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1. TBI THERAPY WEBINAR: ADULT STEM CELLS FOR TBI By Dr. John Hughes January 31st, 2018

2. DR. JOHN HUGHES, DO • Doctor of Osteopathy • From Georgia • Arizona College of Osteopathic Medicine – 2007 • Aspen Integrative Medicine – 2009 • TBITherapy – 2014

3. LEARNING OBJECTIVE • What is a traumatic brain injury (TBI)? • What are stem cells? • How do stem cells help TBI?

4. WHAT IS A TBI? • “Brain dysfunction caused by an outside force, usually a violent blow to the head.” • Occur mostly during sports injury, auto accidents, falls, blasts, blunt force trauma

5. SYMPTOMOLOGY Loss of consciousness Confusion Head pain Blurry vision Difficulty concentrating Memory loss Dizziness Nausea and vomiting Cognitive: memory loss, slow reaction time, inability to pay attention, slow learning, difficulty understanding, etc. Physical: headache, fatigue, sleep disorders, tinnitus, loss of smell, sensitivity to light and sound, etc. Psychological: irritability, frustration, anxiety, personality changes, disinhibitions, suicidality, depression, etc. IMMEDIATE PERSISTENT

6. HOW DO YOU HEAL FROM A TBI? • Rest • Medication • Rehabilitation • Cognitive behavioral therapy

7. BUT WHAT ABOUT REGENERATION?

8. WHAT IS REGENERATION? “The action or process of regenerating or being regenerated, in particular the formation of new animal or plant tissue.”

9. PLURIPOTENT • Can a single stem cell regenerate a whole animal? YES • Flatworms (planaria) have pluripotent stem cells • These cells that can make ALL the cell types of the animal’s body • Are these the same cells to regenerate a lizard’s tail? NO • These are multipotent tissue-specific stem cells • These cells only make the types of cells in that particular tissue MULTIPOTENT WHAT IS REGENERATION?

10. DO HUMANS REGENERATE? Epidermis Gut lining Liver = Multipotent Tissue-Specific (like a lizards tail)

11. REGENERATION AND THE BRAIN Cell death occurs after a brain injury New cells are needed to regenerate new brain tissue

12. WHICH TYPE OF STEM CELLS ARE NEEDED TO GROW NEW BRAIN TISSUE? Multipotent Tissue – Tissue Pluripotent Any Tissue Type

13. PLURIPOTENT STEM CELLS • Recently discovered in peripheral blood • Behave like embryonic stem cells • Give rise to all the cell types • Long lifespan • Stem cells work in combination with PRP

14. PLATELET RICH PLASMA (PRP) • Also from the blood • Full of growth factors • Promotes cell differentiation and maturation

15. STEM CELLS AND PRP WORK TOGETHER • Stem cells = seeds • Growth factors = soil/water/fertilizer/sunlight • Without growth factors, the seed cannot mature and grow

16. STEM CELL AND PRP PROCEDURE 1. Draw blood 2. PRP and stem cells go through harvesting 3. Cells reinfused through IV 4. Cells reinfused through nose

17. JOURNEY THROUGH THE NOSE • Through the olfactory nerves • Bypasses the blood-brain barrier • Into the CSF within 10 minutes

18. TBI Therapy Protocol HBOT (10-15) sessions before and after stem cells PRP infused IV and intranasally the day before stem cells Stem cells are infused IV and intranasally the day after PRP Cranial osteopathy administered throughout treatment

19. How This Helps TBI HBOT enhances healing, upregulates stem cells PRP guide the stem cells to the proper area Stem cells regenerate and rebuild tissue Cranial osteopathy allows the cells to bathe the brain

20. PATIENT RESULTS Improved mental stamina Improved memory Less emotional stress Increased ability to prioritize Better mental clarity Improved quality of life Less sensitivity to light and sound

21. STUDIES & REFERENCES “Intranasally administered cells could bypass the blood-brain barrier by migrating from the nasal mucosa through the cribriform plate along the olfactory neural pathway into the brain and cerebrospinal fluid (CSF).” Danielyan, L., Schäfer, R., von Ameln-Mayerhofer,A., Buadze, M., Geisler, J., Klopfer,T., … & Buniatian, G. H. (2009). Intranasal delivery of cells to the brain. European journal of cell biology, 88(6), 315-324. “Pluripotent stem cells are responsive to any lineage-induction agent … across all three primary germ layer lineages.” Young, H. E., & Black, A. C. (2005). Differentiation potential of adult stem cells. In Stem Cells in Endocrinology (pp. 67-92). Humana Press. “The ability to store, expand, and differentiate these PSC from autologous peripheral blood should make them valuable candidates for transplantation therapy.” Zhao, Y., Glesne, D., & Huberman, E. (2003). A human peripheral blood monocyte-derived subset acts as pluripotent stem cells. Proceedings of the National Academy of Sciences, 100(5), 2426-2431.

22. Q&A Learn more at tbitherapy.com or call 303-447-1257 video