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Cialix second heart pumping for us and at that point you're you're in a milieu that's very very reparative there's a lot of opportunity for repair and so we think that by unloading we're recapitulating some of the basic fundamental biology and physiology but the hip one experiments that we should today are the first signal that actually from a biologic perspective we may not be seeing as much ischemic burden even though the epicardial vessel is occluded and I think that's to your point and also to this point that in fact we are an anti ischemic approach as well as a anti reperfusion pathway so have you and you considered maybe looking at sort of maybe intravital microscopy to look at micro circulation to see if you actually still have a sustained flow in those regions you know that strikes me as something that could be done to actually there has been some work with that with unloading it's been done in peripheral organs so organs 

   

Cialix Male Enhancement   heart the only time our hearts are actually unloaded in life is when we're a fetus and in fact we have a outside of the heart where they've looked at micro circulatory flow through the cheek or through the intestines we can see the flow and there is indeed enhanced flow but I think the for the myocardium it still remains open but microsphere studies from several different labs around the world have confirmed this finding when we're adding is this component of the biology and that's why if one and the PhDs are really a nice hypoxia sensitive group of proteins and we can start to take a deeper dive engine great thank you very good a good question here from Christopher solace he says very nice work does STI one alpha pathway upregulation represent a therapeutic opportunity or is unloading still necessary it's a great question so as you can see from the work we present and it we certainly wanted to chase down the SDF one pathway a little bit further the AMD 3100 experiments suggested that it's really important 

Cialix BUY by the anonymous attendee is it then true to say these sites are exposed to ischemic environments in to have SDF 1 there we found that actually we did do a series of studies in that paper which I didn't show you today where we actually gave recombinant SDF 1 in an effort to try to drive the credit protective signaling and we did that with and without unloading and what we found actually was that the unloading itself was reducing the infarct infarct better than either arm SDF 1 alone or an EF one without logging so there's so the the the effective St of one seems to be redundant on top of the unloading and didn't seem to have a synergistic effect the second question about unloading still necessary this brings up that question though about whether or not during that 30 minutes of unloading if the semi DQ pivotal trial is successful it now suggests that cyclosporine and davia all of the drugs that have been attempted in this arena according particular feeling maybe the issue was that you couldn't get the drug to the area and risk in time for there to be a car a protective effect but now if you have 30 minutes and you're standing there with the catheter in the coronary you might actually be able to do that and so that's one of our hopes 

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