Inflammaging, the Immune System, and the Hidden Biology of Aging — A Conversation with Alan Landay, Ph.D.

In this episode of Decoding Longevity, host Raghav Sehgal and co-host Macsue Jacques explore one of the most powerful — and often overlooked — drivers of aging: the immune system.Joined by immunologist Alan Landay, the conversation uncovers how chronic inflammation — often described as inflammaging — shapes biological aging at the cellular level. Drawing on decades of HIV research, Dr. Landay explains how persistent immune activation, gut barrier dysfunction, and microbiome imbalance contribute to age-related diseases long before symptoms appear.The episode dives into:• Why aging is a biological process — not just the passage of time • How immune dysregulation accelerates cardiovascular and metabolic disease • The role of gut health and microbial metabolites in systemic inflammation • Biological aging clocks and emerging biomarkers • Promising interventions — from lifestyle strategies to immune-targeted therapiesThis conversation reframes aging as an immune-driven process and highlights how understanding inflammation may be key to extending healthspan.