How To Heal Injury, Illness & Disease with Regenerative Medicine | Dr. Adeel Khan

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Episode Transcript:

Dr. Adeel Khan: [00:00:00] The holy grail of regenerative medicine is basically this intersection between cell therapy, gene editing, or gene therapy and tissue engineering. So all three of those is kind of what’s the next era of medicine. And combining all three of those in a very sophisticated way is what’s going to allow us to regrow organs and fix any disease known to man. I think especially once Crispr becomes a reality, you should be able to fix any genetic defect. We’re getting there. We’re not there yet, but I think that’s going to definitely happen as these technologies continue to evolve.

Jonathan Fields: [00:00:32] So I have to tell you, the conversation I’m about to share kind of blew my mind in the best of ways. What if you could regrow damaged tissue, reverse chronic illness, cure neurodegenerative disease, even slow aging? By harnessing the power of your own body and cells? It may sound like science fiction, but incredible breakthroughs in the emerging field of regenerative medicine are making this a reality. And at the same time, the hype machine here is on overdrive. So I wanted to sit down with a true visionary in the field to understand what’s real, what’s not, and where we’re headed. My guest today is Doctor Adeel Khan, a visionary leader in this exciting new domain of regenerative health care. And as a physician-scientist on the cutting edge of cellular therapies, he is really pioneering treatments that are transforming lives. In this conversation, you’ll discover how things like stem cells, gene editing, PRP, prolotherapy, and tissue engineering are converging to create powerful new ways of repairing the body that just a generation ago, seemed like the stuff of fantasy. And Adeel shares insights from the front lines of developing these game-changing technologies, along with the profound results that he’s achieving with patients, with everything from neurodegenerative conditions to muscle loss. Yet he’s also really candid about the current limitations and risks, stressing the importance of rigorous science and safety alongside the incredible promise. And we do a lot of myth-busting about some of the rampant claims about regenerative medicine interventions. Talk about what’s real, what’s hype, what is coming down the pike.

Jonathan Fields: [00:02:04] And his passion for democratizing access really shines through, along with just this grand vision for the future integration of cellular medicine. So get ready to have your mind pretty much melted the way mine was. When it comes to what may be possible in health care, from regenerating organs to reversing chronic disease, curing illness, and reversing aging altogether, but also gain deeper wisdom for navigating this emerging landscape responsibly as a patient today. So you know what to ask. Adeel’s balance, perspective, and wealth of knowledge really provides the perfect primer to this most hopeful and hyped field of medicine. So excited to share this conversation with you! I’m Jonathan Fields and this is Good Life Project.

Jonathan Fields: [00:02:52] I think medicine is in such an interesting state right now. A lot of people are railing against different elements of medicine and health care systems, stuff like that. And then we see this field of regenerative medicine sort of emerging, almost like out of the ether, like in the mode of a savior, you know? And I feel like there’s there’s a lot of hope and there’s a lot of hype. And I want to go into a bit of that with you. And then I’d love to dive into some of the specific modalities that are getting a lot of attention and really talk about them and, and what the future holds. But when we use the phrase regenerative medicine these days, just more broadly, what are we actually talking about here?

Dr. Adeel Khan: [00:03:31] Yeah, at a very basic level, the best way to understand it is we’re just trying to repair or fix tissue back to the way it was. So instead of cutting things out. So for example, if you have a bad knee right now, they may take it out and they’ll put in a new knee artificial one. But imagine if we can grow you a new knee, so to speak, or grow you some new cartilage. So that’s the idea or promise of regenerative medicine. Obviously this concept has been around for decades, but we’re finally, as Arnold Kaplan put it, who’s a kind of pioneer scientist in regenerative medicine that we’re at the beginning of the end, so to speak. So meaning the end of just like the scientific discovery area. And now we’re actually beginning the actual clinical translation of everything that the last 30 years of science has taught us.

Jonathan Fields: [00:04:21] So is it possible that things like knee replacements or like a lot of what’s orthopedic surgery today in ten, 20, 30, 40 years will kind of look back at that and say, how on earth did we ever allow that to happen?

Dr. Adeel Khan: [00:04:35] Oh, there’s so many, I think, and not even, you know, in 30 years, I think we’ll look back and we’ll be like, wow, I can’t believe this is how medicine used to be from all chronic diseases, not just orthopedic, but all cardiovascular disease, COPD, psoriasis, inflammatory conditions, even cancer is going to look very archaic in 30 years from now, because right now it’s just a nuclear approach, which is just kill all your cells in the body, including the good ones with chemotherapy. And eventually it’s going to be designer cells that I believe will be the solution to a lot of these, as we’ve already seen. And this is stuff that’s already happening now, and it’s only getting more sophisticated as time goes on. So it’s not something that’s 50 years down the road. It’s already kind of happening in practice, and I’m obviously treating patients already with a lot of these technologies, and the results are only getting better every year because the technology keeps getting better.

Jonathan Fields: [00:05:30] Yeah. I’m curious just on a personal level, you know, when you decide I’m going to enter the field of medicine, did you know from those early days, oh, this is the particular branch that I want to go into. Or did you enter it and then like something happened?

Dr. Adeel Khan: [00:05:42] No, there’s regenerative medicine is not even a thing in medical school. It’s this. It’s, uh, we weren’t taught anything about. I mean, we were taught embryology and obviously stem cell biology, but there’s no, like, regenerative medicine curriculum or anything like that. And so it was more almost out of frustration of not being able to help people the way I wanted to help them, especially because I started out as a sports doctor and family doctor and in primary care medicine and sports medicine. It’s traditional medicine is quite not only mundane, but it’s a lot of patients don’t get better and it the options are basically just cortisone injection. If you have pain physiotherapy, acupuncture, shockwave you know, some stuff like that. And if that doesn’t work then they send you off to surgery. And a lot of times patients don’t want surgery. And sometimes the surgery is risky or dangerous or they can’t even do surgery. So then you have patients with chronic pain who are living with it and suffering, and there’s no one to help them. And that’s really got me into it. Because chronic pain is not an easy field in general, but it’s also one of those things that affects more than just quality of life. Because, as we probably all know now, longevity is highly correlated with movement and exercise and putting on muscle. But if you’re in chronic pain, you can’t really exercise, you can’t move properly, you can’t load the muscles the way you want, so your health deteriorates. And then chronic pain is also associated with mental health issues. Depression a lot of times chronic pain patients have history of trauma. And so there’s all these other factors that interplay into it as well. And that was my big driving force is kind of just helping these people that no one else seemed to want to help. And then I just started helping them and at which regenerative medicine. And it just kind of went from there.

Jonathan Fields: [00:07:20] Yeah. I mean, I’m curious also because when you make this sort of like left turn, like you’re doing this thing, you’re using all the traditional modalities, you’re sort of like following standard of care. That has been standard of care for generations at this point. Right. And you’re doing the thing and you’re like, okay, so sometimes it’s working, but oftentimes it’s not. And then you advance to the next level. And that thing, sometimes it works. I mean, I think we’ve probably all heard countless stories and maybe folks listening in have proceeded all the way through surgery and then gotten through that and gone through the rehab, and then they’re still actually not better, and I. Can’t imagine the futility that sets in when you figure like, okay, I’ve done all the things, I’ve checked all the boxes I paid, all the money I’ve endured, all the suffering and the added pain and the recovery. And I’m still not feeling better. You know, on an individual level that’s that can be brutalizing. And I imagine for a physician that’s also got to be like, like psychologically kind of brutalizing it is.

Dr. Adeel Khan: [00:08:14] And that’s actually why most physicians are burnt out. It’s not because job satisfaction is highly correlated with your ability to help your patients, because that’s why we become doctors. We want to help people at a very fundamental level, most doctors. And so if you can’t see your patients get better, it becomes very frustrating and you start getting burnout. And a lot of doctors are burnt out because they’re working in a broken system, and they’re not able to provide meaningful solutions to their patients. It’s just a revolving door or it’s just kind of a Band-Aid solutions. And there are obviously traumas and stuff like that where surgery is needed and you have to get surgery. But there’s by far the vast majority of the reason our health care system is breaking down is exacerbation of chronic conditions and increase in chronic diseases, and we know these things are majority preventable with lifestyle. Over 80% has been the statistic that’s already published. So why don’t people change. And then there’s so many other issues on that. So I think we’re kind of almost past that point where I’m kind of like, okay, people are going to be, people are. It’s also because our environment is set up to for failure. It’s so hard to live a healthy lifestyle when we have a obesogenic environment with toxins, foods, everything that that shouldn’t be approved in the food chain is approved. And and so it’s just all these other factors that make living a healthy lifestyle really challenging. But regenerative medicine has the ability to increase your physiology and your resiliency. So you can deal with the modern environment and you can live a healthy lifestyle easier. And that’s, to me is the most impactful thing about what we can do for a lot of people.

Jonathan Fields: [00:09:53] Yeah, I mean, that sounds very cool. So when you make this decision and you’re like, all right, this isn’t the path for me, I want to take this other path. And like you described, you didn’t get any training in this in med school. I’m curious, how do you actually go about saying, I need to actually understand what this is and get trained and competent on a level where, like, I feel like I can turn around and offer this to patients.

Dr. Adeel Khan: [00:10:13] Yeah, I guess this is like that quote where it’s like everyone goes left and then you go right, and then you’re kind of left on your own trail and trying to figure it out. So that’s that’s what I did. And I, I was fortunate because a doctor in Canada, Doctor Anthony Galea, who was kind of a pioneer in platelet-rich plasma injections, which is older technology now, but something that was used quite a bit in regenerative medicine for muscle tears and tendon tears. So a lot of athletes were doing it. And so I got fortunate to work with him on that regard. And I learned a lot. But then I traveled traveling into Asia, traveling into Europe, Middle East and all these other places where, hey, guess what? They’ve been using regenerative medicine for a long time, and especially in Japan, which is probably the birthplace of cellular reprogramming and all this genetic modification to cells and kind of the holy grail of regenerative medicine, really, which is making an old cell young again, the Yamanaka factors that was birthed in Japan. And so that alone made me very curious about Japanese culture and everything. And so when I worked there, I learned a ton.

Dr. Adeel Khan: [00:11:15] And then just kind of shadowing different doctors and learning and then putting it all together because instead of looking at the body in a siloed approach, which is still what most doctors do with chronic disease, there’s more similarities than there are differences between chronic illness. There’s something called 12 hallmarks of aging. And if you look at them, they tend to repeat themselves with not just aging, but with heart disease, with neurodegenerative conditions, with cancer, with osteoarthritis, it’s all the same root cellular dysfunctional patterns that drive the illness. And so once you start seeing themes and patterns and repetition, then you put the pieces together. And I guess I was I managed to put the pieces together, I think, before a lot of other people did. Maybe then that’s why I’ve been able to be very fortunate in helping some patients that no one else has been able to help. And then you get a reputation for helping these patients that no one else can help. And word spreads pretty quickly, especially amongst the communities that I’m working with, you know, celebrities and high net worth people and stuff like that.

Jonathan Fields: [00:12:14] Yeah, I want to dive into some of the different modalities and get even a little bit into the weeds with you, because I think each one, there are a lot of questions. People have probably heard about them, like, are they real or are they not? What are they for? Not for. So you just brought up one that I think is probably the one that a lot of people hear about and talk about. Commonly shorthanded often is PRP, platelet-rich plasma. What are we actually talking about? What is that?

Dr. Adeel Khan: [00:12:36] Yeah, I like what you said at the beginning of the talk, which was hope or hype. And that’s really the biggest problem with regenerative medicine still is the lack of standardization and the amount of, unfortunately, charlatans and predatory doctors who are claiming that regenerative medicine. Experts and don’t really know much and are just trying to make a quick buck off a patient. With that said, and that’s a big problem with PRP. So platelet-rich plasma is where we take your blood, we centrifuge it. And when you spin it real fast it separates into different layers. And the plasma kind of sits on top. And you can isolate that because when you centrifuge it, it concentrates the platelets, hence the name platelet rich because it’s rich in platelets. And those platelets actually release growth factors and signals to reduce inflammation and promote regeneration. So they send signals to repair tissue. But those signals are relatively weak. So they don’t work for many conditions. They work for really only muscle tears or tendon tears and usually not chronic degenerative stuff. But more acute is really where it shines. And even then, the problem is again is lack of standardization. There’s different types of PRP. If you don’t get the right type, then it may not work even for a tear.

Dr. Adeel Khan: [00:13:47] So you have to be careful. You really have to go to someone who kind of understands. There’s a nuance, even with PRP, and it has to be because if you use the wrong type of PRP, it can actually make things worse. And the same thing with any of these technologies. So you have to understand the science and not just be a clinician. And that’s the tricky part about this field. And regenerative medicine is very dense in that way. It’s not just being a doctor in a sense. You’re just injecting people or being a surgeon with your hands or mechanics. You also have to understand the science and basic science, and a lot of that is traumatizing to doctors because they have to memorize all these pathways and medical school, and they just want to forget about them, and they don’t want to review that stuff at all. So I enjoy that stuff for whatever reason. So I find it fascinating. And I am an interventional doctor now. And so I obviously inject people and treat them all the time with my hands. But I’m also reading all the time because I have to understand the science.

Jonathan Fields: [00:14:37] Yeah. And it sounds like it’s a type of field also where the science is just changing and emerging and there are new things being discovered, you know, like almost on a daily basis. But it’s interesting that one of the knocks that I’ve heard on PRP is that I’ll talk to ten different people who’ve gone to ten different doctors and had PRP treatments for like, let’s say, a similar condition, a knee injury or a tendon injury. And some will say it literally changed my life. It stopped me from having surgery. It healed everything. I’m pain free and others will walk around and basically say like nothing. Like there’s literally it had zero effect. Is that more about some things just aren’t aren’t responsive or some people aren’t aren’t responsive? Or is it more about not properly matching the modality?

Dr. Adeel Khan: [00:15:22] That’s exactly what it is the most doctors. Unfortunately. Regina medicine because it is a relatively nascent field. Unless you’ve gone through the progression and you have a lot of experience because a lot of people dabble in it, especially surgeons, they’re good at it. Surgeons are great at cutting people, but they’re not very good at injection, and they’re not very good at basic science, that’s for sure. And so it’s a lot of times they’re trying to do something, but they don’t fully understand all the nuances behind it. And that’s why you get all these mixed results. Because PRP probably shouldn’t have been offered to that patient in the first place if it was not the right indication and the right patient. And there’s a lot of factors, of course, there’s going to be cases where you think it should have worked, but it didn’t, and then you should have other tools, hopefully in your toolbox to help that patient. But a lot of times doctors don’t because they don’t understand that there’s a progression in how you can kind of approach patients and use different modalities. And basically I think it’s more just matching the right modality with the right patient. I think that’s really what it comes down to, and that’s where I feel fortunate, just because I’ve had patients from all over the world and some of the most complex cases I’ve been able to, obviously, it’s not like I got here overnight. I had to kind of experiment a little bit and try different things on different patients and, and figure out what works, what doesn’t, what are patterns. And there’s a lot of that. And now we’re trying to do it in more formal settings where we’re doing, you know, various clinical trials and to really show the efficacy of what we’re doing in real life.

Jonathan Fields: [00:16:45] Yeah. Are you doing clinical trials with PRP right now or focusing more elsewhere?

Dr. Adeel Khan: [00:16:49] Uh, more on stem cells. So we’re doing a clinical trial with stem cells and osteoarthritis right now. And then gene therapy as well.

Jonathan Fields: [00:16:55] Very cool. Um, you know, one of the curiosities that you’re talking also is and I’ve seen this, I’ve had some experience with, um, regenerative medicine myself. And one of the things that surprised me right away is, you know, you’ll often walk into an office with either x rays or, you know, like an MRI or your typical scans, and then you’re sat down and somebody says, well, that’s nice, but I’m going to actually do a completely different type of diagnostic on you. And very often, like the default is some sort of super high-power ultrasound, which I had always sort of like looked at as well. That’s the quote, lesser way. Like that’s the lesser tool to do diagnostic. But it seems like ultrasound is is really a central tool in a lot of the diagnostic side of regenerative. Was that just my experience or is that pretty common?

Dr. Adeel Khan: [00:17:39] No, it’s it’s completely true for especially for musculoskeletal like joint muscle tendon nerves that type of stuff. Ultrasound dynamic ultrasound especially is often more accurate than MRI. But it depends on the user. And that’s the biggest issue, because MRI can just go into a machine and anyone can do it. But ultrasound is so dependent on the probe and how you hold it and all these other little finicky things. So that finesse of ultrasound skills is very rare, actually. So you must have gone to a good physician if they knew how to use it properly.

Jonathan Fields: [00:18:08] Yeah. What’s the difference between dynamic and sort of meaning?

Dr. Adeel Khan: [00:18:11] They get you to do actual movements or they’ll get you to like move your shoulder, do different positions because an MRI is static, right? You can only be in one position really. Right. And that’s why standing MRIs are becoming more popular too, because then you can see stuff that you can’t always see in the laying position.

Jonathan Fields: [00:18:27] That makes a lot of sense. So on the hype side of PRP, well, I guess what you’re saying is when people talk about PRP, you’re really looking at soft tissue injuries, probably around joints is sort of like the prime reason. Yeah, it’s.

Dr. Adeel Khan: [00:18:39] Not good for chronic degenerative stuff. And I find it sad when I see patients spend money and get told that it may help with this, but in reality it wouldn’t have helped. And then the doctors just like, yeah, it’s 5050, it may work, it may not. And patients just like, yeah, I’ll try it then. And but they should have just they just don’t have the understanding to say like no this is very unlikely to work. We should try something else. Yeah. And I’m very honest with my patients and I rather I rather them not do anything at all than do something that I don’t that doesn’t have a high chance of success. That’s my personal take on patients. But not everyone’s like that. But PRP is is not great for degenerative processes, and a lot of patients are living with degenerative conditions and looking for support in those regards.

Jonathan Fields: [00:19:18] Yeah. And we’ll be right back after a word from our sponsors. So one of the other things I’ve seen, PRP and this feels like it falls on the hype side based on what you’re saying, is, um, for hair regrowth or hair stimulation. Yeah, yeah, I am like definitely in the camp where I don’t have a lot of hair left, but I haven’t gone down that road myself at all. Not interested, but I’ve seen it promoted that way in a lot of different ways. Real or hype.

Dr. Adeel Khan: [00:19:46] Yeah, no, it was definitely more hype than real. So it can help in select cases if you it’s very I would say hit or miss. And I’ve tried it myself personally and I mean I have good hair now, but not because of PRP. Uh, but uh, but because I’ve seen many other patients do it too. And it tends to be so hit or miss and I just don’t recommend it anymore personally, because I just don’t know if it will actually work. And most of the time it doesn’t. It feels like, uh, because it’s just not strong enough. The signal for regeneration and for what you’re trying to do and achieve is not going to be there. And there’s just better technology now. So I personally wouldn’t recommend it for that.

Jonathan Fields: [00:20:21] Got it. Okay. If somebody is exploring PRP, what are a couple of good questions that they might ask or ask a physician to sort of like, see, is is this person right for me or, and this, this modality right for me.

Dr. Adeel Khan: [00:20:33] Yeah. I think if you should ask what type of PRP is it? And do you have different types of PRP because most physicians don’t. But those sophisticated ones, which there are a handful in the US, do have different types of PRP and understand the nuance behind the different types, so that right away will give you insight that this physician really knows what they’re doing. And then the other big thing is, as you said, was ultrasound guidance, because there are many doctors, especially surgeons, who think they can inject into a joint or a tendon without ultrasound, but they can’t. There’s been studies showing this, and an experienced orthopedic surgeon still injects into the wrong spot in a knee joint injection 20% of the time it goes into the fat pad instead of going into the joint. So it does not matter if who you are, you can’t just palpate. It’s not. This isn’t, uh, you know, this is modern era. You need to use image guidance. And the problem is it’s a steep learning curve. It’s not an easy thing to use ultrasound. So a lot of doctors just don’t want to learn.

Jonathan Fields: [00:21:28] Um, that’s PRP. I want to talk about one other modality before we dive into what I think, um, will be a richer conversation around stem cells and potentially even gene editing. But there’s one other modality that I’m familiar with is prolotherapy, which which seems like maybe that’s actually the oldest modality of all of these.

Dr. Adeel Khan: [00:21:46] Yeah. So around since the 60s.

Jonathan Fields: [00:21:47] Yeah. Yeah. So so what what is that what like what do we use it for. What do we not use it for.

Dr. Adeel Khan: [00:21:52] Yeah. The principle of that was basically using well it’s really just dextrose and saline which is just sugar water essentially. And the reason they use sugar water was to just I think they were just experimenting with different things. And they found that at when they looked at, uh, how it affected the ligaments, it caused proliferation, which means it’s stimulating inflammation and helping things to become stronger. So you don’t want to promote inflammation in certain areas. For example, in a joint, you definitely you wouldn’t want to be doing prolotherapy just from a scientific level, although there are still people doing it. But again, I don’t think they understand the principles of what you’re trying to achieve. If you’re trying to achieve a pro-inflammatory response, you want to do that generally for a muscle tear, or you want to do that for ligament instability. So if the ligaments aren’t stable, for example, we have patients with Ehlers-Danlos syndrome who have severe ligament instability. And that’s where we do prolotherapy. And we use we may use a mixture. Dextrose and saline is a very old technology. It still works, but you may have to do like six, seven, eight sessions. What we use personally is we use something called bone marrow aspirate. And then we use something called copper peptide. And these help to stimulate collagen production and proliferation. And they’re much stronger and much more potent. And I find people only need one procedure with it.

Jonathan Fields: [00:23:07] Oh, that’s so interesting. Yeah. Because I’ve always heard about it in the context of anywhere from like 3 to 10, like in a series or something like that. But but it sounds like it’s, that’s because it’s using an older technology basically.

Dr. Adeel Khan: [00:23:18] Exactly.

Jonathan Fields: [00:23:19] Yeah. And it makes sense that that wouldn’t be because if that’s actually encouraging inflammation, I guess, because that then becomes a signal for the body to send blood and nutrients to an area to try and, like, actually heal what wasn’t healing. Yeah. Then you wouldn’t want to do that in an area that was already inflamed.

Dr. Adeel Khan: [00:23:35] Exactly. Which is why PRP, if you use something called leukocyte-rich PRP or there’s PRP, can come in two colors, it can be golden or it can be red. So the red PRP is generally not that advantageous for most things unless it’s just a chronic muscle tear. But a lot of doctors don’t understand the difference, and they’ll put red PRP into a joint. But that’s pro-inflammatory. So you’re actually potentially making the patient worse, which I’ve seen.

Jonathan Fields: [00:23:59] Well got it. Let’s talk about the the area that I think is getting just so much attention. I would imagine you’re spending a lot of time. Well, it sounds like you’re already running trials and which is stem cells because I think this is this is a bigger, more complex topic. Um, so let’s start out with a basic question. When we’re talking about stem cells, what are we actually talking about?

Dr. Adeel Khan: [00:24:20] I think the best way to explain stem cells is an analogy. And. So imagine your body is like a city. You have the central library where all the information is to tell your body on the instructions on what to do and that central library. Think of it as your nucleus where the DNA is. Those are the instructions. And then you have the mitochondria, which is like a nuclear power plant. And then you have all these different districts and cities in your body, which is like the organ systems. And then over time, what happens is the library starts becoming damaged, like the books, and the instructions start becoming wrong as they replicate, because your cells are always undergoing replication. But then you have these little repair guys who come in there and fix things. Those are the stem cells. Their job is to come and repair DNA damage, to repair damaged tissue. And they’re kind of these cool little architects, but also construction workers at the same time. And they’re able to figure out how to fix things when they go wrong. But unfortunately, over time, the library starts getting too much damage and the books start getting more and more damaged, and the repair guys can’t keep up.

Dr. Adeel Khan: [00:25:29] And then this is what’s called genotoxicity or DNA damage. And this is what leads to aging. When your DNA repair isn’t the way it was when you were younger. And to put that in context, when you’re a child or a baby, you have 200 stem cells per one cell. And then by the time you’re 80, you have one stem cell per cell. So it’s gone down by an order of yeah, 200 basically. Right. An order of magnitude. So it’s quite a bit different. So that means the stem cell decrease in function and number is called stem cell exhaustion is one of the most important hallmarks of aging. And that’s why stem cells are such a hot area of research, not just because of their applicability to chronic pain and all this stuff. But aging is and longevity is one of the hottest topics right now. And so many people want to learn how can they live longer and healthier and better lives. And that’s this potential is obviously in stem cells, because once you understand why we age, you can understand why stem cells have so much potential.

Jonathan Fields: [00:26:27] Got it. So if these are so powerful when we talk about using stem cells in regenerative medicine contexts, then take me deeper into that.

Dr. Adeel Khan: [00:26:39] Yeah. The biggest issue with stem cells and similar to PRP is lack of standardization. So there’s so many different types of stem cells. And the word itself is almost meaningless because are we talking about a mesenchymal stem cell or hematopoietic or induced pluripotent stem cell. There’s all these different types. But the most important thing to understand is how do we control the stem cell to do what we want? Meaning how do we almost program it in a way so that it sends the signals that we want it to send? And that’s called cellular engineering, and that’s kind of the era we’re living in now. Whereas before we were kind of just taking stem cells from your body or from an umbilical cord, and then we were just injecting them back in. And the results have been very mixed for that. And it continued to be because there’s no standardization. And so although we still use it in biblical core stem cells, in practice, we have now engineered stem cells and engineered products that we’re using because we know better how they’re going to function once you put them in the body and it allows for better standardization. This is kind of where we’re headed now.

Dr. Adeel Khan: [00:27:41] And when I mentioned earlier about that Japanese fellow Yamanaka pressing the reset button on an old cell, making it young again, that’s called induced pluripotent stem cell, or IPSC. And those iPSCs are kind of the holy grail of stem cells, because they can turn into any type of tissue in your body, and they have the ability to actually engraft, which means they can actually regrow new tissue. And this has been shown in clinical trials with Parkinson’s disease, with diabetes. And now there’s so much research happening for so many different organs. And the sky’s the limit, right? If you can grow any type of cell and repair the body, then you can theoretically eventually fix any degenerative condition in the body and even aging eventually, I think maybe not cured, but definitely at least severely slowed down. Because if you can make all your cells in your body young again, theoretically you could live forever. And that’s the immortal jellyfish is at least it lives for 5000 years or something ridiculous because it can de-differentiate cells. It can make its old cells young again at will, which is kind of crazy. Yeah.

Jonathan Fields: [00:28:46] I mean, you mentioned Yamanaka, and I know he was known as discovering these as you described induced pluripotent stem cells. Yeah, I think induced meaning. He’s sort of like, like figured out a way to create them pluripotent meaning these are stem, I guess. Didn’t they often start with like, skin cells or just really basic cells and then.

Dr. Adeel Khan: [00:29:05] Yeah, skin. Exactly.

Jonathan Fields: [00:29:06] Right. And then find a way to literally turn them into stem cells that could then turn into whatever type of other cell that you wanted to. But that research, if I remember correctly, it’s probably it’s got to be about 15 years old at this point when I’m almost 20.

Dr. Adeel Khan: [00:29:22] It was 2006. Yeah, right.

Jonathan Fields: [00:29:24] So my question is, because you’re not seeing a lot of those iPSCs in clinical or out there. And like, so what’s we are.

Dr. Adeel Khan: [00:29:32] Now because the problem was up until now, the risk with these iPSCs is because when you coax them, you’re coaxing a cell basically to become young again. But that has some risks with it. And the biggest risk with it is that they’re essentially embryonic in nature so they can grow into tumors or cancer. And sometimes the DNA can be damaged, and sometimes maybe it might turn into something you don’t want it to turn into if you put in the body. So learning how to differentiate these cells into the right cell lineages and making sure the local environment you put them into do what you want. That took some time to figure out, but for the most part it has been figured out for meaning. They have figured out how to differentiate these cells into neural progenitor cells, into beta islet cells for the pancreas, into cardiomyocytes, for the heart. So now we have all these different processes to differentiate these cells. And there’s a company that we’re working with specifically that has a technology. It’s their proprietary tech that prevents these iPSCs from growing tumors or cancer. It’s called fail-safe. And it’s basically a gene edit inside of the iPSCs. So if they start replicating uncontrollably, if you have uncontrolled proliferation, it will act as a kill switch. So meaning you’ll stop the cells from dividing. So you have that safety mechanism built into it. And that’s the company we’re using. And that’s the reason we partnered with them is because of that technology. So we can feel comfortable putting these iPSCs into patients because we know they have that fail-safe built into it.

Jonathan Fields: [00:31:00] Yeah. How far are we now with actually seeing patient outcomes with these iPSCs?

Dr. Adeel Khan: [00:31:08] Well, Bluerock therapeutic is the one that did a clinical trial for Parkinson’s and they took iPSCs. But these don’t have the fail-safe mechanism. So there’s obviously some risk of having cancer potentially, but it’s probably 1% or so. But obviously patients are okay to do it. And so there was 12 patients or so and they took these iPSCs and they turned them into dopamine producing neurons. And then they transplanted them via surgery into the area of the brain where they lose the dopamine-producing neurons called the basal ganglia. And they actually engrafted, meaning patients were actually producing new neurons that were able to produce dopamine. So this is the holy grail, right? You’re actually creating new tissue that’s fixing the problem instead of just masking it. And these patients go into remission, which is unbelievable. And the dose there was two dosing groups. And the dosing group that had higher seemed to have better results. So it’s just amazing to see the potential, though of what this technology can do. And I think this is just the beginning of the era of the IPSC era. There’s 40 IPSC companies now, I think, and they’re just exploding. And it’s definitely gonna be a, you know, there’s not gonna be 40 companies in 20 years from now. There’ll probably just be a few that end up having the technology and owning it and really getting the best results. But this is the field regenerative medicine is headed towards now.

Jonathan Fields: [00:32:22] Yeah, I mean that’s amazing. Especially when you talk about the results in the brain like that. Because I was always taught that, you know, you hit a certain point in life like you have X number of brain cells. And yes, there’s neuroplasticity, but that’s largely about, you know, synapses rewiring. It’s not you’re not generating new neurons, you’re not generating new brain cells. But it sounds like what you’re describing is actually like generating new neurons.

Dr. Adeel Khan: [00:32:44] Exactly. That’s why I’m very excited about the neural progenitor cells that we’re going to. We’re going to create them from iPSCs, and we’re going to explore that for dementia, Alzheimer’s, and I mean even MS, there’s so many different conditions you can use this stuff for.

Jonathan Fields: [00:32:58] So I guess my curiosity around that is like if we take MS or Parkinson’s as an example, if there’s some sort of genetic signal, or maybe I’m making an assumption here if something’s happening, which is basically stopping in Parkinson’s case, you know, like dopamine generating neurons from actually like generating dopamine anymore. And then you do an IPSC intervention and all of a sudden you start generating new neurons that are generating dopamine. And that’s which is the counter to Parkinson’s. Are you changing the genetics of the existing neurons, or are they just dying and getting replaced by ones that actually are fixed? What’s actually happening there?

Dr. Adeel Khan: [00:33:34] Yeah, no. They’re actually so the old neurons are dying off essentially because they’re dead. You know, they’re not doing what they’re supposed to or they’re dysfunctional or they’re senescent, meaning they become these zombie cells and they’re not doing what they’re supposed to. So they’re essentially just, you know, and they’re not being cleared up the way they should. So when you put in these new cells, it changes the signaling and the local environment as well, which means it helps to reduce neuroinflammation. It helps with oxidative stress and it helps with other kind of cellular hallmarks, as we talked about earlier, that are associated with Parkinson’s, because we know that a lot of these chronic diseases, you know, have all these different hallmarks. So for example, in Parkinson’s, they found there was a trial last year that showed that even certain gut bacteria is linked to Parkinson’s. So like gut dysbiosis or having the wrong bacteria can increase your risk of Parkinson’s. Even Alzheimer’s. So there’s all these other things that are contributing factors, which I think ultimately are the ones that alter gene expression. So even if you have a genetic predisposition, I don’t think genetics play that big of a role as compared to obviously, epigenetics, which we understand way more about now, and how gene expression is altered and turned on and turned off based off the environment.

Jonathan Fields: [00:34:45] Mm. No, that makes a lot of sense. So we’re really kind of talking about this one cutting-edge type of stem cell, the induced pluripotent stem cells. And that’s where like that’s where the edge is. That’s where people like you are just starting to actually do the work and the science behind it and using it clinically. But when the vast majority of people talk about having some sort of stem cell procedure these days, they’re not talking about that. They’re often talking about, you know, you described earlier mesenchymal or like fat derived stem cells, what are those and what are sort of like the common use cases for those, like where does that make sense.

Dr. Adeel Khan: [00:35:21] Yeah. So mesenchymal stromal cells is a technical right nomenclature. But we just call them stem cells because everyone now says that. But stromal because they have a little bit of scaffolding effect. And mesenchymal is just kind of an embryological term. But essentially these are multipotent cells. They’re not pluripotent. So that’s important to remember.

Jonathan Fields: [00:35:41] So what’s the difference there?

Dr. Adeel Khan: [00:35:42] Yeah exactly. So pluripotent means they can differentiate into all three cell lineages called ectoderm and endoderm and mesoderm. But multipotent just means they have what’s called a tri-lineage differentiation capacity, which means they can only turn into cartilage, fat, muscle and bone. Really. So it can’t go into all the different can’t grow new neurons or other things like that. So there’s much more limitations with multipotent mesenchymal stem cells as compared to induced pluripotent stem cells. So the question is can we engineer mesenchymal stem cells so they have more pluripotency? And that’s kind of where the research is going. Now if you just go to your typical doctor I guess this is where there’s problems in this field is if you go in the US, they’re going to tell you you’re getting a stem cell procedure. But stem cell procedures are still illegal in the US and if not FDA approved, obviously that’s not stopping people from doing it, which I get. I mean, I understand people don’t agree with them, but at the same time there, you know, there’s a big black market now for stem cells and exosomes and all this stuff. And it’s creating some problems because it ruins the reputation of people who are trying to follow the rules and trying to do the good work. And if you go to a doctor in Florida where they’re doing stem cells, they’re more than likely either offering you your own stem cells, which aren’t true stem cells, or you’re taking your bone marrow or your fat, and then they’re just processing it and they’re injecting it back in. Those are technically committed progenitor cells, which means they’ve already committed to a cell lineage, and they can’t actually turn into different types of tissue.

Dr. Adeel Khan: [00:37:15] They’re just more reducing inflammation. They’re more signaling molecules than anything else. And then let’s just say if they’re in Florida or Florida is the most commonplace. That’s why I’m using Florida as an example, where there’s so many clinics that are offering this and say, say you get five stem cells or exosomes or something like that, and they get from an umbilical cord. They’re usually going to be derived from umbilical cord tissue, but they’re not often going to be culture-expanded because culture and expansion is very illegal in the US. And so FDA can get you can get quite a bit of trouble for that if you’re not doing it under a clinical trial. It’s typically that’s what most people are getting. I would say, for the most part are getting umbilical cord tissue or exosomes, which are kind of the soup that the stem cells grow in. Personally, where I do most of my work is in Los Cabos, Mexico and Dubai and Europe and Tokyo. I’m working in the summer. These are all places where stem cells are regulated and approved. And, you know, we can debate all day about why they’re not approved. But the point is they’re just not approved yet by FDA, probably more so do politics and safety or efficacy. But the problem, as we were saying, with with these mesenchymal stem cells is they’re multipotent. So meaning they don’t really have that much pluripotency. A lot of patients are thinking they’re getting these in hopes they’re going to regenerate new tissue, but they’re not really doing that.

Dr. Adeel Khan: [00:38:28] They’re just kind of reducing inflammation, which can still be very helpful for chronic pain. Longevity, too, because inflammaging and chronic inflammation is a big driver of aging. So they’re still they’re still useful, but just being very clear and transparent about what they can do and what they can’t do. And to that extent, we are now working with a company that has something called Muse Cells. Muse cells are very fascinating, and this is getting a little bit into the weeds, but I think people will find this interesting because it’s another Japanese technology. It’s called multilineage differentiating stress-inducing cells. So muse mu sec and mu s mu cells are usually only 1 to 5% of the population of mesenchymal stem cells, but they’re responsible for most of the pluripotency. There are muse cells are pluripotent, basically, and they’re stress-enduring, meaning they can survive harsh environments, whereas regular stem cells, a lot of them die. Once you inject them into the body. And so muscles. If one of the goals of the last kind of decade of research has been, how do we increase the muscle concentration? Because then we can increase the efficacy of mesenchymal stem cells. So there’s there’s a group that uses a Japanese technology. And instead of being 1 to 5% of mesenchymal stem cells, they’re like 70%. So you have potentially like a 30 x increase in the muscle cells. It’s going to be significantly better in terms of effect. And I’m seeing this clinically now. I’m starting to use these new cells. And there was also have just been incredible for chronic inflammation and a variety of conditions.

Jonathan Fields: [00:40:01] Got it. I mean so what I’m hearing in part is like if you live in the US. Um, yeah. Be careful. Yeah. Like really be super careful and ask a lot of questions. And not necessarily that any people who are who are providing services like regenerative medicine services are malintended, but it sounds like just the learning curve here. And the speed at which things are developing is so fast that it takes a huge amount of effort to sort of like stay on top of what’s going on. I’d always been sort of like before I heard about the Yamanaka cells, the iPSCs. I heard about mesenchymal stem cells, and I think that’s probably if anyone’s talked about it or thought about it, been that’s what comes up. And then the only options were, well, it’s either bone marrow-derived meaning like you take a little bit of bone marrow and basically spin it out or it’s fat-derived, you know, you take a little bit of fat from your body and derive it from that. And those cells then have the ability to differentiate into damaged tissue and in doing so heal it. But it sounds like you’re saying that’s not really what happens.

Dr. Adeel Khan: [00:41:03] No. Doctor Arnold Kaplan wrote a paper on this in 2017. I believe it was published in nature. And it was basically we need to rename these cells, call them medicinal signaling cells. Don’t call them mesenchymal stem cells because they’re not stem cells. They’re signaling. They’re essentially just doing signals that reduce inflammation. They’re not really differentiating and turning into different types of tissue. And in fact, even if you were to, let’s say, isolate the mesenchymal stem cell from the fat or bone marrow and then culture and expand them. The problem is after age 40, your stem cells, just like your body age. And so they undergo exhaustion, which means they don’t work that well. And so do you really want to use your own cells after a certain age? Probably not. And wouldn’t you rather have a baby’s or or engineered cells that are embryonic in nature? So just intuitively, I think most people understand that their cells aren’t going to be great as what’s off the allogeneic cells, which are from donors. And people sometimes obviously are concerned about don’t you have to match? But with mesenchymal stem cells, you don’t. They have what’s called low HLA antigen expression. So they don’t express much of the antigen. So there’s no risk of graft versus host disease. It’s not like hematopoietic stem cells which are bone marrow stem cell transplants that you have in the hospital. Those you have to have match but not for MSCs.

Jonathan Fields: [00:42:23] Got it. So if you do have that procedure, especially in the US and you feel some relief, it’s very likely not because the tissue has regenerated or been healed, it’s because inflammation in that area has been reduced, at least temporarily. And that’s probably what you’re feeling. So interesting. And I guess as you noted, the potential ethical issues. Well, you know, I think there’s been wide debates about the use of umbilical stem cells and like people feel one way or the other about it, but it sounds like the iPSCs are kind of like they’re the next generation work around around this, because you can just take anybody’s skin cell and effectively turn it into something close enough to an umbilical one, right?

Dr. Adeel Khan: [00:43:01] Yeah. No, it’s in fact, it’s probably even better than umbilical because it’s more of like embryonic. I think the ethical issues often were from embryonic stem cells, because you have to take them from aborted fetuses or growing fetuses in labs. And obviously there’s so many ethical issues around that. Plus they can cause cancer. And there’s but that doesn’t stop people from offering them. There’s clinics in Mexico. I’ve seen them. They offer embryonic stem cells. It’s scary, number one, and it’s dangerous. And so you got to be very careful where you go. And that’s why unfortunately, I think the stem cell landscape outside of the US two is riddled, riddled with people who are just taking advantage of patients. And we’re trying to really educate people and just trying to do things the right way, while understanding that this is still a very new field and we have to do a lot more research to really push it forward.

Jonathan Fields: [00:43:47] Yeah, and we’ll be right back after a word from our sponsors. So you mentioned the use of these, um, the, the IDs, ID induced pluripotent stem cells in things like neurodegenerative conditions. More broadly, what about things like heart disease, diabetes or other sort of like chronic systemic illnesses?

Dr. Adeel Khan: [00:44:11] Yeah. Well, it turns out that all disease starts in the cell. There was a good Nobel Prize laureate who said that, and I think that rings true for any chronic illness. So where does cardiovascular disease start? It starts in the blood vessels called the endothelial cells. And the endothelial cells become dysfunctional. Why do they become dysfunctional? Because there’s all these toxins. There’s poor lifestyle. There’s all these things that lead to the cells in the lining of your blood vessels to start getting damaged, and they can’t repair themselves, like we talked about earlier, is that city and that that can’t repair the library the way it wants. And then eventually and we think there’s something called the unitary theory of aging. And it’s called unitary theory, because we think that the most foundational cause of cellular dysfunction and chronic disease progression has to do with the mitochondria. So mitochondria are much more than just powerhouses, as we were taught in high school biology. They do a lot more than that. They help to maintain tissue homeostasis, which is very important because that’s entropy over time. And changes in the epigenetics is what really leads to aging. And so the mitochondria become dysfunctional. And that signal meaning they can’t deal with oxidative. There’s too much oxidative stress. They can’t the free radicals build up. And then that leads to inflammation senescence and all these other kind of hallmarks of aging.

Dr. Adeel Khan: [00:45:35] So for cardiovascular disease or diabetes at a very fundamental level, they’re still have the same kind of dysfunctional cellular problems. And if you can restore those cellular dysfunctions then you can help to treat those conditions. And that’s why stem cells are almost magical sometimes, because if they’re done the right way with the right dosing, and especially with these engineered stem cells, now they can treat a variety of conditions. And that’s why it’s confusing for traditional physicians. And it almost looks like and I thought it was a charlatan thing too. When I got into it, I was like, how can they how can stem cells treat like 20 different conditions? That doesn’t make any sense. But then once you understand it, you’re like, oh, it’s because it’s treating the underlying cellular dysfunction and it’s restoring the cellular signaling and the processes that are going wrong in the first place. So for example, in diabetes, they’ve done clinical trials just with bone marrow stem cells or umbilical cord stem cells, not even engineered IPS ones. And they culture expanded though, and they inject them into the pancreas. And patients can get off insulin. And it’s for type two diabetes. So how is it doing that mechanistically. It’s not regrowing new pancreas cells. It’s just because it’s reducing inflammation helping with oxidative stress, helping with the telomeres, helping with all these different things that are the hallmarks of aging.

Jonathan Fields: [00:46:46] It’s almost like you’re talking about like the magic bullet. Yeah.

Dr. Adeel Khan: [00:46:49] Well that’s it kind of I think it’s about figuring out what cell is going to be the magic bullet. But I think one day we will engineer a cell that will be a magic bullet. Yeah.

Jonathan Fields: [00:47:00] So here’s one of my brain’s going. Also, I’m so curious about this. If this can literally go into your body and help with so many different things, from acute things to chronic things. Let’s say the typical person in their 40s, 50s, 60s or later, they’re going to have a lot of different things that need remedying in their body, like all at the same time. How does the stem cell, like you put it into the body and the stem cells like, oh, I could fix that, I could fix that, I could fix that, but how does it know where to go?

Dr. Adeel Khan: [00:47:28] Yeah, yeah. No. Especially so the mu(?) Cells specifically which are the subpopulation of mesenchymal stem cells. So they’re inside of them. They seem to be responsible for most of the homing ability. So there there is a known homing ability of MSCs of mesenchymal stem cells. But the muscle cells are even more much more so. So we think there’s something called chemokines which are released when tissues damage. Chemokines are signals that say to your body help come help me. And so your body mobilizes its immune response to do that. But then oftentimes that immune response leads to chronic inflammation. And that chronic inflammation is what kind of leads to so much degenerative processes. Because you get stuck kind of stuck in this loop. And so what the stem cells can do is go in there and they change what’s called the microenvironment, and they change the cellular signaling. This is called macrophage polarization, which is just a fancy word for saying we’re retraining your immune system. So instead of being a pathogenic phenotype where you’re sending pro-inflammatory signals, you’re now going to have a much nicer phenotype where you’re sending anti-inflammatory signals. And so that’s basically what’s happening with these stem cells when you put them intravenously throughout the body.

Jonathan Fields: [00:48:41] So basically as you described, like you could pick an organ and go directly into it. But if there are sort of like multi-system things you’re talking about, it’s almost like they have these built-in homing devices to figure out, like. Where is the most important place to go?

Dr. Adeel Khan: [00:48:53] Exactly. Yeah, yeah, that’s why it is wild. I know I read a paper a couple of weeks ago, and they described they had a visual of how these stem cells go into the blood vessels and how do they home. It’s almost like these cells are smart. And I think that’s and I think that’s the conclusion I’m coming to personally based off also Michael Levine’s work, who’s a bioelectricity scientist, and he talks a lot about that with Bioelectricity. But I agree with him in that sense that they’re almost like these little, you know, smart little things that kind of know what to do when you put them in the right place. But it’s just it’s all about the environment. And the environment dictates the signaling that they’re going to be told. And how to know to do the right thing depends on the environment. And that’s why if the microenvironment has too much inflammation or is hypoxic and there’s all the wrong signals being sent, then the stem cells won’t work. So that’s why prepping the body and having the right microenvironment is very important for the best results.

Jonathan Fields: [00:49:47] Yeah, that makes sense. I mean, as you’re describing that, I remember talking to a physician who was in the field at one point and they were saying that they have been injecting stem cells IV and then using effectively, shockwave therapy to induce inflammation in particular areas that they wanted to direct the stem cells to. And the stem cells would kind of find their way to them because they’d intentionally inflamed that particular area. Does that make sense?

Dr. Adeel Khan: [00:50:17] Yeah, I’ve heard of that. I’ve heard of people doing Shockwave or Laser or other things to try to get the stem cells to go where they want to, but I think that’s a crude way of doing it personally. And I also don’t know if there’s any published data on that. I think I think you just have to engineer the cells so that they have better homing abilities, which is what we’re doing now.

Jonathan Fields: [00:50:36] Yeah, right. And it’s almost like you’re adding inflammation to a system that’s already like inflamed as a way to try and like, direct these things. Yeah. And yeah.

Dr. Adeel Khan: [00:50:43] My counterargument to that also would be we know that if there’s too much inflammation, the cytokines, the proteins that cause that inflammation, they can interfere with the stem cells to do their job.

Jonathan Fields: [00:50:52] Right. Yeah. So it kind of defeats the whole process. The last thing I want to circle around, and I think this falls at least in part under the the auspices of regenerative medicine is gene editing. I think a lot of people have read about CRISPR and sort of like the evolutions that are being made there is in your mind and in the work that you’re doing. Does that fall under.

Dr. Adeel Khan: [00:51:11] Like because regenerative. So regenerative medicine and the holy grail of regenerative medicine is basically this intersection between cell therapy, gene editing or gene therapy and tissue engineering. So all three of those is kind of what’s the next era of medicine. And combining all three of those in a very sophisticated way is what’s going to allow us to regrow organs and fix any disease known to man. I think especially once Crispr becomes a reality, you should be able to fix any genetic defect. And it’s we’re getting there. We’re not there yet. But that’s I think that’s going to definitely happen as these technologies continue to evolve.

Jonathan Fields: [00:51:47] Yeah. So in super simple terms, what is Crispr? What does it do?

Dr. Adeel Khan: [00:51:50] It’s basically a very simple level. It’s essentially just this bacteria. It’s called the Cas9 system. And basically what it does is you can take any cell out of your body and you could basically like imagine you like take scissors and you cut you cut out this code of DNA that you don’t want in there. And then you can stitch it back together and then you can put it back in, and then you can change the genome in that way. But the problem is with Crispr is that there’s something called off-site targets. And this has been the biggest issue. And because people are probably wondering why haven’t we saved humanity if Crispr is a real deal? You know, because it sounds in theory, it sounds amazing, but there’s there’s all these off-site targets, which means it edits things that we don’t want it to edit. And there may be things, uh, an unintended side effects. And that’s why it took 12 years for one product to come out. Finally, they finally have one. I think it’s for sickle cell if I if I’m not mistaken.

Jonathan Fields: [00:52:39] Yeah, I was just reading about that recently actually.

Dr. Adeel Khan: [00:52:42] Yeah. Yeah. So I think that that’s the first FDA or you know, or was European approved product. And so but it took 12 years and that’s only one product and it still has risks with it. And so I think we’re still pretty far away from seeing this become a reality. I’m not saying Crispr doesn’t have a lot of potential. It has a huge potential. But it just seems like the commercial value of it is going to take a lot longer than we thought. Now the technology we’re working with is called Minicircles, and I may be biased because I work with them, but I think Minicircles have a lot more commercial value. They don’t have the same power capability as Crispr because we can’t cut out things and correct them, but we can add genes, so that’s what our technology can do. So we can add any gene, any peptide or protein in the body, up to 10,000 base pairs, which is fairly big but not as big as obviously Crispr can just pretty much do anything. But again, the good thing about our technology is that there’s no off-site targets. So what is a mini circle? A mini circle is a plasmid that’s derived from E coli, a bacteria, and a plasmid is just something that is used to exchange information.

Dr. Adeel Khan: [00:53:48] So a plasmid is just when if you look at it under a microscope is a circular strand of DNA, and so hence the name mini circle, because it’s like a mini circle. And you can insert whatever gene of interest you want onto this mini circle, and then you can inject it into a patient and it’ll tell the local cell there, hey, you have this new information. So your library now has a new book, and you can read that book and they’ll tell you to produce more of the peptide or protein that we insert it onto this mini circle. So you can add anything that we want on there. So you can imagine there’s a lot of possibilities because we can add on any peptide. And peptides are becoming very popular in the in just general kind of public now because of ozempic. But there’s so many other peptides that we can do gene therapy forms of. So the first product we did was called follistatin gene therapy. And the reason we chose Follistatin is because it’s a it’s been around for 20-plus years.

Dr. Adeel Khan: [00:54:40] It’s very well studied and we understand all the mechanisms. And B it helps to preserve muscle mass and and increases muscle mass. And we I think we all like we said earlier, muscle is definitely the organ of longevity. As Doctor Gabrielle Lyon always says. And we know that if we can help to slow down muscle loss and or increase muscle gain, we’re going to help with your longevity and healthspan. And so that’s why we chose Follistatin as our first target. And so we basically it’s that Follistatin gene therapy is just an injection in your arm or stomach. And it’s it’s not changing your DNA. But all it’s doing is adding this gene and it’s telling your cell to produce more follistatin. And then it goes into your blood and it does what it does, which is (?) A bioidentical peptide hormone that allows you to increase muscle mass and decrease the systemic inflammation. So it’s quite powerful for aging. And we showed that in our clinical trial, which is being published momentarily. It’s available on our website if you want to read it at minicircle. Io. But we are publishing it in a journal. We’re just deciding which journal to put it in.

Jonathan Fields: [00:55:37] Got it. And is that, um, permanent change? Is it short-term? Do we know yet?

Dr. Adeel Khan: [00:55:42] It’s the world’s first reversible plasmid gene therapy. So reversible, meaning you can take an antibiotic called tetracycline or doxycycline any anything in that class and it will act as a kill switch. So. Oh wow. So that’s why this is a real cool technology because it’s reversible and no other. There’s no other reversible gene therapy in the world. And the other cool thing about our technology is that it’s temporary. So because let’s just say you don’t want to do it again. I mean, everyone wants to do it again after it wears off, but it lasts for 18 to 24 months, so it does wear off and then you can just get it done again.

Jonathan Fields: [00:56:14] So effectively, if I’m hearing it right, you’re adding, let’s say your body like there’s either you don’t have the gene or the gene is damaged. That would let you produce an enzyme that’s necessary for you. Exactly. Maybe down the road Crispr actually can swap in like the right one or fix a broken one. But what you’re saying is this technology effectively says, well, we can take that. Like whatever, like the snip is, and we can essentially add it in in addition to what’s there. So even if the one that you have isn’t functioning, you’ve now got like this extra one that’s actually going to make it generate what you need.

Dr. Adeel Khan: [00:56:45] Yeah, exactly. And that’s why it’s a good technology for conditions like cystic fibrosis where they’re not making enough of a protein. Right. And that causes epi. So we have all these rare conditions that I believe we can really change these people’s lives where we’re starting out with kind of longevity and cosmetics. We have copper peptide gene therapy coming out. But the reason we’re doing that is because those are the ones that are going to generate revenue. So we can reinvest into the more rare and more, I think, ones that are going to really change people’s lives now.

Jonathan Fields: [00:57:15] It’s like my mind is exploding with the potential here. I’m sure, like you working in this every day, it’s just got to be like, how do you even, like figure out what do I focus on? Because there’s so many different things. You could choose so many different directions. You could go, yeah.

Dr. Adeel Khan: [00:57:27] Between this and cellular engineering, my mind is very entertained.

Jonathan Fields: [00:57:31] Yeah. And to a certain extent, it sounds like that. Like this what you were just talking about, maybe it’s not the long-term thing, but maybe this bridges a gap between now and when Crispr hits a point where it’s actually safe enough, where you can actually make the genetic swap and then like that lasts for life.

Dr. Adeel Khan: [00:57:45] Yeah, exactly. I could see Crispr taking off eventually, and it’ll just be unbelievable when it does. Yeah.

Jonathan Fields: [00:57:52] Of either the things that we’ve talked about or things we haven’t talked about yet, is there like one thing that you’re most excited about right now?

Dr. Adeel Khan: [00:57:58] Yeah, I think the thing I’m most excited about is definitely putting the Yamanaka factors into our gene therapy. So basically the Yamanaka factors are four transcription factors that were that we talked about that basically make the old cell young again. But we can take those. So we can take they’re called OSC. And then c dash m y c. But that last one is the one that’s associated with like tumors and cancer. But you can use OSC and you can still get cellular reprogramming. And so not maybe as strong, but you can still make an old cell relatively young again. So what we’re going to do is we’re going to put the OSC into a plasmid gene therapy. And then we’re going to we’re going to do a trial where we can see if we can rejuvenate organs and make them young again.

Jonathan Fields: [00:58:46] Kind of the holy grail.

Dr. Adeel Khan: [00:58:48] Yeah. Pretty exciting.

Jonathan Fields: [00:58:50] Yeah. That is a reason to get up in the. Morning to sort of, like, dive into all of that stuff.

Dr. Adeel Khan: [00:58:54] Yeah. And the one we’re going to do first, the organ I want to do first is the thymus, because the thymus gland is this little gland that sits around your sternum and it involutes, which means it starts atrophying since you’re basically a kid. And so it just becomes smaller and smaller as you get older, and it becomes pretty useless by the time you know, you’re in your 60s or 70s, which means that. And that’s why so many people get chronic diseases as they get older, because the thymus gland is so important for regulating your immune system. So if we can do thymus regeneration, then we’re talking.

Jonathan Fields: [00:59:25] Yeah that’s amazing. It’s just like it’s so exciting. I feel like it’s a cool time to be alive when it comes to all of this stuff. It feels like a good place for us to come full circle in our conversation as well. So in this container of Good Life Project., if I offer up the phrase to live a good life, what comes up?

Dr. Adeel Khan: [00:59:41] Peace, being at peace with where you’re at in life and being content with what you have and with with who you have it with.

Jonathan Fields: [00:59:50] Mm. Thank you. Yeah.

Dr. Adeel Khan: [00:59:51] Thanks for having me.

Jonathan Fields: [00:59:53] Hey, before you leave, if you love this episode, Safe bet, you’ll also love the conversation we had with Doctor Frank Lipman about the six pillars of well-being. You’ll find a link to Frank’s episode in the show notes. This episode of Good Life Project was produced by executive producers Lindsey Fox and Me, Jonathan Fields. Editing help By Alejandro Ramirez. Kristoffer Carter crafted our theme music and special thanks to Shelley Adelle for her research on this episode. And of course, if you haven’t already done so, please go ahead and follow Good Life Project. in your favorite listening app. And if you found this conversation interesting or inspiring or valuable, and chances are you did. Since you’re still listening here, would you do me a personal favor? A seven-second favor and share it? Maybe on social or by text or by email? Even just with one person? Just copy the link from the app you’re using and tell those you know, those you love, those you want to help navigate this thing called life a little better so we can all do it better together with more ease and more joy. Tell them to listen, then even invite them to talk about what you’ve both discovered. Because when podcasts become conversations and conversations become action, that’s how we all come alive together. Until next time, I’m Jonathan Fields, signing off for Good Life Project.can