Admin note: Dr. Burton Feinerman has gone back to private practice in Wellington, Florida. He can be reached at (941)592-6613) (561)557-3358 or bfeinerman@stemcellgm.com

The Lung Institute now has 4 locations - Tampa, Nashville, Scottsdale and Pittsburgh


About Burton Feinerman MD

Burton Feinerman, MD, is the medical director of Regenerative Medicine Solutions and Lung Institute. He earned his medical degree from New York Medical College and completed his fellowship at the renowned Mayo Clinic in Rochester, Minnesota. Dr. Feinerman has been practicing medicine for over half a century and has dedicated his practice to bettering the lives of his patients through the life-changing results of regenerative medicine. As one of the original physician scientists to create protocols and patents for regenerative medicine, Dr. Feinerman is internationally recognized as an expert in stem cells and gene therapy. He believes in challenging the incurable with regenerative medicine, and providing a new pathway to overall health and longevity of life.

Lung Institute
201 E Kennedy Blvd Suite 425, Tampa,FL 33602
1-855-4MY-LUNG
http://lunginstitute.com/

Nashville facility
2001 Mallory Lane
Suite 302
Franklin, TN 37067

Q and A

Q: Can you clarify this information I read about? "PlGF are increased in patients with COPD, which might contribute to the pathogenesis of COPD. Subjects with higher PlGF levels in serum and BAL fluid had worse lung function. A study showed that human bronchial epithelial cells can express PlGF, and continuous stimulation of PlGF and proinflammatory cytokines can suppress VEGF. Persistent PlGF expression might have adverse effects on lung parenchyma by downregulating angiogenesis. The mechanisms behind the observed detrimental effects of PlGF remain to be clarified."
My question is - would there be a way to reduce PIGF?

A: PIGF can be utilized as part of the treatment for COPD. Using an agent that inhibits PIGF yields results similar to genetic loss of PIGF showing a reduction in pathological angiogenesis, chronic inflammation, fibrosis and pulmonary hypertension. A similar result would occur if we would use the shRNA agent to knock out the PIGF gene. I have access to obtain PIGF inhibitors to add to the treatment of both COPD and Pulmonary Fibrosis patients.

Q: Can stem cell therapy be used to treat asthma? If so, what type of treatment would be the most beneficial?
A: The treatment for asthma patients has essentially not changed for asthma patients for the past fifty years. Children and adults have been using bronchodilators, glucocorticoid inhalers and Prednisone during this long period. At the Lung Institute I have recently become aware of a large number of patients usually past forty years with persistent episodes of shortness of breath, wheezing, decreased pulmonary function. Their asthma is severe and refractory to therapy. To their treatment I have added mesenchymal stem cells either from their peripheral blood or adipose tissue given intravenously and double pressure nebulizer plus Glutathione by nebulizer. The mesenchymal stem cells are immunomodulartory and assist in the management of these patients. An effective factor, n monoclonal antibody targets against IgE (immuonglobulin E) called Xolair (omalizumab).
This antibody plus the mesenchymal stem cells offer considerable help in cases of severe asthma. Other agents are being evaluated that are anti-cytokines such as anti-IL 4,5,13 (interleukins) These agents need to be further evaluated and probably need to be individualized based on specific phenotypes. It is however exciting that these new biological agents form a new approach to the management of severe asthma. Patients that have severe asthma can contact the Lung Institute in Tampa, Florida.

Q: A recent news story discussed the wonderful improvement a spinal cord injury patient had made after being treated with olfactory ensheathing cells (OECs) at a hospital in Poland. There were no apparent side effects and the doctor is now wanting to treat more patients. However, I read another article of a young woman with a spinal cord injury developing a tumor after receiving OEC stem cells. The article said that this woman was actually growing a nose in her spinal area at the site of injection! Is there something that researchers and doctors should be doing to safeguard against something like this or was this unfortunate woman treated by doctors who simply took no precautions or didn't know what they were doing?
A: The use of olfactory ensheathing cells(OECs) have the advantage that they can favorably co-exist with astrocytes and prevent an unfavorable response of astrocytes to injury including the buildup of inhibitory proteoglycans. Essentially OECs release neurotrophic factors that help to repair injured spinal cords. Using only autologous OECs will prevent the development of tumors or growing a nose. My own treatment for spinal cord injuries involves the administration of neuron stem cells mixed with brain derived neurotrophic neurotrophic factor, nerve growth factor, neurotrophin-4, oligodendrocytes to facilitate axon remyelination and glial cells into the injured spinal cord area. This treatment of mine has been developed over a period of eight years and is available to patients suffering from spinal cord injury. Contact me at bfeinerman@hotmail.com for further information.

Q: The Lung Institute has recently expanded to North Carolina. Will the same treatments be available there as are available in Tampa? I vaguely remember reading something about sleep apnea treatments, but I thought the Lung Institute was strictly for stem cell treatment. Are there any plans for further expansion into other states?
A: The Lung Institute now in Tampa has expanded to Nashville, TN; will most likely have offices in Scottsdale, AZ and possibly in Dallas, TX in the coming year (2015). At present only the facility in Nashville offers sleep apnea treatment.

Q: Do you think there will ever be a cure for COPD? Stem cells seem like they have the potential to slow it down, but I mean a real cure as in regenerated blood vessels and alveoli and something to turn off the inflammation permanently.
A: I do think that there will major advances in treatment of COPD which will involve stem cells, tissue engineering, gene therapy and nanotechnology. Key progenitor ectodermal and endodermal stem cells, resident progenitor lung cells, induced pluripotent stem cells, surfactant associated protein, fibroblast growth factors expanded in vitro and added to a proper extracellular matrix then seeded into a biodegradable polymer scaffold. This three dimensional functional tissue can create a bioartificial lung graft providing proper gas exchange. Creation of the proper scaffold, differentiation of the lung specific cell populations and full maturation of the engineered lung is already being worked on at centers focusing on the bioartificial engineering. Animal models have already showed some initial signs of progress. One such location is at Harvard Stem Cell Institute/Massachusetts General Hospital. I had occasion to meet with its chief investigator, H. Ott, M.D. and speak with him when I was a speaker the annual Aspen Lung Meeting the summer of 2014.

Q: What is the best treatment for pulmonary hypertension?
A: It amazes me how few patients with advanced COPD have been evaluated for pulmonary hypertension. To get a proper study done either with a echocardiogram or right heart catherization I recommend patients go to the following website:
http://www.phassociation.org/findadoctor. Doctors who specialize in pulmonary hypertension will be best at advising the most effective new medication or inhaler to use if the patient has the condition. Biologicals such as FOX-1 inhibitor or PIDF may play a role in the future management of pulmonary hypertension. Iloprost is one that has been used to treat pulmonary hypertension but there are now newer ones that work well and do not cause adverse side effects.

Q: Recently Dr. Chris Centeno wrote an article on how damaging steroids are to stem cells. He is an orthopedic doctor. Since many lung patients do inhale corticosteroids on a daily basis and take oral steroids such as prednisone from time to time would this apply to stem cell treatments for lung patients as well? I am a bit confused because he seems to be talking about steroid injections in orthopedic procedures. Here is the article:
http://www.regenexx.com/2014/10/new-...er-stem-cells/
A: It has been known for at least a year or more that injecting cortisone like medications into the joints of osteoarthritis patients decreases the effectiveness of the use of mesenchymal stem cells. I have not seen this same problem with patients that have COPD that are on prednisone. However, I usually recommend weaning patients off the prednisone routinely slowly after they have received stem cell treatments. At the same time 1-3 months after a stem cell treatment I try to get my patients off oxygen.

Q: Do you foresee anything in the near future that will eliminate senescent cells in our bodies?
A: The question regards the possible ways of eliminating senescent cells from our bodies. Recently in laboratory animals elimination of p-16 gene expression in cells delayed the onset of age related diseases. A number of avenues have been explored to avoid the accumulation of senescent cells. Most well known are telomerase activators that reverse telomere shortening thereby delaying the loss of replication of cells. Enhancing the immune system will also assist in eliminating senescent cells. I personally do not feel that focusing on eliminating senescent cells is a key avenue in developing therapies for anti-aging. This is such a broad area to discuss in this short answer. However I think that people that want to get some advanced ideas on this subject will be rewarded by reading two books- “Longing for this World” by Jonathan Weiner and “Ending Aging” by Aubrey De Grey. The aging of the human body is just like the aging of man made machines and results from accumulation of various types of damage. As with man made machines the damage can be periodically repaired. We already know the type of damage that accumulates in the human body especially in the lysosomes and our biotechnology is moving in the direction of removing this damage.

Q: How much exercise should someone with pulmonary hypertension and lung disease undertake? What role does diet play in keeping someone with these conditions healthier?
A: First of all I think that all patients whether they have mild, moderate or severe pulmonary hypertension should receive treatment. I have discussed my approaches to that in a previous question. All patients that have COPD, Emphysema, Pulmonary Fibrosis and Pulmonary Hypertension should do some type of exercise even if it seems minimal. Get out of the bed or chair and try to walk regularly even if it is only ten steps. When sitting try to raise some weights- 2, 8, 10 pounds two to three times daily. Move your legs up and down, sideways and abduct your hips when sitting. Use a Power Lung Device to improve your muscles of respiration. In the summertime or if you have a heated pool walk around the shallow portion. Regarding diet I particularly recommend the Mediterranean diet as ideal but a diet rich in fruits, vegetables and fish should be emphasized. I hate fish but I regularly eat salmon three times a week. Take your Omega 3 Fish Oil, Co-Enzyme Q 400 mg a day, Vitamin D3, Selenium, Niacin, Zinc. Take Lutein and Zexanthin to protect your retinas and of course Telomerase to lengthen the telomeres in your genes.

Q: How did you get interested in stem cell research? Have you ever had stem cell therapy yourself? You never seem to age!
A: It was when I was practicing anti-aging medicine in Maui, Hawaii that I first became fascinated with the emerging science of stem cells ten years ago. I couldn't stop reading about it and became convinced that I had the creative ability to challenge the label “incurable” about such diseases as ALS, Parkinson, Alzheimer's, Multiple Sclerosis, Cerebral Palsy, Autism, Diabetes, End Stage Kidney Disease, COPD, Pulmonary Fibrosis, Tay Sachs, Huntington Disease, Sandhoff Disease, Cystic Fibrosis. I have decided I have no time to waste dying and so I must work on for at least another fifteen years in order to challenge the incurable. What amazes me is to see how a new development has occurred in medicine in which patients have the bravery to fight on and search for physicians out of the box who will work with them. I have been working with a friend whom I have known for the past thirty years who is a M.D. In Neurosurgery and a Ph.D in Molecular Biology, Dr. Javier Paino. Together we have treated large numbers of patients with these diseases; we continue to learn and advance our ideas and have tasted success in many cases that have been given up as hopeless. So the fight goes on.....

Q: Hello: I was reading about a specific blood protein that decreases as you age, here: http://singularityhub.com/2014/05/17...-blood-factor/
Seems it's vital to overall stem cell activity in the body, and I was wondering if blood cells are produced by mesenchymal cells, in specific? If so, that would seem to explain, or at least start to explain, why they are so multi-potent. As is, mesenchymal cells are the marrow stem cells that at least make antibodies, yes?
Dunno about you, but if mesenchymal cells are indeed the same marrow cells that produce blood cells, but a good test (in rats) would be to knock out the gene producing this specific protein, and just see how potent the mesenchymal cells would be without 'em. I'm betting there'd be a steep decline, at least. If, on the other hand, this protein is separate from mesenchymal cells, they still probably possess a collaborative effect, and that, my friends, should be studied. Me, if I were getting stem cell treatment, I'd want the cells as potentized as possible, which would mean surrounding the cells with the various stem cell factors causing growth. You ask me, GDF-11 is one of the most powerful, or at least a likely candidate.
A: I agree that when engineering a stem cell treatment that adding growth factors will enhance the therapy and have greater longevity especially if we add specific healthy genes as well. The agent GDF-11 has been reported by Harvard researchers and in the journals of Science and Nature of reversing the aging process of major organs in mice reversing DNA damage. Enlargement of hearts in mice was reduced in aged mice; organs showed heightened levels of function throughout the body; restored brain function that may help to restore cognition; weak and aged muscles have returned to healthy ones. Other scientists questioned some of these findings but it certainly is an agent that needs to be studied in human clinical trials. The field of anti-aging research is exciting to speculate what new developments will occur in hopefully the near future.

Q: Pulmonary Fibrosis patients are given little hope to live beyond a few years after diagnosis. Is there anything new on the horizon for this disease and are you treating patients with pulmonary fibrosis with stem cells?
A: Never give up hope......
It is a common situation when I see patients with advanced pulmonary fibrosis the negative feelings they have experienced when consulting with pulmonologists . Essentially the patients are told there is no treatment available expect a lung transplant. An example of how things can change almost overnight is the very recent approval of Intedimib (commercially called OFEV) by the FDA. This medication is effective against pulmonary fibrosis in slowing down its progress and does not have the serious adverse effects of Pirfedidone . But along with this announcement came news that hepatic growth factor and anti-PIDF are effective in reducing fibrosis. Even more exciting is the news of how dramatic the use of micro RNA-29 in removing all fibrosis and scarring from laboratory animals that had pulmonary fibrosis. This agent is now going through preliminary clinical trials. For patients with pulmonary fibrosis I recommend a combination of mesenchymal stem cells isolated from peripheral blood, bone marrow and adipose tissue given intravenously and by double pressure nebulizer plus hepatic growth factor; nebulizer Glutathione and Trans Retinoic Acid plus Intedimib (OFEV) and in the near future anti-PIGF and micro RNA-29.

For those who wish to communicate with me you can send your remarks to the blog at http://www.stemcellpioneers.com
I can also be reached at bfeinerman@hotmail.com
I also have an e-book on Amazon.com called “Stem Cells- Challenging the Incurable".
Burton Feinerman, M.D.