Latest / Resiliency Radio with Dr. Jill Carnahan, MD / 331: Resiliency Radio with Dr. Jill: Immune Resilience: The Future of Longevity with Dr. Isaac Melamed

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331: Resiliency Radio with Dr. Jill: Immune Resilience: The Future of Longevity with Dr. Isaac Melamed · Resiliency Radio with Dr. Jill Carnahan, MD

• 0:00
  Dr. Jill Carnahan: Welcome to Resiliency Radio, your go to podcast for the most cutting edge insights integrative and functional medicine.
• 0:07
  Dr. Jill Carnahan: I'm your host Dr. Jill and with each episode we dive into the heart of healing and personal transformation.
• 0:14
  Dr. Jill Carnahan: Join me as I interview medical experts, thought leaders, innovators of all types helping you on your journey to healing and optimal performance.
• 0:23
  Dr. Jill Carnahan: Today is no different.
• 0:24
  Dr. Jill Carnahan: You will want to stay tuned if you have any questions about the immune system or IVIG.
• 0:28
  Dr. Jill Carnahan: We're talking to one of the world leading experts in my personal immunologist, Dr. Isaac Melamid.
• 0:34
  Dr. Jill Carnahan: I'll introduce him in just a moment, but I promise you will enjoy this show.
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• 1:11
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• 1:28
  Dr. Jill Carnahan: Also, if you didn't know, we are accepting new patients at my clinic, Flat Iron Functional Medicine in Lewisville, Colorado.
• 1:34
  Dr. Jill Carnahan: We do accept virtual patients and if you're looking for a great provider for complex clinical conditions or medical mysteries, you can look no further.
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• 1:43
  Dr. Jill Carnahan: You can do a free introductory call with one of our providers, 303-993-7910 or email infoatironfunctionalmedicine.com okay, let me introduce my colleague, Dr. Isaac Melamond.
• 1:57
  Dr. Jill Carnahan: He's a national recognized immunologist, physician and researcher with more than 35 years of clinical experience and over two decades dedicated to advancing the understanding of immune related dise.
• 2:07
  Dr. Jill Carnahan: Founder of Vero's Health, he's known for his pioneering work in primary and secondary immune deficiencies and the critical connection between the immune system and the nervous system, which we're going to talk about today.
• 2:17
  Dr. Jill Carnahan: He has authored more than 100 scientific publications, lectured internationally, and received numerous honors for his contributions in clinical immunology.
• 2:25
  Dr. Jill Carnahan: Let's welcome one of my Favorite people in the world, Dr. Isaac Melamid.
• 2:29
  Dr. Jill Carnahan: Dr. Melamid, you have been a very special person in my life because you have been my personal immunologist.
• 2:36
  Dr. Jill Carnahan: And I say this very publicly so often, and I really believe you've been part of saving my life after cancer and all the things I've been through.
• 2:43
  Dr. Jill Carnahan: So you have a very special place in my heart because the complexity and fascination with the immune system is so profound.
• 2:51
  Dr. Jill Carnahan: And you are one of the few brilliant physicians who I feel really understands and continues to learn and study and pull in all of the things that we're finding out about the immune system.
• 3:02
  Dr. Jill Carnahan: So today we're going to talk about that.
• 3:04
  Dr. Jill Carnahan: But before we jump into the immune system, I want to know just a little bit about you and your personal journey into medicine and then into immunology.
• 3:13
  Dr. Isaac Melamed: So that.
• 3:13
  Dr. Isaac Melamed: Thank you, Jill.
• 3:14
  Dr. Isaac Melamed: And it's my honor to help you and many other patient that what I'm doing for almost 40 years, how I started my life, I you can see from my accent that I was born in Israel.
• 3:27
  Dr. Isaac Melamed: And in Israel you have to go to the Israeli Defense Force.
• 3:32
  Dr. Isaac Melamed: I was lucky that I went to medical school before and I served as a physician in the army.
• 3:38
  Dr. Isaac Melamed: And in the last two years of my army I was involved in research and my plan in medicine was neurosurgery.
• 3:47
  Dr. Isaac Melamed: I started when I was 15 years old.
• 3:50
  Dr. Isaac Melamed: And one of the question that they presented to me while I was in the army.
• 3:57
  Dr. Isaac Melamed: So soldier with splenectomy, how's the immune system after splenectomy if they can continue to serve?
• 4:05
  Dr. Isaac Melamed: So I tried to figure out who's the expert in immunology and splenectomy and then found my mentor that passed away.
• 4:12
  Dr. Isaac Melamed: And his name, Professor Shapiro.
• 4:14
  Dr. Isaac Melamed: And I can say that definitely his mentor in terms of how to approach patients for many years.
• 4:19
  Dr. Isaac Melamed: And he is as a mentor saying, Isaac, you really need to go to be my successor in neurology.
• 4:26
  Dr. Isaac Melamed: We end up.
• 4:27
  Dr. Isaac Melamed: He sent me to Canada, toronto to continue one of my fellowship.
• 4:33
  Dr. Isaac Melamed: And actually in Toronto, when I started to work on the immune system with the hope to get back to Israel, the chairman from in Toronto just moved to National Jewish.
• 4:44
  Dr. Isaac Melamed: And he said, Isaac, before you get to Israel, just be in National Jewish for another two years.
• 4:49
  Dr. Isaac Melamed: And the reason I came, which actually is the introduction for what I like to discuss with you today, is that I found two kind of a major area in the immune system.
• 5:00
  Dr. Isaac Melamed: The first one find a receptor that's called ngf, which is nerve growth factor.
• 5:07
  Dr. Isaac Melamed: And I found that this nerve growth factor is existing on the immune cells, on B cells.
• 5:15
  Dr. Isaac Melamed: And actually more than that, we found that there is a genetic mutation of patient that is called cipa, which is cipa, which actually it's a summary of congenital insensitivity and pain.
• 5:30
  Dr. Isaac Melamed: And this mutation of this NGF actually started for me a journey, a 40 year journey of two major stories.
• 5:40
  Dr. Isaac Melamed: One of them is the crosstalk between nervous and immune system.
• 5:45
  Dr. Isaac Melamed: And the second one to try to look at the immune system as a core mechanism to different disease that I will share with you today.
• 5:54
  Dr. Isaac Melamed: But the chairman of National Jewish, the chairman from Canada moved to National Jewish and he said Isaac just come to National Jewish to be an attending in the National Jewish.
• 6:04
  Dr. Isaac Melamed: And I came just as a personal disclosure.
• 6:07
  Dr. Isaac Melamed: My son started medical school and he's a neurosurgeon today.
• 6:11
  Dr. Isaac Melamed: And the family decided to stay in Colorado.
• 6:17
  Dr. Isaac Melamed: But I switched my being just in academic life to a private which we developed over the last 40 years.
• 6:25
  Dr. Isaac Melamed: And that too I would say key element from the story that I share with you, Gilbert, as I mentioned, one of them is this NGF that's crossed off between nervous and immune system.
• 6:35
  Dr. Isaac Melamed: What's the meaning?
• 6:36
  Dr. Isaac Melamed: Yes, the second one is that the immune system is a core that for our discussion today.
• 6:44
  Dr. Isaac Melamed: Because if you look at the mainstream medicine today, one of the challenges of mainstream medicine today is actually it's a very.
• 6:55
  Dr. Isaac Melamed: It's a healthcare that really focus on your symptoms in your organ.
• 7:00
  Dr. Isaac Melamed: So if we speak about disease, that can be chronic fatigue, if we speak about disease as pain, if we speak about cognitive changes, the approach is how we can help you with the symptoms.
• 7:12
  Dr. Isaac Melamed: We all know in United States we are dealing with an epidemic that cause pain.
• 7:16
  Dr. Isaac Melamed: And the answer is opiate.
• 7:18
  Dr. Jill Carnahan: Yes.
• 7:19
  Dr. Isaac Melamed: And the question is what's the underlying for the pain?
• 7:21
  Dr. Isaac Melamed: That's kind of the question.
• 7:23
  Dr. Isaac Melamed: And then so that took me kind of this coastal between nervous and immune to the question is what's the cause?
• 7:31
  Dr. Isaac Melamed: What's the underlying disease?
• 7:33
  Dr. Isaac Melamed: And as my I would say focus is immune system.
• 7:36
  Dr. Isaac Melamed: I focus on the immune system as a cause.
• 7:39
  Dr. Isaac Melamed: The immune system is a presentation actually we're talking about three major presentation.
• 7:46
  Dr. Isaac Melamed: One of them is in the infection history.
• 7:50
  Dr. Isaac Melamed: The second one is in the autoimmune or inflammatory condition and the third one is in cancer.
• 7:56
  Dr. Jill Carnahan: Yeah.
• 7:57
  Dr. Isaac Melamed: And you just discussed Jill, in your patient journey that as a patient disclose it with all the audience.
• 8:05
  Dr. Isaac Melamed: This is unfortunately a story today in 2026 that we do have patient that going almost 20 years in this journey.
• 8:16
  Dr. Isaac Melamed: Yes, it start with cancer or infection and autoimmune disease.
• 8:21
  Dr. Isaac Melamed: And, and the reason is that the medicine today, maybe it's going to change with AI.
• 8:28
  Dr. Isaac Melamed: AI may be a very sophisticated story to try to bring all of them together to look at the cause.
• 8:34
  Dr. Isaac Melamed: But today we are very focused on the symptoms themselves.
• 8:38
  Dr. Isaac Melamed: So that's how I started my journey.
• 8:42
  Dr. Isaac Melamed: And another thing that I like to share with you, which is kind of interesting for the history.
• 8:47
  Dr. Jill Carnahan: Yes.
• 8:48
  Dr. Isaac Melamed: One of the physician, Jim Jones that has been a national Jewish that as a faculty and being sharing a room with me.
• 8:58
  Dr. Isaac Melamed: And he told me, Isaac, I don't know why, but everybody with chronic fatigue syndrome does have allergies.
• 9:07
  Dr. Isaac Melamed: And that's what I like to share with you Jean, today that when we say the definition of immune system.
• 9:14
  Dr. Jill Carnahan: Yes.
• 9:15
  Dr. Isaac Melamed: One she that we see today and what's unique today, it's actually the partner of the immune system.
• 9:21
  Dr. Isaac Melamed: I really like to really emphasize that when we say immune system 20 years ago, 30 years ago in terms of B cell and T cell, that's the only player.
• 9:32
  Dr. Isaac Melamed: And now we say there's some other partner.
• 9:34
  Dr. Jill Carnahan: Yeah.
• 9:35
  Dr. Isaac Melamed: And long time ago when he mentioned that chronic fatigue is connected to the allergies.
• 9:40
  Dr. Isaac Melamed: 30 Years fast forward, I would say that the allergies as a partner of the immune system is a key story in some evolution of how we look at disease.
• 9:52
  Dr. Isaac Melamed: When you ask me about what's the role of master lactation, what's the role of EDs in terms of the immune system?
• 9:59
  Dr. Isaac Melamed: What's the role of disease that we call them angioderma.
• 10:03
  Dr. Isaac Melamed: And my answer is that all of them connected because the immune system is not fragmented.
• 10:09
  Dr. Isaac Melamed: It's symphony that they talk with each other.
• 10:11
  Dr. Isaac Melamed: And the beauty is to look at all this symphony and to divide it in three categories in the immune system.
• 10:18
  Dr. Isaac Melamed: One of them, which is a challenge is what are the epigenetic trigger that leads to the activation of the immune system?
• 10:28
  Dr. Isaac Melamed: What's the partner of the immune system that respond to this epigenetic.
• 10:33
  Dr. Isaac Melamed: And the consequence of this interaction is basically what we call it today, the consequence which is autoimmune disease, cancer or infection.
• 10:43
  Dr. Isaac Melamed: And I will use one of the disease that is the most common immune deficiency, but the most unknown immune deficiency today.
• 10:55
  Dr. Isaac Melamed: And I would like to quote a sentence that can represent what I'm trying to share with the audience.
• 11:01
  Dr. Isaac Melamed: It's a disease that we call it CVID or common viable immune deficiency.
• 11:07
  Dr. Isaac Melamed: And this disease is actually the people describe it is an old disease with new faces.
• 11:15
  Dr. Jill Carnahan: Yes.
• 11:16
  Dr. Isaac Melamed: What are the new faces?
• 11:17
  Dr. Isaac Melamed: The new faces that we are talking today is we see some new faces that they Present with a different presentation.
• 11:26
  Dr. Isaac Melamed: You can see patients that I see that present with autoimmune first and then the infection.
• 11:31
  Dr. Isaac Melamed: Some people can present with cancer that have leukemia and then infection and then autoimmune.
• 11:38
  Dr. Isaac Melamed: So the new faces is the evolution of the immune system in presentation can be over years.
• 11:44
  Dr. Isaac Melamed: And one of the challenge is that actually even you speak about physician.
• 11:50
  Dr. Isaac Melamed: There's no training or there's no fellowship.
• 11:53
  Dr. Isaac Melamed: That's called autoimmune disease.
• 11:54
  Dr. Jill Carnahan: Right?
• 11:55
  Dr. Isaac Melamed: It's a disease.
• 11:56
  Dr. Isaac Melamed: It's kind of a looking at different disease from an eyes of immunology and trying to understand it.
• 12:05
  Dr. Isaac Melamed: And that's what I've been doing for 40 years.
• 12:07
  Dr. Jill Carnahan: Hey guys.
• 12:08
  Dr. Jill Carnahan: Just a quick interruption to this incredible interview with Dr. Melamed to remind you that my book Unexpected talks about my own journey through my strange immune system with cancer, Crohn's disease, mold related illness and all of the things in between.
• 12:23
  Dr. Jill Carnahan: It's a deep dive into a true immunology case like mine.
• 12:26
  Dr. Jill Carnahan: And I often get comments from patients that it was encouraging just to help them on their journey.
• 12:32
  Dr. Jill Carnahan: I share a lot.
• 12:32
  Dr. Jill Carnahan: I share deeply.
• 12:33
  Dr. Jill Carnahan: I share authentically about all areas, spiritual, physical, emotional and healing on all levels.
• 12:39
  Dr. Jill Carnahan: And there's practical tips if you're suffering from autoimmune disease or immune deficiency or anything in between.
• 12:44
  Dr. Jill Carnahan: So check it out.
• 12:45
  Dr. Jill Carnahan: You can get a copy@readunexpected.com you can get one on Amazon anywhere books are sold.
• 12:50
  Dr. Jill Carnahan: And if you want a signed copy for me go to Dr. Jill health.com okay, back to our show.
• 12:56
  Dr. Jill Carnahan: Amazing how you put that together because.
• 12:58
  Dr. Jill Carnahan: And again I don't mind sharing my personal history.
• 13:00
  Dr. Jill Carnahan: I've talked about it before.
• 13:01
  Dr. Jill Carnahan: So anything we want to share here that's relevant because I am a prototype of this having had cancer at 25, multiple autoimmune diseases, Crohn's and Hashimoto's, thyroiditis and other auto antibodies and then also multiple infections that have been under control with your treatment and the IVIG.
• 13:18
  Dr. Jill Carnahan: But what's interesting is like you mentioned, we can have this present.
• 13:22
  Dr. Jill Carnahan: Any number of those could be the forefront, the first thing that we see.
• 13:26
  Dr. Jill Carnahan: And what's in some ways kind of counterintuitive that you would have an overactive autoimmune attack of self and an underactive, maybe T or B cells for fighting infection can all occur at the same time.
• 13:39
  Dr. Jill Carnahan: Can you talk a little bit about what we know, the state of the research as to what might be some of the mechanistic causes or besides just genetics, Are there other things that are contributing to this in our patients.
• 13:51
  Dr. Jill Carnahan: Is it increasing incidence?
• 13:55
  Dr. Isaac Melamed: So first of all, it's a great question and it kind of a quick answer.
• 14:00
  Dr. Isaac Melamed: There's a lot that we don't know and we continue to explore.
• 14:03
  Dr. Isaac Melamed: I will share with you first in terms of as a patient that you just disclosed and I always remember a lecture that was in Budapest and there was a lawyer from England very similar to your story.
• 14:19
  Dr. Isaac Melamed: Very, very similar to your story again, Crohn's disease, cancer disease and autoimmune determined and what she died, was diagnosed with immune deficiency 20 years later.
• 14:31
  Dr. Isaac Melamed: And she described her condition as a prison of her disease.
• 14:37
  Dr. Isaac Melamed: And the problem on this and I think this sentence always for me is a huge I would say dry force to try to help the patient.
• 14:45
  Dr. Isaac Melamed: And I say how can I help you to get out of this prison and to see you?
• 14:49
  Dr. Isaac Melamed: Because it's kind of the challenge is and I will share with you some where we're going the research area, but there's a lot of I would say area of timing between science in medicine, practice of medicine.
• 15:08
  Dr. Jill Carnahan: Yes.
• 15:08
  Dr. Isaac Melamed: And also insurance companies.
• 15:10
  Dr. Isaac Melamed: So the vision of some of in the American community, some in the insurance, some of the patient.
• 15:16
  Dr. Isaac Melamed: There's a lot of kind of not clear.
• 15:20
  Dr. Isaac Melamed: And one of the question that we always have to ask ourselves and we may come to this later is what do we feel is the reason that some of the impact of autoimmune disease and longevity in the United States is different from European and different from other states?
• 15:38
  Dr. Isaac Melamed: What is the role of the immune system in this discussion?
• 15:41
  Dr. Isaac Melamed: So go back to your first question is where the science is going today.
• 15:45
  Dr. Isaac Melamed: I will start with the research that we are involved in the last almost 15 years in terms of the symphony of the immune system.
• 15:54
  Dr. Isaac Melamed: In one major question that we have and that's the interaction between I like to use the name infectious and immune in various autoimmune or neuroimmune.
• 16:07
  Dr. Isaac Melamed: And I think that the model that I'm talking about this interaction between infectious and immune in the science it actually started long time ago.
• 16:16
  Dr. Isaac Melamed: And there's a paper in 1926 we are talking many years ago and that was in related to a child, a teenage that has been exposed to strep infection and develop some ticks and some movement disorder, but in the same time develop some type of psychiatry in terms of anxiety and OCD and depression.
• 16:43
  Dr. Isaac Melamed: That was many years ago.
• 16:45
  Dr. Isaac Melamed: Then the concept of chorea has been described connected to the strength fast forward.
• 16:50
  Dr. Isaac Melamed: We've been talking about EBV and the connection of EBV to chronic fatigue syndrome.
• 16:57
  Dr. Isaac Melamed: Yes, one of we are.
• 16:59
  Dr. Isaac Melamed: My organization is doing quite an extensive collaboration with Stanford and with LSU in Eurovisions.
• 17:09
  Dr. Isaac Melamed: In Stanford there is a very famous scientist named Larry Steinman.
• 17:13
  Dr. Isaac Melamed: And Larry Steinman is looking at the connection between EBV and the immune system leading to multiple sclerosis, which is all clear.
• 17:22
  Dr. Isaac Melamed: The multiple sclerosis is an autoimmune condition.
• 17:25
  Dr. Isaac Melamed: And all therapy that we have today is really try to target some of the lesion but not really to understand the immune underlying disease.
• 17:36
  Dr. Isaac Melamed: So when we speak about the connection between EBV and the immune system, almost 30 years of research and we are not clear.
• 17:43
  Dr. Isaac Melamed: Then we came to the COVID and the COVID actually has been leading with a high percentage of patients.
• 17:50
  Dr. Isaac Melamed: They develop multi organ effects specifically with neurologic symptoms.
• 17:56
  Dr. Isaac Melamed: And those multi organ can be cardiac and joint pulmonary and gi.
• 18:02
  Dr. Isaac Melamed: And the question is this Covid is one of the interesting interaction between infection and immune that leads to pandemic of autoimmune disease specifically neurologic symptoms.
• 18:17
  Dr. Isaac Melamed: So all the connection between EBV and covi and there was a lot of work and discussion about Lyme and post Lyme and immune system.
• 18:27
  Dr. Jill Carnahan: Yes.
• 18:28
  Dr. Isaac Melamed: And by various research.
• 18:32
  Dr. Isaac Melamed: So this interaction between infectious and immune system is one of the research that we are working and part of the work that in the research we also explore that it's not just the B cell and the T cell.
• 18:47
  Dr. Isaac Melamed: We do have some other partner that we have seen involved.
• 18:51
  Dr. Isaac Melamed: Like what you just mentioned, the muscle activation.
• 18:54
  Dr. Isaac Melamed: Yes, like the complement system that we have like Alpha 1 trypsin that we have seen and we've seen some in some other player like the.
• 19:05
  Dr. Isaac Melamed: In net immunity.
• 19:07
  Dr. Isaac Melamed: So the net immunity, the inn ate immunity which was an immune system including the complement that we basically ignored it for years and years.
• 19:18
  Dr. Isaac Melamed: We say yes, but it's a very basic immune system that is really a core in our future research.
• 19:28
  Dr. Isaac Melamed: And why.
• 19:28
  Dr. Isaac Melamed: Yes, the reason is that if we speak about an immune system, I want to bring two kind of the area of the research that are relevant to our story.
• 19:41
  Dr. Isaac Melamed: The first one is the question is that this relationship between infections and immune system does it play a major role in some autoimmune disease?
• 19:52
  Dr. Isaac Melamed: But what is the relevant in terms of longevity, for example, and I will give you one example is why do we give a vaccine against shingles as you get older?
• 20:05
  Dr. Isaac Melamed: And the answer is that your immune system that has been educated how to respond to the shingle is losing its mind or losing its memory to the shingle and suddenly you need to renew the shingle vaccine and to re educate the immune system to this vaccination to the shingle.
• 20:28
  Dr. Isaac Melamed: That's a memory defect that depends on the innate immunity that lost the immunity to the shingle.
• 20:35
  Dr. Isaac Melamed: But this loss of the immunity to the shingle can happen to you earlier in life.
• 20:42
  Dr. Isaac Melamed: And I define it in one of the paper I published I use the name Alzheimer of the immune system.
• 20:47
  Dr. Jill Carnahan: brilliant.
• 20:49
  Dr. Isaac Melamed: And it's very interesting because a paper just recently published about they say and they saw that people who get the vaccine against children has less incidence of Alzheimer and we will come back to this connection that with ulcer.
• 21:06
  Dr. Isaac Melamed: So I think that our research is trying to understand that actually the innate immunity respond to different type of epigenetic and what are the partner that may lead to this Alzheimer.
• 21:22
  Dr. Isaac Melamed: If it's the complement, if the mast cell if the alpha 1 trypsin.
• 21:26
  Dr. Isaac Melamed: And part of this dysfunction between the infection and the immune system is actually leading to this area that we have interest which I like to call it nor immune.
• 21:38
  Dr. Jill Carnahan: Yes.
• 21:39
  Dr. Isaac Melamed: So I'll give you a few examples in the clinical setup.
• 21:42
  Dr. Isaac Melamed: The first one is actually this paper that was published more than 100 years ago on the Korea and the children with type of anxiety.
• 21:54
  Dr. Isaac Melamed: And even in this paper he mentioned increase in suicide attempt.
• 22:02
  Dr. Isaac Melamed: So 10 years ago we started to get explored to a condition that we see in teenage and children.
• 22:12
  Dr. Isaac Melamed: And the story with the children is that they get sick and after they get sick the mother is telling, you know, it's not the same child.
• 22:22
  Dr. Isaac Melamed: Yes, I know my child.
• 22:24
  Dr. Isaac Melamed: This is not the same child.
• 22:26
  Dr. Isaac Melamed: And the child is getting anxiety, the child is getting ticks, getting ocd.
• 22:33
  Dr. Isaac Melamed: He doesn't go to school, he gets a major.
• 22:36
  Dr. Isaac Melamed: And the first response that I want to mention it to you, Jill.
• 22:40
  Dr. Isaac Melamed: And this is what I'm trying to teach new residents and new students and I try to teach them something that for me being 40 years in medicine and for There are few things that you know when somebody when the mother is telling you a story and he tells you.
• 22:57
  Dr. Isaac Melamed: But this is my child, just listen to the mother.
• 23:00
  Dr. Isaac Melamed: The mothers knows the child better than everyone else.
• 23:03
  Dr. Isaac Melamed: Even that you are a physician and if you don't know the answer, it doesn't mean it doesn't exist.
• 23:09
  Dr. Isaac Melamed: It just means that we just don't know.
• 23:11
  Dr. Isaac Melamed: We need to do more research and we need to understand.
• 23:14
  Dr. Isaac Melamed: But don't tell the mother.
• 23:15
  Dr. Isaac Melamed: It's just in your head and.
• 23:17
  Dr. Isaac Melamed: And it's not an issue.
• 23:18
  Dr. Isaac Melamed: It took me many years and we're doing Quite a lot of research with, as I mentioned with stanford and with Dr. Frankovich and Dr. Melzo passed away in this area.
• 23:30
  Dr. Isaac Melamed: And the point is that what we try to understand if this connection between strep and the immune system leading to some psyche is the immune system is involved and fast forward for almost 10 years of research, the answer is yes.
• 23:49
  Dr. Isaac Melamed: And we found in the research that basically what happened we do have the interaction between the infections and the immune system.
• 23:58
  Dr. Isaac Melamed: And that's what I want to go back to.
• 24:01
  Dr. Isaac Melamed: What I share with you for one of the failure most probably is the innate immunity which we evaluate.
• 24:08
  Dr. Isaac Melamed: It's called Toll like receptor that we look at the signaling of toll like receptor and we see that the TLR is actually low in the patient with infection.
• 24:19
  Dr. Isaac Melamed: And as it is being low, what happened is the immune system is producing poor inflammatory mononuclear cells.
• 24:30
  Dr. Isaac Melamed: So there is in the immune system a balance between pro inflammatory mononuclear cells and anti inflammatory monocle cells.
• 24:40
  Dr. Isaac Melamed: So basically when you do have this interaction between the infection immune, those point inflammatory cells are over activated.
• 24:50
  Dr. Isaac Melamed: We see now that they are moving to the brain to the blood brain barrier.
• 24:56
  Dr. Isaac Melamed: So those type of mononuclear cell can affect the permeability of the blood brain barrier.
• 25:04
  Dr. Isaac Melamed: And from the blood brain barrier they are getting to the microglia.
• 25:09
  Dr. Isaac Melamed: They're affecting the microglia.
• 25:11
  Dr. Isaac Melamed: And we see that using IVIG for example, that knows how to immune modulate the system.
• 25:19
  Dr. Isaac Melamed: Those anti inflammatory monoclonal cells get upregulated and able to reduce and get the balance.
• 25:28
  Dr. Isaac Melamed: And that's how we see the clinical response.
• 25:31
  Dr. Isaac Melamed: But that's the point is that I want to share with you Jill, that this is science that speaks about an interaction between infectious and immune in the strip condition.
• 25:42
  Dr. Isaac Melamed: But presented with a psychiatry word which is anxiety, depression and ocd.
• 25:50
  Dr. Isaac Melamed: And as this patient mentioned so many years ago, which is suicide.
• 25:55
  Dr. Jill Carnahan: Yes.
• 25:55
  Dr. Isaac Melamed: Which brings a question to the scientific world.
• 25:59
  Dr. Isaac Melamed: And there's a lot of science that we are involved in all other place in the world from different psychiatry that speaks about a condition that we define it psychiatry, which is depression, anxiety and fatigue, that actually it's an inflammatory condition that the immune system is involved.
• 26:19
  Dr. Isaac Melamed: And we just need to continue to understand and research and how we can model it.
• 26:24
  Dr. Isaac Melamed: So that's one area that we've been in our relationship between infectious me.
• 26:32
  Dr. Isaac Melamed: The second one that I want to mention in our research is actually this, the COVID and the interaction with COVID and immune system.
• 26:40
  Dr. Isaac Melamed: And here we really evaluated few partner which is the complement system.
• 26:46
  Dr. Isaac Melamed: And Other system of the immune system that as I mentioned the alpha one subsidiary and the innate immunity.
• 26:52
  Dr. Isaac Melamed: But the end result now brings to a very interesting panel that I think that the future is.
• 27:02
  Dr. Isaac Melamed: Is the cognitive changes and all what we see in the cognitive and the deterioration today disease like Alzheimer's and the cognitive change is the immune system is involved.
• 27:12
  Dr. Isaac Melamed: And I think that the answer is yes.
• 27:15
  Dr. Isaac Melamed: Some of the area that we don't understand.
• 27:18
  Dr. Isaac Melamed: But more science is coming and more that it's coming to the concept of that we use the name mitochondria and that's the mitochondria that we are bringing to the picture is just imagine that you have the innate immunity that is like a bridge that is trying to support all the different epigenetic.
• 27:40
  Dr. Isaac Melamed: And you know very well because you describe it many one and you're doing much better and describe it the net immunity about the stress and epigenetic that and nutrition and other components that lacks in the innate immunity.
• 27:56
  Dr. Isaac Melamed: And as a failure we get some inflammasome or we get some inflammation area that affect the mitochondria and affect the mitochondria.
• 28:07
  Dr. Isaac Melamed: And suddenly a paper that just published in Nature by my corporation in LSU that showed that those mitochondria injury and fragmentation can actually move and lead to some of the effect on the cognitive.
• 28:24
  Dr. Isaac Melamed: So that's.
• 28:25
  Dr. Isaac Melamed: Those are the area that in the neuromin is focused on my research from as he described it.
• 28:31
  Dr. Isaac Melamed: I like to describe myself as a translation medicine.
• 28:33
  Dr. Isaac Melamed: Taking the patient story and going to the science and trying to get some answer.
• 28:39
  Dr. Jill Carnahan: Wow, that was so much great information.
• 28:41
  Dr. Jill Carnahan: And what I really love is you're also teaching medical students and residents that to really listen to the patient and the mother.
• 28:48
  Dr. Jill Carnahan: Because I know in my own journey of being a physician so often if I'm just curious and I listen even if it doesn't make sense from the training we can start to learn because we're like huh, that's an interesting pattern that we're seeing.
• 29:00
  Dr. Jill Carnahan: Let's look deeper.
• 29:01
  Dr. Jill Carnahan: And then what happens is over time we start to find the reasoning which you just described.
• 29:05
  Dr. Jill Carnahan: You know, way back in the day, early days in the 1920s of first describing this neuro, psychoneuro, endocrinology and the connection between.
• 29:15
  Dr. Jill Carnahan: So one thing that I think patients suffer from is there's inflammation in general and then there's weak immune system fighting infections.
• 29:23
  Dr. Jill Carnahan: And then there's also autoimmunity.
• 29:26
  Dr. Jill Carnahan: And the one of the big tools that you've used is IVIG, which is intravenous Immunoglobulins.
• 29:33
  Dr. Jill Carnahan: Can you tell us a little bit about the story and the history of IVIG?
• 29:36
  Dr. Jill Carnahan: Because I feel like you're one of the world leading experts and it can, it's not always the answer, but many times it can be very powerful.
• 29:46
  Dr. Isaac Melamed: Sure.
• 29:47
  Dr. Isaac Melamed: First of all, I like to always I compare to the patient IVIg to red wine.
• 29:53
  Dr. Isaac Melamed: And the reason I compare it to red wine is a we start with the same grape and end up with a different wine.
• 30:00
  Dr. Jill Carnahan: I love it.
• 30:02
  Dr. Isaac Melamed: What happened between the grape and the red wine?
• 30:04
  Dr. Isaac Melamed: We just don't know.
• 30:05
  Dr. Jill Carnahan: Yes.
• 30:05
  Dr. Isaac Melamed: And the research of IVRG has been almost more than 35 years.
• 30:11
  Dr. Isaac Melamed: And some of the leading research that we collaborate to try to understand the mechanism of IVR gene has been gone for almost 35 years.
• 30:19
  Dr. Isaac Melamed: And the beauty is that this is nature, I like to call it holistic nature that produced ivrg.
• 30:26
  Dr. Isaac Melamed: And we really don't understand.
• 30:29
  Dr. Isaac Melamed: And I will share with you, first of all, what's ivrg?
• 30:35
  Dr. Isaac Melamed: So one of the things that if we look at the immune system, I like to kind of speak about, leave it for all the audience, some part of the basic mechanism of the immune system.
• 30:50
  Dr. Isaac Melamed: And the immune system, actually, if you look at the cell, you can imagine that the cell has some membrane which is the COVID of the cell and has a nucleus.
• 31:02
  Dr. Isaac Melamed: And what I published many years ago, that actually even the structure of the cell, which is called cytoskeleton, plays a role in transition of signal.
• 31:12
  Dr. Isaac Melamed: So just imagine that you have a cell and you have a cover of the cell.
• 31:15
  Dr. Isaac Melamed: You have the nucleus in.
• 31:17
  Dr. Isaac Melamed: So the signal between the membrane into the nucleus, which we use the name signal transduction.
• 31:25
  Dr. Isaac Melamed: This has been the focus on research almost the last 40 years.
• 31:29
  Dr. Isaac Melamed: And there are many proteins involved in this transaction of signaling from the membrane to the nucleus.
• 31:36
  Dr. Isaac Melamed: But the end result of this journey that takes only a few minutes from the membrane to the nucleus is the endpoint of two major things that I would like to which I think it's basic.
• 31:49
  Dr. Isaac Melamed: One of them, we use the name apoptosis.
• 31:52
  Dr. Isaac Melamed: So the name apoptosis, Just imagine that every cell in our body is supposed to die.
• 31:58
  Dr. Isaac Melamed: This is the nature and the cell needs to die and to rejuvenate with a new cell.
• 32:05
  Dr. Isaac Melamed: So the process of rejuvenation, it's a normal nature process.
• 32:12
  Dr. Isaac Melamed: As we get older, this process, which is controlled by the immune system is getting weaker and weaker.
• 32:20
  Dr. Isaac Melamed: And as the apoptosis process get weaker or dysfunction, you basically end up as a result to an inflammatory consequence.
• 32:32
  Dr. Isaac Melamed: Basically, just imagine that you have a very long journey that the immune system supposed to clear the junk, let the inflammation.
• 32:40
  Dr. Isaac Melamed: And it doesn't matter if the junk or inflammation is the skin, or it's in the joint, or it's in the brain, or it's your cardiac or in the any organ is the same process, inflammation process.
• 32:55
  Dr. Isaac Melamed: Then the second story, from the membrane to the nucleus.
• 33:00
  Dr. Isaac Melamed: It's the signal that leads in the nucleus, what we use the name activation.
• 33:06
  Dr. Isaac Melamed: So activation of the nucleus.
• 33:09
  Dr. Isaac Melamed: It has about few, at least seven that we know today, but maybe more, which it's called check and balance.
• 33:18
  Dr. Isaac Melamed: So the immune system is doing check and balance on this activation.
• 33:22
  Dr. Isaac Melamed: And sometimes that you get some dysfunction in the check and balance.
• 33:27
  Dr. Isaac Melamed: That's what you end up with cancer.
• 33:29
  Dr. Isaac Melamed: So you see two major process that we call apoptosis and activation of the cell controlled by the immune system.
• 33:38
  Dr. Isaac Melamed: Now all this, what I share with you, which is a very complicated and continue on the research start most probably in some receptor that sits on the surface of this membrane and some of these receptors sitting in many different cells.
• 33:53
  Dr. Isaac Melamed: And this receptor has a name, fc.
• 33:56
  Dr. Isaac Melamed: So this receptor is called FC receptor.
• 33:59
  Dr. Isaac Melamed: So just imagine for simplicity.
• 34:03
  Dr. Isaac Melamed: So this FC receptor is like a key.
• 34:06
  Dr. Isaac Melamed: So now you have a relationship of a key and a lock relationship.
• 34:12
  Dr. Isaac Melamed: So if the infection is the key and this FC is the log, you have a key and a lock relationship.
• 34:21
  Dr. Isaac Melamed: So suddenly the relationship between the key and the lock are this function for some reason.
• 34:28
  Dr. Isaac Melamed: So now what you do, you take an IVIG which is built the same story.
• 34:33
  Dr. Isaac Melamed: IVIG also has an FC receptor.
• 34:36
  Dr. Isaac Melamed: And this FC receptor is coming to this FC receptor that you are in this dysfunction immune system.
• 34:44
  Dr. Isaac Melamed: And one of the mechanism can be in this dysfunction reason it has a name, it's called mimicking.
• 34:51
  Dr. Jill Carnahan: Yes.
• 34:51
  Dr. Isaac Melamed: So what's a mimicking?
• 34:52
  Dr. Isaac Melamed: The mimicking is that.
• 34:54
  Dr. Isaac Melamed: Let's use what I discussed with before on EBV and let's say that your FC receptor, which is the lock, is looking at EBV as the key and says I want to produce a good relationship, but somebody is get confused.
• 35:11
  Dr. Isaac Melamed: So instead of producing a response to the kid is doing a mimicking and producing antibodies in your brain against your joint.
• 35:20
  Dr. Isaac Melamed: Again, that's what we call autoimmunity.
• 35:23
  Dr. Isaac Melamed: So now the FC is coming to this receptor and try to train the FC how to behave and how to really produce the antibodies in a normal way.
• 35:35
  Dr. Isaac Melamed: That's one mechanism.
• 35:37
  Dr. Isaac Melamed: Second mechanism that has been as a potential.
• 35:40
  Dr. Isaac Melamed: If you look at the key and the log relationship on the fc.
• 35:44
  Dr. Isaac Melamed: So basically the FC suddenly From key and the lock become a master key.
• 35:49
  Dr. Jill Carnahan: Yes.
• 35:49
  Dr. Isaac Melamed: So now instead of one key you have master key.
• 35:52
  Dr. Isaac Melamed: All the keys are the same.
• 35:54
  Dr. Isaac Melamed: So the key can be opened by this EBV as a key can open all the keys.
• 35:59
  Dr. Isaac Melamed: And then we use the name super antigen.
• 36:02
  Dr. Isaac Melamed: So this super antigen leading that we use it in the immunology in the post Covid people are using a lot of the name which is called Cytokine Storm.
• 36:13
  Dr. Isaac Melamed: What is cytokine storm is basically imagine that the immune system producing an inflammatory stone.
• 36:19
  Dr. Isaac Melamed: Yes.
• 36:19
  Dr. Isaac Melamed: And this inflammatory stone can be an autoimmune joint braid and cardiac and etc.
• 36:25
  Dr. Isaac Melamed: So then the IVRG is coming and training this kid to behave and not don't be a master key, just be.
• 36:34
  Dr. Isaac Melamed: So we're using a name in the IVIG.
• 36:37
  Dr. Isaac Melamed: We're using a name in two properties.
• 36:39
  Dr. Isaac Melamed: One of them that it use immune replacement.
• 36:43
  Dr. Jill Carnahan: Yes.
• 36:44
  Dr. Isaac Melamed: Prevent infection and immune modulation.
• 36:46
  Dr. Isaac Melamed: And the immune modulation.
• 36:48
  Dr. Isaac Melamed: What I share with you is trying to really modulate the immune system.
• 36:52
  Dr. Isaac Melamed: And.
• 36:53
  Dr. Isaac Melamed: And I will share with all of you many of the area is that even that started.
• 36:57
  Dr. Isaac Melamed: I'll give you two examples here that happened.
• 37:01
  Dr. Isaac Melamed: And I was involved actually 40 years ago in the research on both of them When I was in Canada with the rheumatology team.
• 37:09
  Dr. Isaac Melamed: The first disease that I would like to share with you it's called Kawasaki.
• 37:13
  Dr. Isaac Melamed: And the Kawasaki story is meaning in the 80s and the Kawasaki story we saw children that had some exposure maybe to infection.
• 37:23
  Dr. Isaac Melamed: We're not clear but they showed a full autoimmune inflammatory skin and joint and high fever.
• 37:31
  Dr. Isaac Melamed: We had no clue what is going on.
• 37:33
  Dr. Isaac Melamed: There was a lot of speculation in the ATM research in different and people tried to do steroids people treatment.
• 37:39
  Dr. Isaac Melamed: We had no clue what is going on.
• 37:42
  Dr. Isaac Melamed: And when we've been in Canada and was a good immunology rheumatology team together we say maybe it's an immune related disease.
• 37:51
  Dr. Isaac Melamed: Maybe.
• 37:52
  Dr. Jill Carnahan: Yes.
• 37:52
  Dr. Isaac Melamed: So we use IVIG as again as a holistic approach.
• 37:57
  Dr. Isaac Melamed: If it's an immune system, let's use it and see what happens.
• 38:01
  Dr. Isaac Melamed: We gave the first infusion of IVIG in immunomodulation and I will never forget the child who was with a high temperature with joint is being overnight is getting better.
• 38:13
  Dr. Jill Carnahan: Wow.
• 38:14
  Dr. Isaac Melamed: And so IVIG now it's been a treatment of choice.
• 38:18
  Dr. Isaac Melamed: Now I will share with you one interesting story that happened.
• 38:23
  Dr. Isaac Melamed: So we gave the idea to the Kawasaki but not everybody agree and not everybody.
• 38:29
  Dr. Isaac Melamed: So years later, maybe 10 years later we have seen teenage that playing basketball and they suddenly fall and die from cardiac arrest.
• 38:40
  Dr. Isaac Melamed: So children has been dying from cardiac arrest and nobody could understand why.
• 38:47
  Dr. Isaac Melamed: So the science went back and found the children that died from cardiac issue actually had Kawasaki early age in life and never been treated with ivrg.
• 38:59
  Dr. Jill Carnahan: Yes.
• 38:59
  Dr. Isaac Melamed: So what interesting is that the immune system doesn't stop with the Kawasaki.
• 39:04
  Dr. Isaac Melamed: It just continue to some cardiomyopathy and cardiac issue.
• 39:08
  Dr. Isaac Melamed: And now it's a mandatory when you have a Kawasaki to treat you with hydrogen, you'll ask me Jill, do we know what is the actual mechanism in Kawasaki that happened today?
• 39:22
  Dr. Isaac Melamed: We don't know.
• 39:23
  Dr. Isaac Melamed: But what I'm trying to say is not only is the full science will give you all the answer the question is that we like to do is to try to figure if the immune system is involved.
• 39:38
  Dr. Isaac Melamed: And now it's a mandatory.
• 39:40
  Dr. Isaac Melamed: The same happened about the pandas.
• 39:41
  Dr. Isaac Melamed: The other example would also happen in Canada and I will never forget it.
• 39:47
  Dr. Isaac Melamed: That's another disease which we call Guillain Barre.
• 39:50
  Dr. Isaac Melamed: And Guillain Barre is a disease that you get exposed to an infection, unknown infection and you get paralyzed.
• 39:58
  Dr. Isaac Melamed: You just get paralyzed.
• 40:01
  Dr. Isaac Melamed: So you're speaking about the connection between infection and immune system later paralyzed.
• 40:06
  Dr. Isaac Melamed: And IVIG has been shown to really recover all the neurologic cell.
• 40:11
  Dr. Isaac Melamed: It's a mandatory non gambling.
• 40:13
  Dr. Isaac Melamed: But still we don't understand the mechanism of the IVRG in gambling and it doesn't mean that it doesn't work.
• 40:22
  Dr. Isaac Melamed: So I think that IVRG that I am looking at IVIG is in two kind of a statement.
• 40:28
  Dr. Isaac Melamed: Yeah, is your disease immune?
• 40:31
  Dr. Isaac Melamed: And we will do all the efforts scientifically with all the signs that we are trying to understand who are the player of the immune system.
• 40:38
  Dr. Isaac Melamed: And I think that's the beauty.
• 40:40
  Dr. Isaac Melamed: We are going to learn more and more about the immune system and then to try to have the tool how to do the immuno rehabilitation.
• 40:48
  Dr. Isaac Melamed: And IVIG is one of them.
• 40:52
  Dr. Isaac Melamed: And now there are many interesting because the prediction that we are going to see what I call biologic therapy in all immune related they are flaring because the immune.
• 41:05
  Dr. Isaac Melamed: The industry is understanding that the immune system is a key player.
• 41:10
  Dr. Isaac Melamed: So now you have so many new biologics that really focus on the immune system in the allergy world.
• 41:17
  Dr. Isaac Melamed: And if it's an asthma, if it's hives, it's a chronic hives.
• 41:20
  Dr. Isaac Melamed: If it's any disease that's affect the connection between allergies and immune system and so many in the area of angioderma and so many other examples and the other area that we are going to See more and more in the future is the concept of cancer and the immunotherapy in terms of the cancer.
• 41:43
  Dr. Isaac Melamed: The second I would say protein in our body which is a very interesting body that or as well needs more research and more understanding.
• 41:53
  Dr. Isaac Melamed: But I like to bring you to your question on my veggie is called albumin.
• 41:58
  Dr. Isaac Melamed: And I think the albumin is another interesting protein that sits in your major plasma.
• 42:06
  Dr. Isaac Melamed: And albumin has many interesting binding sites.
• 42:11
  Dr. Isaac Melamed: And those binding side actually sits as a nature issue to say okay, I understand that your immune system is not doing so well getting old.
• 42:21
  Dr. Isaac Melamed: Your immune system is not doing well as you would like to see.
• 42:26
  Dr. Isaac Melamed: And the end result is this inflammation that we discuss.
• 42:30
  Dr. Isaac Melamed: So we are bringing the albumin is produced and circulated and continue with the binding cell to get.
• 42:37
  Dr. Isaac Melamed: Get your bind.
• 42:38
  Dr. Isaac Melamed: Get.
• 42:38
  Dr. Isaac Melamed: Get all those inflammatory that I just mentioned from the mitochondrial failure and the inflammation failure and really get all of them clear and get them clear from you.
• 42:49
  Dr. Isaac Melamed: And the albumin is also a been target in terms of research and say what can be done.
• 42:56
  Dr. Isaac Melamed: Let's speak about super albumin.
• 42:58
  Dr. Isaac Melamed: The albumin has more binding side is more effective.
• 43:03
  Dr. Isaac Melamed: And it was a kind of a very interesting paper in the New York A Magazine about albumin in terms of.
• 43:11
  Dr. Isaac Melamed: Our body is like oil change.
• 43:13
  Dr. Isaac Melamed: You are basically.
• 43:14
  Dr. Isaac Melamed: This is the older you need to change your machine.
• 43:18
  Dr. Isaac Melamed: And this is a world that has been involved.
• 43:21
  Dr. Isaac Melamed: People have been using it today in longevity or other reason in our ML that we have.
• 43:28
  Dr. Jill Carnahan: So that's a perfect transition to talk about something that you and I have been really excited about is bringing some of these services.
• 43:35
  Dr. Jill Carnahan: What happens, and maybe you can speak to this as well is there are certain covered indications for IVIG.
• 43:41
  Dr. Jill Carnahan: And unfortunately I think a lot of the indications that may have use are not always covered.
• 43:46
  Dr. Jill Carnahan: And I know one of your things in your clinic is for the patients who really need it.
• 43:50
  Dr. Jill Carnahan: For example, a Crohn's or colitis patient.
• 43:52
  Dr. Jill Carnahan: That isn't a typical indication for IVIG.
• 43:54
  Dr. Jill Carnahan: But you and I have shared several patients who have benefited from the indication and if it can get covered.
• 44:00
  Dr. Jill Carnahan: So one of the things with plasma exchange with albumin or IVIG or even IVs with vitamins or nutrition or glutathione.
• 44:09
  Dr. Jill Carnahan: We have both seen a big need for these offerings to patients to be able to pay for the kinds of things that they want to get.
• 44:16
  Dr. Jill Carnahan: And I'd love for you to talk just a little bit about your vision and.
• 44:18
  Dr. Jill Carnahan: And what we sat down and had a discussion about your legacy, which I really love.
• 44:22
  Dr. Jill Carnahan: Because I think no greater thing than we leave a legacy in the world.
• 44:26
  Dr. Jill Carnahan: And I really love your heart around this and creating a whole new entity for providing these services for patients who want them.
• 44:34
  Dr. Isaac Melamed: No.
• 44:34
  Dr. Isaac Melamed: Thank you, Jill, for your nice work.
• 44:38
  Dr. Isaac Melamed: I think that there are two few areas that I like to focus when we mentioned what I'm doing for so many years in legacy.
• 44:46
  Dr. Isaac Melamed: I think the number one issue is the patient that I see.
• 44:51
  Dr. Isaac Melamed: And I feel that there are frustrated in terms of the complex.
• 44:55
  Dr. Isaac Melamed: But let's speak about.
• 44:57
  Dr. Isaac Melamed: I'm saying three major areas today that we see there is some challenge in healthcare.
• 45:07
  Dr. Isaac Melamed: And we can speak about.
• 45:08
  Dr. Isaac Melamed: Number one is pain.
• 45:10
  Dr. Isaac Melamed: That we can speak.
• 45:10
  Dr. Isaac Melamed: We can speak about cognitive deterioration.
• 45:13
  Dr. Jill Carnahan: Yes.
• 45:14
  Dr. Isaac Melamed: And we can speak about a question is why we still see the story of depression and suicide.
• 45:22
  Dr. Isaac Melamed: So just my granddaughter that she is in high school and she's 16 years old just called me two days ago about a child 16 years old in her high school committed suicide.
• 45:33
  Dr. Isaac Melamed: And just four kids in her high school committed suicide.
• 45:37
  Dr. Isaac Melamed: So I assume that the question is from a medicine standpoint is that I brought all those three areas that we have from the concept is we from My approach is to try to understand the role of the immune system in the three area that I share with you, which is the pain, the psychiatry and the cognitive ratio.
• 46:00
  Dr. Isaac Melamed: And when I say the immune system is not an isolated everything that I share with you.
• 46:06
  Dr. Isaac Melamed: The complexity of the immune system is something that we need to learn and to research and to understand and to work with the manufacturer to develop some new drug and new super IVRG or super albumin and to try to help the patient.
• 46:20
  Dr. Isaac Melamed: But in the same token is what you are contributing and that's a huge interaction and complement what you're doing.
• 46:28
  Dr. Isaac Melamed: And we are trying to do is I always compare it to the gun.
• 46:33
  Dr. Isaac Melamed: The gun can be loaded with your gene.
• 46:35
  Dr. Isaac Melamed: But if you don't trigger the gun is not be active.
• 46:39
  Dr. Isaac Melamed: So the trigger is that we all speak about the epigenetic that yes, I can talk about them, but you are the expert and them how to really do it.
• 46:50
  Dr. Isaac Melamed: So we all agree that this immune system is really and the gene that you have is really responsing.
• 46:58
  Dr. Isaac Melamed: Very, very intimate to stress.
• 47:01
  Dr. Isaac Melamed: Yes, very intimated to nutrition.
• 47:05
  Dr. Isaac Melamed: Very intimate to your physical activity, very intimate to the sleep, very intimate to the other environmental.
• 47:11
  Dr. Isaac Melamed: If it's a mold or elder environment.
• 47:14
  Dr. Isaac Melamed: All of them are very important over the time and very important is to discuss how they work with the immune system and more study to have and discuss.
• 47:27
  Dr. Isaac Melamed: So this epigenetic is a key element in terms of the complement that the two of us can do to understand the interaction between epigenetic immune.
• 47:38
  Dr. Isaac Melamed: We'll do our best to understand the immune system.
• 47:41
  Dr. Isaac Melamed: And I think that the cellular immunity, the mitochondrial immunity, the player of the immune to understand.
• 47:47
  Dr. Isaac Melamed: It's just the diagnostic the next years that we'll have more and more autoinformation and the next one that is very important.
• 47:56
  Dr. Isaac Melamed: I think that all what I mentioned to you that the pain and the cognitive change and the psychiatry.
• 48:02
  Dr. Isaac Melamed: I think that the approach that we need from a patient standpoint to listen them to early as much as we can get to the early diagnosis of the patient and focus on the prevention concept versus to go to the crisis mode.
• 48:18
  Dr. Jill Carnahan: Yes.
• 48:18
  Dr. Isaac Melamed: Because we all know very well.
• 48:21
  Dr. Isaac Melamed: We know it.
• 48:22
  Dr. Isaac Melamed: When you do have a patient with Alzheimer's disease and he does have depression.
• 48:26
  Dr. Isaac Melamed: Plug all the area that we call plaque delivery or plug.
• 48:31
  Dr. Isaac Melamed: It's not working.
• 48:32
  Dr. Isaac Melamed: And we know that.
• 48:33
  Dr. Isaac Melamed: And the question is, who is in the age of 30, 40, 50 that women.
• 48:38
  Dr. Isaac Melamed: What do we need to do to change from immune system and epigenetic to.
• 48:42
  Dr. Isaac Melamed: To change it.
• 48:43
  Dr. Isaac Melamed: We all know that any cancer and what cancer and how it's involved.
• 48:47
  Dr. Isaac Melamed: Yes.
• 48:48
  Dr. Isaac Melamed: Gene is gene.
• 48:49
  Dr. Isaac Melamed: But there are some other effect that can affect it.
• 48:51
  Dr. Isaac Melamed: So I think that the pain is a great example is do we understand why the pain is there and what we want to do with the pain and.
• 49:03
  Dr. Isaac Melamed: And are we going to tell the patient the only thing that you have an option is use opiate.
• 49:09
  Dr. Jill Carnahan: Yeah.
• 49:10
  Dr. Isaac Melamed: And get to the opiate crisis or to try to say, you know what, I agree that you have pain.
• 49:15
  Dr. Isaac Melamed: Let me try to figure that thing out.
• 49:17
  Dr. Jill Carnahan: Yes.
• 49:17
  Dr. Isaac Melamed: And I want to bring the pain as something new in our research that we are collaborating with South Carolina.
• 49:25
  Dr. Isaac Melamed: And that's a condition that I. I don't have answer to explain you why.
• 49:32
  Dr. Isaac Melamed: Maybe because we have more patient that come to.
• 49:35
  Dr. Isaac Melamed: It's a new condition.
• 49:36
  Dr. Isaac Melamed: We call it hypermobility or eds.
• 49:39
  Dr. Jill Carnahan: Yes.
• 49:40
  Dr. Isaac Melamed: So this EDS and hypermobility that we start to see more and more young female that have a history of hypermobility and some joint dysfunction.
• 49:53
  Dr. Isaac Melamed: And all of them have some pain.
• 49:56
  Dr. Jill Carnahan: Yes.
• 49:57
  Dr. Isaac Melamed: And the pain also being diagnosed by neurology by a condition called small fiber neuropathy.
• 50:05
  Dr. Isaac Melamed: Yes.
• 50:06
  Dr. Isaac Melamed: Meaning you have a biopsy and you have an evidence that small fiber neuropathy is there and you do have pain.
• 50:16
  Dr. Isaac Melamed: And.
• 50:16
  Dr. Isaac Melamed: And I'll say from our approach on the medical.
• 50:20
  Dr. Isaac Melamed: We have no approach.
• 50:22
  Dr. Isaac Melamed: The whole thing is get on tramadol or any opioid do physical therapy and live with it.
• 50:30
  Dr. Isaac Melamed: And I can see, I'm speaking about young female that I can see them in wheelchair and they cannot function.
• 50:39
  Dr. Isaac Melamed: And.
• 50:40
  Dr. Isaac Melamed: And we are trying to figure what is going on.
• 50:43
  Dr. Isaac Melamed: So there is very interesting now science that we are involved in others we start to understand with the genomic and all the testing of doing that actually there are few partner of the immune system that are involved.
• 50:56
  Dr. Isaac Melamed: And we're trying to explore if this partnership of the involved is leading to this EDS and how we can address it.
• 51:05
  Dr. Isaac Melamed: The question comes is to that I had a discussion with Dr. Maitland, her name is professor in South Carolina and she is seeing a lot of patients with a with eds.
• 51:20
  Dr. Isaac Melamed: And one of the images she sent me, you know we've been going to the same direction for many years.
• 51:26
  Dr. Isaac Melamed: She's working on the muscle activation.
• 51:28
  Dr. Isaac Melamed: I'm the corporate and we're getting together in this EDS and it's interesting.
• 51:34
  Dr. Isaac Melamed: So my proposal was because I'm interesting and doing a lot of research on the connection between infectious and immune.
• 51:41
  Dr. Isaac Melamed: Is the COVID really trigger some of this immune underlying leading to the EDS is.
• 51:47
  Dr. Isaac Melamed: That's kind of the underlying.
• 51:49
  Dr. Isaac Melamed: She raised a very interesting point that I like to bring to you Jill.
• 51:53
  Dr. Isaac Melamed: And because it's kind of a one of the leading in this theory that she is claiming that some childhood stressful event is leading to some autoimmune.
• 52:11
  Dr. Isaac Melamed: So I'm sure that you know more than person Professor Mate from Budapest.
• 52:17
  Dr. Isaac Melamed: He's very famous and he does a lot of work about childhood stress and autoimmune condition.
• 52:25
  Dr. Jill Carnahan: Yes.
• 52:25
  Dr. Isaac Melamed: The reason I mention is that I absolutely believe Dr. Mate, I believe with others and that I'm going back to the first what I share with you about what I my disclosure about this GF and it's clear.
• 52:44
  Dr. Isaac Melamed: Yeah.
• 52:44
  Dr. Isaac Melamed: That when you get exposed to stress, your NGF production is much higher in some susceptible immune system.
• 52:54
  Dr. Jill Carnahan: Yes.
• 52:55
  Dr. Isaac Melamed: So this NGF production is linked to stress.
• 53:01
  Dr. Isaac Melamed: And this NGF we have now more data how it's related to neuroimmune and pain and others.
• 53:07
  Dr. Isaac Melamed: So it's very interesting that we all agree that stressful environment is a very important point.
• 53:16
  Dr. Isaac Melamed: Either from childhood stress that we had in terms of life or from ongoing stress that we have day in life.
• 53:24
  Dr. Jill Carnahan: Yes.
• 53:25
  Dr. Isaac Melamed: And I think that again in medicine when you see your physician he can mention that stress is important, but how we reduce it, how what is the lifestyle that we need to have.
• 53:39
  Dr. Isaac Melamed: Which brings another point that you raised it before and I agree with you.
• 53:44
  Dr. Isaac Melamed: And just to Mention that as much as I will focus on the immune system, I cannot ignore the stress and the physical therapy that is associated with reduction of the stress because this is a tool, simple tool, physical activity.
• 54:04
  Dr. Isaac Melamed: Keep your lifestyle.
• 54:05
  Dr. Jill Carnahan: Yes.
• 54:06
  Dr. Isaac Melamed: Everything that you're doing help your immune system to function in a better way.
• 54:11
  Dr. Isaac Melamed: So lifestyle and nutrition and stress relief and everything that you can do.
• 54:18
  Dr. Isaac Melamed: I cannot give you advice because I myself lives in.
• 54:21
  Dr. Isaac Melamed: In this stressful environment.
• 54:24
  Dr. Isaac Melamed: I never found any recipe, but I will share with you.
• 54:27
  Dr. Isaac Melamed: My answer is I love what I do.
• 54:29
  Dr. Isaac Melamed: Yes, I love to help patients and that's my legacy and that's what keep me to help people and to continue to do what I'm doing.
• 54:39
  Dr. Jill Carnahan: What a beautiful synopsis of this thing we call psychoneuroimmunology and all the ways the systems interact.
• 54:47
  Dr. Jill Carnahan: And, and really, even though we have so much more information, we're still kind of at the doorway of the complexity of the system.
• 54:54
  Dr. Jill Carnahan: And like you said, maybe AI will start to even bring more research to the table and, and we'll understand it better.
• 55:00
  Dr. Jill Carnahan: But I just want to say, first of all, thank you for your 40 plus years of work and all the many patients we've shared.
• 55:08
  Dr. Isaac Melamed: Many.
• 55:08
  Dr. Jill Carnahan: And you.
• 55:08
  Dr. Jill Carnahan: And I'm one of them that you have helped.
• 55:11
  Dr. Jill Carnahan: I'm super excited about the immuno wellness concept that we're going to hopefully bring to the Denver area.
• 55:18
  Dr. Jill Carnahan: And if you want more information, I think they can find information about your clinic at immuno e health.com or veroshealth.com is that correct?
• 55:28
  Dr. Isaac Melamed: That's correct.
• 55:29
  Dr. Isaac Melamed: And thank you again, Jill.
• 55:30
  Dr. Isaac Melamed: It is, it was a pleasure to work with you.
• 55:33
  Dr. Isaac Melamed: And 12, I think the beauty with you is, really is from your experience as a patient, you took it to help other people in the world.
• 55:42
  Dr. Isaac Melamed: And I think that's.
• 55:45
  Dr. Isaac Melamed: If that's a great.
• 55:47
  Dr. Isaac Melamed: Thank you again for inviting me and thank you.
• 55:51
  Dr. Jill Carnahan: You're welcome.
• 55:51
  Dr. Jill Carnahan: I look forward to our future collaborations.
• 55:54
  Dr. Jill Carnahan: Hey, guys.
• 55:54
  Dr. Jill Carnahan: Hope you enjoyed that fascinating deep dive into immunology with Dr. Isaac Melamid, one of my favorite humans and someone I deeply respect for his own role as a physician in my health and recovery from cancer and Crohn's.
• 56:06
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• 56:09
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• 56:13
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• 56:14
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• 56:17
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• 56:22
  Dr. Jill Carnahan: As you know, we have new episodes out every single week.
• 56:24
  Dr. Jill Carnahan: On Wednesdays they're released.
• 56:26
  Dr. Jill Carnahan: And I look forward to seeing you next week for another episode of Resiliency Radio.