Claudia von Boeselager (00:00)
back, dear audience, to the Longevity and Lifestyle Podcast. I'm your host, Claudia von Bözelaga, and today's guest is someone I've been very excited to sit down with. Because in a world where everyone is talking about peptides, and I mean everyone, it's rare to find a physician who was actually in the room when the story began. Dr. Alexander Grinberg is a physician executive with over 35 years of experience across integrative medicine.

Peptide and regenerative therapeutics, gene therapy, clinical immunology, and biotechnology. He's the founder of Infinity Epigenetics, a precision medicine practice in San Francisco, and serves as the director of R&D at Rvax, a longevity-focused clinical translation platform. But here's what makes today's conversation unlike anything I've heard. Back in the 1980s, Dr. Grinberg was one of the physicians actually monitoring patients receiving.

Cavinson bioregulators as experimental drugs, combined with therapies like Plasmapheresis and hyperbaric oxygen, decades before any of these terms entered the mainstream conversation. He's someone who separates real science from hype and turns it into safe, individualized care.

Dr. Grinberg welcome to the Longevity and Lifestyle Podcast. It's such an honor and pleasure to have you with us today.

Alexander Grinberg, M.D. (01:14)
Thank you. It's my honor and pleasure to be here.

Claudia von Boeselager (01:17)
And you've got up so early at six AM San Francisco time to take this call. So thank you also for that. maybe it's part of your peptide protocol. So we'll dig into this. and I want to discuss around peptides without the hype, right? And as we know, it's peptides have become one of the most talked about areas of longevity, and the conversation is either wildly enthusiastic or deeply dismissive.

How do you think people should be thinking about peptides more responsibly?

Alexander Grinberg, M.D. (01:44)
Well, as a physician and scientist, I am very enthusiastic about peptides. I've been working with them for more than three decades. of course, judgment is the first thing. So we are enthusiastic about many things, but it's very important how to approach them and how to use them to get the most benefits from them and to mitigate as much as possible risks.

associated with many interventions in healthcare and medical practice.

Claudia von Boeselager (02:11)
So there's a lot of information in there. And I think let's unpack that a little bit because I think one of the key things you said is, you know, that it's used in the correct way. But what does that mean? Because as we know, Instagram, TikTok, influencers pushing different peptides, telling you protocols, et cetera. So as a physician, as a scientist that's worked with peptides for decades, what are the stones to

looking towards using peptides in a responsible and in the right way. What would you recommend?

Alexander Grinberg, M.D. (02:40)
recommend to approach them other medical interventions, as strong biologically active pharmaceuticals or pharmacologically active substances. And definitely if someone approaches some treatment, first thing people do is gathering as much health information as possible before starting something and doing as many labs and tests as indicated to get good picture.

what we're starting with, what is the terrain before we started something, even as seemingly innocent and safe as peptide BPC157 or GHK, still we need to know our terrain and deal with when we start the treatment and what our goals and targets are and how we're gonna do it as we're talking about dosing and frequency and...

more checkpoints, what to check when we do it. So, lot of things in this business.

Claudia von Boeselager (03:31)
And so what are some of main markers that you look for when deciding for things that as you call are, you know, BPC 157, we've heard about the G HK, women love this, obviously for the skin and the hair and all the rest of it What are some of the core markers you look for? And are there any contraindications or flags that people should know off the bat where it shouldn't be used for them?

Alexander Grinberg, M.D. (03:54)
First, I would say first line of getting information would be basic blood biochemistry, blood cells count, and eliciting the medical history. simple things if someone has history of cancer or in remission of cancer or history of some chronic conditions that should be specifically addressed with a knowledgeable physician.

as even once again is common and frequently used peptides as BPC157 or GHK peptides in different conditions they may be contraindicated. For example, people talk about cancer, of course, course, response to signals promoting the growth of blood vessels would be counterproductive for someone struggling with cancer.

And for some other conditions, for example, wet macular degeneration where vascular overgrowth is another problem, it can be also aggravated by BPC 157. For example, there are many more conditions. There are thousands of conditions and diseases, and sometimes people know they have them, and sometimes people are not aware they may have them, so it's a problem.

There are some other conditions. GHK peptide, usually people take the form GHK copper of this peptide. In some conditions with some liver disorders, excessive accumulation of copper may be very counterproductive. And even for healthy people, they need to know the basic level of nutrients, microelements, and even copper. Once again, even for healthy people, build up of copper.

maybe dangerous and counterproductive people may have some hereditary diseases, some genetic abnormalities that make them particularly sensitive to these seemingly minor things. frequently people ask me what is my favorite peptide and I ask them what is their favorite organ or what is their favorite function.

Claudia von Boeselager (05:48)
The

brain, the brain, I'd say.

Alexander Grinberg, M.D. (05:50)
Well, there are peptides

for brain as well. But people should realize what they want to start with. Sometimes we're talking about longevity. Everyone is aging differently. And when people may have some, weak links in the chain of the processes that leads to aging or helps to slow down the aging.

People may have genetically weak links, some genes responsible for methylation, some genes participating in the process how body tolerates inflammation and all these things are very important and they help to choose proper peptide to peptide interventions so to improve the overall terrain and microenvironment in the body, make the body most receptive to

a therapy any other advanced therapies people can think about like stem cells, cell medicine, gene therapies. We need to know the terrain, what we're dealing with to properly address the problem.

Claudia von Boeselager (06:50)
And I'd love for you to expand on, you know, your journey a little bit too. one point to what you were just saying is that I think there's so few medical professionals in the world that are trained in so many multifaceted ways that they can actually do this analysis and then the protocols. so I think that's part of the challenge that the average physician that people go to see, they're not aware even.

partially or they're not educated in the protocols, the diagnostics, maybe genetics. some of them aren't trained in hormones, et cetera, et cetera, which all are are such important components to understanding the holistic person. Would you agree?

Alexander Grinberg, M.D. (07:26)
Absolutely, I agree with that and I can comment that I was very lucky to start my peptide journey and my work with peptides under specific conditions. So probably by now many people know that many peptides that are used by people now and by regulators, many of them come from works of Professor Khavinson and his groups.

They were based in St. Petersburg and the Institute of Gerontology. So their focus was on gerontology and you may see a lot of research confirming that groups of people getting certain peptides had reduced mortality over a period of observation and overall positive response. At the same time, I was starting work with peptides.

in the clinical institutions in the 80s. I was in Moscow in the old Soviet Center for Immunology Institute. And there we had the access to Professor Khavinson peptides, primarily thymus-derived peptides, for very targeted interventions. We were not dealing with gerontology. We were working with clinical populations. So

You can compare it to clinical trials where we had groups of people with autoimmune conditions like rheumatoid arthritis, lupus, some forms of asthma and groups of people suffering with viral infections, first wave of HIV AIDS patients and people suffering from other viruses. Another group for observation and to see how they respond to peptides.

working closely with the oncology center where these peptides were used for mitigation of cancers as well. and also we had people coming from places like Chernobyl. It was after 1986. So people struggling with consequences of exposure to nuclear leak, exposure to some chemical leaks and...

to bacterial infections back at this time in Soviet Union. Peptides were looked at as a possible means of mitigation of exposure to weapons of mass destruction or things related to that. And so we had clinical observations. Basically in gerontology, you deal more with statistics related to mortality over periods of time here.

It was a clinical intervention where we had baseline health history for each patient and then we had amazing laboratories working with us, over 30 different laboratories that let us to have hands-on feedback on what was changing, different things. Say some person had a rare form of immune deficiency and his white blood cells could not completely destroy it.

bacteria and pathogens, incomplete phagocytosis. Would thymosin improve this? And we could get essays in real time and create personalized essays to see what happens to immune system even back then in 80s. we still had immunology as a very developed science. work with amazing world-known immunologist, Rem Petrov.

was doing amazing work in immunology. Khaitov was director of our institution. So they were all very interested in developing essays. And even back then we had a lot of people from the West, scientists, people coming there and working with us. we were able to, considering that it was in 80s,

We had pretty good structure to do immunological testing and so I could see and how active biologically peptides were. Back then we had a little different names for thymus derived peptides. had names like T-activine, B-activine, T-malol, things like that. Epitalon was already...

and used back then. from that I could develop my approach as a clinician to peptides to see all the subtle parameters, markers, how they change. We started with immune markers, CD marking of the cells, how we see the redistribution of CD markers on the cells. Now more and more people get more and more educated and people know that it's very important to understand.

what happens with immune system, redistribution between helper lymphocytes, memory lymphocytes, and so on. And even for senescent cells now we know CD markers. We know which redistribution functional lymphocytes is important to remove senescent cells, which cells of immune system and their proliferation is important to fight cancer or to prevent cancer like...

NK cells and their subpopulations. It can all be influenced with peptides. We can follow that. We can observe that and we can make it very targeted intervention.

Claudia von Boeselager (12:08)
amazing answer and so incredible. And I mean huge congratulations. And I think it's so mind blowing and incredible that back in the eighties you were working on this because obviously now such the hype, et cetera. But it just goes to show the longevity of the research around it and how it can be used and the different use cases. And I think, you know, you mentioned many conditions or diseases from the MS, multiple sclerosis, asthma, lupus, etcetera. And so

I'm curious, what are you seeing now? And how do you structure your programs now with your patients in terms of understanding the landscape? What are the different diagnostics that you are doing as one of the pioneers in the space? And then what are some of the protocols that you recommend? Obviously, it's personalized, but sort of a let's say generalization for cases with cancer, for MS. could you talk about that a little bit? And then also for the ones that are looking at.

The longevity side of things too.

Alexander Grinberg, M.D. (13:02)
Definitely, definitely. I will be happy to.

So over the years, we've seen development and emergence of many novel addition to many bioregulators originally developed by Professor Khavinson group, scientists all over the world more and more peptides. A good example would be GLP group of peptides.

Claudia von Boeselager (13:28)
Huge.

Alexander Grinberg, M.D. (13:29)
which

amazing peptides affecting many metabolic conditions and beyond them they have a lot of receptors outside and I would say typical what people know about metabolic conditions, weight loss. There are receptors in the brain and the blood vessels that help the GLP ones provide very beneficial effects on many other things.

and many other peptides. It's now when we live in the time of response associated structure, searched by pharmaceutical industry, it's more and more possible to predict with better and better accuracy, which targets the diseases and the physiological processes and pathways can be affected by specifically designed peptide and even predict

turning to right or left, particular isomer of amino acid or some other minor chemical modifications, how it may affect the physiological effect. And currently over 80 peptides are in different phases of clinical development by Big Pharma and people who follow the development in Big Pharma, see that there's emergence of peptides, they treat specific conditions like psoriasis.

of eye conditions, some specific retinitis pigmentosa and so on. So there is development of specific antimicrobial peptides targeting very specific pathogens from oral infections to cerebral form of Lyme disease where the pathogen is very hard to reach by regular antibiotics, but scientists look for the ways to target it with peptides.

and so on, but they are more specific. They are in the realm of pharmaceutical and target specific diseases. I'm sure for our audience, it's very interesting to learn how to use available research peptides and with most benefit mitigating possible risks. So, looking about different conditions, for example, you mentioned multiple sclerosis and autoimmune conditions, definitely.

Once again, the best thing to do it is to do it together with a knowledgeable physician. And as there are many aspects for which of these conditions and autoimmune conditions can target affect broad range of organs and systems. And frequently we see few physicians engage in the treating patient. Example for

lupus or rheumatoid arthritis, is a rheumatologist, a nephrologist, and sometimes cardiologist, immunologist treating these conditions. So it's very important not to activate in this case, not to cause undue activation of immune system. I'm giving some, I would say, broad educational things because it's...

very dangerous for people, particularly with specific conditions to do something without knowing what they're doing. first thing is not to harm, not to activate immune system and not to activate autoimmune process. But second thing is find peptides that are safe for the patient and are protective. So to stop damage of the cells by autoimmune process, by the antibodies or by cytotoxic lymphocytes.

And for this, once again, it's not that I'm sharing the knowledge. It's not specifically to treat particular disease. But in this case, it will benefit.

Claudia von Boeselager (16:47)
Yeah. For educational

purposes only. Yeah, exactly. This is a disclaimer for sure. Yes.

Alexander Grinberg, M.D. (16:53)
But in this cases, people benefit from peptide epithelon that definitely helps to improve, I would say, cellular health at the level of telomeres. It's good to use some of the mitochondria targeting peptides. For example, humanin peptide can be protective because it can stop the cells that are on the way to apoptosis.

So it can prevent cell death and that's very important. And it can prevent further damage of the cells that hypothetically prevents the exposure to one's own immune system and may reduce the acuity of autoimmune process. Then obviously some other processes should be considered like fibrosis that becomes important things in many pathological process at certain stage.

GHK, I prefer GHK basic that doesn't have copper. This one helps to turn the collagen production toward the synthesis of healthy collagen versus the types of collagen that accumulate as extracellular matrix and trigger progress of fibrosis. So these basic things based on common sense that you get when you learn about physiology and

have some degree of medical knowledge, you can identify certain peptides that would be safe at least protect the cells and slow down the progression of autoimmune process. And of course then with ongoing labs, you can see what is working well. And then the target organs that suffer because of autoimmune process, for example, kidney.

can be supported by peptide for example SS31 that helps membranes of mitochondria in the kidney cells and not only in kidney cells People are asking frequently about peptide MOTS-c for example, this is also peptide targeting mitochondria It's a very amazing peptide. But once again based on my understanding and knowledge I don't use it as a first line because

Claudia von Boeselager (18:42)
Mm-hmm.

Alexander Grinberg, M.D. (18:52)
to capitalize on its ability to help mitophagy, its ability of mitochondria, so to say to eat its old part. First, mitochondria has to be in healthy state, so I prefer to start with milder mitochondrial peptides that help first to stabilize mitochondrial membranes and improve some biochemical process in mitochondria. And only after that I would...

dare to simulate mitophagy.

Claudia von Boeselager (19:19)
as you can see, everyone listening and hearing, it's quite a science and an art. And so I wonder what your view is, or what would you like people to know about the biggest risks of self-experimenting, which a lot of people are, right? So they're seeing some influencer talking about taking MOTS-c or BPC 157, the Wolverine stack with the TB500. What are some of the risks people should know?

Alexander Grinberg, M.D. (19:25)
.

Claudia von Boeselager (19:43)
about self experimenting. You've obviously mentioned about cancer, but are there other things that you would like people to know and understand why it's so important to take peptides as part of a larger medical oversight and conversation?

Alexander Grinberg, M.D. (19:55)
Definitely. And I still have to comment about cancer because I see cases when people take a number of peptides that promote release of growth hormone, either through activating growth hormone, releasing hormone or growth hormone releasing peptide. frequently I see that, for example, for male patients, even their prostate antigen wasn't checked.

before they started doing that. they have high, already have as a baseline, have borderline or high PSA and they start using a growth hormone, stimulating peptides. I think it's very dangerous and counterproductive. Very simple example. And once again, first I want to rule out very dangerous conditions. That's why talk about cancer. now there are...

Claudia von Boeselager (20:34)
Mm-hmm.

Alexander Grinberg, M.D. (20:46)
number of clinical markers for let's say early detection of cancers and there are companies that provide some early detection of cancer signals as well if patients have opportunity to check them it's good but in addition to these examples I when we do pre-screening to start peptide treatment some other hormones may be out of sync or their high levels may indicate

that patient needs additional research sometimes. I see people have high level gastrin or some other rare GI hormones. It's another problem. Then it's good to check insulin sensitivity by checking not only fasting glucose, but because of the late hemoglobin levels. It's very important because if they are borderline and people start using

some of growth hormone releasing peptides. This may to decrease of insulin sensitivity and promote and aggravate some pre-existing metabolic disorders as well. Then for example, there is a peptide called adiponectin and

Some people use it for weight loss, but once again in preclinical studies and some of research animals it caused kidney failure and we don't know what was the cause of that. Was it too fast lipolysis and kidney couldn't cope with that or it's some other action, but once again it's very significant risk and...

I just named a few. there are number of other conditions and family risk of having some conditions for which certain peptides can be counterproductive. So it's very important to understand that.

Claudia von Boeselager (22:30)
Yeah, thank you for sharing that too. And I want to look at epigenetics and signaling. So you've spoken about peptides as tools for tuning epigenetic signaling systems. So can you explain that in simple terms? perhaps with a a few examples.

Alexander Grinberg, M.D. (22:44)
Well, everything in our bodies depends on signaling, proper signaling. Proper communication translates into proper function, of proteins that necessary to maintain us functional and alive. so epigenetic and genetic, there is a difference.

Epigenetic is by definition, translation is over genetic. So things like DNA methylation, changes in expression of genes, all epigenetic. So without altering the genes themselves. So interventions that don't alter the genes, but help the genes to say function or be expressed differently.

those are epigenetic and things that...

help genes to change, fix the mutation in the genes, insert the novel gene or suppress certain gene that is responsible for some pathological process, this would be classified as gene therapy.

So peptides are definitely great tool of epigenetic regulation. They're to penetrate cells, they're to penetrate cell nuclei and get into the chromosomes, through DNA, There is a subtle process how peptides get close to certain groups of genes, how they start activating them.

how peptides are coded in certain genes. So it's very interesting. Talking about peptide MOTS-c it's very interesting peptide. can travel from mitochondrial DNA, at the times of cellular stress. It can travel to nuclear DNA, to main DNA, and can help cell to adjust to cellular stress and improve cellular resistance, particularly in the areas of...

glucose metabolism and energy production. So, peptides are really good messengers. They affect the receptors populations and they not only depend on the receptors to get into the cells, but they can affect and modify the receptors on cell membranes from the inside because they affect the genes.

that are responsible for expression of receptors on the surface of the cell. So they participate in all these complex processes. And that's why the peptides action is very dependent on pharmacogenomics. So it would be interesting for people because many people notice that some of them responded to Ozempic but had not sufficient response to Mounjaro

Some people respond well to Retatrutide but don't respond well to Tirzepatide Tirzepatide is a prototype peptide for Mounjaro and semaglutide is prototype peptide for ozempic. And that's a very clear example of pharmacogenomics. It depends on the density and presence of receptors on the cells. And that's why there are responders and non-responders to different peptides.

This is not only related to GLP peptides, but for any other peptides. I was always interested in customized, highly individualized interventions. That's why years ago is a company specializing in omics. I was doing research, harvesting blood samples of my patients and doing prospective ex vivo, it means out of human body in the tube.

incubation of peptides with a patient's blood cells and observing with one peptide individually with combination of peptides and learning how many groups of genes, expression of which genes was affected by these peptides, how immune cells were affected by these peptides, DNA methylation, how was DNA methylation affected by these peptides and

The first finding was very interesting in first degree relatives brother and sister mother and son They had only 60 % of overlap of their response how gene expression was responding to to the same peptide and it's as you can see it's very complex and very interesting as obviously entire genomic setup participates in how one responds to peptides because there are genes

that suppress or activate how other genes respond to something. And obviously, that's why the genome is so important and pharmacogenomics and the way how receptors are distributed through the body and how they respond to certain peptides is very important. And I will add one more thing. Dose dependency is very different for one person, say 50 microgram of peptide.

can trigger a desirable effect. And some people take milligrams, that's hundreds of thousand times more of this peptide and still experience effect or not. It's very diverse how people respond to peptides. And it's very important as well because even such a seemingly benign and beneficial peptide as humanin at higher doses than necessary doses.

can participate in the pathways leading to cancers. That's another thing to mention and people should be aware that each peptide, depending on the dose, render a very different effect on the cells.

Claudia von Boeselager (27:52)
Which is so important for people to understand, you know, what they're doing and not just take it into their own hands So yeah. I'd love to discuss the brain is an area of passion for me, particularly also because my mother sadly passed with Alzheimer's last year. We discovered things too late, et cetera. And I'd love to hear your experience, without obviously naming any names, et cetera, but what are some

Cases in patients that you have seen that have really impressed you in terms of improving cognition, improving brain health. Can you share some examples?

Alexander Grinberg, M.D. (28:23)
Absolutely. Brain health is extremely important and overall in the protocols we create for longevity, it's very important part of helping brain to stay functional and if possible, improve its functional and operational capacity. And here we have deal with broad range of conditions.

neurodegenerative conditions like Alzheimer's disease, other forms of dementia, Parkinson's disease, consequences of traumatic brain injury, so many different things, and just what people call age-related decrease of cognitive functioning as well. So there are number of peptides that we can classify as neurotropic peptides.

well-known peptides like C-Lung and C-Max and PE2228 and the Dehexa and definitely some other peptides that not traditionally associated with brain but they contribute very well into improving brain functioning through other mechanisms but let's talk about this first group that people traditionally associate with brain health like

C-Lung and C-Max. So this peptides, for C-Lung is great peptide. It helps neurons to create more synaptic connections, more growth of exons.

Basically, we can compare it with an old computer that gets additional operational capacity and able to work faster and more efficiently because more connections between different elements significantly increases the speed of operation. And C-Lung is analog of natural substance Chonluten that helps to promote this effect. And people use it intranasally or...

through subcutaneous injections. And it's interesting, some people feel more effect from intranasal application, but once again, some medical things have to be considered. For example, if people have chronic inflammation, it's nasal cavities, sinusitis, the absorption through this route of administration can be very difficult and not reliable.

At the same time, many people respond well to subcutaneous injections and those ranges also very wide those range to which people respond as a definitely as a safety or precaution. It's always good to start with the low amounts. There is no problem to start low and then it's talking about most common sense method to gradually increase it to the amounts that

give actionable or sensible effect. So usually with appropriate dose of C-Lung, people feel calmer and more focused and able to be multitask with less also good peptide for people who have gradual worsening of short-term memory and loss of cognitive function.

takes time usually for people to determine what is the cause, but definitely C-Lung contributes to slowing down the process of cognitive loss.

see that there are

also modifications of peptides called N-acetyl-C-lung or Cmax-emidate. These additional molecules that attach to original one, they make the half-life of the peptide longer. And what we see, some people don't respond to short-acting original peptide, but they respond to prolongation peptide that has

prolonged action, obviously because it's able to reach certain other targets or needs more time to... we can only speculate what happens because for many peptides we don't have such depths of the studies. So sometimes when people don't respond to regular one, they may respond to peptide that modified and to give prolonged action.

So to C-max, there also C-max and N-acetyl C-max amidate. This peptide is related to adrenocorticotropic hormone in the brain and this hormone and its derivatives have anti-inflammatory effect. So in cases when people have some inflamming on the central nervous system, particularly now we deal with so many people who have long COVID.

and brain fog after COVID or some viral infections, I see good effects for using C-max. And C-max somehow has a mild, or for some people even moderate, activating effect. So they feel less ⁓ sleepy, less drowsy, less somnolent, and definitely it helps them to push the brain fog away to some degree.

And once again, certain things like high blood pressure, if people have baseline high blood pressure, some brain activation needs close monitoring, they need to check if it affects their blood pressure. people who have insomnia shouldn't use it close to the bedtime. Simple things, common sense precautions and...

These peptides are definitely working and people see good effects. And once again, for different forms of dementias and different stages of dementias, they should be, they can be used, but it's good to catch the process when it starts because when dementia is progressing, many medications, including peptides may have... ⁓

Claudia von Boeselager (33:38)
Mm-hmm.

Alexander Grinberg, M.D. (33:43)
paradoxical effect and agitation and triggers some even delusions or hallucinations in some cases.

Claudia von Boeselager (33:52)
That's good to know And I think the biggest challenge, because I see a lot of people with relatives who are suffering from cognitive decline, I think also in part because of, you know, me speaking about it a lot, because of my mother's journey. And it's so difficult for them to find practitioners who are knowledgeable on, you know, using peptides when it's applicable, stem cells and and different practices too. So

I think finding the right practitioners that are able to help is one of the challenges I think out there and knowing what's also even available, right? and I'd love to touch on some of the other modalities that you also I understand use in your practice, like plasmaphoresis and hyperbaric oxygen therapy, IV laser. and these were used long before they became these longevity trends.

Can you explain why you have been using them for so long, why you like them, and how they can be used in combination of a longevity protocol?

Alexander Grinberg, M.D. (34:43)
Thank you.

So once again, I was lucky enough to participate in the trials and actually many of these methods were already used as established treatments when I started my fellowship and PhD program in 80s in the former Soviet Union. We used a lot of plasmapheresis, it's a form of blood filtration where we separate cellular elements from plasma and

is different modification of this plasmapheresis we were able to do different things we were able to process cellular fraction with certain pharmacological agents and medication we were able to deliberately remove certain antibodies fraction from the plasma and definitely we've seen very good results we were using it for

primarily first for autoimmune conditions and then observing certain positive dynamic in and lab parameters for the patient. We extended it to use it in other conditions and eventually for longevity. And now I see it as an ultimate detoxification procedure, safe detoxification procedure, even for healthy people where it can remove unnecessary...

antibodies produced and potentially attacking patients' own cells and tissues. And it happens even in healthy people, not necessarily diagnosed with autoimmune conditions, but with aging due to protein changes. Simple example would be protein glycolization when sugar molecules get attached to proteins and

proteins become targets for one's own immune system and many other conditions. Everyone had the viral infections through the course of their lives. So proteins become not what they're supposed to be originally. immune system starts attacking cells, expressing these proteins. And it's very important to remove this excessive and unnecessary...

antibodies that create autoimmune and other forms of inflammation and of course other things like complexes of heavy metals that are bound to proteins, even microparticles of plastic and spikes protein that people got either from infection or from vaccination can be removed. So that's a great procedure and it can be

are customized to patient weight and to patient condition and the amount of plasma exchange can be customized as well. the procedures not necessarily have to be too exhausting. They can be focusing on filtering and cleaning amounts of plasma that tolerated well by the patient. So depending on the condition and desirable outcome,

they can be customized and once again we see good results and now lot of groups extend studies to see if it slows down progression of Alzheimer's disease where certain antibodies and proteins and beta amyloid protein are very important part of pathogenesis. They study if

Claudia von Boeselager (37:37)
Mm-hmm.

Alexander Grinberg, M.D. (37:45)
Plasma-feresis alone or in combination with additional interventions is more useful for slowing down progression of these conditions. Definitely autoimmune conditions, but for all other interventions in longevity field, I love plasmapheresis because it prepares the terrain very well. So if we want to use stem cells or exosomes, definitely it's better use

they provide much better effect in terms of differentiating and homing and grafting. So doing what they're suppose to do when in simple words the blood is less contaminated by unnecessary antibodies, when the inflammation is reduced, when there are less of toxins, be them endotoxins or toxins from bacteria and

Infection and use toxins definitely creates much better environment for regenerative medicine. Therapeutics work better and we see. So it clearly becomes a part of protocol.

Claudia von Boeselager (38:43)
Can

I ask a question that just to ask on the plasmaphooresis? Because obviously almost everybody on planet Earth, because of the exposures we have to toxins in the environment, be it pathogens in the air, to mold in our homes, the food we eat, microplastics, et cetera, that you were saying. So as part of a longevity protocol, would you say that everyone should look at doing plasmaphoresis to get that blood detox? Or is that too much of a generalization and it's only for certain use cases?

Alexander Grinberg, M.D. (38:52)
Thanks

In medicine, I would avoid the word everyone. But there is another aspect of this. I see that in biohackers circles, almost everyone is talking about chelation and detoxification. So when people are focused on detoxification, they should understand the dangers. For example, certain forms of chelation, EDTA,

potentially they may have some probability of affecting kidney, or if people don't know, they have undiagnosed early stage of CKD, kidney or compromised liver function as well. There's some chelations and some even detoxification herbal combinations can be counterproductive for the kidney or liver. And definitely in this case, plasmapheresis would be much safer.

that would be the safe statement to make.

Claudia von Boeselager (39:58)
Yes, exactly. I know. We've to caveat it to what no medical claims and all the rest of it too. So it's a bit of a generalization. And so that's in the relevant cases and assuming all the testing is done in advance, it's a great way, the plasmapheresis of clearing the plasma of toxins, etcetera, as a foundation to then layer on regenerative therapies. You were mentioning the stem cells, I guess peptides would even be also part of that protocol

Can you talk a little bit about that layering system that you then do and those foundations? So obviously the testing, you know, assuming somebody is healthy for the most part, then the plasmapheresis and then looking at other interventions. Can you talk about some of the other interventions

Alexander Grinberg, M.D. (40:36)
Yes. So definitely thank you, mentioned about peptides. see the people report back to me that after plasmapheresis they experience more effect from peptides at the same dosing.

definitely we see it again and again that how it works. so both peptides of regenerative medicine have a long experience combining them and doing them after plasmapheresis. I also use plasmapheresis as a very important part of synolytic protocol. Of course,

Talking about longevity, lot of people know about the importance of sinolysis and removing senescent cells and their products.

Claudia von Boeselager (41:16)
So

zombie cells essentially, right? That's another kind of nickname. So the cells that are then cannibalizing or eating then the other healthy cells around them. So clearing them out is the senescence, correct?

Alexander Grinberg, M.D. (41:25)
Yes, so senescent cells are cells that stop dividing. They stuck in the cell cycle and cannot divide any longer. they have some metabolic changes inside them, that produce endotoxins. Now there is a growing science of endotoxicology, how our own cells can produce undesirable substances that...

preventing other cells that are active and functional fully and healthy. And besides this in essence cells because of changes on and then the membranes, they become targets for immune system and the immune response can broaden and be overgeneralized to healthy cells. the factors that trigger the immune process that we see with aging.

even when we think people are healthy, we see increase of inflammatory markers, pro-inflammatory factor cytokines. They are triggered by accumulation of senescent cells. They, in simple words, irritate and activate immune system against them. But unfortunately, this activation is not only leads to elimination by senescent cells, by natural killer cells, but also to

sustain attacks by immune system against healthy cells and that's one of the factors of aging. So plasmapheresis helps a lot with that and I prepare people to plasmapheresis, activate synolysis and there are different ways to activate synolysis. Simple ways include using Fisetin and Quercetin and other flavonoids.

and there are different protocols for synolysis using some plant-derived supplements and ingredients. I also use peptides to activate synolysis. is peptide FOXO4, and FOXO4 peptide has its effect associated with protein P53 that is a key protein determining the fate of the cells, whether they...

stay alive or leave this world. yeah, and it helps to trim all of these senescent cells and after certain lengths of protocol, say this FOXO4, some other peptides activating immune system. In some cases, then we can complete the protocol with plasmaparessis that will help to eliminate this trimmed off cells and the products of

They're debris, so to say. Once again, it's very complex thing as for example, talking about regenerative medicine, Muse cells, actually, the action is based on finding the debris cell, debris and damaged cells. And for them, it's important to absorb fragments of damaged cells based on the, there is a substance called sphingomyelin.

It's like fingerprint for cells and somehow Muse cells able to determine which cells were damaged by million fragments. then is in relatively short time, they actually turn them to them and not only turn them to them, but they travel and get into the places from which this damaged cells originated and replace them there. So that sounds too good to be true, but obviously.

Our biology is much more versatile and provides much more resilience than we can imagine. And we constantly discover new lines, new types of stem cells that have very amazing function. So making this example of Muse cells, would say that sometimes it's good to completely remove senescent and damaged cells. Sometimes you need to think where...

and how to position it inside the protocol so patient can benefit from Muse cells that can find the fragments of these damaged cells and turn into them. has to be very well studied to maximize the benefits. And once again, after the plasmaparessis and I prefer to do it a few

Again, we are talking about longevity now for clinical protocol targeting specific diseases that case by case, but for longevity, it's good to do it a few times. And you need to understand which interventions would you consider next after plasma for asis. So if we work with cell medicine, say NK cells, so NK cells derived exosomes.

Claudia von Boeselager (45:13)
Yes.

Alexander Grinberg, M.D. (45:32)
I would position them before I do plasmapheresis because they can kill and eliminate senescent cells and mutated cells, cells affected by virus or even cancer cells. And it would be good to clear this debris and all these products with plasmapheresis. If I consider application of different forms of stem cells for...

Claudia von Boeselager (45:50)
Mm-hmm.

Alexander Grinberg, M.D. (45:55)
Regeneration for growth, would do it after Plasmapheresis

Claudia von Boeselager (45:59)
So you're cleaning then you detox with the Plasmapheresis and then you're laying around the regenerative therapies thereafter. So it sounds like an excellent protocol.

Alexander Grinberg, M.D. (46:08)
and people are very happy with these protocols and definitely they enjoy the effects. And now we have emergence of certain gene therapies it helped to develop them. But the plasma delivery or mRNA delivery of...

Claudia von Boeselager (46:19)
Crisper. Mm-hmm.

Alexander Grinberg, M.D. (46:27)
sequence coding for Klotho protein It's amazing thing. It's amazing tool that we can use. And the same for vascular endothelial growth factor for Follistatin (FST) and for telomerase activation. So all these gene therapies, some of them deliver it on plasmids, some of them deliver it on viral vector. Again, case by case, therapy by therapy, vector by vector, we need to determine

how to do it for viral delivery. Definitely we need to consider that people may have some compromised immune system and viral vector and give them some side effects for other forms of delivery. We also need to focus on how to prepare the micro terrain. And once again, longevity interventions are limitless as time passes by and it's uphill battle. We need constantly

alternate different interventions for longevity because body has so many different cells and systems it's absolutely impossible to give person many different peptides to target all the body systems and organs at the same protocol or to do all these interventions we mentioned on the same protocol so we need to understand that epigenetic intervention helps system to function at different level it's

a simple example, some genes that responsible for response to nitric oxide. It's very important for longevity and feeling youthful. If we improve, increase the expression, let's say 20%, I don't want to push the system more. want to leave it alone because system needs to adapt to this level of activation of genes. You can't push it indefinitely. That's why patients frequently ask me,

Claudia von Boeselager (48:10)
Mm-hmm.

Alexander Grinberg, M.D. (48:12)
What is the length of protocol? Is it four weeks? Is it six months? And so on. What is the frequency of administration of peptide? Because we need to be careful not to over push the system, not to exhaust receptors, not to close down regulators or receptors by constantly pushing the same button. That's very important. How to observe it?

Claudia von Boeselager (48:31)
Mm-hmm. So that's

cycling. Yeah.

Alexander Grinberg, M.D. (48:34)
it's not yet easy to observe because this would require very careful monitoring. It's a very high level of proteomics and different omics to see these subtle processes. for the lack of availability of this advanced testing, we need to be very astute physicians. We need constantly get feedback from the patient what's happening. And even based on this, at some point when I...

feedback that certain level of improvement achieved, I gradually switch to working on other system. for example, with simple example would be neurotropic peptides, like we mentioned C-Lung, C-Max, and there is peptide, D-Hexa, that is very strong one, strong cognitive activator, but it has potential for unlimited proliferation of certain process leading to cell growth.

significant risk of cancer and how to use it, Even the best AI can give you good ratio of risk benefits. If you have some elderly person has higher risk of progression of dementia, how to compare the risks? You give him a short course of the hexa to slow down dementia or...

you avoid it because of higher risk of cancer and here you need to add additional testing, imaging, MRIs to see pre-existing terrain and if you can take the risk and activate the brain with such peptide. And of course you need to understand that brain is a complex organ. are blood vessels, are inner immune systems, so

It's not enough to activate synaptic connections or neuroplasticity. You need to maintain vascular health inside the brain. And many people, when they develop dementia, you see microvascular changes, or sometimes they have growth changes due to strokes and cerebrovascular accidents, or they have microvascular, so-called vascular dementia.

And there are peptides that help to address this. You can improve vascular health using some of bioregulators that can even reduce very small scars in the brain tissue. You can use Cerebrolysin That's another amazing peptide. You can think about certain products developed when we work with stem cells. Some of byproducts are growth factors, brain...

BDNF factors and nerve growth factors. But once again, it has to be very carefully dosed and considered with entire clinical picture for the patient. And of course, even mitochondrial peptides improve brain function because neurons are not exempt, they have mitochondria and they need the mitochondria to make energy and to function better. So many different things.

and many different considerations and feedback that you need to get.

Claudia von Boeselager (51:20)
Yeah, so as you've portrayed it's it's quite a complex system and quite an art to understand and the implications of it too. So hopefully people listening are not just doing their own injections and just hoping to see what happens, but seeking out professionals that are trained in this that can help I appreciate we've gone over time. so I just wanted to finish up with asking you a little bit about your view of the future. So what developments in longevity science are

You looking at at the moment, what do you find most fascinating? What are you most excited about in the next one, two, five years to come?

Alexander Grinberg, M.D. (51:52)
Thank you. So my passion is developing engineering combination of advanced So how to combine, let's say, peptides, regenerative medicine, cell medicine, immunotherapy, and gene therapy in the way that it's mutually enforcing that we get the most effect of combining them, how to combine them, how to figure out how to do it in the most productive way, how to mitigate the risk. This is very interesting and

I see few, I would say, lines of developing that probably will help us to move to limitless longevity. At some point, I work with the companies that are able to reprogram cells. They do cell banking. Some of the companies reprogram the cells into induced pluripotent stem cells, and then they're able to...

keep reprogramming them into creating progenitor cells for different organs. So obviously it sounds like a supply to make sure we can sustain the functioning of the organs for much longer time. Other companies are able to program your cells, your somatic cells into your embryonic version of your cells, the autologous cells, but they are your cells that are at the stage when you were an embryo and

and they're able to mitigate the risks. People know that the risks associated with embryonic stem cells were unlimited growth, cancer growth, but these companies work on the creating cell lines that don't have this risk. Instead, they have highest close. There is pluripotency and there is totipotency, and totipotency is ability of stem cells to turn virtually into any cell.

And if we're able to achieve that without having risk of growing cancers, and we are on the be successful there, it's great development. then peptides, there are millions of peptides to be developed and they can be very highly customized and they help to totally fine tune the complex orchestra of our signaling and intimate process of gene regulation.

And immune therapies, of course, we're working with the companies that help to develop cells that would regulate immune system to stop diabetes, to stop autoimmune conditions and to keep the cells that vigilant and eliminating cells and factors that lead to either very serious diseases or to premature aging or even aging.

And they're also a key to work on them and create immunotherapies that would significantly extend life.

Claudia von Boeselager (54:27)
Do you think a person who's able to live healthily to two hundred years old is born already today, based on the science, the AI technology that we have and all these developments that we're seeing?

Alexander Grinberg, M.D. (54:40)
I think so. I believe so.

Claudia von Boeselager (54:42)
Very exciting. Will you be that person?

Alexander Grinberg, M.D. (54:44)
Well, I'm open to this opportunity.

Claudia von Boeselager (54:47)
So as we finish up today, where would you like people to learn more about what you're up to, your work, maybe social media handles? Where can people follow what you are doing? Where would you like to send them? And we'll put it in the show notes.

Alexander Grinberg, M.D. (54:59)
I will share with you my website, infinityepigenetics website. And that's a good way to get in touch with me.

Claudia von Boeselager (55:04)
Yeah and we'll

Beautiful. Do you have any parting thought or message for our audience today?

Alexander Grinberg, M.D. (55:11)
Yes, So the most important thing and we all are moving to the times when we benefit from the development of longevity science, science of rejuvenation, is not to harm yourself. It's extremely important because to live longer first, you need to be healthy now.

So prerequisite to start longevity protocols is definitely to improve your health and get rid as much as possible from the clinical conditions that people may have. For longevity is extremely important as a good foundation. So first is healing, curing the conditions that may be obstacles to living longer. And then on top of this building up resilience and regeneration.

Claudia von Boeselager (55:53)
Beautiful. Thank you so much for your time for coming on today and thank you, dear audience, for tuning in. It's been an absolute pleasure.

Alexander Grinberg, M.D. (55:59)
Thank you so much, Claudia, and thank you for all of yours.