Installment 46 - Ask the Doctor with Dr. Jesus Perez, Regenerative Medicine Institute

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Jeannine

Pioneer Founding member
Ask the Doctor with Dr. Jesus Perez, Regenerative Medicine Institute, Mexico

About the Regenerative Medicine Institute
Dr. Jesus Perez is the Medical Services Coordinator for Regenerative Medicine Institute, Mexico. To find out more information about the clinic and the doctors who are associated with RMI, please visit

http://www.regenerativemedicine.mx/ or call 1-619-421-0700.

You will find an informative video on the website narrated by Dr. Jesus Perez. Regenerative Medicine Institute, Mexico prides itself in its commitment to safety and efficacy and is a participant in the ICMS accreditation program among others.

The mission of the Regenerative Medicine Institute is to provide a high-quality, coordinated patient-centered plan for chronic degenerative disease diagnosis and treatment that promotes the dignity of the individual, family, and friends.

In support of this, we are committed to:
  1. Maintaining a compassionate, responsive, patient-centered practice.
  2. Educating the community against the threat of chronic degenerative disease, and for those affected the hope of effective treatment and care.
  3. Providing a staff of highly trained care-givers dedicated to serving our patients, survivors, family members, and friends.
  4. Ensuring a level of excellence and integrity in medical management that serves as a model in the community.
We are in the process of submitting our protocols to Clinicaltrials.gov which is a service of the National Institutes of Health (NIH), in conjunction with the National Library of Medicine (NLM) and the Department of Health and Human Services.Six of our protocols are already up and the rest have been submitted and are pending review. This is a lengthy process, but we are confident that the protocols already found on the site will provide interested parties with an overview of our commitment to patient safety, the meticulous planning and creation of specific protocols, and our commitment to the publication of the results yielded by these research protocols.
Finally, Regenerative Medicine Institute is a pseudonym for Instituto de MedicinaRegenerativa, which is the legal name of our corporation. This name is used in an effort to overcome any language barriers that may be experienced.

Q: Hello from India. I have my niece and nephew living in Birmingham, UK diagnosed with Bloom Syndrome - an autosomal recessive genetic disorder which makes them short and prone to cancers. Can stem cell therapy help this condition? If so, what kind?
A: I am terribly sorry to hear about your niece and nephew. Unfortunately, we are currently not engaging in research dealing with specific genetic disorders or any form of cancer.

Q: Why did you decide to become involved in the ICMS accreditation program? How long does it take to accomplish, what is required, and what is the advantage of this program for patients?
A: Our interest in accreditation by ICMS stems from a commitment to patient safety. ICMS is an organization dedicated to ensuring that the highest standards of patient care are being met while providing scientifically sound, validated and independently reviewed treatment protocols. It’s a form of 3rd party audit that will ensure that we are held to the highest standard of care for our patients.

Q: Is the testing required in your protocols included in the treatment price or are there additional costs to patients that I need to know about?
A: Our protocols are patient sponsored. Therefore, the costs involved will cover transportation from and back to San Diego International Airport and everything related to the protocol itself, pre-operative lab work, X-rays and imaging studies, hospital stay, nursing, medication during the patient’s stay, meals for patient and guest and operating theater costs, with the exclusion of cell laboratory procedures. This price is all inclusive for the patient and one family member. The cost of harvesting and isolation of the final product will be covered by the research institution. Additional costs may stem from a patient requesting an additional night’s stay. Air travel costs are the patient’s responsibility.

Q: When you say you are going to publish the results of the protocols, where will they be published?
A: Preliminary results will be made available to major medical publications before the year is out. As soon as we compile data from a set amount of patients for a specific amount of time we will submit for final publication. There is a minimum follow-up period that must be observed in order to obtain the best possible data on treatment outcomes. And since all patients were not treated at once, the time-table is based on the treatment of the last patient that will be enrolled in the trial.

Q: Have you had any safety issues with patients while under your care for stem cell therapy? If so, please describe them.
A: To date we have not had a single safety issue of any kind. This information can be verified through the research institution and ICMS as a third party auditor in charge of evaluating patient safety.

Q: How old does my child with CP need to be for treatment? Would she have to spend the night in a hospital? If so, I would assume as a parent I could stay with her. Please let me know about what treatment would involve for her.
A: Our inclusion criteria for the CP protocol states that a patient must be between the ages of one and 12 years of age. All patients, regardless of the protocol they will be included in, are required to stay three days and two nights at our facility. Day one includes all pre-op and baseline testing, day two is the day of the procedure, and day three is when the patient is discharged. All patients are allowed one overnight guest. In the case of pediatric patients, we request that the guest be a parent.

Q: Why do you use stem cells from adipose tissue over stem cells derived from the blood? Also, how do you know the stem cells go to the lungs for lung related diseases?
A: We use stem cells derived from adipose tissue as opposed to blood because of the sheer volume of cells available upon harvesting. It’s due to this fact that we don’t need to expand the cell population, thereby ensuring that the cells are not manipulated in any way.
The way we ensure the cells get to the lungs is actually quite simple. There is a basic principle in pharmacology and physiology called the “first-pass lung effect”. Basically when any substance is infused into the venous blood flow, it is directed straight to the right chamber of the heart, and immediately after, to the lungs. All veins lead to the heart (arteries away from the heart). The first-pass lung effect means that any substance infused into venous blood will be absorbed to a certain extent by the lungs. Studies have shown that a high concentration, high-speed infusion will allow only a minimal absorption by the lungs, whereas a slow, diluted infusion will force a large percentage of the substance to be absorbed by the lungs.
Taking this into account, our COPD patients are treated using a slow IV infusion. Cells are diluted into 1000cc of saline medium, and infused over a period of 2 hours. This ensures a very high percentage of the cells infused will stay in the lungs.

Q: Does your adipose treatment require a general anesthesia? How much fat is removed and how is it processed? How long does it take to heal from the liposuction on average?
A: In most cases our procedures do not require general anesthesia. The exceptions are small children and patients with a severe neurodegenerative disorder who can become apprehensive and nervous during the procedure.
We only remove 120cc of fat, which is roughly the equivalent of half a cup. This is then put through a multi-step enzyme digestion and is purified and re-suspended in a saline medium using a proprietary technique.
It usually takes patients between two to five weeks to recover fully from the liposuction. Recovery time will depend on the patient’s adherence to the instructions provided by our board-certified plastic surgeon.

Q: When will you have the results of your COPD protocol? Have the results been long lasting for those that first got treatment and saw improvements or have they needed to be retreated?
A:The full results of our COPD protocol will be available once the follow-up period has been completed on the last patient enrolled. So far, all progress obtained by our patients has been permanent. We have not had any reports of regression, and none have required a second treatment.

Q: About 8 years ago I got a cut penile nerve and lost a lot of sensation. What is the best stem cell treatment out there for me? I think the placenta might be the best and I talked to a few people that said direct injection would be the best way for my scar nerve to regenerate to restore sensation.
A: Placenta-derived cells, like any other allogeneic cells, have a very specific risk associated with them. Specifically, they are a foreign tissue and will be recognized as such by your immune system. So in order for the cells not to be attacked by your immune system, you’d have to undergo immune-suppressive therapy, which could potentially make you vulnerable to opportunistic infections. Not suppressing the immune system will increase the risk of rejection, graft versus host disease, and of course, the possibility that the cells you receive will be killed off by your body without any benefit to you.
While the use of adipose-derived cells in a variety of tissues from the same patient is autologous, it is not considered homologous. However, in our experience these cells have yet to produce any negative effects in any of the tissues they have been introduced to and have proven useful in the regeneration of these tissues. We will continue to monitor this issue as per our protocols.
This is not an issue when using autologous (your own) adult stem cells. They are already a part of your body and cannot be rejected as they are not altered in any way. They have the same ability to repair the damaged tissue, with the added bonus of not requiring immunosuppressive therapy.
The idea of a direct injection, however, is correct. Our protocol has always been to perform direct injection in the corpuscavernosumas our preferred method of delivery for ED, and would be the best and most direct method for reaching damaged nerve tissue in the area.

Q: Would bone marrow or adipose derived stem cells be better for hypoxia (brain injury) of the brain? The hypoxia is due to illness.
A: There is a negligible difference in efficiency as far as the type of stem cell when differentiating between bone-marrow derived stem cells and adipose-derived stem cells even though they are different cell types with a similar germ-origin. The real difference resides in how efficient the harvesting of these cells is and whether or not they need to be cultured and/or manipulated in any way to reach a therapeutic threshold, or minimum amount of cells needed to make an impact in any given condition. In the case of bone marrow-derived cells, not only is harvesting invasive and painful, the yield of cells is very low, meaning that the cell population needs to be expanded in vitro, which can amplify some genetic defects (in some cases) and takes a few weeks in order to get a suitable amount of cells. Adipose-derived cells, on the other hand, are relatively easy to obtain with micro-liposuction. The yield of cells from this technique is so high that the cells can be implanted the same day and require no expansion or manipulation whatsoever.
 
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