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REGENERATION

                 David A. Steenblock, M.S., D.O.
              Personalized Regenerative Medicine TM
                    Mission Viejo, California


26381 Crown Valley Pkwy, St. 130, Mission Viejo, Calif, USA; 800-300-1063
REGENERATION
 For optimum regeneration of a damaged
  organ or entire body, there are three
  important factors that need to be present.
 Healthy Stem cells of a newborn
 Growth factors- levels of a newborn
 Thymus factors- levels of a newborn
What are Stem Cells?

 Stem cells are the first cells of the embryo that
  build new life.
 Stem cells continue to help with growth and
  tissue repair as we age, BUT slow down after
  40 years of age.
 Stem cells divide to create more stem cells so
  theoretically if all of your stem cells remain
  youthful, the body could repair itself forever
  and you would only die from accidents.
Hematopoietic Stem Cells

   Hematopoietic stem cells (called CD34+)
    are multipotent, undifferentiated
    hematopoietic blood forming stem cells
    (RBC, WBC, Platelets).
   Normal stem cells found in umbilical cord
    blood and bone marrow.
   Form endothelial progenitors and
    endothelial cells of vessels.
   CD34+ facilitates cell migration
Hematopoietic Stem Cells
Mesenchymal Stem Cells

 Multipotent “structure forming” stromal stem
  cells.
 They produce bone cells, skin, chondrocytes,
  fat cells, tendons, ligaments and muscle cells
  and the extracellular matrix that supports the
  neurons and other cells.
 Most primitive are from Wharton’s jelly and
  umbilical cord blood.
Mesenchymal Stem Cells

 More recently, they have been able to produce
  liver cells, pancreatic cells, heart cells, kidney
  cells and neuron-like cells.
 They suppress immune function and are
  beneficial for auto-immune conditions
 Fat is said to have 500 times more
  Mesenchymal cells per gram than
  unstimulated bone marrow has.
Mesenchymal Stem Cells
Neural Stem Cells

 Both the bone marrow of adults and the
  umbilical cord blood of newborn babies have
  very primitive cells that can easily divide into
  neurons and retinal (eye) cells.
 This primitive subset of the hematopoietic stem
  cells has the CD34+CD 133+ (CD=Cluster of
  Differentiation molecule) on their surfaces.
 Used for most stem cell treatments in a variety
  of conditions
Umbilical Cord Derived
                      Stem Cells
   Human umbilical cord derived stem cells include
    hematopoietic stem cells, mesenchymal stem
    cells, CD133+ neural progenitor cells, and Very
    Small Embryonic-like stem cells (VSELs).
    These cells are neuroprotective and can survive
    and often thrive in the ischemic brain.
         Sun T and Ma QH. Repairing Neural Injuries Using Human Umbilical
    Cord Blood. Mol Neurobiol 2012: Dec 30. Epub ahead of print.
VSELs

 Very small embryonic-like stem cells are the
  smallest (1-3 micron) and most primitive stem
  cells currently being studied and used in
  clinical human medicine around the world.
 Work especially well in ALS CSF treatments
  and in severely damaged, ischemic tissue since
  they thrive in an ischemic environment.
Stem Cells


   Stem cells are able to migrate, secrete
    trophic factors, promote neuroprotection
    and modulate the immune response.
         Costa C, et al. Stem cell-based treatment of neurologic
    diseases. Med Clin (Barc) 2012; 139(5): 208-14.
Stem Cells

   Stem cells create cell repair and
    replacement through the growth
    factors that they produce.
Live Cell Therapy

  Paul Niehans in 1931, believed that the patients
  improved with Live Cell therapy because:
1) cells injected into the muscles remain alive and
  migrate towards the organs that need them.
2) injected cells remain alive at the injection site for
  a prolonged period, being nourished there by the
  host’s circulation and activating the deficiencies
  of degenerated organs at a distance. ---
  (Growth Factors)
Stem Cells

   Several studies have shown that the
    growth factors in stem cells are the
    healing factors. When the growth
    factors are removed by antibodies, there
    is little or no improvement in the
    animals.
The Dilemma of Stem Cells

 Growth factors are very important.
 Growth of stem cells is what creates the
  healing growth factors
 Death or inhibition of the stem cells will stop
  the production of the growth factors
 Stem Cell treatments then fail!
Failure of Stem Cells

 The raw material not healthy i.e.
 In bone marrow the patient must be
  ambulatory for the bone marrow stem cells
  to be good.
 Chronic hypoxia such as in severe COPD
  will make the bone marrow “sick” and
  poorly functional.
Failure of Bone Marrow tm

 Acute or chronic infections.
 During traveling the person picks up a cold or
  bacterial infection.
 Trauma to the head or other treated part will
  disrupt growing blood vessels.
 Lack of growth hormones, thyroid, etc.
Failure of Bone Marrow tm

 Severe vibration from 3 days to 40 days after
  the transplant – as in prolonged driving over
  rough roads.
 The vibration destroys the new blood vessels.
 Severe stress for whatever reason
 Toxins such as alcohol will kill newly forming
  tissue.
Bone Marrow Transplants

 Treat everyone as if they have just gotten
  pregnant and so need to follow the same
  guidelines.
 For example, avoid all fish so as to avoid
  heavy metals.
 Most patients with chronic disease should be
  properly treated for heavy metals, intestinal
  dysbiosis and infections before treatment.
Growth Factors
Growth Factors
 Adrenomedullin (AM)
 Angiopoietin (Ang)
 Bone morphogenetic proteins (BMPs)
 Brain-derived neurotrophic factor (BDNF)
 Cartilage-derived angiogenesis inhibitor
 Ciliary neurotrophic factor (CNTF)
Growth Factors
 Epidermal growth factor (EGF)
 Erythropoietin (EPO)
 Fibroblast growth factor (acidic and basic
  FGF)
 Glial-derived neurotrophic factor (GDNF)
 Granulocyte colony stimulating factor (G-
  CSF)
Growth Factors
 Granulocyte-macrophage colony-stimulating
  factor (GM-CSF)
 Hepatocyte growth factor (HGF)
 Insulin
 Insulin-like growth factor 1α and II (IGF)
 Interferons α,β, and γ (IFN)
Growth Factors

 Interleukins
 Macrophage-activating factor (MAF)
 Macrophage colony-stimulating factor (M-
  CSF)
 Melanocyte-stimulating hormone (MSH)
 Nerve growth factor (NGF)
 Neurotrophins 3 and 4 (NT-3 and NT-4)
Growth Factors

 Placental growth factor (PIGF)
 Platelet-derived growth factor (PDGF)
 Transforming growth factor α and β (TGF)
 Thrombopoietin (TPO)
 Tumor necrosis factor α and β (TNF)
 Wnt Signaling Pathway
 Vascular endothelial Factor (VEGF)
Additional Growth Factors

 Some of the best growth factors available
  for the clinicians of today include:
 Cerebrolysin (extract of embryonic pig
  brain)
 Thymus extracts
 Placenta extracts
Cerebrolysin

 Cerebrolysin has neurotrophic factors and
  peptide fragments that reduce the effects of
  neurotoxicity.
 Cerebrolysin attenuates blood-brain barrier
  disruption and brain damage from heat
  exposure.
    Sharma HS, et al. Neuroprotective effects of cerebrolysin, a combination
    of different active fragments of neurotrophic factors and peptides on the
    whole body hyperthermia-induced neurotoxicity. Int Rev Neurobio 2012;
    102: 249-76.
Cerebrolysin

 Cerebrolysin decreases β-amyloid
  deposition and tau phosphorylation.
 It also promotes neurogenesis in the dentate
  gyrus of the hippocampus.
 In stroke studies, cerebrolysin stabilizes the
  structural integrity of cells by inhibition of
  calpain and reduces apoptosis in ischemic
  lesions.
Cerebrolysin

   Cerebrolysin promotes axonal regeneration,
    neuronal plasticity and neurogenesis in
    stroke, traumatic brain injury, Alzheimer’s
    and spinal cord injury.
    Masliah E et al, The pharmacology of neurotrophic treatment with
    Cerebrolysin. Drugs Today 2012; 48 Suppl A: 3-24.
Cerebrolysin

   The safety of Cerebrolysin from clinical trials
    and clinical use has shown that adverse
    reactions were generally mild and transient.
    Most adverse effects included vertigo, agitation,
    rash and feeling hot. The results in clinical
    trials showed the adverse events similar to the
    placebo-treated groups.
    Thome J and Doppler E. Safety profile of Cerebrolysin. Drugs Today (Barc)
    2012; 48 Suppl A:63-9
Thymus Extract

 The thymus plays a crucial role in
  generating T cells and maintaining
  homeostasis of the immune system.
 With more than 30 peptides, they
  comprise an effective group of regulators,
  mediating important immune functions.
Thymus Extract

 Thymosin fraction 5 stimulates
  lymphocyte proliferation and
  differentiation.
 Prothymosin α and thymosin α1 show
  promise in immunodeficiencies,
  autoimmune disease, and malignancies.
Thymus Extract

   Prothymosin α is able to trigger
    anticancer immune responses.
    Ioannou K, et al. Prothymosin alpha: a ubiquitous polypeptide
    with potential use in cancer diagnosis and therapy. Cancer
    Immunol Immunother 2012; 61(5): 599-614.
Thymus Extract

   Thymic stromal lymphopoietin (TSLP) is an
    interleukin-7-like cytokine that is expressed in
    epithelial cells at barrier surfaces. TSLP
    strongly activates dendritic cells but without
    producing proinflammatory cytokines
    interleukin12, 6, TNF and interleukin 1.
    Hanabuchi S, et al. TSLP and Immune Homeostasis. Allergology
    International 2012; 61:19-25.
Thymus Degeneration

 Serious involution occurs at 50 years of age.
 Associated with the development of
  autoimmune diseases.
 Increased absorption of endotoxins from GI
  tract.
 Results in increased inflammation of body,
  osteoarthritis, RA, hypertension and other
  diseases of aging.
Thymus Regeneration

 Supplements of equal parts of Arginine and
  lysine 3 grams of each per day,
 Thymic epithelial progenitor cells,
 Mesenchymal stem cells,
 Immune stimulation-repetitive.
Thymus Regeneration

 Interleukin 22 administration (mice),
 Thymus extracts from young animals,
 Growth Factors, cytokines,
 Androgen blockade in men (also increases
  success rate of bone marrow stem cell
  transplantation).
Placental Extract

 Human placenta has been used for wounds,
  healing of burns, chronic ulcers and skin
  defects.
 In this study with placental extracts, the mice
  showed an acceleration in the reduction of
  the wound size compared with the control
  group on the 3rd to 9th day.
Placental Extract

 On the 6th day, there was a significant increase
  in transforming growth factor beta in the
  experimental group and on the 14th day, there
  was a statistically significant increase in VEGF
  in the experimental group.
 The authors conclude that placental extract
  directly promotes wound healing.
    Hong JW, et al. The effect of human placenta extract in a wound healing
    model. Ann Plast Surg 2010; 65(1): 96-100.
Placental Extract

   In Korea, human placental extract is being
    used to treat various diseases, including
    chronic liver diseases, menopause syndrome,
    chronic fatigue, skin pigment diseases, etc. In
    this study menopausal women were given
    placental extract, resulting in reduced
    symptoms and reduced fatigue.
     Kong MH, et al. Effect of human placental extract on menopausal
    symptoms. Menopause 2008; 15(2): 296-303.
The Nervous System
The Nervous System

 Neurotrophic growth factors promote
proliferation in specific cells as well as
regulate programmed cell death (apoptosis)
in other cells.
 Neurotrophins include nerve growth factor,
brain-derived neurotrophic factor, ciliary
neurotrophic factor, neurotrophin-3 and -4,
and glial-derived neurotrophic factor.
Neural Growth Factor




     Nerve Growth Factor
Neural Growth Factor (NGF)

 Nerve growth factor is important for the growth,
  maintenance, and survival of certain neurons.
 It functions as a signaling molecule.
 NGF is critical for the survival and maintenance
  of sympathetic and sensory neurons. Without it,
  these neurons undergo apoptosis (programmed
  cell death).
Neural Growth Factor

 Nerve growth factor promotes synaptic
  plasticity in cholinergic neurons.
 It improves memory impairment.
 It also stimulates neurite outgrowth by
  regulating cytoskeletal organization and
  cell adhesion.
Brain-derived Neurotrophic Factor
Brain-derived Neurotrophic Factor

 Brain-derived neurotrophic factor (BDNF)
  also supports neuronal survival.
 It promotes neurogenesis and synaptic
  function.
 BDNF also promotes long-term memory.
 BDNF is also expressed in the retina, motor
  neurons, the CNS, the kidneys, prostate and
  pancreas.
Ciliary Neurotrophic Factor

   Ciliary neurotrophic factor promotes
    neurotransmitter synthesis and neurite
    outgrowth. It also assists with neural and
    oligodendrocyte survival.
Neurotrophin-3
Neurotrophin-3

 NT-3 supports neuronal survival and
  differentiation.
 It also promotes the growth and
  differentiation of new neurons and
  synapses.
Neurotrophin-4




NT-4/5 interacts with the low affinity NGF
receptor and promotes neurite outgrowth.
Glial-derived Neurotrophic Factor

   GDNF promotes the survival and
    differentiation of dopaminergic neurons and
    prevents apoptosis in motor neurons. It also
    assists with kidney development.
Glial-derived Neurotrophic Factor

 GDNF creates a signaling complex with the
  receptor tyrosine kinase molecule RET which
  requires the presence of heparan sulfate
  glycoaminoglycans.
 The GDNF family includes neurturin,
  artemin, and persephin.
 GDNF shows promising results with
  Parkinson’s disease,ALS, alcohol and drug
  addiction.
Vascular Endothelial Growth Factor

Vascular endothelial growth factor is also
  important to neural function by
 promoting the growth and repair of blood
  cells in the central and peripheral nervous
  system and
 eliciting the assistance of BDNF and FGF
  in neurogenesis.
Stem Cells and the Brain

Mesenchymal stem cell transplants
 promote endogenous neuronal growth,
 reduce apoptosis and free radicals,
 promote synaptic connections from
  damaged neurons, and
 reduce inflammation.
Stem Cells and the Brain

Mesenchymal stem cells augment growth
  factor support to the brain by releasing
 Brain-derived neurotrophic factor
 Glial-derived neurotrophic factor
 Nerve growth factor
 Fibroblast growth factor-2
 Insulin growth factor-1
 Vascular endothelial growth factor
Stem Cells and the Brain

Mesenchymal stem cell transplants also
  release:
 Extracellular matrix molecules that
  support neural cell attachment, neural
  growth and axonal extensions.

  Joyce N, et al. Mesenchymal stem cells for the treatment of
  neurodegenerative disease. Regen Med 2010; 5(6): 933-946.
Stem Cells and the Brain

 Hematopoietic stem cells
 release VEGF for improving blood
  circulation,
 Release GDNF to promote the growth of glial
  cells and astrocytes to repair the white matter.
  Cerebral palsy responds well to white matter
  repair.
Stem Cells and the Brain

Hematopoietic stem cells also
 Release neurotrophin 3, nerve growth
  factor, brain-derived neurotrophic factor
  and promote the growth of neural
  progenitor cells to stimulate the growth of
  a small percentage of neurons.
 Bracci-Laudiero L et al. J Neuroimmunol 2003; 136(1-2): 130-9.
 Chouthai NS et al. Prediatr Res 2003; 53(6): 965-9.
Stroke and Growth Factors

   Stem cell therapies can have little or no
    effect in those who drink alcohol or have
    infections or stress. Combining stem cell
    therapies with growth factors helps the
    patient get better results, whether or not the
    stem cells survive.
Stroke and Growth Factors

   Cerebrolysin administration to 529 patients
    with a placebo group of 541 subjects showed
    better performance on the NIH Stroke Scale.
    In addition, the cerebrolysin group had a 10.5%
    mortality rate compared to a 20.2% rate with
    the placebo group.
    Heiss WD, et al. Cerebrolysin in patients with acute ischemic stroke in
    Asia. Stroke 2012; 43(3): 630-6.
The Heart
Atrial Natriuretic Peptide

ANP is a
 powerful vasodilator and a polypeptide
  hormone secreted by heart muscle cells.
 It maintains homeostasis in water,
  sodium, potassium and fat.
 It is released in response to high blood
  pressure.
Fibroblast Growth Factor

 FGF is involved in angiogenesis, embryonic
  growth and wound healing.
 It is involved in the proliferation and
  differentiation of various cells.
 Heparan sulfate proteoglycans are required
  for FGF signal transduction.
Hepatocyte Growth Factor

 HGF regulates cell growth, and is important for
  embryonic development, adult regeneration and
  wound healing.
 It is released by mesenchymal and hemato-
  poietic stem cells and acts on endothelial cells,
  epithelial cells and hematopoietic progenitor
  cells.
 It activates a tyrosine kinase signaling cascade
  to promote the growth of new cells.
Insulin-like Growth Factor
Insulin-like Growth Factor

 IGF is mainly secreted in the liver when
  stimulated by growth hormone.
 It promotes cell proliferation and inhibits
  apoptosis (programmed cell death).
 IGF 2 assists with fetal development and
  IGF1 assists with achieving our maximum
  growth and regulates neurogenesis. It is also
  involved in hearing.
Platelet-derived growth factor

 PDGF can promote angiogenesis and
  regulates cell growth and differentiation.
 It is a potent mitogen for mesenchymal
  derived cells, including smooth muscle
  cells and glial cells.
 It has a tyrosine kinase receptor.
Transforming Growth Factor

 TGF alpha induces epithelial development.
 It is also involved in tissue regeneration, cell
  differentiation, embryonic development and
  immune system regulation.
 It is produced in macrophages, the brain and in
  keratinocytes.
 TGF is upregulated in some forms of cancer.
Vascular Endothelial Growth Factor

 VEGF stimulates vasculogenesis and
  angiogenesis.
 It creates new blood vessels during
  embryonic development, new blood vessels
  after injury and when other vessels are
  blocked, and new muscle after exercise.
 VEGF is required for cancer metastasis and
  overexpression is seen in retinal diseases.
The Heart and Growth Factors

Angiogenesis and vasculogenesis are important
  factors in cardiovascular health.
 Endothelial progenitor cells help to repair
  damaged and dying blood cells.
 Platelet-derived growth factor receptor alpha
  cells can generate significant numbers of
  smooth muscle cells and endothelial cells.
Chong JJ, et al. Progenitor cells identified by PDGFR-alpha expression in
  the developing and diseased human heart. Stem Cells Dev 2013, Feb 7.
The Heart and Growth Factors

 Angiogenesis is increased by vascular
  endothelial growth factor, hepatocyte growth
  factor and insulin-like growth factor-1.
 Natriuretic peptide, transforming growth
  factor-beta 1, cardiotrophin-1, urocortin,
  acetylcholine, insulin and carbon monoxide
  can help the heart to mimic post conditioning.
    Maslov, LN. et al. Trigger mechanism of adaptive phenomenon of
    ischemic heartpostconditioning. Ross Fiziol Zh Im I M Sechenova 2012;
    98(9): 1053-69.
The Heart and Growth Factors

 Heparin and fibroblast growth factor-2
  have been shown to reduce scarring in the
  infarcted mycardium.
 There was reduced inflammation, fibrosis
  and cardiomyocyte death and greater
  cardiac contractibility.
    Chu H, et al. The effect of a heparin-based coacervate of fibroblast
    growth factor-2 on scarring in the infarcted myocardium.
    Biomaterials 2013; 34(6): 1747-56.
The Heart and Growth Factors

   Secretoneurin, an angiogenic factor,
    stimulates vascular endothelial growth
    factor and fibroblast growth factor receptor-
    3 in rats with myocardial infarction.
    Albrecht-Schgoer K, et al. The angiogenic factor secretoneurin
    induces coronary angiogenesis in a model of myocardial infarction by
    stimulation of vascular endothelial growth factor signaling in
    endothelial cells. Circulation 2012; 126(21): 2491-501.
The Heart and Growth Factors

 Rats administered oxytocin for 2 weeks showed
  greater protection against myocardial infarction.
 The oxytocin raised atrial natriuretic peptide
  levels, as well as p38-MAPK, Akt kinase and
  heat shock protein 27 in the left ventricular
  heart tissue.
    Ondrejcakova M, et al. Prolonged oxytocin treatment in rats affects
    intracellular signaling and induced myocardial protection against
    infarction. Gen Physiol Biophys 2012; 31(3): 261-70.
The Heart and Growth Factors

   Cardiac function improved after acute
    myocardial infarction in rats that were given
    hepatocyte growth factor and vascular
    endothelial growth factor in a hydrogel.
    Salimath AS, et al. Dual delivery of hepatocyte and vascular
    endothelial growth factors via a protease-degradable hydrogel
    improves cardiac function in rats. PLoS One 2012; 7(11): e50980.
The Heart and Growth Factors

   In addition to growth factors, both hematopoietic
    stem cells and mesenchymal stem cells release
    exosomes that improve myocardial function.
    Exosomes fuse with target cells, transferring
    specific miRNA molecules between the cells.
The Heart and Growth Factors

   Exosomes can also act as vectors for genetic
    information. They have been shown to
    establish a communication network among
    the cells.
    Barile L, et al. Ultrastructural evidence of exosome secretion by
    progenitor cells in adult mouse myocardium and adult human
    cardiospheres. J Biomed and Biotech 2012. Article ID 354605 (Epub
    ahead of print)
The Lungs
The Lungs and Growth Factors

 Fibroblast growth factor-7 (known as
  keratinocyte growth factor) enhances the
  repair of injured alveolar epithelium in
  endotoxin-induced lung injury in rats.
 Prostaglandin E2 re-programs alveolar
  macrophages to secrete anti-inflammatory
  interleukin-10.
The Lungs and Growth Factors

 Angiopoietin-1 (Ang), promotes
  angiogenesis and reduces endothelial
  permeability.
 Mesenchymal stem cells secrete
  Angiopoietin-1 as well as FGF-7,
  prostaglandin E2 and Interleukin-10.
The Lungs and Growth Factors

   Mesenchymal stem cells also secrete an
    antimicrobial peptide, LL-37 that is
    upregulated from bacterial stimulation.
    Lee JW, et al. Concise Review: Mesenchymal stem cells for actue lung
    injury: Role of paracrine soluble factors. Stem Cells 2011; 29(6): 913-
    919.
The Lungs and Growth Factors

   Hematopoietic stem cells along with
    fibroblast growth factor-7 (keratinocyte
    growth factor) was shown to stimulate
    epithelial cell proliferation and reduce
    bleomycin-induced pulmonary fibrosis.
    Aguilar S, et al. Bone marrow stem cells expressing keratinocyte growth
    factor via an inducible lentivirus protects against bleomycin-induced
    pulmonary fibrosis. PLoS One 2009; 4(11): e8013.
The Lungs and Growth Factors

   Hematopoietic stem cells support the lung
    during ischemic conditions with VEGF,
    platelet-derived growth factor, insulin-like
    growth factor and fibroblast growth factor to
    support angiogenesis.
    Lu J et al. Neovascularization and Hematopoietic stem cells. Cell
    Biochem Biophys 2011 Oct 30 (Epub ahead of print)
The Lungs and Growth Factors

 Autologous endothelial progenitor cells show
  positive effects against endotoxin-induced
  acute lung injury in rabbits.
 Polymorphonuclear cell infiltration and
  hemorrhages in the lung tissue was decreased
  by the endothelial cells.
 Nitric oxide and malondialdehyde were also
  inhibited.
The Lungs and Growth Factors

 Superoxide dismutase, interleukin-10, and
  VEGF were increased from the endothelial
  progenitor cells.
 Interleukin-1β, E-selectin, intercellular adhesion
  molecule-1 and inducible nitric oxide synthase
  were reduced.
     Cao JP, Autologous transplantation of peripheral blood-derived circulating
    endothelial progenitor cells attenuates endotoxin-induced acute lung injury in
    rabbits by direct endothelial repair and indirect immunomodulation.
    Anesthesiology 2012; 116(6): 1278-87.
The Lungs and Growth Factors

   Intermittent hypoxia, as seen with obstructive
    sleep apnea, was found to mobilize bone
    marrow derived very small embryonic-like
    stem cells (VSELs) in mice that promote organ
    repair.
The Lungs and Growth Factors

   More than 1100 unique genes were
    differentially expressed in the VSEL stem
    cells that activated organ-specific
    developmental programs.
     Gharib SA, et al. Intermittent hypoxia mobilizes bone marrow-derived
    very small embryonic-like stem cells and activates developmental
    transcription programs in mice. Sleep 2010; 33(11): 1439-46.
Wound Healing
Wound Healing and Growth Factors

 Non-healing wounds are a significant cause of
  disability, death and financial expense.
 Mesenchymal and hematopoietic stem cells
  have been found to accelerate wound closure
  and enhance wound repair quality with
  increased tensile strength.
Wound Healing and Growth Factors

 With stimulation from bone morphogenetic
  protein-4, mesenchymal stem cells are able to
  produce K14+ keratinocytes.
 VEGF promotes angiogenesis and
  vasculogenesis.
 Epidermal growth factor, erythropoietin and
  stromal cell-derived factor-1α are also
  expressed by mesenchymal stem cells.
Wound Healing and Growth Factors

   Fibrin spray and collagen matrix systems
    with cultured autologous mesenchymal stem
    cells have also increased wound healing.
    Chen JS, et al. Therapeutic potential of bone marrow-derived
    mesenchymal stem cells for cutaneous wound healing. Frontiers in
    Immunology 2012; 3: 192.
Wound Healing and Growth Factors


   The use of placental extract shows positive
    results for various skin conditions, including
    chronic wounds, pressure ulcer and burns.

    Chakraborty PD et al. Human aqueous placental extract as a wound
    healer. J Wound Care 2009; 18(11): 462, 464-7.
Alternatives in Growth
  Factor Production
Alternatives in Growth Factors

 There has been a shortage of human organs
  for transplantation. In 2011, over 111,000
  Americans were on the waiting list for organ
  transplants.
 An alternative that is gaining credibility is
  the use organs and growth factors from
  animals. This is called xenotransplantation.
Alternatives in Growth Factors

   According to the World Health Organization,
    xenotransplantation, animal to human, is
    defined as “living cells, tissues or organs of
    animal origin and human body fluids, cells,
    tissues or organs that have ex vivo with these
    living, xenogeneic materials.”
    (http://www.who.int/transplantation/xeno/en)
The History of Xenografts

   The Papyrus of Ebers (1500 B.C.), the
    writings of Aristotle(384-322 B.C.) and Pliny
    the Elder (A.D. 23-79), all contained many
    preparations made from human and animal
    organs to treat diseases.
The History of Xenografts


   2400 years ago Hippocrates (460-370 BC)
    advocated that animal skin be used to cover
    human ulcers and burns.

   Hippocrates also put forth the idea that a
    diseased organ could be treated by giving the
    patient, fresh, healthy tissue of the same type.
The History of Xenografts

 1762 - Dr. Hunter in England, and in 1849, Dr.
  von Berthold in Germany, implanted testes in
  castrated roosters and demonstrated positive
  responses.
 In 1889 Dr. Brown-Sequard injected himself
  with testicular extract from guinea pigs and
  was “tremendously rejuvenated.”
The History of Xenografts

 June 13, 1920 – Dr. Serge Voronoff did an ape
  to human- testicular implant.
 January 1928 – One thousand Surgeons
  participating in a medical conference held in
  Austria agreed that “The gland
  transplantation operation devised
  by Dr. Serge Voronoff afforded
  transient regeneration.”
The History of Xenografts

 1920-1930s
  Dr. Paul Niehans
 “The Father of
  Cell Therapy” and
  xenotransplantation.
The History of Xenografts




  Type of operating room used by Dr Niehans to
transplant organ tissues from fetal sheep obtained
       via “C” Section to adjacent patients.
The History of Xenografts

   In 1964, Dr. Reemtsma transplanted a
    kidney from a chimpanzee into a patient
    with end-stage renal disease. The operation
    extended the patient’s life for nine months.
         Denner, J and Ralf R. Tönjes. Infection Barriers to Successful
    Xenotransplantation Focusing on Porcine Endogenous Retroviruses.
    Clin Microbiol Rev 2012; 25(2): 318.
Alternatives in Growth Factors

   In 1995, researchers showed that
    hematopoietic-promoting factor and stem cell
    factor from the porcine kidney were able to
    proliferate mouse hematopoietic progenitor
    cells, granulocyte-macrophage colony-forming
    units, and erythropoietic burst-forming units.
         Kashiwakura I et al. Effect of a hematopoietic promoting factor
derived from porcine kidney on the proliferation of mouse hematopoietic
hematopoietic progenitor cells in liquid culture. Biol Pharm Buill 1995;
18(11): 1476-81.
Alternatives in Growth Factors

   In collaboration with the International
    Xenotransplantation Association, the
    University Hospital Geneva and the World
    Health Organization, an international inventory
    has been established to collect basic
    data on xenotransplantation procedures in
    humans. (http:www.humanxenotransplant.org)
Alternatives in Growth Factors

   The International Human Xenotransplantation
    Inventory has found 29 human applications of
    xenotransplantation, including islets of
    Langerhans, kidney cells, chromaffin cells,
    embryonic stem cells, fetal and adult cells
    from various organs or the use of
    extracorporeal perfusion from hepatocytes, the
    liver, spleen or kidney.
          Sgroi A, et al. International Human Xenotransplantation Inventory.
    Transplantation 2010; 90: 597-603.
Porcine Research
Alternatives in Growth Factors


   Porcine neonatal islets of Langerhans with
    porcine Sertoli cells were administered to
    12 children with type 1 diabetes (insulin-
    dependent) without immunosuppression.
Alternatives in Growth Factors

   The authors reported a significant reduction in
    exogenous insulin requirements during the 4
    year follow-up among six patients, two of
    whom became temporarily insulin-
    independent.
         Valdes-Gonzalez R et al, Long-term follow-up of patients with type 1
    diabetes transplanted with neonatal pig islets. Clin Exp Immunol 2010;
    162(3): 537-42.
Alternatives in Growth Factors

   With the genetic modification of pigs, cell
    transplant studies such as those of pancreatic
    islets are leading to more hopeful results. The
    range of possibilities offered by this
    technology will be unlimited, making it
    possible for xenotransplantation to be a
    clinical reality soon.
          Costa Valles C, Manez Mendiluce R. Transgenic organs and
    xenotransplants. Adv Exp Med Biol 2012; 741:73–88.
Sheep Research
Alternatives in Growth Factors

 With sheep, the Center for Living Cell
  Therapy in Lenggries, Germany was started
  by Dr. Siegfried Block who had worked with
  Dr. Hans Niehans.
 The Center raises 700 sheep in the high
  mountains, away from damaging
  environmental effects.
Alternatives in Growth Factors

 85 different fetal or neonatal organs are
  available for live sheep cells that are used to
  treat specific health functions.
 The clinic offers cells to treat aging,
  impotence, Down’s syndrome, AIDS and
  many other conditions.
 http://www.frischzellen-kur.de
          Sgroi A, et al. International Human Xenotransplantation Inventory.
    Transplantation 2010; 90: 597-603.
Rabbit Research
Alternatives in Growth Factors

   In Russia, the use of rabbit newborn
    pancreatic grafts with kidney extracts
    showed a survival rate of 75% in 26 type 1
    (insulin-dependent) diabetic children. The
    results included insulin stabilization,
    reductions in glycoslyated hemoglobin,
    reduced exogenous insulin and a small
    increase in serum C-peptide.
Alternatives in Growth Factors

   In diabetic nephropathy children, there was
    also a decrease in albuminuria from about
    220 to 60 mg/day.
    (http://nikrrom.chat/ru/list1_en.htm)
         Sgroi A, et al. International Human Xenotransplantation
    Inventory. Transplantation 2010; 90: 597-603.
Alternatives in Growth Factors

   As stem cell research has expanded,
    there have been organizations that
    promote rabbit fetal precursor stem cells
    (BCRO: Bio-Cellular Research
    Organization in Russia and Eco-
    Ultrafiltrates in Europe).
Alternatives in Growth Factors

   Rabbit progenitor cells have been used in
    clinical studies around the world for
    diabetes, immune deficiency disorders,
    neurological degeneration, cardiovascular
    disease, and genetic disorders in children.
Alternatives in Growth Factors

   Article on rabbit progenitor cells and the diabetic
    retina:
        Zubkova S.T., Danilova A.I., Kovpan N.A.:
    ("Condition of vessels of retina and of lower
    extremities in diabetic patients after
    transplantation of cultures of islet cells of
    pancreas"), Summary, in: Proceedings of 4th
    Congress of Ukrainian Endocrinologists, Kiev
    (now Ukraine), 1987. p. 153.
Alternatives in Growth Factors

   The rabbit fetal progenitor cells have also
    been given 3 times a year to children with
    Down’s Syndrome.
Alternatives in Growth Factors

   From Dr. Molnar’s article:
        E. Michael Molnar, Gebrevnikova NV,
    Burkova MI, Sukhikh GT, Fisenko NA, Ionova
    AP: Influence of the transplantation of fetal
    tissue on the development of higher mental
    functions in children with Down Syndrome.
    Klinicheskij Vestnik, 12 (4): 1995; 341.
Alternatives in Growth Factors

 FCTI (Eco-ultrafilterates from Europe) is
  using ultrafiltration and nanotechnology to
  create rabbit derived progenitor cells and
  growth factors without the proteins.
 Do these products actually promote
  regeneration?
Alternatives in Growth Factors

 The ready-to-use Eco-ultrafiltrates contain
  components up to a nominal molecular weight
  of 10 kDa – about 1/9th of the smallest virus
  known at this time.
 The first ultra-filtrate for the skin and the
  mucosa was from a histological study by Dr.
  F. Leyh in 1981. Since then, the FCTI
  company was formed and more products have
  been created.
Alternatives in Growth Factors

   Eco-ultrafiltrates have a variety of cell
    products that support the skin, mesenchyme,
    placenta, male and female revitalization,
    thymus, immune, kidney, liver, adrenal
    cortex, adrenal medulla, prostate, pituitary,
    pancreas, bone, cartilage and synovia, lungs,
    blood, spinal cord, heart, eye, colon, transfer
    factor, thyroid, etc.
Growth Hormone

 Growth hormone - 22,124 daltons.
 Even though structurally similar to growth
  hormones from animals, only human and old
  world monkey growth hormones have
  significant effects on the human growth
  hormone receptor.
 No animal product can be used as a substitute
  for human growth hormone.
Alternatives in Growth Factors

 Xenotransplantation businesses are expanding
  throughout the world.
 xenograft organ extracts (porcine and sheep-
  ovine) are available and have been used in
  Germany for many years on patients.
 In general, little side effects.
 No reported transmission of micro-organisms
  when prepared in GMP lab.
Our Treatment Program
Bone Marrow Treatments

 Our clinic offers autologous bone marrow
  stem cell therapies with the person’s own
  growth factors.
 The FDA classifies the simple removal and
  re-injection of bone marrow as routine
  medical practice.
 Culturing of the patient’s stem cells makes
  these a drug and can not be advertised.
Bone Marrow Treatments

 Optimum treatment today:
 Neupogen shots daily for 5 days,
 14-15 days later bone marrow is aspirated
  from each hip and given back intravenously,
 Gives much better results than simple bone
  marrow but in people under 40, a simple bone
  marrow treatment is usually good.
Fat Stem Cells

   Fat stem cells have recently been classified
    by the FDA as drugs, so advertising the use
    of these for anything other than cosmetic
    purposes could be a problem.
Treatments
Treatments

            After the
           transfusion,
          the stem cells
             circulate
         throughout the
         body to repair
            or replace
          damaged and
           aging cells.
Support for the Stem Cells

   The stem cell treatments can benefit a
    variety of hard-to-treat conditions.
   The elimination of toxins, infections and
    other problems before, during and after stem
    cell treatments (including checking for sleep
    apnea).
   The use of hormones, growth factors and
    additional therapies enhances the results.
Support for the Stem Cells
 Each case is different and some may take
  more time to prepare for the procedure to
  achieve optimum results.
 The combination of stem cell/progenitor cell
  therapies with electromagnetic therapy
  provides increased improvement for a longer
  time.
Treatable Conditions

   Osteoarthritis (DJD)       Diabetes I and II
   Acute & chronic heart      Eye disorders
    disease, heart attack      Autoimmune diseases
   Cerebral palsy             Multiple sclerosis
   Sports injuries            ALS
   Cartilage repair           Parkinson’s disease
   Spinal disc disorders      Dementia
   GI disorders               Huntington’s disease
   Kidney disorders           Other Genetic Disorders
Together,
we can make a difference.
For Further Information

     Check out our websites and sign up for our
                    newsletter at:
   http://www.stemcellmd.org
   http://www.stemcelltherapies.org


            My clinic toll free number is
                   800-300-1063

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Regeneration with Dr. David Steenblock

  • 1. REGENERATION David A. Steenblock, M.S., D.O. Personalized Regenerative Medicine TM Mission Viejo, California 26381 Crown Valley Pkwy, St. 130, Mission Viejo, Calif, USA; 800-300-1063
  • 2. REGENERATION  For optimum regeneration of a damaged organ or entire body, there are three important factors that need to be present.  Healthy Stem cells of a newborn  Growth factors- levels of a newborn  Thymus factors- levels of a newborn
  • 3. What are Stem Cells?  Stem cells are the first cells of the embryo that build new life.  Stem cells continue to help with growth and tissue repair as we age, BUT slow down after 40 years of age.  Stem cells divide to create more stem cells so theoretically if all of your stem cells remain youthful, the body could repair itself forever and you would only die from accidents.
  • 4. Hematopoietic Stem Cells  Hematopoietic stem cells (called CD34+) are multipotent, undifferentiated hematopoietic blood forming stem cells (RBC, WBC, Platelets).  Normal stem cells found in umbilical cord blood and bone marrow.  Form endothelial progenitors and endothelial cells of vessels.  CD34+ facilitates cell migration
  • 6. Mesenchymal Stem Cells  Multipotent “structure forming” stromal stem cells.  They produce bone cells, skin, chondrocytes, fat cells, tendons, ligaments and muscle cells and the extracellular matrix that supports the neurons and other cells.  Most primitive are from Wharton’s jelly and umbilical cord blood.
  • 7. Mesenchymal Stem Cells  More recently, they have been able to produce liver cells, pancreatic cells, heart cells, kidney cells and neuron-like cells.  They suppress immune function and are beneficial for auto-immune conditions  Fat is said to have 500 times more Mesenchymal cells per gram than unstimulated bone marrow has.
  • 9. Neural Stem Cells  Both the bone marrow of adults and the umbilical cord blood of newborn babies have very primitive cells that can easily divide into neurons and retinal (eye) cells.  This primitive subset of the hematopoietic stem cells has the CD34+CD 133+ (CD=Cluster of Differentiation molecule) on their surfaces.  Used for most stem cell treatments in a variety of conditions
  • 10. Umbilical Cord Derived Stem Cells  Human umbilical cord derived stem cells include hematopoietic stem cells, mesenchymal stem cells, CD133+ neural progenitor cells, and Very Small Embryonic-like stem cells (VSELs). These cells are neuroprotective and can survive and often thrive in the ischemic brain. Sun T and Ma QH. Repairing Neural Injuries Using Human Umbilical Cord Blood. Mol Neurobiol 2012: Dec 30. Epub ahead of print.
  • 11. VSELs  Very small embryonic-like stem cells are the smallest (1-3 micron) and most primitive stem cells currently being studied and used in clinical human medicine around the world.  Work especially well in ALS CSF treatments and in severely damaged, ischemic tissue since they thrive in an ischemic environment.
  • 12. Stem Cells  Stem cells are able to migrate, secrete trophic factors, promote neuroprotection and modulate the immune response. Costa C, et al. Stem cell-based treatment of neurologic diseases. Med Clin (Barc) 2012; 139(5): 208-14.
  • 13. Stem Cells  Stem cells create cell repair and replacement through the growth factors that they produce.
  • 14. Live Cell Therapy Paul Niehans in 1931, believed that the patients improved with Live Cell therapy because: 1) cells injected into the muscles remain alive and migrate towards the organs that need them. 2) injected cells remain alive at the injection site for a prolonged period, being nourished there by the host’s circulation and activating the deficiencies of degenerated organs at a distance. --- (Growth Factors)
  • 15. Stem Cells  Several studies have shown that the growth factors in stem cells are the healing factors. When the growth factors are removed by antibodies, there is little or no improvement in the animals.
  • 16. The Dilemma of Stem Cells  Growth factors are very important.  Growth of stem cells is what creates the healing growth factors  Death or inhibition of the stem cells will stop the production of the growth factors  Stem Cell treatments then fail!
  • 17. Failure of Stem Cells  The raw material not healthy i.e.  In bone marrow the patient must be ambulatory for the bone marrow stem cells to be good.  Chronic hypoxia such as in severe COPD will make the bone marrow “sick” and poorly functional.
  • 18. Failure of Bone Marrow tm  Acute or chronic infections.  During traveling the person picks up a cold or bacterial infection.  Trauma to the head or other treated part will disrupt growing blood vessels.  Lack of growth hormones, thyroid, etc.
  • 19. Failure of Bone Marrow tm  Severe vibration from 3 days to 40 days after the transplant – as in prolonged driving over rough roads.  The vibration destroys the new blood vessels.  Severe stress for whatever reason  Toxins such as alcohol will kill newly forming tissue.
  • 20. Bone Marrow Transplants  Treat everyone as if they have just gotten pregnant and so need to follow the same guidelines.  For example, avoid all fish so as to avoid heavy metals.  Most patients with chronic disease should be properly treated for heavy metals, intestinal dysbiosis and infections before treatment.
  • 22. Growth Factors  Adrenomedullin (AM)  Angiopoietin (Ang)  Bone morphogenetic proteins (BMPs)  Brain-derived neurotrophic factor (BDNF)  Cartilage-derived angiogenesis inhibitor  Ciliary neurotrophic factor (CNTF)
  • 23. Growth Factors  Epidermal growth factor (EGF)  Erythropoietin (EPO)  Fibroblast growth factor (acidic and basic FGF)  Glial-derived neurotrophic factor (GDNF)  Granulocyte colony stimulating factor (G- CSF)
  • 24. Growth Factors  Granulocyte-macrophage colony-stimulating factor (GM-CSF)  Hepatocyte growth factor (HGF)  Insulin  Insulin-like growth factor 1α and II (IGF)  Interferons α,β, and γ (IFN)
  • 25. Growth Factors  Interleukins  Macrophage-activating factor (MAF)  Macrophage colony-stimulating factor (M- CSF)  Melanocyte-stimulating hormone (MSH)  Nerve growth factor (NGF)  Neurotrophins 3 and 4 (NT-3 and NT-4)
  • 26. Growth Factors  Placental growth factor (PIGF)  Platelet-derived growth factor (PDGF)  Transforming growth factor α and β (TGF)  Thrombopoietin (TPO)  Tumor necrosis factor α and β (TNF)  Wnt Signaling Pathway  Vascular endothelial Factor (VEGF)
  • 27. Additional Growth Factors Some of the best growth factors available for the clinicians of today include:  Cerebrolysin (extract of embryonic pig brain)  Thymus extracts  Placenta extracts
  • 28. Cerebrolysin  Cerebrolysin has neurotrophic factors and peptide fragments that reduce the effects of neurotoxicity.  Cerebrolysin attenuates blood-brain barrier disruption and brain damage from heat exposure. Sharma HS, et al. Neuroprotective effects of cerebrolysin, a combination of different active fragments of neurotrophic factors and peptides on the whole body hyperthermia-induced neurotoxicity. Int Rev Neurobio 2012; 102: 249-76.
  • 29. Cerebrolysin  Cerebrolysin decreases β-amyloid deposition and tau phosphorylation.  It also promotes neurogenesis in the dentate gyrus of the hippocampus.  In stroke studies, cerebrolysin stabilizes the structural integrity of cells by inhibition of calpain and reduces apoptosis in ischemic lesions.
  • 30. Cerebrolysin  Cerebrolysin promotes axonal regeneration, neuronal plasticity and neurogenesis in stroke, traumatic brain injury, Alzheimer’s and spinal cord injury. Masliah E et al, The pharmacology of neurotrophic treatment with Cerebrolysin. Drugs Today 2012; 48 Suppl A: 3-24.
  • 31. Cerebrolysin  The safety of Cerebrolysin from clinical trials and clinical use has shown that adverse reactions were generally mild and transient. Most adverse effects included vertigo, agitation, rash and feeling hot. The results in clinical trials showed the adverse events similar to the placebo-treated groups. Thome J and Doppler E. Safety profile of Cerebrolysin. Drugs Today (Barc) 2012; 48 Suppl A:63-9
  • 32. Thymus Extract  The thymus plays a crucial role in generating T cells and maintaining homeostasis of the immune system.  With more than 30 peptides, they comprise an effective group of regulators, mediating important immune functions.
  • 33. Thymus Extract  Thymosin fraction 5 stimulates lymphocyte proliferation and differentiation.  Prothymosin α and thymosin α1 show promise in immunodeficiencies, autoimmune disease, and malignancies.
  • 34. Thymus Extract  Prothymosin α is able to trigger anticancer immune responses. Ioannou K, et al. Prothymosin alpha: a ubiquitous polypeptide with potential use in cancer diagnosis and therapy. Cancer Immunol Immunother 2012; 61(5): 599-614.
  • 35. Thymus Extract  Thymic stromal lymphopoietin (TSLP) is an interleukin-7-like cytokine that is expressed in epithelial cells at barrier surfaces. TSLP strongly activates dendritic cells but without producing proinflammatory cytokines interleukin12, 6, TNF and interleukin 1. Hanabuchi S, et al. TSLP and Immune Homeostasis. Allergology International 2012; 61:19-25.
  • 36. Thymus Degeneration  Serious involution occurs at 50 years of age.  Associated with the development of autoimmune diseases.  Increased absorption of endotoxins from GI tract.  Results in increased inflammation of body, osteoarthritis, RA, hypertension and other diseases of aging.
  • 37. Thymus Regeneration  Supplements of equal parts of Arginine and lysine 3 grams of each per day,  Thymic epithelial progenitor cells,  Mesenchymal stem cells,  Immune stimulation-repetitive.
  • 38. Thymus Regeneration  Interleukin 22 administration (mice),  Thymus extracts from young animals,  Growth Factors, cytokines,  Androgen blockade in men (also increases success rate of bone marrow stem cell transplantation).
  • 39. Placental Extract  Human placenta has been used for wounds, healing of burns, chronic ulcers and skin defects.  In this study with placental extracts, the mice showed an acceleration in the reduction of the wound size compared with the control group on the 3rd to 9th day.
  • 40. Placental Extract  On the 6th day, there was a significant increase in transforming growth factor beta in the experimental group and on the 14th day, there was a statistically significant increase in VEGF in the experimental group.  The authors conclude that placental extract directly promotes wound healing. Hong JW, et al. The effect of human placenta extract in a wound healing model. Ann Plast Surg 2010; 65(1): 96-100.
  • 41. Placental Extract  In Korea, human placental extract is being used to treat various diseases, including chronic liver diseases, menopause syndrome, chronic fatigue, skin pigment diseases, etc. In this study menopausal women were given placental extract, resulting in reduced symptoms and reduced fatigue. Kong MH, et al. Effect of human placental extract on menopausal symptoms. Menopause 2008; 15(2): 296-303.
  • 43. The Nervous System Neurotrophic growth factors promote proliferation in specific cells as well as regulate programmed cell death (apoptosis) in other cells. Neurotrophins include nerve growth factor, brain-derived neurotrophic factor, ciliary neurotrophic factor, neurotrophin-3 and -4, and glial-derived neurotrophic factor.
  • 44. Neural Growth Factor Nerve Growth Factor
  • 45. Neural Growth Factor (NGF)  Nerve growth factor is important for the growth, maintenance, and survival of certain neurons.  It functions as a signaling molecule.  NGF is critical for the survival and maintenance of sympathetic and sensory neurons. Without it, these neurons undergo apoptosis (programmed cell death).
  • 46. Neural Growth Factor  Nerve growth factor promotes synaptic plasticity in cholinergic neurons.  It improves memory impairment.  It also stimulates neurite outgrowth by regulating cytoskeletal organization and cell adhesion.
  • 48. Brain-derived Neurotrophic Factor  Brain-derived neurotrophic factor (BDNF) also supports neuronal survival.  It promotes neurogenesis and synaptic function.  BDNF also promotes long-term memory.  BDNF is also expressed in the retina, motor neurons, the CNS, the kidneys, prostate and pancreas.
  • 49. Ciliary Neurotrophic Factor  Ciliary neurotrophic factor promotes neurotransmitter synthesis and neurite outgrowth. It also assists with neural and oligodendrocyte survival.
  • 51. Neurotrophin-3  NT-3 supports neuronal survival and differentiation.  It also promotes the growth and differentiation of new neurons and synapses.
  • 52. Neurotrophin-4 NT-4/5 interacts with the low affinity NGF receptor and promotes neurite outgrowth.
  • 53. Glial-derived Neurotrophic Factor  GDNF promotes the survival and differentiation of dopaminergic neurons and prevents apoptosis in motor neurons. It also assists with kidney development.
  • 54. Glial-derived Neurotrophic Factor  GDNF creates a signaling complex with the receptor tyrosine kinase molecule RET which requires the presence of heparan sulfate glycoaminoglycans.  The GDNF family includes neurturin, artemin, and persephin.  GDNF shows promising results with Parkinson’s disease,ALS, alcohol and drug addiction.
  • 55. Vascular Endothelial Growth Factor Vascular endothelial growth factor is also important to neural function by  promoting the growth and repair of blood cells in the central and peripheral nervous system and  eliciting the assistance of BDNF and FGF in neurogenesis.
  • 56. Stem Cells and the Brain Mesenchymal stem cell transplants  promote endogenous neuronal growth,  reduce apoptosis and free radicals,  promote synaptic connections from damaged neurons, and  reduce inflammation.
  • 57. Stem Cells and the Brain Mesenchymal stem cells augment growth factor support to the brain by releasing  Brain-derived neurotrophic factor  Glial-derived neurotrophic factor  Nerve growth factor  Fibroblast growth factor-2  Insulin growth factor-1  Vascular endothelial growth factor
  • 58. Stem Cells and the Brain Mesenchymal stem cell transplants also release:  Extracellular matrix molecules that support neural cell attachment, neural growth and axonal extensions. Joyce N, et al. Mesenchymal stem cells for the treatment of neurodegenerative disease. Regen Med 2010; 5(6): 933-946.
  • 59. Stem Cells and the Brain Hematopoietic stem cells  release VEGF for improving blood circulation,  Release GDNF to promote the growth of glial cells and astrocytes to repair the white matter. Cerebral palsy responds well to white matter repair.
  • 60. Stem Cells and the Brain Hematopoietic stem cells also  Release neurotrophin 3, nerve growth factor, brain-derived neurotrophic factor and promote the growth of neural progenitor cells to stimulate the growth of a small percentage of neurons. Bracci-Laudiero L et al. J Neuroimmunol 2003; 136(1-2): 130-9. Chouthai NS et al. Prediatr Res 2003; 53(6): 965-9.
  • 61. Stroke and Growth Factors  Stem cell therapies can have little or no effect in those who drink alcohol or have infections or stress. Combining stem cell therapies with growth factors helps the patient get better results, whether or not the stem cells survive.
  • 62. Stroke and Growth Factors  Cerebrolysin administration to 529 patients with a placebo group of 541 subjects showed better performance on the NIH Stroke Scale. In addition, the cerebrolysin group had a 10.5% mortality rate compared to a 20.2% rate with the placebo group. Heiss WD, et al. Cerebrolysin in patients with acute ischemic stroke in Asia. Stroke 2012; 43(3): 630-6.
  • 64. Atrial Natriuretic Peptide ANP is a  powerful vasodilator and a polypeptide hormone secreted by heart muscle cells.  It maintains homeostasis in water, sodium, potassium and fat.  It is released in response to high blood pressure.
  • 65. Fibroblast Growth Factor  FGF is involved in angiogenesis, embryonic growth and wound healing.  It is involved in the proliferation and differentiation of various cells.  Heparan sulfate proteoglycans are required for FGF signal transduction.
  • 66. Hepatocyte Growth Factor  HGF regulates cell growth, and is important for embryonic development, adult regeneration and wound healing.  It is released by mesenchymal and hemato- poietic stem cells and acts on endothelial cells, epithelial cells and hematopoietic progenitor cells.  It activates a tyrosine kinase signaling cascade to promote the growth of new cells.
  • 68. Insulin-like Growth Factor  IGF is mainly secreted in the liver when stimulated by growth hormone.  It promotes cell proliferation and inhibits apoptosis (programmed cell death).  IGF 2 assists with fetal development and IGF1 assists with achieving our maximum growth and regulates neurogenesis. It is also involved in hearing.
  • 69. Platelet-derived growth factor  PDGF can promote angiogenesis and regulates cell growth and differentiation.  It is a potent mitogen for mesenchymal derived cells, including smooth muscle cells and glial cells.  It has a tyrosine kinase receptor.
  • 70. Transforming Growth Factor  TGF alpha induces epithelial development.  It is also involved in tissue regeneration, cell differentiation, embryonic development and immune system regulation.  It is produced in macrophages, the brain and in keratinocytes.  TGF is upregulated in some forms of cancer.
  • 71. Vascular Endothelial Growth Factor  VEGF stimulates vasculogenesis and angiogenesis.  It creates new blood vessels during embryonic development, new blood vessels after injury and when other vessels are blocked, and new muscle after exercise.  VEGF is required for cancer metastasis and overexpression is seen in retinal diseases.
  • 72. The Heart and Growth Factors Angiogenesis and vasculogenesis are important factors in cardiovascular health.  Endothelial progenitor cells help to repair damaged and dying blood cells.  Platelet-derived growth factor receptor alpha cells can generate significant numbers of smooth muscle cells and endothelial cells. Chong JJ, et al. Progenitor cells identified by PDGFR-alpha expression in the developing and diseased human heart. Stem Cells Dev 2013, Feb 7.
  • 73. The Heart and Growth Factors  Angiogenesis is increased by vascular endothelial growth factor, hepatocyte growth factor and insulin-like growth factor-1.  Natriuretic peptide, transforming growth factor-beta 1, cardiotrophin-1, urocortin, acetylcholine, insulin and carbon monoxide can help the heart to mimic post conditioning. Maslov, LN. et al. Trigger mechanism of adaptive phenomenon of ischemic heartpostconditioning. Ross Fiziol Zh Im I M Sechenova 2012; 98(9): 1053-69.
  • 74. The Heart and Growth Factors  Heparin and fibroblast growth factor-2 have been shown to reduce scarring in the infarcted mycardium.  There was reduced inflammation, fibrosis and cardiomyocyte death and greater cardiac contractibility. Chu H, et al. The effect of a heparin-based coacervate of fibroblast growth factor-2 on scarring in the infarcted myocardium. Biomaterials 2013; 34(6): 1747-56.
  • 75. The Heart and Growth Factors  Secretoneurin, an angiogenic factor, stimulates vascular endothelial growth factor and fibroblast growth factor receptor- 3 in rats with myocardial infarction. Albrecht-Schgoer K, et al. The angiogenic factor secretoneurin induces coronary angiogenesis in a model of myocardial infarction by stimulation of vascular endothelial growth factor signaling in endothelial cells. Circulation 2012; 126(21): 2491-501.
  • 76. The Heart and Growth Factors  Rats administered oxytocin for 2 weeks showed greater protection against myocardial infarction.  The oxytocin raised atrial natriuretic peptide levels, as well as p38-MAPK, Akt kinase and heat shock protein 27 in the left ventricular heart tissue. Ondrejcakova M, et al. Prolonged oxytocin treatment in rats affects intracellular signaling and induced myocardial protection against infarction. Gen Physiol Biophys 2012; 31(3): 261-70.
  • 77. The Heart and Growth Factors  Cardiac function improved after acute myocardial infarction in rats that were given hepatocyte growth factor and vascular endothelial growth factor in a hydrogel. Salimath AS, et al. Dual delivery of hepatocyte and vascular endothelial growth factors via a protease-degradable hydrogel improves cardiac function in rats. PLoS One 2012; 7(11): e50980.
  • 78. The Heart and Growth Factors  In addition to growth factors, both hematopoietic stem cells and mesenchymal stem cells release exosomes that improve myocardial function. Exosomes fuse with target cells, transferring specific miRNA molecules between the cells.
  • 79. The Heart and Growth Factors  Exosomes can also act as vectors for genetic information. They have been shown to establish a communication network among the cells. Barile L, et al. Ultrastructural evidence of exosome secretion by progenitor cells in adult mouse myocardium and adult human cardiospheres. J Biomed and Biotech 2012. Article ID 354605 (Epub ahead of print)
  • 81. The Lungs and Growth Factors  Fibroblast growth factor-7 (known as keratinocyte growth factor) enhances the repair of injured alveolar epithelium in endotoxin-induced lung injury in rats.  Prostaglandin E2 re-programs alveolar macrophages to secrete anti-inflammatory interleukin-10.
  • 82. The Lungs and Growth Factors  Angiopoietin-1 (Ang), promotes angiogenesis and reduces endothelial permeability.  Mesenchymal stem cells secrete Angiopoietin-1 as well as FGF-7, prostaglandin E2 and Interleukin-10.
  • 83. The Lungs and Growth Factors  Mesenchymal stem cells also secrete an antimicrobial peptide, LL-37 that is upregulated from bacterial stimulation. Lee JW, et al. Concise Review: Mesenchymal stem cells for actue lung injury: Role of paracrine soluble factors. Stem Cells 2011; 29(6): 913- 919.
  • 84. The Lungs and Growth Factors  Hematopoietic stem cells along with fibroblast growth factor-7 (keratinocyte growth factor) was shown to stimulate epithelial cell proliferation and reduce bleomycin-induced pulmonary fibrosis. Aguilar S, et al. Bone marrow stem cells expressing keratinocyte growth factor via an inducible lentivirus protects against bleomycin-induced pulmonary fibrosis. PLoS One 2009; 4(11): e8013.
  • 85. The Lungs and Growth Factors  Hematopoietic stem cells support the lung during ischemic conditions with VEGF, platelet-derived growth factor, insulin-like growth factor and fibroblast growth factor to support angiogenesis. Lu J et al. Neovascularization and Hematopoietic stem cells. Cell Biochem Biophys 2011 Oct 30 (Epub ahead of print)
  • 86. The Lungs and Growth Factors  Autologous endothelial progenitor cells show positive effects against endotoxin-induced acute lung injury in rabbits.  Polymorphonuclear cell infiltration and hemorrhages in the lung tissue was decreased by the endothelial cells.  Nitric oxide and malondialdehyde were also inhibited.
  • 87. The Lungs and Growth Factors  Superoxide dismutase, interleukin-10, and VEGF were increased from the endothelial progenitor cells.  Interleukin-1β, E-selectin, intercellular adhesion molecule-1 and inducible nitric oxide synthase were reduced. Cao JP, Autologous transplantation of peripheral blood-derived circulating endothelial progenitor cells attenuates endotoxin-induced acute lung injury in rabbits by direct endothelial repair and indirect immunomodulation. Anesthesiology 2012; 116(6): 1278-87.
  • 88. The Lungs and Growth Factors  Intermittent hypoxia, as seen with obstructive sleep apnea, was found to mobilize bone marrow derived very small embryonic-like stem cells (VSELs) in mice that promote organ repair.
  • 89. The Lungs and Growth Factors  More than 1100 unique genes were differentially expressed in the VSEL stem cells that activated organ-specific developmental programs. Gharib SA, et al. Intermittent hypoxia mobilizes bone marrow-derived very small embryonic-like stem cells and activates developmental transcription programs in mice. Sleep 2010; 33(11): 1439-46.
  • 91. Wound Healing and Growth Factors  Non-healing wounds are a significant cause of disability, death and financial expense.  Mesenchymal and hematopoietic stem cells have been found to accelerate wound closure and enhance wound repair quality with increased tensile strength.
  • 92. Wound Healing and Growth Factors  With stimulation from bone morphogenetic protein-4, mesenchymal stem cells are able to produce K14+ keratinocytes.  VEGF promotes angiogenesis and vasculogenesis.  Epidermal growth factor, erythropoietin and stromal cell-derived factor-1α are also expressed by mesenchymal stem cells.
  • 93. Wound Healing and Growth Factors  Fibrin spray and collagen matrix systems with cultured autologous mesenchymal stem cells have also increased wound healing. Chen JS, et al. Therapeutic potential of bone marrow-derived mesenchymal stem cells for cutaneous wound healing. Frontiers in Immunology 2012; 3: 192.
  • 94. Wound Healing and Growth Factors  The use of placental extract shows positive results for various skin conditions, including chronic wounds, pressure ulcer and burns. Chakraborty PD et al. Human aqueous placental extract as a wound healer. J Wound Care 2009; 18(11): 462, 464-7.
  • 95. Alternatives in Growth Factor Production
  • 96. Alternatives in Growth Factors  There has been a shortage of human organs for transplantation. In 2011, over 111,000 Americans were on the waiting list for organ transplants.  An alternative that is gaining credibility is the use organs and growth factors from animals. This is called xenotransplantation.
  • 97. Alternatives in Growth Factors  According to the World Health Organization, xenotransplantation, animal to human, is defined as “living cells, tissues or organs of animal origin and human body fluids, cells, tissues or organs that have ex vivo with these living, xenogeneic materials.” (http://www.who.int/transplantation/xeno/en)
  • 98. The History of Xenografts  The Papyrus of Ebers (1500 B.C.), the writings of Aristotle(384-322 B.C.) and Pliny the Elder (A.D. 23-79), all contained many preparations made from human and animal organs to treat diseases.
  • 99. The History of Xenografts  2400 years ago Hippocrates (460-370 BC) advocated that animal skin be used to cover human ulcers and burns.  Hippocrates also put forth the idea that a diseased organ could be treated by giving the patient, fresh, healthy tissue of the same type.
  • 100. The History of Xenografts  1762 - Dr. Hunter in England, and in 1849, Dr. von Berthold in Germany, implanted testes in castrated roosters and demonstrated positive responses.  In 1889 Dr. Brown-Sequard injected himself with testicular extract from guinea pigs and was “tremendously rejuvenated.”
  • 101. The History of Xenografts  June 13, 1920 – Dr. Serge Voronoff did an ape to human- testicular implant.  January 1928 – One thousand Surgeons participating in a medical conference held in Austria agreed that “The gland transplantation operation devised by Dr. Serge Voronoff afforded transient regeneration.”
  • 102. The History of Xenografts  1920-1930s Dr. Paul Niehans  “The Father of Cell Therapy” and xenotransplantation.
  • 103. The History of Xenografts Type of operating room used by Dr Niehans to transplant organ tissues from fetal sheep obtained via “C” Section to adjacent patients.
  • 104. The History of Xenografts  In 1964, Dr. Reemtsma transplanted a kidney from a chimpanzee into a patient with end-stage renal disease. The operation extended the patient’s life for nine months. Denner, J and Ralf R. Tönjes. Infection Barriers to Successful Xenotransplantation Focusing on Porcine Endogenous Retroviruses. Clin Microbiol Rev 2012; 25(2): 318.
  • 105. Alternatives in Growth Factors  In 1995, researchers showed that hematopoietic-promoting factor and stem cell factor from the porcine kidney were able to proliferate mouse hematopoietic progenitor cells, granulocyte-macrophage colony-forming units, and erythropoietic burst-forming units. Kashiwakura I et al. Effect of a hematopoietic promoting factor derived from porcine kidney on the proliferation of mouse hematopoietic hematopoietic progenitor cells in liquid culture. Biol Pharm Buill 1995; 18(11): 1476-81.
  • 106. Alternatives in Growth Factors  In collaboration with the International Xenotransplantation Association, the University Hospital Geneva and the World Health Organization, an international inventory has been established to collect basic data on xenotransplantation procedures in humans. (http:www.humanxenotransplant.org)
  • 107. Alternatives in Growth Factors  The International Human Xenotransplantation Inventory has found 29 human applications of xenotransplantation, including islets of Langerhans, kidney cells, chromaffin cells, embryonic stem cells, fetal and adult cells from various organs or the use of extracorporeal perfusion from hepatocytes, the liver, spleen or kidney. Sgroi A, et al. International Human Xenotransplantation Inventory. Transplantation 2010; 90: 597-603.
  • 109. Alternatives in Growth Factors  Porcine neonatal islets of Langerhans with porcine Sertoli cells were administered to 12 children with type 1 diabetes (insulin- dependent) without immunosuppression.
  • 110. Alternatives in Growth Factors  The authors reported a significant reduction in exogenous insulin requirements during the 4 year follow-up among six patients, two of whom became temporarily insulin- independent. Valdes-Gonzalez R et al, Long-term follow-up of patients with type 1 diabetes transplanted with neonatal pig islets. Clin Exp Immunol 2010; 162(3): 537-42.
  • 111. Alternatives in Growth Factors  With the genetic modification of pigs, cell transplant studies such as those of pancreatic islets are leading to more hopeful results. The range of possibilities offered by this technology will be unlimited, making it possible for xenotransplantation to be a clinical reality soon. Costa Valles C, Manez Mendiluce R. Transgenic organs and xenotransplants. Adv Exp Med Biol 2012; 741:73–88.
  • 113. Alternatives in Growth Factors  With sheep, the Center for Living Cell Therapy in Lenggries, Germany was started by Dr. Siegfried Block who had worked with Dr. Hans Niehans.  The Center raises 700 sheep in the high mountains, away from damaging environmental effects.
  • 114. Alternatives in Growth Factors  85 different fetal or neonatal organs are available for live sheep cells that are used to treat specific health functions.  The clinic offers cells to treat aging, impotence, Down’s syndrome, AIDS and many other conditions.  http://www.frischzellen-kur.de Sgroi A, et al. International Human Xenotransplantation Inventory. Transplantation 2010; 90: 597-603.
  • 116. Alternatives in Growth Factors  In Russia, the use of rabbit newborn pancreatic grafts with kidney extracts showed a survival rate of 75% in 26 type 1 (insulin-dependent) diabetic children. The results included insulin stabilization, reductions in glycoslyated hemoglobin, reduced exogenous insulin and a small increase in serum C-peptide.
  • 117. Alternatives in Growth Factors  In diabetic nephropathy children, there was also a decrease in albuminuria from about 220 to 60 mg/day. (http://nikrrom.chat/ru/list1_en.htm) Sgroi A, et al. International Human Xenotransplantation Inventory. Transplantation 2010; 90: 597-603.
  • 118. Alternatives in Growth Factors  As stem cell research has expanded, there have been organizations that promote rabbit fetal precursor stem cells (BCRO: Bio-Cellular Research Organization in Russia and Eco- Ultrafiltrates in Europe).
  • 119. Alternatives in Growth Factors  Rabbit progenitor cells have been used in clinical studies around the world for diabetes, immune deficiency disorders, neurological degeneration, cardiovascular disease, and genetic disorders in children.
  • 120. Alternatives in Growth Factors  Article on rabbit progenitor cells and the diabetic retina: Zubkova S.T., Danilova A.I., Kovpan N.A.: ("Condition of vessels of retina and of lower extremities in diabetic patients after transplantation of cultures of islet cells of pancreas"), Summary, in: Proceedings of 4th Congress of Ukrainian Endocrinologists, Kiev (now Ukraine), 1987. p. 153.
  • 121. Alternatives in Growth Factors  The rabbit fetal progenitor cells have also been given 3 times a year to children with Down’s Syndrome.
  • 122. Alternatives in Growth Factors  From Dr. Molnar’s article: E. Michael Molnar, Gebrevnikova NV, Burkova MI, Sukhikh GT, Fisenko NA, Ionova AP: Influence of the transplantation of fetal tissue on the development of higher mental functions in children with Down Syndrome. Klinicheskij Vestnik, 12 (4): 1995; 341.
  • 123. Alternatives in Growth Factors  FCTI (Eco-ultrafilterates from Europe) is using ultrafiltration and nanotechnology to create rabbit derived progenitor cells and growth factors without the proteins.  Do these products actually promote regeneration?
  • 124. Alternatives in Growth Factors  The ready-to-use Eco-ultrafiltrates contain components up to a nominal molecular weight of 10 kDa – about 1/9th of the smallest virus known at this time.  The first ultra-filtrate for the skin and the mucosa was from a histological study by Dr. F. Leyh in 1981. Since then, the FCTI company was formed and more products have been created.
  • 125. Alternatives in Growth Factors  Eco-ultrafiltrates have a variety of cell products that support the skin, mesenchyme, placenta, male and female revitalization, thymus, immune, kidney, liver, adrenal cortex, adrenal medulla, prostate, pituitary, pancreas, bone, cartilage and synovia, lungs, blood, spinal cord, heart, eye, colon, transfer factor, thyroid, etc.
  • 126. Growth Hormone  Growth hormone - 22,124 daltons.  Even though structurally similar to growth hormones from animals, only human and old world monkey growth hormones have significant effects on the human growth hormone receptor.  No animal product can be used as a substitute for human growth hormone.
  • 127. Alternatives in Growth Factors  Xenotransplantation businesses are expanding throughout the world.  xenograft organ extracts (porcine and sheep- ovine) are available and have been used in Germany for many years on patients.  In general, little side effects.  No reported transmission of micro-organisms when prepared in GMP lab.
  • 129. Bone Marrow Treatments  Our clinic offers autologous bone marrow stem cell therapies with the person’s own growth factors.  The FDA classifies the simple removal and re-injection of bone marrow as routine medical practice.  Culturing of the patient’s stem cells makes these a drug and can not be advertised.
  • 130. Bone Marrow Treatments  Optimum treatment today:  Neupogen shots daily for 5 days,  14-15 days later bone marrow is aspirated from each hip and given back intravenously,  Gives much better results than simple bone marrow but in people under 40, a simple bone marrow treatment is usually good.
  • 131. Fat Stem Cells  Fat stem cells have recently been classified by the FDA as drugs, so advertising the use of these for anything other than cosmetic purposes could be a problem.
  • 133. Treatments After the transfusion, the stem cells circulate throughout the body to repair or replace damaged and aging cells.
  • 134. Support for the Stem Cells  The stem cell treatments can benefit a variety of hard-to-treat conditions.  The elimination of toxins, infections and other problems before, during and after stem cell treatments (including checking for sleep apnea).  The use of hormones, growth factors and additional therapies enhances the results.
  • 135. Support for the Stem Cells  Each case is different and some may take more time to prepare for the procedure to achieve optimum results.  The combination of stem cell/progenitor cell therapies with electromagnetic therapy provides increased improvement for a longer time.
  • 136. Treatable Conditions  Osteoarthritis (DJD)  Diabetes I and II  Acute & chronic heart  Eye disorders disease, heart attack  Autoimmune diseases  Cerebral palsy  Multiple sclerosis  Sports injuries  ALS  Cartilage repair  Parkinson’s disease  Spinal disc disorders  Dementia  GI disorders  Huntington’s disease  Kidney disorders  Other Genetic Disorders
  • 137. Together, we can make a difference.
  • 138. For Further Information Check out our websites and sign up for our newsletter at:  http://www.stemcellmd.org  http://www.stemcelltherapies.org My clinic toll free number is 800-300-1063