How To Power Up Your Heart With Stem Cells

Leonardo Gonzalez, MD

Thank you, too. That was a very kind introduction. I appreciate it. I’m very happy to be here and to be able to explain to everybody what stem cells do for heart failure and other cardiac conditions.

Joel Kahn, MD, FACC

Yes. Let’s clear something up now. The terminology of stem cell therapy can be quite overwhelming to those who are doing it day-to-day. We’re not talking about embryonic stem cells, which bring up a whole host of ethical and sometimes even legal topics. If anybody’s with you now and saying, I hope Dr. Gonzalez isn’t talking about embryonic, we’re not going to talk about that, right Doc?

Leonardo Gonzalez, MD

That’s right. Yes. Embryonic stem cells are very controversial, and they’re very hard to use. They’re being used just for research purposes. They haven’t been able to be used in humans. I think so far it hasn’t proven to be very helpful. We’re using it. Yes.

Joel Kahn, MD, FACC

We’re not going to offend anybody or take on anybody’s sensibilities. That’s not the topic tonight. But we are going to introduce some tough words, and the abbreviation is MSC. It stands for a Mesenchymal Stem Cell. Not a word we say every day. M-E-S-E-N-C-H-Y-M-A-L stem cells. Why don’t you just give us a short explanation? What is a mesenchymal stem cell that you’re using?

Leonardo Gonzalez, MD

Okay, so we have different types of stem cells. As you mentioned, we have embryonic; we have fetal. We also have mesenchymal stem cells. The mesenchymal stem cells are those that we have in our body; they’re considered adult stem cells, and they’re inside of our bodies to regenerate and create new tissues, mostly from the connective tissue kind like muscles, tendons, cartilage, and things like that. But they’ve got this very potent quality, which lets them become all the types of tissues, like neurons, or cardiomyocytes, like different types of cells in different organs.

Joel Kahn, MD, FACC

Maybe if some people listening have had a heart attack, they have a spouse, say, a family member friend, or a coworker who’s had a heart attack; that’s a damaged heart. What we’re talking about now in Reversing Your Heart Disease, Naturally Summit is the possibility that stem cells may help repair. I don’t want to say necessarily renew, but repair the heart. We’re going to focus on mesenchymal stem cells. You get mesenchymal stem cells from something nobody’s ever heard of. It’s called Wharton’s jelly. W-H-A-R-T-O-N-‘-S jelly. I thought, of course, we’re going to talk about something made with fruits like strawberry jelly but tell us what jelly is,  what is working with it, and how do we get stem cells out of it?

Leonardo Gonzalez, MD

Wharton’s jelly refers to the jelly material that we find on the umbilical cord. The umbilical cord has, like, three blood vessels. We have this jelly material around the blood vessels, protecting and giving support, nutrition, and different systems since the blood vessels are going to need to be healthy in some way. That’s where we find the mesenchymal stem cells. We get a piece of the umbilical cord, and then we take Wharton’s jelly, and that’s where we get the stem cells from.

Joel Kahn, MD, FACC

Of course, at every birth, there is an umbilical cord. After the baby is born, there’s no real use for the umbilical cord. You’re using that aspect of nature that there happen to be mesenchymal stem cells in the umbilical cord that otherwise have no purpose at that point. Nobody gets hurt by extracting stem cells from the umbilical cord after the birth of a baby. 

Leonardo Gonzalez, MD

The beautiful thing, and this is something that nature made this way, is that everything that is on the umbilical cord doesn’t belong to the mom or the baby. They have very specific characteristics and qualities that make this tissue, like the connective tissue, an organ that is between the mother and the baby. That way, the stem cells on the umbilical cord have the same quality, and that’s how we can use those cells on anybody. After we get the cells out of the umbilical cord, we can use those cells on any other person.

Joel Kahn, MD, FACC

That’s the interesting thing I was going to ask about because we’re not using these mesenchymal stem cells in the umbilical cord. We’re not using them on the baby or the mother. We’re taking them, or we’re going to use them, on a 55-year-old truck driver who had a big heart attack and has a damaged heart. You’re going to use your institute to help them. How come our immune system doesn’t react and reject these stem cells that are coming from another person?

Leonardo Gonzalez, MD

Their cells are immunoprivileged, and what that means is that they don’t express something that we call the immunocompatibility complex, and that’s something that our bodies used to reject, like different organs or things. The cells don’t express the histocompatibility block complex, and that’s what we can give them.

Joel Kahn, MD, FACC

You gave us a fancy, scientific answer. But the bottom line is that our immune system doesn’t recognize these as foreign and gradually destroys the materials. There’s a chance they’re going to help a person long-term in their tissues.

Leonardo Gonzalez, MD

Yes.

Joel Kahn, MD, FACC

How does? Maybe not. But do we know that a stem cell from an umbilical cord put into a human with a damaged heart can become a heart cell because most people don’t need to grow an umbilical cord? We know we need to grow heart cells. We know that happens.

Leonardo Gonzalez, MD

Many years ago, when all this started, we used to think that the stem cells that we were injecting in different parts of the body were differentiating or becoming a different type of cell. Now we know that the most important part of the action of stem cells is by producing different substances like cytokines, anti-inflammatory factors, and growth factors. That’s what produced regeneration. It stimulates our own body’s regeneration and healing processes. That’s probably 60–70% of what the stem cells do. Of course, we have a few of those cells that are going to be able to implant to stay on that tissue, and they’re going to be able to differentiate into whatever cell we need to. But it’s a small percentage.

Joel Kahn, MD, FACC

You’re telling us a secret here of stem cell doctors like you: some of the benefits of introducing stem cells to the body are not just that they might become a heart cell, which is possible, but that they secrete chemicals and all kinds of fancy words, cytokines, and exosomes, and that these stem cells secrete growth factors that may help a damaged organ. In this case, we’re talking about a damaged heart.

Leonardo Gonzalez, MD

Yes. For example, when we talk about heart failure and myocardial infarction, we know that the inflammatory process is going to be there all the time. That’s what the stem cells are going to control. They’re going to decrease the inflammation. That’s how we’re going to prevent more damage. We are going to reduce the scarring process. That’s one of the most important things that stem cells do in the heart.

Joel Kahn, MD, FACC

Okay. Interesting. It’s now something that the audience knows stem cells can cause the secretion, the release of a whole family of chemicals that can help heal injured tissue and repair wound healing. It’s also fascinating. Let’s take that person with a condition we call congestive heart failure. Maybe they had a heart attack. They’ve got an area of their heart that’s weak, and it probably involves scar tissue and the rest. How are you at your institute in Columbia? I think you want us to also learn that you’re going to be expanding soon to the Bahamas, and we’re going to have to talk for a minute about why this isn’t available yet in the United States. But how are we going to get the stem cells to the person and to the area of the person that’s damaged, like the heart?

Leonardo Gonzalez, MD

Okay. That’s a very important question because, for us, that’s one of the more important aspects of the treatment. We want to deliver the cells exactly. and to the place where the cells are needed. How do we do that? By the process called catheterization, which is like inserting a needle at first and then a wire inside the arteries that go into the heart, then we’re going to find the coronary arteries. Then if we want to inject the whole heart, we’re going to inject the cells into the coronary arteries. That way, the blood supply is going to bring the cells to the whole heart. If, for example, we need to inject the cells directly into the heart muscle, We use a different type of catheter, and we can inject the cells directly into the heart muscle.

Joel Kahn, MD, FACC

Okay. At this point, we can’t just drink these stem cells. We can take a capsule of these stem cells. We can rub them on her skin. We have to have a cardiac catheterization and have them placed into the heart arteries through a catheter. You must be working with Cardiologists in Columbia.

Leonardo Gonzalez, MD

Correct? In my team, I have an Interventional Cardiologist working with me; they’re very experienced. They have done it for thousands of days. They do many catheterizations a day. It’s a procedure that, when everything goes smoothly, takes between 20 and 25 minutes.

Joel Kahn, MD, FACC

It’s an outpatient procedure. How often can you do it now through a little artery in the wrist? You just get a bandage at the end of the procedure, and they go home. Do they usually have the stem cells from the umbilical cord, the Wharton’s jelly? Do they have that introduced just once, or are they going to have to potentially have more than one treatment?

Leonardo Gonzalez, MD

That varies and that depends on the type of patient that we’re treating, how long they’ve been suffering from the condition, like how advanced it is, for example, heart failure. But, I will say that about 60–70% of patients only need one treatment. We have about 30–40% of those patients that may need two treatments.

Joel Kahn, MD, FACC

What’s your ideal patient? Or give me an example of your ideal patient. The one you would predict is going to respond the best, and how are we going to measure if they benefited?

Leonardo Gonzalez, MD

Okay. Probably a lot of things in medicine, the sooner the better. If we can treat the patients when they’re just diagnosed with heart failure, and probably that heart failure is not that advanced or stage one or two, we can predict that they’re going to benefit right away. Those are the patients that, for sure, are going to need just one treatment. If we have patients with more advanced heart failure, we’re probably going to need two treatments. But we measure, we do a whole lab work. Before we do echocardiograms to measure the ejection fraction. Then we do all the testing necessary for us to be able to prove that the treatment worked. The patients improve their ejection fraction, by at least 50–60% after the first treatment.

Joel Kahn, MD, FACC

There will be lab work before and after, and echocardiograms before and after to measure the heart strength. You’re taking careful histories from the patients to see what’s better. If they walk better, their breathing’s better, if their ankle swellings better—all the things that make up congestive heart failure.

Leonardo Gonzalez, MD

Yes. All those symptoms, you start seeing improvement within a couple of weeks. It’s amazing because all these anti-inflammatory factors that the stem cells release bring the inflammation down, and we start seeing improvements in all those symptoms.

Joel Kahn, MD, FACC

If they improve, what you tell them is the chance they’re going to stay better for a year or five years. What’s the duration of the benefit?

Leonardo Gonzalez, MD

For example, if we see a change in the ejection fraction, that’s going to last for years because that’s a definite change. It’s not temporary. The symptoms, the change in some symptoms, and all that. Most of the time, we see that they improve over time; they get better and better. I think probably the very first patient for whom we did a cardiac catheterization was nine years ago. and he’s just like, he’s fine now and he’s just like, he probably got back to before he started having heart failure symptoms.

Joel Kahn, MD, FACC

Wow. It’s quite durable.

Leonardo Gonzalez, MD

That’s yes.

Joel Kahn, MD, FACC

That’s exciting.

Leonardo Gonzalez, MD

Yes. But of course, that’s where, for example, you and all the other colleagues that practice functional medicine because, of course, it is very important to do an integrative approach that we can handle if the patient is overweight. We have to help them to eat healthy, to exercise, because if the patient is going to continue in this cycle of bad habits or things, of course, the heart is going to get damaged again.

Joel Kahn, MD, FACC

Sure. Yes, that makes total sense. I would hope that people would be so excited about their improvement that they were finally serious about managing their lifestyle and all the factors you just mentioned.

Leonardo Gonzalez, MD

I like that.

Joel Kahn, MD, FACC

I want to know why I’m interviewing somebody from Columbia who’s also going to open in the Bahamas. Why is it not available at this time in the United States?

Leonardo Gonzalez, MD

Unfortunately, I just want to say that the FDA hasn’t approved this type of treatment. There are going to be a lot of reasons, not because they don’t work, not because they’re not safe, and not because they don’t help patients. They’re going to be, or the reasons why they don’t want to prove that here in the U.S.

Joel Kahn, MD, FACC

Because you’re not exactly competing with bypass surgery. You’re not exactly competing with stent procedures. The big money procedures. Maybe you’ll make people healthy, and they’ll stay out of the hospital. There’ll be empty hospitals. I guess you’re competing with, and you think it’s the pharmaceutical industry that’s not happy with what you’re doing?

Leonardo Gonzalez, MD

Of course, yes. That’s it; that’s the main reason.

Joel Kahn, MD, FACC

Yes. That’s terrible. But we know that the FDA is largely run by people who, having been in the pharmaceutical industry, are going to end up in the pharmaceutical industry. That’s certainly not a conspiracy theory. That’s just pure fact. That’s disappointing. 

Leonardo Gonzalez, MD

Yes.

Joel Kahn, MD, FACC

We’ve talked about Wharton’s jelly and umbilical cords producing or providing us with mesenchymal stem cells that you can put down the coronary arteries or even inject directly into the heart. Does the direct injection in the heart require surgery, or can you directly inject the stem cells into the heart muscle through a catheter?

Leonardo Gonzalez, MD

We can do it through a catheter. We don’t need to do heart surgery.

Joel Kahn, MD, FACC

That’s pretty fascinating. Do those people go home the same day, or are they going to stay up?

Leonardo Gonzalez, MD

They have the same post-operative observation period. They stay in the hospital for 2 hours after the procedure, and after that, they go back to the hotel. In this case.

Joel Kahn, MD, FACC

An American patient could travel to Columbia and, next year or sometime later in 2024, to the Bahamas. But could travel, could become a patient of yours, could stay in a hotel, and could get this treatment. That’s what’s happening.

Leonardo Gonzalez, MD

Exactly. Yes, that’s how we’ve been doing it for all these years.

Joel Kahn, MD, FACC

Okay. I’m sure you’ve probably taken care of some people who are from Colombia. Is that?

Leonardo Gonzalez, MD

Yes, of course. Yes. We also treat Colombian patients.

Joel Kahn, MD, FACC

How many people in a month do you think you get to treat like this? Of course, it’s quite an undertaking, but a dozen people in a month at your center.

Leonardo Gonzalez, MD

For, like, cardiac issues?

Joel Kahn, MD, FACC

Of course, we could spend hours talking about all the other applications, but just cardiac.

Leonardo Gonzalez, MD

Yes, I believe that’s about eight to twelve patients per month.

Joel Kahn, MD, FACC

Yes. It takes a motivated patient. Your Blue Cross in your Medicare is not going to cover this. This is something that you’re going to be paying for out of pocket on your own. That’s excellent. The fact that you’re being so kind with your time that I get to interview you means more people know about it and spread the word. Because I don’t even think most cardiologists in the United States have too much direct experience with all this. This is great. 

Well, I’ll tell you what, Dr. Gonzalez, don’t go anywhere. We’re going to come back and answer a few more questions. We’re going to say goodbye for a moment to our general audience and come back and spend a few more minutes with our premium audience. We’ll cover a couple more topics. Thank you so much.

Leonardo Gonzalez, MD

Thank you again.

Joel Kahn, MD, FACC

We’re back with Dr. Leonardo Gonzalez, who is kind enough to spend time with us from the International Stem Cell Institute in Bogota, Colombia, and soon to be the Bahamas. Give us a little idea. Somebody is interested. Tell us about the economics and the possible costs, but also what would be the costs if they didn’t get this therapy and went downhill?

Leonardo Gonzalez, MD

Yes. I think that’s something very important for patients and for the public to know that the cost of, for example, heart failure for U.S. patients could go between 6,000 and 10,000 a month. We’re talking about medication, co-payments, all the different things that they have to pay just to get treated here, in the U.S., and the same thing, annually, they’re spending between 30 to $200,000, if they’d required surgery or different procedures or diagnostic testing, different things. the cost of managing heart failure here in the US. Is this quite, quite expensive? On the other hand, when we do stem cell treatment, the cost varies depending on the number of cells that we use and the type of procedure that we are going to perform. But we’re talking between $25 and $35,000.

Joel Kahn, MD, FACC

Okay. Is the supply of mesenchymal stem cells pretty good? If you have a patient lined up, you’re not going to have too much trouble getting them.

Leonardo Gonzalez, MD

Yes. The lab that we have in Colombia already has years of experience. I need like, a couple of weeks before the treatment to tell the lab how many cells I need and they will have it ready two weeks later.

Joel Kahn, MD, FACC

That’s not a limitation. Tell us about the future. Why are you expanding to the Bahamas?

Leonardo Gonzalez, MD

The main reason is that we would like to be able to offer this to more patients and more people. We want to make it easy for them to travel; Colombia is like three and a half hours from Florida, which is not bad. But, of course, if we are in the Bahamas, it’s going to be, like,  a half-hour flight. We want to make that easy for everybody. We know that for that same reason, we’re going to be able to help more people.

Joel Kahn, MD, FACC

What about the technique itself? Is there anything else? Do you think the technique is now mature, and this is what you’re going to do for the next three, four, or five years? It’s hard to talk beyond that. Or is there something on the horizon?

Leonardo Gonzalez, MD

Yes. We are starting to work on different research projects, and what I want to do is be able to have different types of cells. We want to be able to find cells that are already differentiated. If we want to treat the heart, we would like to have some heart cells available that we can use in the heart and the same thing in the brain. That’s for the future.

Joel Kahn, MD, FACC

Just give us one, two, or three other conditions outside of the heart that tend to respond well to your stem cell therapies. What are some of the other conditions just for people listening?

Leonardo Gonzalez, MD

Okay. The most common conditions and things that we treat pretty much every day. That’s where the evidence, the studies, and everything else are proven. How effective stem cells are is everything related to bones, muscles, pain, muscle trauma, ligaments, cartilage, etc.; that’s the main thing. If you have a knee problem, we can fix it. If you have a shoulder, same thing; we fix necks and back hips. That is the easy thing. All the conditions are like, I focus on a lot of degenerative diseases like, neurodegenerative, conditions that affect the brain, like Parkinson’s, Alzheimer’s, we’ve been treating a lot, Autism with excellent results. That’s another niche of patients for which we’re very happy with the results. 

Lately. I would say that probably for the last three or four years we’ve been treating a lot of Crohn’s disease patients. We do direct catheterization into the superior mesenteric factory, and we inject the cells there, and the results are just amazing. Those are probably just a few to mention, that, for me, the results that we’ve been getting lately are very good.

Joel Kahn, MD, FACC

Very exciting. We’re now very educated about what you’re doing. Where do people find you? What’s the best place for somebody listening to this? Or they have a family member, and they want to tell them that there’s an expert in Colombia on their way to the Bahamas. How do they find you?

Leonardo Gonzalez, MD

I think probably the easiest would be the website of the International Stem Cell Institute. Also, I don’t know if we have any way to share my email or my phone number. I would not mind to share it with you.

Joel Kahn, MD, FACC

I think it’s easy enough to find the International Stem Cell Institute. Dr. Gonzalez and I don’t think there’s any problem with that. That’s very kind of you. Thank you again for your time. I found this interesting. Is there any patient that you’d turn down? Is it because they have an autoimmune deficiency, or is it somebody who isn’t a candidate?

Leonardo Gonzalez, MD

Unfortunately, the only type of patient that I have not been upset about being treated with when they have an active tumor or cancer present. There is no study or anything that has shown that the stem cells, and especially the type of stem cells that are used, can increase the tumor or tend to produce new tumors. There is nothing they have shown that this type of cell can do that. But it is just a preventative measure because, unfortunately, if something happens and the disease goes out of control or the tumors start growing, they’re probably going to blame the stem cells. and we don’t want that. We ask for at least one year of remission for me to be able to treat them.

Joel Kahn, MD, FACC

Good. This has been a fascinating conversation. Everybody learned a lot. You’re reversing heart disease, no doubt about it. It’s exciting to see what the future is going to be. Hopefully one day there’ll be an International Stem Cell Institute in Sarasota, Florida, and people will be able to come right to you in the United States.

Leonardo Gonzalez, MD

That’d be great. Yes, that’ll be fantastic.

Joel Kahn, MD, FACC

Well, thank you again, Doctor.

Leonardo Gonzalez, MD

Thank you, Dr. Kahn.