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**Disuse and unloading.** Blocking myostatin and activin A protected both muscle and bone in mice flown to the International Space Station, a result with direct relevance to [[space-medicine]] and to the countermeasure problem described in [[microgravity-adaptation]].[^lee2020] Bed rest, immobilisation after surgery and the muscle loss of aging described in [[stem-cell-exhaustion]] present the same physiological problem.**Disuse and unloading.** Blocking myostatin and activin A protected both muscle and bone in mice flown to the International Space Station, a result with direct relevance to [[space-medicine]] and to the countermeasure problem described in [[microgravity-adaptation]].[^lee2020] Bed rest, immobilisation after surgery and the muscle loss of aging described in [[stem-cell-exhaustion]] present the same physiological problem. **Gene therapy.** Follistatin delivered by adeno-associated virus was tested in small open-label trials in Becker muscular dystrophy and inclusion body myositis, with modest changes in walking distance and no control group.[^mendell2015] Follistatin constructs have also been administered outside any trial, marketed directly to individuals by ventures sited beyond the reach of drug regulators, a practice examined in [[biohacking]] and one of the few concrete instances of the scenario anticipated in [[gene-doping]]. Several of the individuals involved took the construct as an anti-aging measure rather than an athletic one, which places it alongside the self-experiments described in [[gene-therapy-for-aging]].**Gene therapy.** Follistatin delivered by adeno-associated virus was tested in small open-label trials in Becker muscular dystrophy and inclusion body myositis, with modest changes in walking distance and no control group.[^mendell2015] Follistatin constructs have also been administered outside any trial, marketed directly to individuals by ventures sited beyond the reach of drug regulators, a practice examined in [[biohacking]] and one of the few concrete instances of the scenario anticipated in [[gene-doping]]. Several of the individuals involved, [[bryan-johnson]] among them, took the construct as an anti-aging measure rather than an athletic one, which places it alongside the self-experiments described in [[gene-therapy-for-aging]]. ## Limitations and risks## Limitations and risks removed, struck through added, underlinedLine numbers count the serialised markdown of each revision, frontmatter included.
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