A lot of my doubts vanished when I encountered peer-reviewed government reference here.
Once TPE is decided, the next issue is replacement plasma. Since I am volunteering and paying for the procedure, I am entitled to design of replacement plasma, in consultation with the doctor who will vet it on me. Basically I am open to dangers, but not to "not done yet". My own choices have to be motivated by advantages for me.
Let us look at what I want
1. Saline, to provide for bulk. Solves Metabolic alkalosis.
2. Albumin, at concentration in blood. It is a neutral tie-in for all proteins being removed, otherwise neutral to aging, Read: experimented with mice by Conboy and Humans in AMBAR. An albumin saline solution seems to be all needed for plasma lost, buttresses by cells, platelets etc, saved and restored in plasma. Albumin is not just neutral, but AMBAR may be interpreted as setting up a fixed ratio between beta-amyloid in brain CSF and blood, and loss of it in the brain to increment in blood to form albumin binding. It is this loss that produces improvements to Alzheimer's patients, despite BBB! Several procedures are needed for cleaning to significant levels, in AMBAR was weekly six times, then monthly for 6 months. Schedule may be smaller for an age/severity-early patient as me. TPE must be, and is, free of side effects beyond tiredness, but significantly donor facts, missing in my case.
3. NMN to protect
it from the liver. Special NMN needed might reach me mid-March. Much
better results are expected than sub-lingual methods used. I plan of
weekly NMN IV for rest of life at $1000 per year unless I venture to
make it in India or convince Ramdev etc to make it, for if it works for me,
many customers as me will need it. If forced into manufacture or
administration, IV can be extended to other similar products as NMN.
A gradual increase in CD38 has been implicated in the decline of NAD+ with age. CD38 inhibitors may be used as therapeutics for the treatment of asthma. CD38 has been used as a prognostic marker in leukemia. Nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) are NAD+ precursors, but when NR or NMN are administered, CD38 can degrade these precursors before they can enter cells. Diluting blood to half CD 38, is likely to help in NMN by IV.
4. Calcium, at concentration in blood (how=TBD) to avoid one side effect seen from TPE. Solves hypocalcaemia.
5. Potassium, at concentration in blood (how=TBD) to avoid one side effect seen from TPE. Solves hypokalemia.
6. ... Others to be
considered like some antibiotic. Pterostilbene is a general purpose broad spectrum antibiotic used by plants for invaders. Its chemical relative, resveratrol, received FDA GRAS status in 2007,[9] and approval of synthetic resveratrol as a safe compound by the European Food Safety Authority (EFSA) in 2016. Pterostilbene differs from resveratrol by exhibiting increased bioavailability (80% compared to 20% in resveratrol) due to the presence of two methoxy groups which cause it to exhibit increased lipophilic and oral absorption.[5] Might Solve decreased immunity. Need it as companion to NMN anyway.
What if this NBE fails?
There seems to be no
gerolavic reasons to K and Ca increment, but you never know! In any
case, NMN by IV will improve! The exact recipe will not be disclosed but becomes a strong
product for replacement plasma. I will seek funding to develop replacement plasma service if it works on me, in this or subsequent efforts' inline with self-sufficient India and a very major export to the entire world, open to any proven solution. There is no established solution to aging, or even a candidate in trial. Only Dr Kirprov in San Francisco may be a competitor, but AMA/FDA delays will make him toothless for a while. What works on me will promise a fast FSSAI valid deserving clinical test. Sir Modi understands bureaucracy.
Is old plasma of any use?
Yes !! In many small volumes, it can be used in many experiments to pin-point the bad proteins and their removal so that eventually the plasma can be cleaned and reused without diluting it! Interesting but true, it can be added to mice-plasma!
Philosophy
As someone taking the risks, I am entitled, as a non-medical scientist, of brief descriptions of my philosophy. I believe in natural evolution, rational scientific speculation, no-God and nonspiritual nature. Thus aging is simply chemistry, interesting as applicable to all mammals extending to a few hundred years as opposed to trees of a few thousand years and potentially unlimited for some reincarnating jelly fishes escaping predation. The higher end mammals survive being top predators and beating cancers. True hibernation may never happen to humans, but resuscitating intervals of up to 100 years are possible by slowing organ human processes and direct external blood processing. That claims of post-death resuscitation are pure sci-fi, not rational scientific speculation is my basis of declaration of post-death cures for killer diseases, a folly view and proud dedication of all my organs post-death in the USA or here (needs dual freeing) to reuse (here you have to pay!).
Two bad guys in aging are mitochondrial permeability transition pore, mPTP and cluster of differentiation CD38. It will be interesting to see if TPE machine can be modified to filter them out with positive anti-aging effect.
Antagonistic Pleiotropy Theory of Aging is my belief i.e. the bad processes were once good, but changed with aging to become bad. Cellular senescence is a simple way of attracting immune system cells to "bad" chemicals in some cases! For one, you can't fix a problem by sheer elimination of villain chemicals - you have to reduce their effects. But I expect the problem to be as hard as management of wild life with many counter-intuitive blind alleys and strange unintended consequences! It essentially means low-hanging fruit for like 20-60 years and then a wall.
