about Ambrosia and his LinkedIn profile--which is where we chose to reach out to him. He answered, and kindly agreed to let us cite him here.

To gain a better understanding of where the blood for these transfusions is obtained, we first asked Mr. Karmazin what controls and definitions they used for these transfusions. Said Jesse, “the blood is obtained from blood banks in the US, and is tested according to FDA requirements,” going on to later describe that “[we] define young blood as 16-25… blood banks do keep track of donor ages.” When asked about that science behind what Ambrosia does, things got a little more abstract. While Jesse did say they would be publishing the results of their clinical trial later this year, he did not give us any more specifics about the outcomes of the study. He did, however, mention that “we’re seeing improvements in illnesses such as Alzheimer’s and other age-related disorders, as well as other things associated with aging, like energy, muscle strength, memory, skin quality, joint pain, etc.” In addition, much of the existing literature Jesse shared with us as the basis of Ambrosia’s work has only been done on mouse “parabiosis” models and rather than with transfusions (an important distinction we’ll get into later) which has only further clouded the legitimacy of this science. This brings us to the centre of the debate about Ambrosia: is there any science to back this up?

What’s the science?

The use of younger people’s blood to improve one’s well-being and prolong life is not a new idea. In fact, history is littered with tales of larger-than-life figures seeking mortality in the blood of the young. Pope Innocent VIII (ironic, we know), who claimed the Holy Chair in 1484, quickly saw his health deteriorate. Following a stroke in 1488, Pope Innocent VIII was desperate and barely clinging to life. So, in attempt to thwart death, Pope Innocent VIII looked to the youth:

And while this experiment with the use of young blood to cure his ailments ultimately failed, the dream of such a therapy has lived on.

Enter Jesse Karmazin.

Jesse Karmazin, the CEO and Founder of Ambrosia, stated his interest in the field of parabiosis started back in 2013, from a study in mice that suggested that some aspects of aging could be reversed when older mice are transfused with younger mouse blood. In this study, researchers identified a compound in blood, GDF11 (a member of the TGF-B family), that declines with age, and suggested that restoration of this compound could reverse age-related cardiac hypertrophy. Though interesting, these results were obtained through a less-than-ideal procedure for humans called parabiosis, which involves literally sewing older mice to their younger counterparts to connect their vasculatures for up to 4 weeks. I don’t know about you, but spending 4 weeks sewn to someone else seems like a high price to pay for restored youth.

The problems with Ambrosia and parabiosis don’t stop there. Ambrosia’s now-complete clinical trial, as registered at ClinicalTrials.gov, yields some serious red flags. Despite still not publishing any results from the trial, the description of the trial states an actual enrolment of 200 participants above the age of 35 that received infusions of plasma derived from young donors between the age of 16-26. In order to assess “spectrum of physiologic pathways with evidence-based connections to aging,” Ambrosia’s trial description also sets out primary outcomes to track a panel of age-associated biomarkers before and after treatment. Such biomarkers include various immunoglobulins, chemokines, cytokines, and lipoproteins that are linked to “specific disease states”. Throughout the trial, participants were also said to have had their “organ function [which will be] specifically measured includes the liver, bone marrow, kidneys, pancreas, muscles, cardiovasculature, cerebrovasculature, and the thyroid. All of this, without any data to show or science to back up their claims.

What are the ethics?

First and foremost, Ambrosia’s commodification of blood undermines the altruism-based framework of both clinical research and blood donation. In its previously-discussed clinical trial, Ambrosia was charging individuals 8000 USD just to participate in a research study with no scientific merit in humans.

As they exist today, blood donation and clinical research both tend to rely on volunteers. Some donors in the U.S. are compensated, however, with donors receiving up to $50 per donation, and some research participants also being compensated for their time. The rationale for compensating volunteers for their time and donation exist in some jurisdictions to avoid coercing volunteers into participation, while alleviating the sometimes-significant barriers to participation.

In either case, by selling blood plasma that has been collected either from volunteers or compensated participants for a staggering $8000 per litre, Ambrosia has commoditized this precious resource in a way that does not reflect how the medical community has chosen to encourage blood collection. Allowing participants to participate in a clinical trial by paying to do so subverts the prevailing framework for medical research where participants are encouraged to participate out of good will. How this trial was approved by a research ethics board remains unclear to us.

In the realm of ethics, a secondary concern also comes to mind: blood is a scarce resource. By diverting blood that would otherwise go to saving lives towards an unproven intervention, people who have proven medical need for blood transfusions may be disadvantaged. Furthermore, should this treatment option become more mainstream and cheaper, already low stockpiles of blood for donation will become even more strained.

Conclusion:

The Epic of Gilgamesh is an ancient Mesopotamian odyssey written in the Akkadian language, and chronicles the adventures of Gilgamesh, the king of the city state of Uruk. While the details of the story are not pertinent to this piece, the ending most certainly is. Upon meeting Utnapishtim, the survivor of the Babylonian flood, he is told the story of the flood and is shown where to find a plant that is capable of everlasting life. Upon finding the plant, Gilgamesh lets his hubris get the best of him, letting his guard down only to have it seized and eaten by a serpent. Gilgamesh never succeeds in his quest for immortality, and returns to Uruk dismayed and defeated.

This story is not unlike that of Jesse Karmazin and all of the other men and women before him who have dreamed of youth and immortality. Indeed, it is a quest that has lasted for all of time, and seems poised to last for the foreseeable future. And like all those who ventured on this quest before it, Ambrosia, LLC, will hopefully be no exception to the trend: a victim to its own hubris. With dubious scientific claims, an uncomfortable ethic basis, and leader unwilling to see right from wrong, it is clear that Ambrosia poses a clear and very real threat to society and itself. Only time will tell how far it goes; and, without serpents to steal its stockpiles of donor blood, what it will take to stop it.


Author: Zach Weiss

Zach Weiss completed his B.Sc. in Microbiology & Immunology at UBC in Vancouver. Over the years, Zach has become increasingly fascinated with the world of politics and policy, and has spent way more hours listening to political podcasts than he’s willing to admit. As a first-year medical student at Schulich, He’s particularly interested in merging his interest in politics and policy with his growing medical knowledge to advocate for and bring awareness to issues that are often overlooked.
Photo Credits: Cava Photos