#177 - Can Stem Cell Therapy Help Autism? Here's What the Science Says

I just want to express that, you know, we're seeing more and more hope for these kids for the future. So we're still at the beginning of stem cell therapy. So much can be done and science is advancing. We can use different adjunct therapies and maybe we can help the cells to develop in a certain way. But right now, even with what we have in stem cell therapy, which I do think is fairly primitive, but primitive as it is, the power is undeniable. Hi, this is Dr. Joy Kong, MD, MD. Joy Kong, welcome back. Today I have a very important topic to discuss with you, which is autism. I'm actually going to give you the presentation I gave in Brazil just a couple of weeks ago. This is a very large autism conference, so I don't know if people are aware, the rate of autism has skyrocketed in the last 20 years. So in the US, it went from 1 in 100 children having autism to 1 in 36. So a very sharp rise, and this is happening all around the world. A lot of people may know that I was trained as a psychiatrist, and then I went on to addiction medicine and anti-aging and regenerative medicine. But as a psychiatrist, of course, in the US, children diagnosed with autism will go see psychiatrists. And as psychiatrists, I don't think we were very helpful, frankly, because the drugs we were using were meant to either sedate them or to help them focus a little better, the stimulants, or we're giving them antidepressant and anxiety medications to treat the depression and anxiety that comes with autism, but nothing was targeting the root cause of what's causing autism. So that wasn't very satisfying and it wasn't very rewarding. And I didn't see kids fundamentally improve, which was one reason I did not go into child psychiatry because it was discouraging. And actually the first time I heard about stem cell therapy was because of the autism case. So I met this doctor, who told me that he was doing stem cell treatments. And I said, what? You're doing stem cell treatments? This is 8 years ago. I was, you know, having the horse blinders on. And when you live in a bubble of your medical training, you don't know what's going on in cutting-edge medicine. So when he said he was doing stem cell therapy, I said, I thought people are still researching this. You're actually using it? He said, yes. And look at this kid I treated that has autism. So he put up his phone and he showed me about 40 different things written by his teacher, by this kid's teacher, after he gave the child umbilical cord blood stem cells. And the child had these drastic improvements in social interactions, eye contact, not procrastinating, verbalization, being able to relate to other kids, play with other kids. There's a whole long list of changes that this doctor saw in this child. And he was not a psychiatrist. He was actually trained as an anesthesiologist. And in a sense, he had no business treating autism, right? But he was making a difference in an autistic kid way more than what I could accomplish as a psychiatrist. That really got my interest in autism and stem cell therapy, right? If I can make that kind of change, in these kids that have a whole life ahead of them and the parents who are, you know, just, these are some of the most giving and dedicated parents and, you know, they're doing everything they could out of sheer love. If I can bring that kind of difference to these families, I mean, that's remarkable. So that's what got me started in stem cell therapy. So I want to share this presentation with you and I'm hoping that this will shed some light on where we're looking at, where we're going with autism treatment. So let's talk about stem cell therapy. So as we know, autism is a very complex disease. There are over 1,000 genes involved in this disease. So it's a complex map. But if all these things are there, what really pulls the trigger? What makes the child end up having autism. So really, it's a lot of environmental factors, of course, some genetic components, and that eventually leads to hypoperfusion, so lack of blood flow into the brain, immune dysregulation, neural inflammation, inflammation in the nervous system, mitochondrial dysfunction, oxidative stress, and hormone balance and abnormal neural connectivity. So cells weren't talking to each other correctly. And right now, there's really no effective treatment. So why are we looking at stem cells? And what are stem cells anyhow? So this is a definition of stem cells. One, they have the capability to self-renew, so they can make more copies of itself. But when they renew themselves, they tend to make one copy of itself to preserve its own population, and another copy is differentiated. So it has gained certain functions. That's a daughter cell that's more developed in a sense that it can perform different jobs in the body. And so that's the differentiation. So these cells have the ability to differentiate, and then they can renew the tissue that they populate. Really, you know, when we talk about stem cells, it has become philosophical. Where do we come from anyhow? And I want to remind people that we all came from a single stem cell. So that's a fertilized egg. And that's what made us. And, you know, what is in that fertilized egg that has the power of forming a full human being, right? That's pretty incredible to think this, this microscopic little cell with the DNA, right, the set of DNA, and just within that, that can form you and me. So if we can tap into that miraculous power, just even a fraction of of it, maybe we can do a lot of good. And science has shown that we can. So let's look at what happens in autism. Here's a study from 2007 looking at the mechanisms of what's causing autism. So hypoxia is one underlying mechanism. So children with autism have been shown to have impaired central nervous system circulation, and as a result, low oxygen, hypoxia. And if you reverse hypoxia, you often can lead to activation of self-repair mechanisms. And umbilical cord blood has been used successfully to stimulate angiogenesis in various models of ischemia. So stimulating new blood vessels to form. And there's a fraction of cord blood cells that actually have the ability to differentiate into endothelial cells. So these are the cells that are lining the blood vessels. The concentration of these type of cells in the in core blood is 10 times higher than in bone marrow. So I talk about how the bone marrow and core blood have very similar cell population and compositions, but the core blood only is a lot more powerful, more potent. So when we give people core blood, so it has been given to over 500 patients at the time that this research, this paper was published. This paper was published quite a while ago. So that's 17 years ago. But at that time, there was not a single person that suffered from graft versus host disease. So basically the new tissue is attacking the host and there's no immune suppression. So you don't have to suppress the host immune system after you give— before you give these cells. There's no problem. When it comes to immune rejection, the younger the cells are, interestingly, the more adaptable they are because perfectly, completely unmatched umbilical cord blood transfusion, right? You don't match to the recipient, has less side effects than perfectly matched bone marrow transplantation. So I want to illustrate to you younger cells, they're quite different from older cells. But anyhow, so this is, you know, something that was shown from transplanting umbilical cord blood cells. And then another mechanism underlying autism is immune dysregulation. So they have done autopsy on 11 autistic children. And then they have controls, age-matched controls. What happened was that in the brain of autistic children, there's active neural inflammation. So all these inflammatory processes were happening in the cerebral cortex, white matter, and cerebellum in the autistic children, but not in the, you know, children that didn't have autism. There were all kinds of immune dysregulation like T-cell and B-cell abnormalities. And the— in autism, the autoimmune-like pathology is very prevalent. There are numerous types of autoantibodies, antibodies that attack itself, has been detected in children with autism but not in healthy or mentally challenged controls. So just because people have lower intellectual capabilities, they're not having these self-attack that's happening, the autoantibodies, the autoimmune-like pathology. And when you look at family members of autistic children, they have a high potential predisposition toward autoimmunity compared to a family member of normal children. And mesenchymal stem cells, MSC for short, can suppress pathological immune responses and stimulate hematopoiesis, stimulate new blood cell formation. And that can be useful in the treatment of defective T-cell numbers associated with autism. So these are two major mechanisms, but there are other proposed mechanisms underlying autism. So one is inflammation, just overall inflammation or oxidative stress or changes in how neurons communicate with each other, mitochondria dysfunction, gut disorders. Endocrine disruptions, or genetic predispositions. So how can stem cells help autism? And these are some of the proposed mechanisms. One, it can reduce inflammation. So it can inhibit microglia activation. These are the immune cells in the brain, and they can reduce pro-inflammatory cytokine secretion. And they can also balance the immune system, reducing autoimmunity. And they can restore neural connectivity, promoting new synapses and balance the neurotransmission within the synapse, the communication juncture between cells. And it also can help through angiogenesis. That's the formation of new blood vessels, and that can help reverse hypoxia caused by low blood flow. And also stem cells can promote antioxidant activities, and that can exert antioxidant protection, thus reduce superoxide production and reduce oxidative stress. It can also promote functional recovery. So these cells can integrate into damaged brain region and promote local regeneration, reducing the effects of trauma. And rescue damaged cells. And there's also this, one of my favorite is mitochondria transfer. So, the new cells, of course, if you're using your own cells, that's, you know, you don't get fresh, new, healthy, more vibrant mitochondria. But if you use young source, like the birth tissue, such as from umbilical cord, then you're going to get fresh, new mitochondria. The infused or transplanted cells actually have been shown to send out mitochondria into either the extracellular environment, or directly, you know, having, you know, sending out a bridge between itself and the host's cells, and the mitochondria can walk across the bridge. So you're actually infusing new energy production factories into your own cells, so elevating your cells' capabilities and activities, so more vibrant. So there are different cell sources. I don't want to spend too much time on it, but just very quickly, because some of the studies are going to mention some of these cell sources. You know, the mononuclear cells are very primitive immune cells. They can come from either core blood or bone marrow. These are the main sources. Or mesenchymal stem cells, very famous these days, MSC for short. And they can come from the umbilical cord tissue or fat. Fat has a lot of mesenchymal stem cells also. And then there's a distinction between autologous versus allogeneic. Autologous means coming from your own body. Allogeneic means coming from another human being. So I want to quickly give you an illustration of a case study. So all these cases are people that I have treated at our clinic. So this first case was a 7-year-old Indian girl with autism. She first started showing symptoms at age 2 and a half, just prior to the stem cell treatment at our clinic. She was nonverbal, had lack of concentration with hand flapping, and was always putting things in her mouth, had hyperactivity, especially after sugar intake or being in a new place. And she was going to special needs school. She wanted to play with other kids but didn't know how to communicate with them. She was on diapers. She was still having urinary and bowel incontinence, so she couldn't control, you know, urine and bowel movements. And she had hypotonia. So low muscle strength, very low strength to the point where she could not climb up the stairs on her own. She had to always be carried upstairs by parents in the house. And before she came into our clinic, she had one intrathecal injection one year prior of her own bone marrow stem cells. So this was in India and with some improvement. So when she came to our clinic, During the first stem cell treatment, she received an intravenous stem cell treatment. It was 3 cc of CharaCore. So CharaCore is a combination product of MSCs and umbilical cord mononuclear cells. So again, MSCs, very important cells throughout the body conducting a kind of regeneration communication functions. So really help coordinate the regeneration and repair of the body. And the mononuclear cells have capabilities to, of course, replenishing your immune system. So both cell types are quite important. Each cc of the child core contains 10 million cells, and they're from the umbilical cord blood, the cord tissue, and amniotic membrane. So within the 10 million cells per cc, 2 million are MSCs, so high concentration of mesenchymal stem cells, which are calming as far as helping the immune system because when I have used products that just contained cord blood, there's more potential for side effects. Whereas the mesenchymal stem cells is very calming for the immune system, so calming to the point where it can be used to treat graft versus host disease. So if somebody got an organ transplant, and I said liver transplant, they will do better at accepting the new organ if they were given mesenchymal stem cells, because then your body is calmed down, your immune system is not going attack. So there's no mutual attack between the organ and the host. And the cells in CharCore are what's called native cells. So they've never been manipulated in a sense that no enzymes or chemicals were used in the extraction process. And also, they were not expanded, meaning they were not put in a petri dish or some kind of container, a culture medium, and put in the incubator to let them grow because the FDA believes that if you start growing the cells, you are changing the cells, which is true. That is the case. I just put out a video last week about the stem cells being expanded, what happens with the expansion process. So I do believe if you use cells that are not expanded, you only need to use a fraction of the cells. It's just as potent, if not more potent, with less side effects. Anyhow, so this child was given this IV treatment of 3 cc of this product. She— and then she was brought in by parents 9 months later. At that time, she was already off diapers completely. She was able to tell her parents that she needed to go potty and was able to hold it until parents could locate a bathroom nearby. So, so now the parents can take him, take her to different stores, right, not worrying about having an accident. She also tried to communicate by pulling down her pants and wanted parents to help her. So that was a huge improvement, and she was also able to speak some words. So instead of completely not speaking, she was able to speak some words and no longer put things in her mouth all the time. She was also learning to interact with other kids and was calmer. As far as the low muscle strength, she now can walk up the stairs on her own. So these changes were more profound than the changes her parents noticed from the intrathecal injection of her own bone marrow stem cells. So this is another kind of, in a sense, a controlled study, I guess. A child, you know, at age 6 went to India and got her own stem cells from the bone marrow and put into her spinal canal, thinking that we're targeting the brain, targeting the brain. My philosophy, and from our understanding of a lot of chronic conditions, including autism, is that this is a systemic condition. The inflammation is not just restricted to the brain. And also, you want to talk to the immune system. When you give somebody cells through the IV route, you are allowing them to communicate with your immune system, and that can produce profound changes. This is, you know, she's a year older. And by giving her a simple IV infusion, we're actually seeing more profound changes than using her own cells, putting into the intrathecal portion. And of course, her own bone marrow stem cells, I believe, is not as potent as umbilical cord cells. We know, first of all, people with autoimmune, autoimmune conditions, or other type of chronic illnesses, or even just normal aging, their stem cells have declined in quality. And the umbilical cord stem cells is not just day 1 or day 0, you know, when the baby's born. It's not the age of the baby. It's younger than the newborn. Because when the umbilical cord was forming, these cells were trapped in the cord and they stayed in that more primitive state. That's why they have surface markers that are consistent with embryonic stem cells that are no longer present in the baby stem cells. So these are actually earlier and younger and more potent than the baby stem cells. Of course, you know, this child, when she got her own bone marrow stem cell transplant, she was 6 years old. So she was already, you know, not nearly as young as a newborn, but the umbilical cord is much younger than the newborn cells. And then so at her second treatment, the parents wanted the patient to receive a higher dose. So she received 5 cc instead of 3 cc. And at the clinic, the patient was noticed to make eye contact with the doctor, smiled and said thank you during treatment. So that was really heartwarming. Warming. And within 4 months after the second treatment, the patient was able to hold a pen in her hand and connect dots. She was also able to count to 10 and name the alphabets and was able to write her own name. So that was, you know, just wonderful, right? Really, really rewarding to be able to bring about that kind of improvement in a child.

Hello, my loyal listeners. I want to interrupt this podcast for just a second because I want to let you know that if you're looking to help solve a major health issue, or you're looking for health optimization and just for longevity purposes, you can find us at Chara Health. We are considered the leader in the regenerative medicine and longevity space, and we utilize modalities like stem cell therapy, peptide therapy, plasmapheresis, ozone treatments, laser therapy, all to create a beautiful symphony to get you to where you want to be. You can find us at www.chara-health.com. That's C-H-A-R-A.

So that was a real-world example. But what do clinical studies show? So I want to show you some clinical published studies. So in this 2023 article, they actually were summarizing the results of many studies. So this is, you know, multiple studies. So they looked at 11 studies of patients aged 3 to 18. So there were 437 patients total. 3 of them used mononuclear cells from a person's own bone marrow. 4 of them used either their own or somebody else's cord blood. And 2 used mesenchymal stem cells from the bone marrow and umbilical cord. 1 had a combination of cord blood and mononuclear cells and MSCs, and one used fetal stem cells. So let's go over the autologous bone marrow mononuclear cell results. So this study was 30 patients aged 3 to 7. They monitored the patients for 12 months. And after bone marrow, you know, mononuclear cell transplant, the severity of the symptoms decreased remarkably in all patients. The improvements were observed in various aspects, including social interaction, eye contact, expressive language, stereotype behavior, communication, and socialization. So multiple fronts improvement. And then on the PET-CT scan, they showed improvements in metabolism in some brain, brain regions. A similar study also showed maximum efficacy of the treatment was within the first year. And now let's look at the autologous and/or allogeneic cord blood cells. Two studies that I will just briefly talk about here. In the 2017 study, only a few of the end measures showed substantial behavioral changes, and the significant effects were visible at 6 months, remained stable for 12 months of the study, and the higher nonverbal IQ was associated with greater behavioral improvement. So the higher the nonverbal IQ, the greater the improvement. And then in a 2022 study, Kersberg study, 165 children were involved in the study, and the brain MRI showed that cord blood infusion caused reconfiguration in the brain network connected with social and communicative skills. So that's really cool. Very encouraging, actually seeing change in brain network that is important for social connection and communication. And let's look at mesenchymal stem cells, the famous mesenchymal stem cell. The 2021 study used autologous bone marrow-derived stem cells, and one— they used one assessment tool that showed significant reduction in disease severity in the treatment group compared to control over a 12-month period. And then in a 2019 study, they used allogeneic umbilical cord MSCs, so from somebody else. They had, you know, 3 sections of the study, and each section was given a different number of doses. So 12 children total. So some were given 1 treatment, some were given 2, some were given 3. So 3 separate treatments in a 2-month interval. And 50% of these children showed improvement. But out of the 6 children that had improvement, 2 received 1 dose, 2 received 2 doses, and 2 received 3 doses. So this kind of goes to show that you— yes, you can receive benefit with one dose, but you can also receive benefits with two or three. So the number of doses I think is important in how it can promote regeneration, like in a wave-like fashion. So you keep bringing about more repair. But can you see an improvement in one? Yes, I've seen that. But you may get more with two. So this one doesn't really talk about the degree of improvements. But as you can see, some, you know, with one treatment, some got improvement, some, you know, got improvement after 2 or 3. And then here we have a chance to look at the only using core blood mononuclear cells versus mesenchymal stem cells plus core blood mononuclear cells. So one group received allogeneic from somebody else, umbilical cord blood cells. And the other group received, again, allogeneic from somebody else, cord blood plus umbilical cord mesenchymal stem cells. And patients were followed for 24 weeks. Each study group received 4 doses at an interval of 5 to 7 days. And they used a combination of both intravenous and intrathecal. Intrathecal is injecting into the spinal canal. The combination group has more significant disease reduction than the cord blood group alone. Right. So this is kind of one of the evidence that is showing how tapping into the potentials of different types of cells can possibly be better than just using one type. This is why I'm including different compartments, cells from different compartments of the cord. To maximize the benefit because all these cells do something a little different. That's what research have shown, and they work together so they can help each other. So I want to give people the maximum benefit. So by putting them together, I think people get a better chance of a greater improvement. So the conclusion from this study is that, one, there's not a single serious side effect related to cell therapy. In these 11 trials. That's a total of 437 patients. Not a single serious side effect, right? And using bone marrow mononuclear cells can reduce disease severity and improve the quality of life without side effects. And intravenous cord blood infusions has inconsistent results. One study in 2017 shows significant improvement, but 3 other subsequent studies found no clinical change. And when you use mesenchymal stem cells and cord blood cells combined, that improved effectiveness compared to using cord blood cells alone. And these two cell types could be acting in synergy, exerting additional therapeutic effects. So that's one study. Here, let me show you another study also published in 2023. So in this study, it talked about how in recent decades there's mounting evidence demonstrating the relationship between autistic spectrum disorder and neuroinflammation, dysfunctional microglia, the immune cells in the brain, and impaired glucose metabolism in certain brain regions. So in this study, they analyzed 10 clinical studies using different cells, mesenchymal stem cells, core blood cells, or bone marrow mesenchymal stem cells, fetal cells, and core blood blood plus cord tissue MSCs. So almost all, so 9 out of the 10 studies showed good outcome with no notable adverse reactions. And the autologous bone marrow mononuclear cells for patients with autism showed improvements in glucose metabolism and various cognitive and behavioral symptoms. And when you infuse the umbilical cord MSCs, and umbilical cord blood cells, they are dispersed to the central nervous system without being trapped in the lungs or blood-brain barrier. I really want to emphasize this because this is one objection I've heard from people who maybe had a, you know, heard or saw a glimpse of some research saying cells were trapped in the lungs, and then they held on to that, not recognizing later on there's more evidence that came out showing no, the cells are not trapped in the lungs. You don't have lung pathology. The cells will migrate out of the lungs. There's no reason for them to stay there. And can they cross the blood-brain barrier? MSCs in particular have been shown to cross the blood-brain barrier. And the MSCs also are able to secrete different exosomes, other cells as well. And those exosomes can also cross the blood-brain barrier. Cross the blood-brain barrier with no problem. In patients who have brain compromises, different kind of brain pathologies, a lot of times their blood-brain barrier is actually compromised. So it's not difficult for the cells to cross. So that's something else to think about, to remember. And MSCs can also suppress excessive microglial activation, which can lead to abnormal neuronal connection. And in a mouse model, and they transplanted MSCs, or exosomes from MSCs, that led to reduction of stereotypical behavior, they led to decrease in cognitive rigidity, and improvement in social behavior. And intravenously transplanted MSCs can suppress inflammation in the injured brain through cell-to-cell interaction between the cerebral endothelium and transplanted MSCs. So that's the blood vessels within the brain. And that can— so the cells lining the blood vessels, and that can speak to the MSCs. There is a cross-communication. So are we making a difference? So after realizing that, yes, you know, stem cells, it seems like there's some evidence, you know, these clinical studies showing that they can be helpful. What about clinically? So I want to present a couple more cases just so you have an understanding that these are real-life patients that have seen improvements, just seeing stem cell therapy in action. So here's our second case study. So this is a 15-year-old African-American boy with autism. He first started showing symptoms at age 2, shortly after receiving MMR vaccines. From that point on, he was no longer connected with mom, did not speak until age 4, and had a lot of anxiety. So he went to school at age 4 but did not do well. He had taken Adderall and guanfacine, which did not help. After taking Abilify, the patient was more aggressive and kicked a teacher once. So all these medications I'm very familiar with because these are the toolboxes from psychiatrists. And they don't have anything like stem cells. And they're not looking at all the underlying causes like the gut microbiome, the metabolism of different biochemistry pathways for different vitamins and just different neurotransmitters or toxicity. So those were not looked at. And so he was a typical child. He was thrown Some medications were thrown at him and it didn't really work very well. So he had fragmented speech that was difficult to understand, and he only had about 30 words that could be understood by others and had echolalia. So he was repeating what other people just said. He did not acknowledge other kids or adults and could not sit for a very long time. Also very hyperactive. At our clinic, he was opening and closing drawers and doors and moving many objects in our treatment rooms. So during his first stem cell treatment, he was given IV mannitol first to help open up the blood-brain barrier. And not to mention, mannitol also has some positive effects on the brain itself. So it's used for, like, if someone had a trauma to the brain, mannitol can be given to prevent swelling of the brain. It helps open up the blood-brain barrier to allow more fluid to come out. But it has some protective effects for the brain as well. And he was given 2 cc of the CharaCore and 1 cc of CharaExo. So that's the exosome product obtained from amniotic fluid. And 2 months after this treatment, family reported that he was doing better, was making better eye contact, and was more engaging. He was also sleeping better for the first 7 to 8 weeks after the treatment. He was going to bed around 8 to 9 o'clock and sleeping through the night until 5 to 6. So this is a huge improvement because before that he was waking up every night at 1 to 2 AM and then wanting to play with family members, right? Wanting to engage them. And so nobody could get very good rest. So family was very grateful about that. And the second stem cell treatment was provided 2 and a half months after the first treatment, the same protocol, exact same treatment. So after the second treatment, he had further improvement in his eye contact and was more able to pick up social cues. These changes were even noticed by people outside of the immediate family. So these are not as subtle, right? Other people could detect. For the first time, the patient was noticed to be able to reciprocate social interactions. For example, at our clinic, he was able to say thank you "Thank you" after his doctor gave him a glass of water, and he actually brought a glass of water to her. Previously, he had never said "thank you" to anyone and was never able to reciprocate. He also had more meaningful verbalization and was able to say words in more appropriate contexts with reduced echolalia. So he is not repeating what other people say as much. Less hyperactivity He was observed to be calm and cooperative at the clinic and no longer touching everything like he did before. So I want to go over the types of cells to use very briefly, just so people understand. You know, I want to talk about the difference between autologous and allogeneic. So either use your own cells or use somebody else's cells. The younger cells, such as ones from the umbilical cord, have different advantages. So I just want to give you just quick generalization. If you want more details, there is a lecture I gave called "Are All MSCs Created Equal?" That's a video on YouTube. So you can just look at the evidence from that. That was dedicated specifically of comparisons between umbilical cord cells versus bone marrow cells versus fat-derived stem cells. So I go into much greater depth, but I want to give you a summary of younger sources. And what happens when you use younger cells? First of all, these cells secrete more anti-inflammatory molecules. They produce more growth factors. They have more immune-modulating properties. They're more neuroprotective. They have more differentiation potentials that they have longer telomeres and more generations remaining. They are more anti-cancer. Using your own cells does carry more risk of promoting existing cancer. So, but these Cells have been shown to be generally anti-cancer because they're so young, they're able to recognize cancer. And they're also less invasive to obtain and easier to administer multi-doses, right? Instead of like drilling into the bone or taking out from fat, you can just get the product that's ready-made off the shelf and cryopreserved, waiting until the time of administration. Then you can thaw it out and immediately give it to to, to the child. And patients with diseases, just remember, they often have defective stem cells. That's something to remember. And then I want to talk quickly about native versus expanded cells. Of course, I have a whole video dedicated to this particular issue because outside the United States, there are a lot of companies who are using expanded cells. In the United States, if your doctor is giving you expanded cells, it's supposed to be under a clinical study. So if it's then that's not really lawful because you can't manipulate the cells and then give it to patients without having enrolled the patient in a clinical study. So that's a rule from the FDA. But in our clinic, we use native cells. So that's considered a tissue transplant. We're not using a drug. We're using a tissue transplant, just like liver transplant, blood transfusion, right? From one person to another. You don't need an FDA approval. This is the practice of medicine. So what happens with cultural expanded MSCs? They've been shown to have altered genetic expression. They have increased instability in their genome. They have reduced potency. They have reduced homing and engraftment capabilities, and they have loss of differentiation potentials and increased senescence. So the cells are getting older. And also, a quick note about single type of cells versus combination of cells. So studies have demonstrated the advantage of using a cell mixture over a subfraction of cells. So that can bring about a cumulative benefit by combining the different cell types. And that's why I think— that's why I developed a formulation that we use, which takes the cells from the umbilical cord blood, the umbilical cord tissue, and the amniotic membrane, because all the different cells cells, even if they're all MICs from these 3 compartments, they have different gene expressions, different growth factor profiles. So, they're all a little different. They're tailored toward different regeneration, like different type of function. Some are more for neurological development, some are more for musculoskeletal. And so, what I want to do is to harness all those potentials. So, dosing and frequency. And that, of course, depends on what kind of cells you use. If you use expanded cells, you may want to use a lot, but even at high doses, you may get less results. And I, I talked about that in the different type of stem cells I was comparing. So in our clinic, we start at 2cc of the product for body weight less than 80 pounds, and then add 1cc for each additional 40 pounds. With CharaCore, Again, is native cells from the core blood, core tissue, and amniotic membrane. And likely 3 sessions will be needed at 1 to 2 months interval. To think 1 session is going to do miracle, that would be, you know, optimistic and idealistic and maybe not realistic. Can it happen? It can, probably can do tremendous good with 1 treatment, but you're going to get cumulative benefits. To keep pushing for regeneration. So I generally recommend for chronic conditions, we do 3 sessions with 1 to 2 months in between. And then route administration. So IV route is the easiest and safest. Children with autism and cerebral palsy often have compromised blood-brain barrier. And, um, the IV route also allow more communication with the immune system. So you can bring the immune system on board to help you repair. And there's evidence that for any organ repair, if you bring the immune system on board, you're going to maximize, you know, you're going to have more benefit. And you can also use mannitol to further enhance the blood-brain permeability to allow more cells to get into the brain. And we can also do intranasal exosomes. So exosomes are going to be absorbed through the mucous membrane right away, and they can go straight across the cribriform plate and get into the brain. So that's another option. What about adjunct therapies? So you can use hyperbaric oxygen, which is great, ozone therapy, supplements. These are some of the supplements we use at the clinic, different peptides, laser therapy. So, all these are potential. So, just remember, I talk about cells being the engine for life because what cells have is the DNA. So, the DNA is where the intelligence is. It's a coding, it's a blueprint. So, it's telling you what to do. It's giving instructions. That's the engine for regeneration. So, if that's defective, then our body, you know, if you think our body as a car, you know, the engine is defective and the car is not going to drive very far or do very well. So, you need intelligence, but you also need fuel, right? Your engine cannot function without fuel. So, all these adjunct therapies is adding fuel, is optimizing the fuel into the engines, the cells cells can function better, right? If you're really toxic, the cells are not going to do well. If you don't have the right amino acids to build new tissue, you know, no matter how much instruction the cells are giving, you can't make the protein, right? So you need amino acids and you need the minerals. The peptides are signals. As we, you know, either because of oxidative damages, because of other toxicity, certain signals may be diminished. So if we can replenish certain signals, then we can promote further regeneration. So, by adding all this light therapy, all these are fuel to the engine. So, you can't go far as a car with no fuel, but you can't go anywhere without the engine, right? Both are important. So, this is why we need an integrative approach, not looking at stem cells as some kind of miracle cure. You don't just use cells and thinking that that will fix all. That will be very naive. That will be a Western conventional medicine kind of view that we think, oh, we found the key, we found the A to B connection, and then you're going to be fixed. No, the body is very complex. You've got to look at the body as a web. So by adding adjunct therapies, we're addressing the web. I want to end with the last case study. So this is the third case study of this 11-year-old East Indian boy with history of autism and Crohn's disease. He was nonverbal until age 6, was hitting himself a lot, and mom knew that he had a lot of gastrointestinal issues. Eventually he was diagnosed with Crohn's disease and then he received treatment for Crohn's, which made him a little better, so helped him overall by addressing the Crohn's disease. And before stem cell treatment, he had a lot of sensory issues, was toe walking, walking on his toes. His ankle area was very tense. He had intestinal cramping, and imaging showed that he had residual stool in his ascending colon extending into small intestine. So he exhibited behaviors such as throwing, giggling, was not very aware of danger. He had self-injurious behavior such as hitting his own head with his wrist, hitting his hand on furniture, or hitting his head against the wall. And he received 3 rounds of stem cell treatment. In Panama. So in Panama, they use expanded umbilical cord-derived stem cells, and almost all stem cell treatments in Central and South America are using these expanded cells because the early research was talking about 0.5 to 2 million cells per kilo, and those were all expanded cells. So they carry on the tradition of using expanded cells. But in the US, because without using cell expansion, we're giving people unexpanded native cells, and then massive amount of clinical evidence has been accumulated that these cells actually can perform the function just as well, if not better, at a fraction of the number of cells. So that's something I want you to, you know, understand. So the first treatment was in 2018. After that, he was able to be toilet trained. But lost the gains a year after the treatment. And then he got the treatment again in 2020 with an improvement in GI symptoms, but not much change in autism symptoms. And third treatment was 2021 with GI symptoms improved further, and then attention span was a little better. At our clinic, he received his first IV stem cell treatment with 2cc CharaCORE and 1cc CharaEXO. 3 weeks after the first treatment, the mom said he was more aware. And more present and was following commands better. He also had less cramps. His improved awareness sustained, and he could also clearly communicate his wants and needs. The parents did not bring the patient in for follow-up stem cell treatment for a year and a half. You know, life happens sometimes, you know, people don't come in as recommended because I was recommending coming in 1 to 2 months later. But when he came back, he was given again 2cc Charcoal and 1cc Char-XO, and this time after mannitol infusion. So the day after the treatment, for the first time in his life, he communicated with parents in parents' native language. And then he was able to say things like, "I want to eat," and "I want water." He also increased social interactions with parents and would go up to them and say, "Pick up," and raise his arms and appear to be more relaxed. 2 months after this treatment, he received the third stem cell treatment at our clinic, again with, you know, mannitol pre-infusion and then 2cc Chiro-Qo and 1cc Chiro-Exo. And 3 weeks after the treatment, mom said he had multiple signs of improvement, including improvements in writing, attention, focus, eye contact, social engagement with family members and therapists. And patient has been able to go to the library and pick a book and flip pages, even though he was not sitting down to read the books, but he was beginning to show interest in what's inside the books and in books that other children seem to be interested in. So he's picking up social cues, right? So he's more interested and He's wondering, you know, what, why are they picking up that book? So, and then due to these improvements, parents enrolled him in a Kumon math and reading class, or reading classes, and he seemed to be enjoying these classes. He's— all his cousins were doing these classes, so parents are really happy that he was able to take these classes. And parents feel that he was also not resisting going to these classes, which is a huge step in the right direction because in the past he had difficulties with trying new classes or socially engaging environments with other students present. So he had a hard time when other people are present in these new environments. So that's the last case. I just want to express that, you know, we're seeing more and more hope for these kids for the future. So we're still at the beginning of stem cell therapy. So much can be done and science is advancing and, you know, we can use different adjunct therapies and maybe we can help the cells to develop in a certain way. But right now, even with what we have in stem cell therapy, which I do think is fairly primitive, but primitive as it is, the power is undeniable and it's very encouraging. So I just want to convey that hope to everybody. And if people have questions, they can reach out to me. Of course, one good place to reach out to me is actually my website, just joykongmd.com. It talks about the clinic and the stem cell company I founded, the academy I founded to train other physicians, my book, et cetera. So, but that's a good place if you want to contact me, just joykongmd.com. And of course, you can email me directly as well. So, So that's my presentation. I hope that this has been helpful and maybe inspired you and giving you some more hope for, you know, your own child or somebody you know. Again, I feel really grateful for the opportunity to be able to provide the treatment. I have to tell you, the parents who bring their kids to me are some of the most amazing human beings. By the time they're willing to do anything for their kid, have done all the research and drag their kids from long distance, sometimes, you know, from another country to come to our clinic to get treatment. The dedication, the love is just beautiful. And yeah, I'm just grateful to have the opportunity to help these kids and these parents because I know they're not expecting miracles. Any small improvement they are happy about. And I just, I'm so, yeah, I'm just moved by, by these parents. Again, now as a regenerative medicine doctor, I can bring about a lot more changes and benefits to these autism kids. It's funny how life, you know, turns out that, that I resisted going into child psychiatry, even though I love intervening at a younger stage, you to prevent psychiatric issues or to help them. That the autism cases were discouraging for me to going into psychiatry for kids. Now, as a regenerative medicine doctor, I'm able to provide some incredible therapies that can bring about changes that I was not able to bring about when I was a psychiatrist. So just very inspiring. So That's it for today. And again, go to my website if you have questions. Please watch my YouTube videos. I have so many answering different questions about different aspects of stem cell therapy. And you can also get on my Instagram if you want to. It's just Dr_Joy_Kong. You can follow me that way and communicate with me. So again, thank you, everybody. Until next week.

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