Stem Cell Therapies with Dr. Neil Riordan. PA. PhD

Dr. Riordan is the founder, chairman, and chief science officer of the Stem Cell Institute in Panama, which specializes in the treatment of human diseases and conditions with adult stem cells, primarily human umbilical cord tissue-derived mesenchymal stem cells.

Learn about some of the exciting applications of stem cell therapy that are currently being researched, and find out how important it is to maintain a proper nutrient balance for stem cell health, and how naturopathic medicine can help to support those efforts.

Rubin: Hi I'm Dr. Dan Rubin with Ad Hoc with a Doc and today we have an extremely special episode. Here talking to one of my mentors, Dr. Neil Riordan. Thank you for coming here. It's really special to be able to talk to you about this.

Riordan: Sure man.

Rubin: Long ago we got to work together, you taught me huge amounts of stuff, helped me learn how to think about oncology and how to approach the whole–approach a patient, and just to approach the whole ‘ology’, and so, thank you for that.  

Riordan: You’re welcome.

Rubin: Taught me about IV vitamin C, about the immune system; and now we're sitting here talking about stem cells, which I know very little about. I know through you most of what I know and I just really, on this Ad Hoc with a Doc, would love to just talk about what types of stem cells you study, you develop, how you go about harvesting or propagating. I know they’re mesenchymal stem cells and there's a difference of those and there's different types of stem cells out there–and so, first off, how did you become interested in stem cells, in general, many years ago? 

Riordan: Well, you know, we used to make dendritic cell vaccines and to make bigger, better dendritic cell vaccines, you needed to start with another kind of stem cell called the HSC, hematopoietic stem cell, which is what you use if you're going to do bone marrow transplant.

Rubin: Okay

Riordan: In oncology, is probably the largest use of bone marrow transplants. There are some autoimmune diseases that they do but–

Rubin: So, you can get those from the bone marrow? 

Riordan: CD34’s can fully restore the blood-cell making system in the body.

Rubin: Okay

Riordan: So, that's what a bone marrow transplant is–wipeout the, you know, the HSCs of a person, and give them donor HSCs and, without getting too much into it–that's not what we do.

Rubin: Okay

Riordan: We don’t use chemotherapy, and we don't wipe out anybody's immune system. We use the other major group of stem cell in the body which is called the MSC, mesenchymal stem cell, we just say MSC.

Rubin: MSC, okay.

Riordan: And so, those are found everywhere in your body, you know, they line the blood vessels, every capillary–the smallest blood vessels in your body is surrounded by them.

Rubin: On the outside?

Riordan: On the outside, yeah. So, actually, they control blood pressure

Rubin: Interesting

Riordan: They control, they're the master controller's of homeostasis or, you know, normalcy in the body; and as we age, or as, you know, certain illnesses are associated with messed up MNCs, and as we age we just run out of them. So, the combination of, you know, if you're quite ill for quite some time, certainly most autoimmune diseases have a dysfunctional–the MSC's are not working properly.

Rubin: Is there a way to quote like “talk to them” or “send them a message”? In, is that part of stem cell therapy?

Riordan: Yeah, they're tons of cross-talk between, well, all the cells in our body. The main reason, one of the main ways besides physical contact is secretions of the cells, and they secrete these small things–so if the cell’s this big, they secrete these little exosomes, these little micro-vesicles, and that's the major, major way of communicating.

Rubin: Is it sort of–is an exosome sort-of like a little envelope, packed full of information that they want to deliver to another cell?

Riordan: Yeah, I don't know if they consciously want to do it, but they do, um, instinctively–

Rubin: Wait, who does? The MSC's make the exosomes…

Riordan: Yep.

Rubin: And then they send that somewhere else in the body.

Riordan: Right, right. So, one of the most interesting things that’s ever come out, since I've been doing this, is the fact that MSC's can triage and deliver mitochondria to somatic cells and it was done in a–basically in a inflammatory, highly inflammatory, you know, they put, put something down into the lungs of animals and the–there's a lot of inflammation and then the cells–there were dead cells, there were dying cells, and there were healthy cells. So, MSC's were able to triage…those cells that had enough mitochondria to make it, and it would leave them alone. The cells that didn't have enough mitochondria make it, they would leave them alone. And the ones that were salvageable, they would form little microtubules and dump mitochondria into them.

Rubin: That's absolutely fascinating.

Riordan: Yeah, and they also bud off these little things called microvesicles which have mitochondria–are capable of carrying mitochondria–and then the microvesicle is made out of the same membrane that the cell…basically the same membrane, like any mammalian cell, and it fuses with the recipient and releases the mitochondria into the cell.

Rubin: Does it act like a little storehouse for them when they need it or they release it generally all at once?

Riordan: Well, normally, MFC's aren't active, they aren't, they don't actively do that.

Rubin: Okay. 

Riordan: But in this, in this particular case, where they demonstrated it, it was a very inflammatory situation. MSC's have–they have natural ways of seeking out inflammation.

Rubin: Would this be a way to maybe treat people with mitochondrial disease?

Riordan: Well, actually it is. We have…um, we’re working on an IND right now–that's investigational new drug application–for the treatment of Leigh syndrome, which is a mitochondrial disease, and we have a couple of patients that were treated under compassionate use that responded really well to MSC IV therapy. So, we don't, you know, mechanistically–we don't know exactly what's going on, but clinically there's a vast improvement.

Rubin: Well that's that sounds a great and wonderful humanitarian work that you're doing. That's a treacherous disease, and that's a disease most people don't survive that disease if I remember right.

Riordan: Correct, yeah, I don’t think any–well, yeah, most die in childhood.

Rubin: What is the source of the MSC’s in that study in compassionate use? Is that autologous?

Riordan: It's, uh no. We're using umbilical cord. So, mom has a baby, and the baby's delivered and the umbilical cord is, you know, tied-off and cut, and babies are taken away, and then mom delivers the afterbirth which is comprised of the placenta, the amnion, and the umbilical cord. And we take the basically structural tissue of the umbilical cord and dissociate it, and we that's, that's our starting culture of MSC's, and we grow them up in large numbers and then they're clinically applicable at that point.

Rubin: And now, do they survive quite a while in your cultures? Or do you have to preserve them before treatment?

Riordan: Well, yeah so they're frozen down in a certain special medium that makes, you know, makes it so that once you thaw them, they're still alive. So, but yeah, all what we do is frozen down and then in our clinic, we have a GMP syringe prep laboratory.

Rubin: Okay

Riordan: So, we have a freezer there–our manufacturing facility is over by the canal, it's not in the city. So, we manufacture there and we have shipments, regular shipments there; and then we have a crew, a team that will then wash the cells, get rid of the cryoprotectant and suspend them ready for application, and then they, it's literally built in the middle of our clinic. So, it's real convenient.

Rubin: Wonderful, and the name of your clinic in Panama is what?

Riordan: The Stem Cell Institute. Simple as that.

Rubin: Interesting. I understand that you've authored now–is it seven books?

Riordan: No, I've only authored two

Rubin: Two books

Riordan: I have no intent to author seven.

Rubin: Okay, wonderful. Well, I saw, yesterday, I saw your book–

Riordan: I think maybe what you're thinking, is it's translated in seven different languages.

Rubin: All right, well I’ll pick up a copy in another language then.  

Dr. Riordan, so we're sitting here in Scottsdale, Arizona and you’re in town because we had the dedication last night at Southwest College of Naturopathic Medicine for the Neil Riordan Regenerative Medicine Institute. Thank you for the work that you're doing.

Riordan: Aw, thanks man, I appreciate it.

Rubin: I just, really, thank you very much. That's at the Naturopathic Medical School, it's wonderful–it's wonderful to see you again. To be able to sit down and talk with you. I’d love to talk about some of the mechanisms of action of MSC’s, and specifically, I get a lot of questions that people ask me about the use of them clinically. We're here in the United States, obviously…your main clinic–you have a clinic in Texas–what's the name of that clinic?

Riordan: It's called the Riordan Medical Institute.

Rubin: Okay. Are you using stem cell therapy there?

Riordan: Yeah, we're using bone marrow.

Rubin: Okay

Riordan: You know, there’s a lot of good studies showing bone marrow can augment standard orthopedic conditions; also augment standard spine surgeries and procedures. So, we use an autologous bone marrow–that's from the patient–

Rubin: Okay

Riordan: So, we have a device that spins it down very quickly so that, you know, the patient can be consciously sedated and we draw the bone marrow and this machine takes two and a half minutes and it's ready to go; and then if we’re doing a joint for example, you just do it in the same procedure.

Rubin: So, if they're having like a joint surgery?

Riordan: Yeah, both surgery and in-office non-surgical procedures.

Rubin: Okay.

Riordan: We do a lot more non-surgical procedures than we do surgical, but we have an orthopedic surgeon that works with us, we have a board-certified pain guy, and we have neurosurgeon that works with us.

Rubin: Excellent

Riordan: The neurosurgeon, obviously, he's going to surgery, but you can augment that healing process using bone marrow, placing it into where you have soft tissue damage–it's also used for helping to fuse, you know if you have to do a fusion. And then, we also use amnion, which is, you know, it's from the same birth tissue that we get, you know, the umbilical cords products; but it's exempt in the US…amnion, as long as it meets certain criteria, so we're able to use amnion. And we’re able to use umbilical cord tissue, but it's not–you can't take that and then grow it and do all this stuff we do in Panama…yet.

Rubin: Okay

Riordan: I think, ultimately, it's going to be a very common practice. But, there's an exemption for tissue, it's called the 361, under federal regulations and so that's what we're able to do here. The reason we moved to Panama is that in 2004, they passed a law that allowed for–it basically banned embryonic stem cell research and treatment

Rubin: Okay 

Riordan: And at the same time, it enabled adult stem cell research and treatment. So, from that 2004 law, we were able to build our laboratory and get fully licensed by the government. Now things, you know, now things are getting…it's maturing a lot, and the regulatory environment is quite strict, but, you know, we're kind of an institution down there, and we employ a lot of people, we work a lot, we collaborate a lot with the other folks down there.

Rubin: I’d imagine you have a lot of people flying in from either out of the country or out of state to come to get treated by you, both in Texas and down in Panama.

Riordan: Right, right. Yeah. And Panama, you know, we do, we probably bring in about now we're between 200 and 250 patients a month that come from all over the place and, you know, a lot from the US, Canada, Australia–mostly English-speaking countries, and then, we have a nucleus that comes from the Arab countries as well. So, we have an economic impact and, you know, over our clinic is on the 63rd floor of a 65 story building and then, that building is attached to a Hilton Hotel

Rubin: Excellent

Riordan: We represent around 30 percent of the business of the hotel and we're now, now we've exceeded their capacity there, so, we're building a new clinic at a hospital facility…

Rubin: Excellent, that’s convenient

Riordan: Thanks, and there's a hospital tower–it's really cool, it's all kind of self-enclosed. It's on a one city block, there's a hospital tower 

Rubin: Yeah 

Riordan: State-of-the-art, there's an office tower, which is, we have the top floor of the office tower, there's a hotel tower, there's a movie theater, there several restaurants, there's a grocery store

Rubin: Nice!

Riordan: So, you don’t even have to leave.

Rubin: Wow, so you just stay inside the whole time

Riordan: Yeah, well it’s a whole complex, so but, uh, since traffic is sometimes challenging, it's–we’re really looking forward to that–we're also looking forward–we have so many patients going up and down the elevator that we're just we're really stuck, so they gave us, that was one of the conditions of us putting a place there is we get our own elevators so we don’t have to share it with anybody else.

Rubin: Is there a typical treatment length of time if people were to come to Panama that they could expect?

Riordan: Yeah there is, you know, for rheumatoid arthritis, for multiple sclerosis, for frailty of aging, for heart failure; it's based on basically cell dosing and cell dosing is based on weight, but for the average person–they need to be treated for between three and four days.

Rubin: Okay 

Riordan: So, a typical thing is, somebody will fly down on Sunday, if they've never been there before, for the first treatment, then, we have to evaluate them and do bloodwork and do a physical exam, and you know, induct them into the process. And then, typically on Tuesday–they'll get 40 million cells IV, Wednesday–40 million, Thursday–40 million, and they can go home on Friday.

Rubin: Wow

Riordan: But, you know, do another physical at the end and then they can go. So, most people are there for about five days.

Rubin: Wonderful. What about the anti-tumor characteristics of MSC’s? Has that been studied?

Riordan: It has been studied. You know, what's interesting is–and I want to talk to you about this afterwards–but epidemiologically, our patient population has a very low incidence of cancer, you know, and I–we've talked to a couple different epidemiologists about doing the math on how many cases of malignancy you should have, but it's very, very rare; and you know, I personally believe that many, many solid tumors–and even some leukemias are, you know, well–there's certainly lack of homeostasis going on, there's active immune suppression, there's under, you know, I mean–immune cells don't behave appropriately when there’s a clinical cancer, and since MSC's rule all that, or at least have something to do with it, my hunch is that the vast majority of cancers are secondary to either localized or systemic dysfunction or depletion of MSC's.

Rubin: Because the good–so can you use MSC therapy then, potentially, to treat somebody with an active malignancy?

Rubin: Potentially, yeah, I mean–we have because–I'll give you two parts on this. One part is that MSC's contribute to tumor growth and metastasis, particularly tumor growth. So they’re stromal cells right? In addition to their perivascular, they can become stromal cells, so–

Rubin: You mean that the MSC’s can be inside of tissues?

Riordan: In tumors, yeah.

Rubin: In tumors

Riordan: Right

Rubin: Do they normally reside in normal tissues?

Riordan: In every normal tissue.

Rubin: In every normal tissue, okay, I just wanted to repeat that.

Riordan: Every blood vessel

Rubin: So, but–

Riordan: Yeah, you have blood vessels pretty much everywhere in your body, and they reside on the blood vessels.  

Rubin: And you have tumors that require blood vessel supply

Riordan: Right

Rubin: So, they're inside tumor–so let's continue, sorry for that interruption

Riordan: Yeah…so there's a lot of, you know, trepidation obviously with something relatively new and when you see that these cells are involved, then it makes you worried right? Well, there's never been a study that showed that these cells induced tumor formation, but there's several studies showing that the cells in the body participate in tumor growth and expansion. So, there's a great study done on where they took umbilical cord cells–so, there's also a big difference between really young healthy cells and cells in a body that's been through a lot

Rubin: You mean MSC's 

Riordan: MSC’s, yeah MFC’s. So, they, in this particular study, they took MSC's that were grown from the adipose, the fat tissue of adults, and then they took umbilical cord, the MSC’ from umbilical cord and grew them like we do, and then they took–I can't remember the model right off the top of my head, but the title tells it all: “Adipose MSC's Promote and Umbilical Cord MSC's Inhibit Tumor Growth and blah blah blah”…medical model.

Rubin: Indeed.

Riordan: Right

Rubin: Fascinating.

Riordan: And probably the most dramatic study was of rat breast cancer, and they used rat umbilical cord…or rat MSC's…umbilical cord, I think…pretty sure, and they grew them up and then they, you know, they implant a bunch of tumor cells in the flank and then that becomes a primary tumor and that–it's a very aggressive thing and it typically metastasizes, and then the animals, they have to be sacrificed–and so you see the tumor growth and they gave, they gave one dose into the tumor, and then another group they gave three doses IV, and then they have controls for both of them–you see the control the tumor’s going like this, and the treated group didn't matter which way they gave them–it goes up, and then it goes like this, and then back down. So, there was no tumor and so, the title of that article was something like: “Original Tumors…Primary Tumors Disappeared and There's No Sign of Metastases A Hundred Days Later.”

Rubin: Wow

Riordan: Which is–never seen anything ever do that before.

Rubin: Wow. The MSC’s communicate with the immune system then?

Riordan: Yeah, so what they concluded in there–well the conclusion of that particular article done at Kansas State University was that they believe that the cancer stem cells had to have been destroyed or induced to apoptosis or necrosed, or whatever, because of that result. Because typically, you have cancer stem cells that then can cause metastasis and they hypothesize–they, there in their discussion that was their hypothesis of what happened in that–

Rubin: But a cancer stem cell can't revert to become a normal MSC-like stem cell and behave appropriately…

Riordan: Well, I'm not sure–I don't think anybody knows the answer to that, but one of the mechanisms of action is transference via exosomes 

Rubin: Okay

Riordan: Normal copies of p53

Rubin: Interesting

Riordan: Which is a gene that induces, that basically tells a cell ‘it’s okay to go ahead and die’.

Rubin: And can't–so that p53, which is the message that tells the cell that it's okay to die, cancer cells tend to have a damaged copy of p53, or lack it altogether.

Riordan: Right

Rubin: So, you're saying that an MSC can say, “Hey, here's some info you might need and give it to them.”

Riordan: Yeah, exactly. That's well-put. Yeah.

Rubin: Very fascinating. What are some of the other projects that you're working on besides your research with Leigh syndrome and the clinic? Do you have any other research projects in the works?

Riordan: Well, we just finished our MS paper

Rubin: Okay

Riordan: Which was a clinical trial of MS patients using MSC’s. Came out, and the results are very good, the side effects–if any–mild in some people. Then our autism study is just–is completed, and we're in the throes of finishing touches. We're going to submit that for publication here pretty soon. Our, we're a little bit down the road on our asthma trial, our frailty trial is going on, and our rheumatoid arthritis is continuing, and our osteoarthritis trial is continuing. Um, the sort-of the number-next for me, clinical trial-wise, in the U.S.–

Rubin: So, these are all U.S. based studies?

Riordan: No those are all Panama

Rubin: Okay

Riordan: And then the U.S., we're gonna soon file the IND for Leigh syndrome, but also we're gonna do a knee osteoarthritis study using the Wharton’s jelly product that we make in Dallas.

Rubin: What’s that?

Riordan: Well, we mechanically dissociate the Wharton’s jelly, which is the source of the cells we grow in Panama, but we can't, you know, census 361 exempt–we can't grow them or anything like that, and we won't…we're applying for an IND to go 351 or, you know, basically, you're going for a biologic license at that point for the non-expanded. I think, you know, strategically FDA is going to be happier with a non-expanded product because there's there's a lot more hoops that you have to jump through. So, it's a minimally manipulated, mechanically dissociated product that has live cells in it that we will, you know, that are quantified, and can be standardized for.

Rubin: The autism study–obviously we can't talk about results, and I'm not asking that, but I'm curious about the study design. Is that something you're able to talk about?

Riordan: Yeah, it was for a pretty tight group of severe autistic right-handed males between the age of six and twelve from the tri-state area because the guy that recruited the doctor that recruited him was at NYU, and so he recruited them, and the trial design was four treatments over a nine-month period. So time zero, time one is three months, time two is six, and nine months out, and then they were followed for one year after that.

Rubin: Excellent, well, as I said, I look forward to those results, and I think, probably, globally people do. Very exciting.

Dr. Riordan, Neil, you taught me long ago when we were at the clinic doing immunotherapy for people, you really introduced the notion of: ‘tumor is an unhealed wound,’ and I hold that truth today and think about that. And so many of the lab tests that we do, and so many of the treatments that we do really attend to that phenomenon; disrupted angiogenesis, etc and, you know, how–just how the healing process is disrupted. In terms of that sort of tumor-associated biology, do MSC's play a role in the healing process insofar as that ‘tumor is an unhealed wound?’

Riordan: Yeah, absolutely, I mean, they really are the key to healing. So, they go in first and they, you know, when we're young, I’ll just use this analogy, like, when you were young you probably fell down, and if you had a friend that fell down and broke his leg or arm, or her leg or arm, and you pretty much don't need to do anything you know under 14 years old; and when you're 84 you're lucky if it even knits, you know? I mean, because–

Rubin: Absolutely, that's the frailty of aging that you're talking about too.

Riordan: Well, frailty of aging, but, you know, your MSC's go like this with age and 50 that that slope gets real steep, you know? And, Arnie Kaplan, my mentor and the guy who named these cells MSC’s up in Cleveland, he estimates that from birth until–we used his age at the time because I asked him the question when I was writing my book, THE RISING TIDE, he–I was like, “Arnie, I know capillary density goes down with time and you know with age, and I know that you know MSC's live on capillaries, so ergo, our total body number of MSC's is going to decline with age. How much is it? I can't find it anywhere in the literature…I spent days trying to find capillary density decline with age and it just doesn't exist!” and he said, “Well, I can tell you my best guess,” because he's the musculoskeletal guy, so he's looking at tissues all the time.

Rubin: Yeah

Riordan: And he says, “In the skin I can tell you exactly, I can tell you the exact number in skin”, because in a baby you have all these you know there's all this up and down like almost like, looking like villi, so you got this folding of the capillary bed, and as we age, that folding disappears and then ultimately it's just flat and then you know the skin gets thin and all the stuff, and he said he said, “We did mine when I was 72, and I'm sitting at 2% of the capillary densities of a newborn.”

Rubin: Wow.

Riordan: So, that's for the skin. So, anyway it's a pretty massive decline, and if that is happening in all the tissues in your body, then those MSC's aren't around to heal the wound anymore, you know?

Rubin: Absolutely.

Riordan: And, if you look at chronic inflammation, then these cells are involved in trying to heal the wound, and if you have chronic inflammation, you're exhausting this pool of them. And this pool is throughout your body, roughly evenly distributed.

Rubin: Got it

Riordan: Your liver has the most being, you know, having so many blood vessels–your spinal cord has the least given as we built this wonderful cage to prevent damage to it and the likelihood of you surviving an insult to it is so low, mother nature, or God didn't waste a whole lot of energy putting blood vessels in there so just barely enough to support it, and that's why a spinal cord injury–oh, I didn’t, we do have spinal cord injury trials going on too–spinal cord injury, all we do is we take we take cells, young healthy cells that secrete stuff that stimulates regeneration and we put them in that space, it's all we do.

Rubin: And let it go

Riordan: It ain't rocket science, let’s put it like that. So, there was a study in Taiwan where they cut spinal cords like that, and they go boink, and then they put cells right in there–they put human umbilical cord MSC's and a fibrin like you know, a biologic gel

Rubin: Yeah?

Riordan: And then, sure enough, they sprouted again, right? And that's all it was there and they–

Rubin: And it imitated the structure of the tissue?  

Riordan: Well, they reconnected, the neurons reconnected.

Rubin: Interesting

Riordan: So. well, the whole spinal cord reconnected to a certain degree. So, all the cells participated in the regenerative process and then because they're human they were able to fish, you know, stain the tissue afterwards, after the repair occurred, and they showed there were human cells, certainly, they were still there, but none of them incorporated into the CNS.

Rubin: Wow

Riordan: They were just, they were there, essentially, prisoners between fibers

Rubin: Got it.

Riordan: And so, they are what heals the body you know? And that's why your liver, you know, they pluck out eighty percent of your liver, it’ll re-grow

Rubin: Interesting, right!

Riordan: Whereas your spinal cord, you go like that, and it’s not very happy.

Rubin: Fascinating, fascinating. So, as a clinician, I'm sitting here listening to your wonderful stories, and I'm wondering, especially regarding the frailty of aging, you're talking about–you know, you start thinking about whether or not there are nutrients that support your stem cells, or there are certain diet strategies; I don't know if these have been figured out, but you know, people ask me that kind of stuff all the time about ‘What diet? What should I eat?’ I just, I'm guessing, that there's the general array of nutrients that MSC's respond to and need, and so, it's kind of, sort of–question number one: Is there anything that–we're not talking about prescribing something for somebody–but, you know, is a good healthy diet reasonable when people are starting to think about MSC’s and frailty of aging? Because, I've noticed that generally in my practice, and when I practiced with you, there was a commonality of certain older people usually over the age of about 72, that despite them having a diagnosis of cancer, generally appeared healthier more vital–and those were the people that generally took B vitamins and garlic from being young adults, and they were into health or they may juice, and so it always struck me…I never connected it between you know with MSC's. I don't know if it has anything to do with stem cells. That's part one, and I actually forgot part two…

Riordan: So, yeah, well…so, I'll use one of my father's axioms, Dr. Hughes axiom

Rubin: I remember your father

Riordan: He would, yeah, he did this more than once, he would say he's giving a lecture, he’d hold up his hand and say, “Okay, what's the most important nutrient?” And then, of course, he did all the Vitamin C stuff, and then some people’d say “Vitamin C, and Zinc, Magnesium”…whatever, you know? He’d say, “You're all wrong–the most important nutrient is the one you're out of.”

Rubin: Ahh

Riordan: And that’s, I mean, that's pretty true. So, I think the best thing is to test people, see, make sure they're not out of something

Rubin: Very nice

Riordan: And, in our autism's study, I can tell you–not in our autism study, but in our autism patient pool, I can tell you the ones that get better they um, get, get the mo’ better–most better–

Rubin: Yeah?

Riordan: The ones that literally go from being severely autistic to not autistic, almost to a person they've been to another, they've been to a practitioner that would clean them up, make sure they didn't have any heavy metals; by the way, we have a cut-off. If you're at, if if you're heavy metals look–they measure lead, mercury–if they're above a certain level, we don't, we don't take you. You have to fix that.

Rubin: In the trial or at the Institute?

Riordan: Across the board.

Rubin: Okay.

Riordan: So, the reason is because they're very toxic. Mercury is the most toxic molecule to MSC's on the planet. It’s parts-per-billion that kills them. So, and we have kids with mercury loads coming down, it's like, ‘Hey, there's no reason to do this, because the likelihood of success is way lower than if you just get your kid in a normal, you get his or her blood level down low enough where it's not going to harm the cells.’ So, heavy metals are no Bueno for MSC’s, and then, if you take one nutrient–one vital nutrient out of the culture medium, they just quit growing.

Rubin: Wow

Riordan: So, it doesn't matter which one, you can take out any one you want and it doesn't matter which one, they will halt. Some of them more quickly than others–glutamine is the number one, you know, if you don't have enough glutamine, just everything will just fall off a cliff.

Rubin: Fascinating!  

Riordan: Yeah

Rubin: Sorry, that's fascinating to me. Alright, last question, because I know we’ve been talking a long time, it's been a long day. Are there any genomics associated with higher or lower or more efficient or less efficient MSC’s or longevity or anything that you're aware of?

Riordan: Umm, there probably are some, but it needs to be looked at further. There, certainly, there's a very big difference in the clinical efficacy of different lots of MSC’s. So, if there's one thing I think that we figured out that nobody else has, is what markers to look for, and they're not genetic markers, we look at other markers in the cells. We did a big three-year study, and we were able to figure out what's different, what molecules are under-expressed, over-expressed, and highly clinically effective cells, and so now we're able to screen at an early stage and get rid of all those. But, you know, when I look at the autism's study the people the clients that we treat, you know, some of them become non-autistic, some of them go from being severe to mild-moderate 

Rubin: Amazing

Riordan: Some of them don't move at all. So, I'd really like to know, genomically, if there's a difference from those super-responders and moderate responders, non-responders. My guess is there is, but we haven't done the studies.

Rubin: Is it, well, the MSC’s that they’re receiving are donor MSC's?

Riordan: Mm-hmm

Rubin: So there could be a difference in the genomics of the donors in association with the genomics of the individual with which they're implanted.

Riordan: Right, and then to study that, you have to take infinity and square it!

Rubin: Right, oh my god, absolutely. Well–any comments before we sign off?

Riordan: Well, just I'm happy to see you man

Rubin: Me too

Riordan: It's been a while, and I’m happy to see you’re doing so well and doing so many great things with oncology, and just saw you had some students in here, and you're spreading the word and taking care of people and I'm just really happy to see and proud of you.

Rubin: Thank you, likewise! And thank you for what you're doing, and just how you've advanced science and treatment of people. I know what's deep in your heart and how much you enjoy helping people, and I know how I just know that that stems from your family, I've known you a long time. Thank you for what you're doing for the naturopathic profession and, you know, for what I'm doing, thank you for helping be a mentor of mine and helping to teach me how to think and to really go out there and help people thank you, thanks for being here!

Riordan: Thanks, man.

Michael Nelson