
Written by a model from the transcript; not yet reviewed.
This live episode of This Week in Startups was recorded in Tokyo during Founder University Japan and features Bilal Karoni, founder and CEO of the longevity startup Ekei Labs. The discussion centers on the burgeoning longevity and biotech ecosystem in Japan, the science of epigenetics, and the unique strategic advantages of building a tech company in Tokyo and Okinawa rather than Silicon Valley. Karoni explains how Ekei Labs generates high-resolution, low-cost epigenetic data and methylation readings for drug discovery and cell therapy manufacturing quality control, while also touching on controversial topics such as the right to try, biological age tracking, and the cultural differences in venture financing, equity distribution, and work-life balance between the United States and Japan.
The conversation dives deep into the realities of early-stage company building, including why Karoni made the difficult decision to cut a cash-generating service for longevity clinics in order to focus entirely on proprietary R&D and data generation. Listeners will gain actionable insights into international fundraising, leveraging non-dilutive bank loans and government grants, and managing the intense demands of startup growth without sacrificing health or long-term value creation. The episode offers a rare, ground-level look at how global startup hubs outside the US are scaling advanced biotechnology with minimal capital.
The show opens with a live audience in Tokyo and a brief sponsor read before introducing the episode’s topic and guest.
The host explains Founder University’s pre‑accelerator model and introduces Bilal Karoni of Ekei Labs, a longevity‑focused startup based in Japan.
Karoni outlines Ekei Labs’ goal of generating high‑resolution epigenetic data for drug development and its focus on aging research in Japan’s aging society.
Karoni explains the science behind epigenetic methylation, how the company collects data from various samples, and its low‑cost, high‑resolution approach.
Karoni discusses how the company uses AI models on its unique data to accelerate drug discovery, the first AI‑designed drug in Phase 3, and future goals of virtual cell models.
Karoni shares how the team shifted focus from short‑term clinic services to long‑term data‑generation IP, balancing runway with value creation.
The discussion covers the validity of blue‑zone studies, the role of sociability and diet, and recent research linking multilingualism to reduced neurodegenerative risk.
The conversation turns to Japan’s fast‑track regenerative‑medicine laws, the availability of startup loans, and the differences between Japanese and U.S. venture capital.
Karoni explains how Japanese VCs, angels, and banks provide funding, the possibility of flipping to a Delaware company for U.S. investors, and the strategic use of non‑dilutive capital.
The host asks about interpreting biological age from wearables and blood tests, and Karoni explains the difference between consumer trends and clinical biomarkers for drug development.
The founders discuss cutting a profitable service to focus on R&D and growth.
Exploration of Japanese culture of kaizen and its impact on startup growth.
Defining Startup Successinsight
The host defines a startup as a team that develops a product that delights a customer base, noting that founders who run multiple companies will eventually hit success.
The guest explains that Ekei Labs generates high-resolution and low-cost epigenetic data for drug development, getting paid for aging discovery and manufacturing quality control.
Leveraging Startup Bank Loansstrategy
The guest reveals that Japanese regional banks act as risk-takers and provide low-interest loans to biotech startups with official institutions acting as guarantors.
Killing Profitable Servicesstory
The guest shares how Ekei Labs completely terminated a growing business selling services to longevity clinics because it was a distraction from core R&D.
Deciding on Strategic Focusinsight
An audience member asks how to know when to drop a service, and the guest clarifies that the decision was based on long-term vision rather than books.
Evaluating Exit Timingstrategy
The guest outlines the framework for considering an acquisition, focusing on whether they can achieve a much higher valuation independently over the next few years.
Venture Capital Power Law Mathdata
The host breaks down the brutal math of venture capital portfolio management, explaining why funds need 30X to 50X outlier returns to succeed.
Great Companies Are Boughtinsight
The host shares Sequoia partner Michael Ruloff's advice that great companies are bought through a competitive process rather than actively sold.
“Today, we’re getting paid for discovery on aging, as well as for manufacturing quality control in cell therapy.”
“If you want investors and potential customers to take your new business seriously, you need to consider forming a Delaware C corp.”
“And we made the difficult choice of cutting a service that was actually generating cash regularly and predictably to really being able to focus on the R and D and trying to cut distractions for the time being.”
“If you waste 10 weeks a year, if you've could have gotten your startup to be 3% more efficient that week and then 3%, I mean, it compounds and it compounds.”
“We are still like AI 1.0, I would say. We don't use agents, for example.”
“If you don't want to get to the office as soon as possible, start working and you can't sleep at night because you're just so engaged, then maybe it's time to sell.”
“If you work hard, you have to play hard.”
This Week In Startups is made possible by: Sentry https://sentry.io/twist Agree https://agree.com Northwest Registered Agent https://northwestregisteredagent.com/twist Today's show: French ex-martial artist Bilal Kharouni is building his longevity startup from Okinawa, one of the world's "blue zones." (These are regions with the most people living long, healthy lives.) In this TWiST taping from Founder University in Tokyo, Jason investigates why a $200K raise in Japan can out-build a $2M raise in San Francisco, and why the best moat for biological AI isn't the model; it's the data no one else has. Plus a tactical and practical discussion of product market fit, why Ekei killed a growing side business to maintain focus, Japan's fast-track for regenerative medicine, and hitting the upper limits for consumer longevity gadgets. Plus a live Q&A with Founder U attendees. Guest Bilal Kharouni on LinkedIn: https://www.linkedin.com/in/bilal-kharouni/ Ekei Labs: https://www.ekeilabs.com/ Relevant Links Okinawa Institute of Science and Tech (OIST): ****https://www.oist.jp/ Life Biosciences: https://www.lifebiosciences.com/ NewLimit: https://www.newlimit.com/ Centivax: https://www.centivax.com/ Medical Daily: "First Human Trial to Reverse Aging Gets FDA Clearance": https://www.medicaldaily.com/first-human-trial-reverse-aging-just-got-fda-clearance-what-epigenetic-reprogramming-actually-476076 Tim Friede snake venom article from Science: https://www.science.org/content/article/he-injected-himself-venom-decades-can-his-antibodies-help-snakebite-victims Micro1: https://www.micro1.ai/ Whoop: https://www.whoop.com/ Station F Paris startup campus: https://stationf.co/ Japan Times: "PM Takaichi sleeps only 2-4 hours a night": https://www.japantimes.co.jp/news/2025/11/14/japan/politics/takaichi-sleep-overwork/ FDLI: "Japan's Regenerative Medicine Regulatory Pathways": https://www.fdli.org/2019/02/global-focus-japans-regenerative-medicine-regulatory-pathways-encouraging-innovation-and-patient-access/ FDA: "Right to Try": https://www.fda.gov/patients/learn-about-expanded-access-and-other-treatment-options/right-try STAT News: "Are Blue Zones Real?": https://www.statnews.com/2026/05/04/are-blue-zones-real-new-scrutiny-longevity-hot-spots/ Timestamps: 0:00 Founder University is back in Japan! 4:05 What Ekei Labs does 5:13 Why Japan is a longevity hub 8:52 The AI biological moat 10:05 Sentry - Your team should be focused on shipping features — not chasing down bugs. New users can get $240 in free credits when they go to https://sentry.io/twist and use the code TWIST 15:58 Right to try and the ethics of experimental therapies 22:30 Agree.com - Stop chasing invoices and automate your entire contract-to-cash stack. Go to https://agree.com and tell them Jason sent you to get 50% off for life! 24:49 Japan's fast-track regenerative medicine law 26:03 Raising in Japan vs. the US 31:32 Northwest Registered Agent - Get more when you start your business with Northwest. In 10 clicks and 10 minutes, you can form your company and walk away with a real business identity — Learn more at https://northwestregisteredagent.com/twist 40:44 Why Ekei killed a profitable service to focus 47:11 Have Blue Zones been debunked? 48:56 How socialization may extend lifespan 51:07 Founder Q&A: Booked vs. forecast revenue 55:42 Amazon's "bar raiser" framework 1:03:31 Social robots and loneliness 1:04:29 Jason on health and hustle culture Subscribe to the TWiST500 newsletter: https://ticker.thisweekinstartups.com Check out the TWIST500: https://www.twist500.com Subscribe to This Week in Startups on Apple: https://rb.gy/v19fcp Follow Lon: X: https://x.com/lons Follow Alex: X: https://x.com/alex LinkedIn: https://www.linkedin.com/in/alexwilhelm Follow Jason: X: https://twitter.com/Jason LinkedIn: https://www.linkedin.com/in/jasoncalacanis Check out all our partner offers: https://partners.launch.co/ Great TWIST interviews: Will Guidara, Eoghan McCabe, Steve Huffman, Brian Chesky, Bob Moesta, Aaron Levie, Sophia Amoruso, Reid Hoffman, Frank Slootman, Billy McFarland Check out Jason's suite of newsletters: https://substack.com/@calacanis Follow TWiST: Twitter: https://twitter.com/TWiStartups YouTube: https://www.youtube.com/thisweekin Instagram: https://www.instagram.com/thisweekinstartups TikTok: https://www.tiktok.com/@thisweekinstartups Substack: https://twistartups.substack.com
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