Above we can see what an actual cytokine “patchless patch” looks like. These patches are absolutely unique. They are the brainchild of Dr. Jo Serrentino. She has devoted a good portion of her life to the study of cytokines. I feel quite privileged to work with Dr. Jo Serrentino. She is my colleague, a mentor, and business partner. She and I have been working on a few cutting edge of the cutting-edge projects for a number of years. There is no doubt that her knowledge and inspiration have helped me design some very unique protocols. She is a fountain of knowledge. One day I may ask her how we can increase the effectiveness of stem cells injected into a joint. On another day, I might call her up to discuss some aspect of a V cell treatment that potentially increases the overall effectiveness of the treatment. She has been instrumental in helping us develop our protocol for the treatment of Osteoporosis with stem cells and different growth factors. Although our series is still small we are obtaining improvements of from 15-30% in bone density values in one year. We seem to be getting a bit off track from the Cyto-Amino Complexes.
We must realize that Cyto-Amino Complexes make use of cytokines. Cytokines are a broad and loose category of small proteins that are important in cell signaling. Their release has an effect on the behavior of cells around them. They are very involved with our immune system and help regulate it and balance it out. In Regenerative Medicine our immune system is of the upmost importance controlling the body’s reactions. Cytokines and the immune system regulate the maturation, growth, and responsiveness of particular cell populations. The environment that the stem cells are found in can cause them to have a profound effect downstream. In certain environments, the stem cells can cause the production of certain immune cells, such as T-Reg cells, that can decrease the effects of an autoimmune condition. Most every condition in medicine typically results from an imbalance in cytokines. If you are dealing with an osteoarthritis, tendinitis, or an autoimmune disease you can be sure that an imbalance of cytokines is at work. Some cytokines enhance or inhibit the action of other cytokines in complex ways. Cytokines are produced by stem cells and also found in platelets. Another source of cytokines is placenta and cord blood products. These are products which contain a multitude of growth factors. Realize that with current FDA regulations they do not contain live cells. If they do than this is in violation of FDA rules. If I physician is proposing to use these products as a stem cell procedure he is not being truthful with his patient. That is a discussion for another day.
I am most beholding to Dr. Serrentino for her guidance and teaching of cytokine therapy. Our journey with patches began with iontophoresis patches. These are patches that have a built-in battery. They look like a large Band-Aid. Like any battery they had a positive and negative end.
On one side, we would place a combination of growth factors and the other side would be saline. At the time, I thought these were quite revolutionary and at the time they were. We had a few different formulas that were utilized with this delivery technique. These patches had to stay on for about 12 hours. I was happy with the results but ultimately these were a stepping stone to what we call the patchless patch.
We have used cytokine therapy to enhance our procedures for a number of years now. I repeatedly get asked the question “am I too old for stem cell therapy?” The answer to this is a resounding no when we are also utilizing Cytokine therapy. Cytokine therapy is one of our secret weapons. A good clinical example of this is concerning a simple PRP injection. As we age the levels of Insulin Growth Factor-1(IGF-1) decrease significantly. IGF-1 is instrumental in the repair of cartilage tissue, tendons, etc. However, if you are starting with low levels because of age or advanced osteoarthritis the repair of that joint may not be forthcoming. This is the beauty of Cyto-Amino-therapy as Dr. Serrentino calls it. We can help correct these deficiencies and encourage repair. Age is no longer an insurmountable road block.
I asked Dr. Serrentino to write about cytokine therapy in her own words. She wrote the following summary for me: “Because initially cytokines were for research purposes only, they could not be used liberally in commercial products. The controversy over growth factors for example has been ongoing for decades; restrictions in using these valuable signaling molecules in medicine is still an ongoing issue, despite the research data proving their countless benefits and safety”. Signaling molecules or Cytokine Therapy, is indeed a boon to modern medicine. For example, the use of recombinant proteins such as IGF-1 to repair cartilage in osteoarthritis, or the use of recombinant Interleukin -10 as an anti-inflammatory can dramatically alter the results of a procedure. Many protocols have been established, but the availability of actual Cytokines in the right combination and dosage has been difficult to source and to regulate. Sources of real cytokines in commercially available products are usually from homeopathic sarcodes or nosodes, (a sarcode comes from an animal part) but these provide only the precursor components not the real thing. Recent advances in technology have enabled Dr. Serrentino to develop clones of signaling molecules that have shown better biological action than actual cytokines. Dr. Serrentino has coupled polyamino molecules with Nano technology to create Cyto-amino® Complexes that mimic the signals and the biological activity of many cytokines.
Dr. Serrentino further explains that: “Because these Cyto-amino complexes are engineered through Nano technology, they do not work like a supplement but rather go directly to the extracellular matrix where they signal cellular tasks. Just like cytokines they tell the cells where to go and what to do. Amino acids are the building blocks of proteins, and cytokines are small proteins, so we can synthesize a clone through certain biochemical techniques with readily available amino acids. But these new molecules are not supplements of amino acids, they do not work like supplemental amino acids. They have a unique structure that gives them the capacity to mimic the action of a bonafide cytokine with extreme precision. They are not dependent on serum levels or need to be broken down like supplements, they work exactly like cytokines at signaling pathways, thus we can use them to program repair, which is the basis of Cytokine Therapy. This Cyto-amino Complex ® goes straight to the extracellular matrix where it gives cells
directions in programming regenerative pathways. CYTO-AMINO COMPLEXES ® can provide some extremely effective practical products for medical therapy, especially regenerative medicine and stem cell therapies. Dr. Serrentino further states that “Exclusive formulations have been developed for Dr. Purita’s Stem Cell techniques and protocols and are solely available through his teaching venue.” This is indeed true we have utilized this science for several years. The true beauty of these complexes is that they are used as a topical with Tegraderm patches. Dr. Jo has combined these cytokines with penetrating molecules. These penetrating molecules deliver the growth factors much more efficiently than an injection. The combinations of growth factors can include FGF-6, FGF-12,
IL-1A, IL-3, IL-10 and a few others. These abbreviations stand for various types of growth factors that can be instrumental in achieving repair.
Every day I continue to learn the intricacies of cytokine therapy. This therapy is truly unique in all stem cell therapy. As time goes on I am sure Cytokine Therapy will continue to make a difference not just in my practice but in that of a fortunate few others. In some circles, there is a notion that stem cells are but a waypoint in our treatment modalities. Eventually, cytokine therapy may replace harvesting stem cells. Every day we are seeing a push now in the use of exosomes. Remember, cytokine therapy mimics stem cell therapy in a much more efficient way. Perhaps I should say in a different manner: Stem cell therapy tries to mimic Cytokine therapy. We will certainly hear more of this as time goes on. Right now, combining the two therapies seems to be the best of both worlds. Thanks Dr. P
This weekend I spent a whirlwind trip to Morocco. I left Miami Thursday night and was back Sunday night. I was invited there to share information with a very interested medical community. Their eagerness reminded me of myself when I began the journey into regenerative medicine over twelve years ago. At that time, I was like a sponge and they seemed to be the same. The faculty included doctors and new friends from Europe, South America, Asia (including India), North America, and Africa. This trip also represented a milestone for me. I have now lectured on every continent with the exception of Antarctica. Something else to check off on my bucket list.
My lecture was designed as a surgery of the field of Regenerative Medicine as it pertained to Platelet Rich Plasma (PRP) and Stem cell therapy. I started out discussing the various aspects of PRP therapy. I explained to the medical community the good the bad and ugly concerning PRP therapy. To try to give them some semblance of order I discussed a paper which I recently published with some colleagues from Brazil. The paper is a classification of PRP preparations. It addresses PRP like no other paper has. I wanted to make sure that the doctors were not lead astray but some sales people telling them that certain components of a PRP product were not necessary. These components are red and white blood cells. We now realize that the full complement of blood is needed to order to properly get the best functioning PRP product. I told them about the “urban legends” of PRP products.
The next portion of my discussion concerned the different types and uses for stem cells. They were given the mechanics of stem cell therapy. I discussed with them why certain cells seem to be favored over other cells. The two most important cells discussed were mesenchymal and hematopoietic stem cells. Each has a very distinct place in the realms stem cell therapy. The mesenchymal stem cell can be likened to a Navy Seal. They are very specialized. A mesenchymal cell is what is called an immune- modulator. What it does is to try to quell the inflammatory response in the vicinity of the other regenerative cells. Thus, as one can see it is much like a Navy Seal. I gets introduced into a hostile are, it may not survive, but its job is to secure the area to allow other cells to accomplish repair. The cells which accomplish repair are the hematopoietic stem cells.
Another very important portion of my talk concerned the relationship between the immune system and stem cells. The two are intimately related. One is very much dependent upon the other. How the immune system responds can lead to success or failure in our treatments.
I ended the talk discussing the various adjuncts that we use to enhance our therapies. These included stimulation of Nitric Oxide (NO). We know that NO will help increase stem cell output from the bone marrow. I discussed various methods that increase NO output including hyperbaric oxygen, supplements and laser therapy. This is a very important aspect of my therapy protocols. We also gave some clues of some of our propriety methods of preparing PRP and bone marrow products. We have methods allow us to harvest increasing amounts of cells. I also discussed the use and reason for using extra corporal shock wave therapy. This is a therapy which utilizes sound waves. It does it in such a way that it resembles a jack hammer. This type of therapy will help stem cells migrate to the area, increases growth factors, and increases micro-circulation. These factors can all enhance the chance of success.
Some of the other lectures proved to be quite interesting. I met my old friend Dr. Bansal from India. He gave an excellent lecture on very small embryonic like stem cells. He and I both have a special interest in these cells. He has had very good success in utilizing these cells for a variety of auto immune diseases. He has also had some success in the treatment of spinal cord injuries. All in all, it was an excellent meeting with excellent speakers. It was worth the short trip. Thanks Dr. P