A preliminary report on stem cell therapy for neuropathic pain in humans

Abstract

ObjectiveMesenchymal stem cells (MSCs) have been shown in animal models to attenuate chronic neuropathic pain. This preliminary study investigated if: i) injections of autologous MSCs can reduce human neuropathic pain and ii) evaluate the safety of the procedure.MethodsTen subjects with symptoms of neuropathic trigeminal pain underwent liposuction. The lipoaspirate was digested with collagenase and washed with saline three times. Following centrifugation, the stromal vascular fraction was resuspended in saline, and then transferred to syringes for local injections into the pain fields. Outcome measures at 6 months assessed reduction in: i) pain intensity measured by standard numerical rating scale from 0–10 and ii) daily dosage requirements of antineuropathic pain medication.ResultsSubjects were all female (mean age 55.3 years ± standard deviation [SD] 14.67; range 27–80 years) with pain symptoms lasting from 4 months to 6 years and 5 months. Lipoaspirate collection ranged from 102–214 g with total cell numbers injected from 33 million to 162 million cells. Cell viability was 62%–91%. There were no systemic or local tissue side effects from the stem cell therapy (n=41 oral and facial injection sites). Clinical pain outcomes showed that at 6 months, 5/9 subjects had reduced both pain intensity scores and use of antineuropathic medication. The mean pain score pre-treatment was 7.5 (SD 1.58) and at 6 months had decreased to 4.3 (SD 3.28), P=0.018, Wilcoxon signed-rank test. Antineuropathic pain medication use showed 5/9 subjects reduced their need for medication (gabapentin, P=0.053, Student’s t-test).ConclusionThis preliminary open-labeled study showed autologous administration of stem cells for neuropathic trigeminal pain significantly reduced pain intensity at 6 months and is a safe and well tolerated intervention.

Platelet-rich plasma in treating peripheral neuropathic pain. Preliminary report

“…This intracellular "GABA-glutamate-glutamine cycle" is maintained for normal physiological homeostasis. Hyperexcitable neurons and and its important role in nerve healing and regeneration (33,34), and considering the valuable effect of grow factors such as TGF-β1, alleviating early-and late-phase neuropathic pain symptoms, such as allodynia and hyperalgesia (17).…”

Cell‐based therapies and natural compounds for pain

“…Of those available, they are mostly in clinical trial phases. A recent Australian study involving a cohort of female patients (aged between 22 and 80 years of age) were treated with a single dose of autologous MSC therapy for chronic neuropathic pain . This preliminary study demonstrated reduction in patient pain scores, accompanied by a significant reduction in daily pain medication requirements, indicating biological (rather than psychological) effects of the treatment.…”

“…Like that of ESCs, adult stem cells have been used in vitro to study the molecular mechanisms of cell‐specific adult cell development and disease, the stem cell niche as well as drug design and screening. In recent years, adult stem cells, in particular, mesenchymal stem cells (MSCs), have generated much excitement for their potential role for autologous cell‐based therapies (discussed below).…”

“…Currently, most cell therapies are still in experimental phases, with very few available for commercial use. As neuropathic pain responds poorly to pharmaceutical intervention, mesenchymal stem cell (MSC) and adipose‐derived stem cell (ADSC) therapy has been suggested as a means of potential autologous therapy for patients with neurological‐based diseases . MSCs and ADSCs are found endogenously within the body and have been shown to reduce inflammation by releasing cytokines involved moderating inflammation.…”

Iatrogenic Resorption of a Mandibular Condyle Following 3rd Molar Wisdom Tooth Surgery

“…Advances in biomolecular approaches should advance the treatment outcomes in difficult to manage OA situations such as the TMJ. Human autologous stem cell therapy administered to the oral and facial region has been shown to be safe and have excellent therapeutic effect for treating trigeminal neurological pain [11]. Interestingly, the biodegradable scaffolds showing most promise for human tissue regeneration are the well-known dental materials of alginate and polyacrylic acids.…”