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Exosomes Regenerative Medicine Transcript

Exosomes doctor spill lectures nationally or some of the most respected societies including the American Academy of anti-aging medicine the American Society of Interventional pain Physicians and speaks at the top Regenerative Medicine Conferences as well as many others and many others he's an expert in Highly Purified Exosomes (iEXOSOMES), endoscopic spine surgery Diagnostic Radiology Interventional pain and regenerative medicine is novel treatment strategies service standards for exosome therapy so very excited to have him with us today we really appreciate his time and without further do doctors still I'll turn the time over to you thank you very much I know we have a lot to so we're going to start at the very beginning and I'm going to assume that no one here as a significant knowledge and exit the war msc's it was very patient and instruct you with pictures when necessary I'll show you examples of some patients that we treated and I'll try to Keon points and I'll try to call your attention to areas that are very very important. I was on a conference and I heard my partner and good friend Duncan Ross talkin about the benefits with a stage 2 facial burn clear up in about a week after you just sprang on some of this Miracle Juice I want to understand the reasons for tell me the biggest reason in the biggest hurdle that I've overcome was understanding that stem cells and grafted in areas of the body so if you're treating the joints of the body and you take adult stem cells from umbilical cord blood cells become soft tissue stem cells that are already inherited many of your body tissues David Arnold Kaplan as reconsider his position when you look it actually sounds very very tiny vesicles from 4209 and then we talked about Michael jessical we'll talk about specific between a hundred meters and the even smaller portions of the don't wear as the larger microvesicles come from the plasma membrane to sell ya when you're dealing with that they are very much the children of their parents so bad parents have been children cancer cells produce a total different type of exercises that also include don't generally pro-growth and anti-inflammatory and they contain proteins messenger and micro RNA what is devoid of DNA because they're made from the membranes of their parents whether from the Endo portions of the membrane of the plasma membrane and cell they contain some of the protein down-regulate your immune system an immunomodulator you without giving you a full-blown immunosuppression regulate ourselves at a regulation and morphology exchange from M1 with your pro-inflammatory back to M2 with your aunt I conditions that can be treated with exercise mirror on the Affliction in the body are somehow affected either by decreased or increased inflammation after that I wrote a book on regenerative medicine that will specifically discuss any of you would likely dabbling in musculoskeletal diseases imma show you how I can use these for autoimmune diseases I do a lot of work with burn scars and ulcers will talk about heart disease lung disease liver disease kidney disease inflammatory bowel disease recently in the last 6 months with the blog a lot like wise to study with patients who are the spinal cord and number of other apps applications I am not the guy to talk about aesthetic applications so we'll keep those to a minimum I try to explain to doctors and Distributors are white people like why exorcisms work and back to music signs that was a hundred fifty years ago where they take all my sin young Miser old rats in young rats and they say together after skinning them and they noticed it after they walk around in the euthanize if you will take on the younger ask for apology and vice versa and too many people believe this was stem cells but was simply not transfer using the stem cells that what we are doing and the walls of blood vessels into each other cells but rather up regulating the cell stem cell and basically none of this would work from a regenerative aspect if you didn't have progenitor cell body but I'm telling you that you have cells in your heart that are almost bites cells in your lung that are almost alveoli cells throughout your body when your nervous system you're almost oligodendrocytes a strictly a microglia neurons that have not yet followed all the way down there cell lineage and then like quiescently number of translational studies on animals that we base much of the work that we've done over the last two years has jobs and then about a year ago I stopped completely now some of the benefits of action shows in these are specific to a distributor in the body there's likely the first six hours they distribute into macrophages in the alveolar macrophages and they likely trafficking we talked a little bit about the protein ligands in their membranes which allow them to home there is information and due to the fact they don't have a chalet to markings on them they're not rejected because tomorrow we have a 5 mg to ml that at 6 mg 1 ml is 8 mg that I use for applications in small spaces when I use one of these is very very concentrated product therapeutic effects target cells and changed by changing ourselves that are no longer producing an acid Associated secretory units that are anti and pro inflammation apoptosis Lake Effect by the Fijian daughter says you getting rid of certain cell organelles that are not functioning well they should we promote regeneration they like to wrap intellectual property around one protein to buy juul ettore factors as well as the messenger RNA the code for the alpha proteins that fight inflammation are available to single bra in the next few slides you'll see that I've outlined a number of the really King anti-inflammatory agents I would direct your attention to Stem Cell factor bnp's tgf-beta tree which is a very anti-inflammatory properties in 1 receptor antagonist can witches anti-inflammatory temp 1 and temp to return Dairy anti-inflammatory and then some significant LEAP program factors like wheel drive through or trophic Factor brain derived neurotrophic Factor so what are the important effects they have again they're going to down-regulate the rigorous inflammatory reaction in many of your cells throughout the body that we use the I'm worried about Joyce and all these specific Protocols are within the chapter that I wrote for you arguments with numerous phds around the country saying that sells required in fact they are and if there were no residents themselves trap all the tissues of your body that have this would work very well but even in the knee you can see outline numerous stem cells that are almost chondrocytes almost done almost to know and what they need to do is be woken up from their sleep the exercise provide the cup of coffee at most of these cells need in order to become activated and start shaking and get back to work and rejuvenating your body show me the key MSC activities that they promote and be seen in this light at your Genesis neurogenesis osteogenesis and muscular Genesis with respect to autoimmunity pictures are quite important I like to show this in the upper left-hand Corner you'll see a patient with Vitiligo no middle I go it's a situation where your immune cells the Tactical out of sight precursor cells in the epidermis to the sub dermal layers cuz it's the only way to get new melanin-producing cells where they live I'm certain areas that they live or within the harebells or the base of the hair follicle where they're generally sequestered away from the immune system after three or four weeks the areas of skin that are filling in the melanocytes cells basically giving you a story effects of Griff relaxing sounds is an example of some topical uses where these are actually intradermal or subdural injections of exercise on the patient with rosacea this is a nice to slide and it talked a little bit about the inflammatory milieu of your body station came to me earlier this year with azoospermia essentially no sperm count and he has been to other facilities where he had gotten shots and was working with the doctor spending about $3,000 a month to look at the top on January 8th 2018 is sperm count was 0 similarly in April and May Leviton July came around I had injected him about three weeks earlier still no sperm count by August but they were non motile sperm bank by 9-6-18 eight or nine weeks after I injected his sperm count was up to 90 million and I seen this and other patients why haven't just given IV what station do at these and shoulders done had been age of sporadic and noticed that he had got up to over 10 million how do you live with lumbar disc disease when you look at white discs hurt most of the reason is due to the immune aspect of the nuclear material and discs repair the disk when you get a herniation that nuclear material leaks out has an autoimmune reaction generally the nucleus of the disc similar to the lens of the eye in the testes and certain CNS tissues are sequestered away from your immune system and when these things get out they are treated as though there for I'm so worried about certain where is Notts the Royals do not work finally mechanical compression large student desks are likely not a good match for regenerative Therapies many of these things in the bottom however annular tears modic changes type 1 acute schmorl's nodes small vodka press of herniation or excellent what goes wrong in the discs as you get older too small to hold less water that keeps the annulus less taught you get in balances so that you more cat kabbalism rather than anabolism and you slowly lose the structural Integrity of the discs you get significant pro-inflammatory cytokines smoking aging and Trauma negatively affects the microenvironment you get decreased oxygen decreased it all these things lead to cell death of the nuclear cells that are only about 1% of the nucleus to begin with and they are responsible for causing the production of all the nucleus pulposus collagen just did a quick example Dolores on the lamp professional athlete with relative disc desiccation in the lowest to lumbar intervertebral discs and then it's four months later you seem rather rigorous increase fluid within the end plates and essentially within the vertebral bodies about this thinking that the patient might have had a lot of myelitis know he felt great happy cetus inflammatory markers were Extremely Loud rather than fluid within the desks from osteomyelitis or diva what are the things I like to do a lot of I do a lot of central nervous system disease and significantly with people who have both autoimmune types of syndromes like Ms Gillard each other symptoms and diseases like Parkinson's Alzheimer's we see a lot of injuries to the CNS spinal cord injuries brain injuries and strokes what are the basic pathophysiology he's with CNS injuries and I'll bring this to the Forefront down you should consider this when we talked about hurting your ankle or hurting your name think of inflammation which begets healing and inflammation in the ankle will last for a few weeks and then give rise to a healing casket unfortunately is not so set up so that if you injure your brain or it's your spinal cord you have an ongoing inflammatory milieu that can last what many many beers in Sac on the decades in urban studies done with actually taking ligands bound them to nuclear materials they bind activated M1 micro essentially the macrophages of your central nervous system and they've been able to find these things after 17 18 19 years after the injury and one of the reasons we believe you have neuropathic pain from these entries are that these activated macrophages are microglia is don't just stay in the area of injury but if the injury was your cervical cord that can be found out of your thoracic cord and up into your bread the first thing to usually goes your gray matter and the secondary problems occur with white matter disease of problems secondary to get abnormal Murano firing mechanical trauma a cement truck buses eventually even spinal Shock by pop the extending below the area of injury free radicals are at the center of this and certainly be active and reactive oxygen species has majored mods of course there's always a paradox is chronic inflammation regulation of the immune system at the same time that they have a dampening of the immune response peripheral these patients who have spinal cord injuries usually have a combined what immunity and immune deficiency and the very same time. And I know I'm going fast you can have all of these slides for yourself degenerative diseases were talking a lot about death of neurons you're getting protein aggregates with your abnormal proteins that are being formed in areas of the intracellular and extracellular if you have an autoimmune disease you have an increased chance of having 17 cells which are autoimmune markers seen in many if you want to view diseases interesting things in this kind of influence when you have inflammatory milieu peripherally and you have inflammation going on in your body heat up a lot of the same if you dampen your peripheral immunity it may be that the amino acid currency that you have and then be diverted centrally to create neurotransmitters similarly I found that the central nervous system and the peripheral immune system are tied in so that they're hardwired into one another and we know now that it was traffic book into and out of the central nervous system all the cases that I do going to Jenner's disease and CNS trauma eye treatment that to some intravenously at the same time that I introduced exorcisms intrathecal it you know there's a need for new Sharpies and what are the reasons is there are very few Sentinel and useful therapy for patients who have strep and a half hours to get TP I like Parkinson's disease makes up to the fact that you're not producing Delta in their substantial Niagara but it doesn't take into effect some of the changes happening in we know now from the research of many many years that when you give stem cells you are not repopulating those neurons unless you had the ability to give a potential said that sells which is illegal in the US or you're using fetal stem cells with us for some more you're facing the useful ability of change on to things changes in immunomodulation and increases within the ability of the neurogenic Niche inform some of these substantial elephants cells that are almost almost almost out of sight but like we actively Runner Mail the Hallmarks of some of these diseases are these protein aggregates Alpha synuclein and Parkinson's is hugging in protein and Huntington's disease receipt out a Beloit plaques in Alzheimer's tdp-43 and ALS they go on in. You are two major methods of protein aggregate clearance one is naturalization secreted by Michael Glen we believe that msc's and their daughters likely enhance this Auto station which is one of the ways that we actually get rid of weakened or damaged organelles and we believe that both msc's and their daughters exercise in effect these changes who are you listening today I know that there's a strong wave of functional and Integrative Medicine Physicians out there and read and written about this homeostasis as we get older it's not just inflammation and there's inappropriate by to Fiji where with jettisoning these mitochondria and we can't produce ATP anymore it should be noted that within the actual Subs that we've asked both the proteins on the messenger RNA we have all five and X in the ATP glycolytic pathway and believe that we can white of the reactive oxygen reactive nitrogen species by strengthening the mitochondria themselves some of the key objectives when you're taking to account information or redox you like to decrease yelled at should we reduce scarring and cavitation we gain healthy neural cells stimulate for sure likes older generation and you need to remodel the niche or get the niche the dishes little bit about CSF flow and for many of these patients I treat them intrathecally at the same time that I treat him intravenously I have some methods that it's time to show you some of the cervical but a little instruction here this will bring it back to something that was in the media is severely anoxic brain injury she was unable to walk dog eat reactive or surroundings horrible MRI administer hyperbaric oxygen to live 40 treatments later 1.3 atmospheres 45 minutes five out of every seven days she's walking talking and doing everything the beneficiaries of hyperbaric oxygen increases activity of stem cells and very importantly as you increase the activity of the stem cells in a 2 year old there's many more stem cells and their able to migrate to areas of ischemia damage what makes sense to talk a little bit about the benefits of exercise and we can touch a little bit when I look at a patient with a CNS injury and I use this as both constructive because we like to treat a lot of the nervous system understand on a very large scale what's happening within the body I try to make the level of intensity of invasiveness match the severity of disease what do I mean by seen remarkable recovery that. 5 or 6 daysthe other hand if you have a spinal cord injury a severe brain injury I'm going to marry an intrathecal injection of exosomes to an intravenous injection what are the things we do when you see one two injections posterior to the court and for many of you who've been out of practice for 20 or 30 years you may remember that this is a older approach for myelogram from radiologist from Days of York the one thing you have to worry about 3% of the time you may have some abnormal for to the lottery so we certainly do work ups with c t n g o s or M o n g s of the neck before doing this I would like to do brain MRIs server glamorize here's an example of a CTA show me the vertebral arteries are purely and all the way up to see tip actually is a picture of an abnormal situation where the posterior inferior cerebellar artery extends below the foramen magnum and if you're doing it all one puncture as I did I realize that I had to stay slightly to the right because the Pica artery was in that space from a no one puncture here that would have been in my way had I gone too far to the left I'm certainly arnold-chiari is of low-lying tonsils make it very difficult to do a no one there was a larger space here 1/2 might have been a better choice but not much space coast year to the cord from the lateral what to is it brief example what it looks like in the center picture you can see the sagittal image the actual image share a no one will look at it comes directly posterior the 1/2 it is a lateral approach and scroll through real quick like a couple of examples navigation to be successfully treated you this was not done by me but rather one of my friends in the Midwest this was a young man is a young man 44 injury I got a call and my buddy said that he was essentially paraplegic excuse the picture here got a great look at the lower thoracic but I will tell you that there was a lower Thrasher cord injury he effectively injected after Subs at L1 to fit intrathecal pump in a couple of weeks. Just moving his right leg can you show me what it started with his like that after a couple of weeks I'm pretty rapid change it is is muscular fitness and he'd gotten better with the left leg and within two months he's actually standing and now he's walking with Walkers already very early early is better and then TV stations to get better anyway this is a 19 year old boating accident would come to me after being treated down in Florida and had both stem cells and exercise some although the injections were interested in the lumbar spine for meeting Nate essentially quadriplegic this is an example of a 1/2 lateral puncture needle coming into the side sure what he was doing much better after I injected it been starting to walk a little bit with assistance recently I gave him a second injection and you'll notice that his truck fight fight this is doing much better now you'll notice it is truncal stability looks better and he's biking around and doing a really really nice job call Jacey for agency in an accident. You and a half years ago but a vehicle accident he's a diver really aggressive God you came to me and had an intrathecal and intravenous injection in March some of his major problems were aladini extreme spasticity disorder Novia stopwatch it all all made me grow his hair before you allowed me to treat a spinal cord soon after he was injected pause working with an area New Jersey this is called push to walk to the very first time that cost it up unassisted holding a standing posture without somebody locking his legs and he's very excited we're going to have to be a little bit like an Parkinson's patients we'll talk a little bit about it is now about nine months out it came to me on 12:00 carbidopa-levodopa today I'm hopefully we can get you a picture of what he's doing with weight but essentially he's got his dosing down to five or six a day and where originally he could barely pick up a five pound weight is up to working out with 35 pounds it's been so you'll see that this way started with me came to me at the time that I am instant he was using about 20 packs without the 35lb of actually being able to run and catch footballs and he's probably scaling down again at about eight months I think we're going to reject him shortly I'm finally Chico I want to show you Chico with a lot of these kids in our group nap this is a pretty ugly spinal cord injury this is C3 for this it true age of a near complete transection of the spinal cord and no one puncture you'll note the date is 8-23-18 so I came right in here with the needle is bent on drugs to maintain his blood pressure I'm even on Midrin three times a day for 7 years in five days you stopped as many of your ability of him to use his legs with the tree and a half weeks there's some lovely over the last six or eight weeks he sent me these shots of him doing multiple different things with his arms and his legs actually even walking with the assistance you see that he's now being able to to fire his thighs is hips are some of the exercise he's still working on getting stronger and stronger with light prices getting some truncal stability as well 8 weeks out here I started doing intranasal delivery of these exercises I use a 1cc syringe you can only get about a quarter CC in a time is maybe up 2.15 CC's can go in through the cribriform plate there's been some good studies with that there's a lot of talk and both with drug addiction which says there's likely a dopamine impoverished brain and there's decreased dopamine receptors and decreased dopamine output recent study to said that msc's may help hope you are tolerance and opioid-induced hyperalgesia what are the things we see with the patients who have no topic pay is that within a week or two and then I believe it goes down and we see that bimodal distribution work starts going down and that is likely secondary to the messenger RNA going to translate proteins to that. Totally blind worried about autism there is a lot of abnormality seen in people with Autism Spectrum disease Somebody's Baby due to NK cells macrophages with T-cell there a lot of different triggers we talked about pcbs we talked about heavy metals on their people with problems across the entire Spectrum there's a fragile X dominance I use both intravenous with intrathecal or intranasal delivery I see decreases and echolalia decreases and self stim improvements and cognition decrease at first I seen actually also recently decreasing seizures with some patients that have a combination of autism and seizures ICD-10 binge eating and most recently at this morning one of my patients mother's it's an EEG technologist and she said that six weeks after treating her son with IV in intrathecal what is EEG has change for the better finally there's a number of CNS code treatments out there there's brain Sonic's and similar acoustic wave machines is transcranial magnetic stimulation hyperbaric oxygen and considering the use of spinal cord stim to increase the uptake in certain areas of the spinal cord after injury finally there is a longevity play I was recently interviewed by Larry King why sat on the panel will be doing a similar panel at 8:40 to talk about the benefits of longevity and how exercise they changed the way you live but the length of your life and the quality of your life I thank you for your attention open for questions great thank you Doctor spill that was fantastic let me let's see let me get these questions up and running here cat the right slide up okay so before we dig into Q&A just a quick most of you know Apex biologix we are doing a Black Friday one time of year biggest all the year on a PRP kit Samuel fluid and we wanted to throw this out there because we're talking to Rex's homes humble also be doing x's on 1 cc of exosomes for 9:50 so that starts with a and ends next Wednesday you have any other questions just please let us know give us a call and with that let me get to some Q&A and just a reminder if if I don't get to your question if you run out of time then we will get doctor spill to answer those afterwards and we will be sending out an email with all that information plus more so first question dr. Spiel are you concerned at all of current FDA regulations of an any regulations that may come due to the popularity of this new treatment so what now none of us can predict tomorrow and right now there are no guidelines associated with cell secretions similar to there being other than you know yet have a sterile fluid within the guidelines for the FBI and or Matt to an IND with one of the ideologies is talking about orphan drug possibilities medication yesterday that called about a stiff man syndrome where your immune system attacks play to do some of these are spin or Matt prinn orphan drug there is some low-hanging fruit where you might want to treat wounds and skin ulcers it works great for that stuff that might are Matt and we may make a separate type of exercise or more separate just to treat that in order to pursue nor matter I end a we have a group of epidemiologist that's working with us would collating data and we'll decide when we are aware that their numbers are the players right now doing cells and cell-based therapies and we wish all them well to you know we believe this is a large group of players one of the things that we've done very well as we've taken in a cellular form of the stem cell medicine we've allowed we've been allowed to basically scale it and concentrated to such a degree that I think anyone else is going to have a very difficult time at preparing either a celular a celular a product that contains as many proteins in messenger RNA that we have an example of people create a tissue lab and you soak a million stem cells for 24 hours in Saline you may secrete about 1 mg of Michael Jackson exercise 150 million shells allergenics in a 24-hour period of time to secrete 15mg tell you that if you call yourself can stay around longer but they only secrete a third of the proteins that you do when your newborn so take your pick I think anyone can have a hard time matching the amount of product that is produced we're good thank you another question do you recommend any treatments that include both PRP and exosomes if so what conditions are best treated with type of combination great question so I use what I'm dealing space weather is highly vascularized areas so in the scalp in the musculoskeletal areas throughout the body in the Corpus cavernosum of the penis area is where there's rich blood supply if you inject these in their going to traffic yet she wanted put it there with the little bit of a scaffold either a PRP or prfm type of thing as well very good okay are there any preservatives in the vials you can use these very very safely Pitch Perfect cast at what sizes in concentrations do exosomes come in and where are the best place to obtain them show Apex is hosting the seminar can get you all the extra Subs you want they do 1 ml that are 8 mg that I used for intrathecal use if there's a 2ml variety that gives you 6 mg of 3 mg per ML and there's a 5ml that gives you 3 mg per ml or 15 milligram okay great how are exosomes isolated and verified to be exosomes prior to delivery is a two-part or three part how are they're liable you delivered how do you know each time you are injecting exosome what you are getting the product you think you are sending was a question so we have on-site ability to to give you concentrations as well as a says so we've actually asks a messenger micro RNA as well as proteins we all set up and out of sight machine in order to quantitatively assess the product and we have phds in the lab evaluating the cells that secrete these exercises everyday and they are shipped on dry ice you have the choice of putting him in dry ice bomb that can be stored Vapor phase in liquid nitrogen if you put them in your freezer - 20 - 40 you're probably still get 3 to 6 months -80 will give you a year the greatest you will grow and multiply them and what we do in order to catch the exorcisms is part of our intellectual Pro gray and you may have already answered this with one of the questions came in how do you harvest and prepare exosomes so if it makes you feel better the last three years we've use one placenta for this a thousands and thousands of units that we stole perfect thank you okay we got time for a few more with spinal cord injuries are the results better for new injuries what about older spinal cord injuries from 5 10 20 years ago I just show you we have spinal cord injuries at a decade or more I just showed you one at 7 years but I showed your new one out two months you always want to treat people earlier but you know we don't get to choose so the earliest that you can trade the you know there's interesting studies with mice so along those lines and it opens up the question who should get extra sounds right studies in mice with Strokes Whatever they've also induced myocardial infarction that by delivering you diminish the amount of little wash and you've also mitigated the cardiomyopathy and decreases and ejection fraction so far up to me if you were coming in with an acute stroke and Mi I would give you IV access sounds right in the edict that is not available so I would tell everyone out there that earlier is better but you get them when they come in and you do the best you can the position when you see that great another question here how does Health Canada treat these I mean where the Canadian doctors are using exercise arms I am not aware of there being any regulations against a Cellular Medic for secretions in Canada okay this was kind of question more, and I'll directed to you Doctor spill malpractice made a distinction per stem injections and we needed more documentation and protocol / them are you going to love this I feel like you been feeding me these questions I've been in discussions with a major liability insurance company NorCal NorCal there in Logan billion dollar insurance medical liability company throughout the 50 states as of December 1st they will be giving both umbrella policies to all of the protocols that they read on my exercise arms as well as a number of stem cell-based procedures I will get all those to dance so he can disseminate go to the jesters directly to you you'll be able to use them either for an umbrella or they would be willing to pick up entire policies for certain doctors kidtastic another question what is protocol for dementia patients with white matter you know I don't differentiate I'm rather agnostic to what the initial insult was so whether the insult was a CVA or a collective neurodegenerative and it's 3 * 1 ml intrathecal call should be covered in the chapter I would hope that you get them to every doctor on the call today there's a really nice 45-50 minute chat that I had with Duncan Ross Ph.D who is the really big bee stinger behind the company he started Kimera labs in 2013 I joined with him a couple years ago it's giving me the opportunity and working with him to go bedside to bench and bench to bed side rather seamlessly and because of his great intellect of a cell bio level it is enabled me to make jumps on the critical level that I could not have done without his tutelage agree dr. Spiel I believe that is as much as we can get to at least for now we have a few more questions coming in and I'm sure they'll be more after this but we're kind of ending towards our time so light I just want to thank you very much for taking the time to be on this call I want to thank everybody else for taking some time to jump on this call we really appreciate hopefully was very helpful again a recording of it this webinar will be sent out along with Doctor spills chapter along with the Q&A so everybody has those in the meantime if you have any questions please feel free to reach out to us here at Apex biologix the doctor still thank you so much thank you very much thank everyone for taking time out of their busy days thank you have a good day...find

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