Stem Cells for the Treatment of Neuropathic Pain
Journal of Anesthesia and Perioperative Medicine
Leu et al. Journal of Translational Medicine 2010, 8:63 http://www.translational-medicine.com/content/8/1/63
Fang Xie1,2, Yun Yue1, Yun Guan3, and Yun Wang1
Aim of review: Neuropathic pain induced by injury to the somatosensory system is a great clinical problem. Despite multiple therapeutic strategies, the medical community still faces a challenge to treat neuropathic pain in a complete and definitive way, since the pathogenesis of this hypersensitive state is very complex. Stem cell transplantation may be an important approach for the treatment of neuropathic pain. This article aimed to review important and illustrative results from recent stem cell studies under various neuropathic pain conditions and to interpret their clinical implications for stem cell transplantation.
Method: We reviewed recent articles and literatures about stem cells for the treatment of neuropathic pain, in order to identify the types of stem cells, delivery approaches and the advances of stem cells for the treatment of peripheral nerve injury induced neuropathic pain, painful diabetic peripheral neuropathy and spinal cord injury (SCI) induced chronic pain.
Recent findings: Recently, the successful use of stem cell for the treatment of a diverse spectrum of diseases in animals has attracted more attentions from pain scientists. Accumulating evidence has shown that stem cell transplantation has a therapeutic effect on neuropathic pain. Stem cell transplantation can effectively relieve neuropathic pain under different pathological conditions. However, it is interesting to point out that peripheral neuropathic pain seems to be more responsive to stem cell therapy than SCI-induced chronic pain. Moreover, stem cell treatment does not always exert positive results in SCI-induced chronic pain (e.g. aggravating pain above the lesion spinal cord segment).
Summary: The analgesic effect of stem cells depends on the capacity to offer a multipotent cellular source for replacing injured neural cells and delivering trophic factors to lesion sites. Stem cell researches should focus on both experimental and clinical studies of neuropathic pain in the future.
Stem cell transplantation can effectively relieve neuropathic pain under different pathological conditions. However, it is interesting to point out that peripheral neuropathic pain seems to be more responsive to stem cell therapy than SCI- induced chronic pain. Moreover, stem cell treatment does not always exert positive results in SCI- induced chronic pain (e.g. aggravating pain above the lesion spinal cord segment). Understanding the molecular mechanisms underlying both positive and negative effects of stem cells on pain processing is very important for the development of novel, specific and effective therapeutic modalities for pain relief. Stem cell re- searches should focus on both experimental and clinical studies of neuropathic pain in the future. In clinical trials, the type and dosage of the in- fused stem cells, the safety and the grafting efficiency should be further investigated. In animal researches, the analgesic mechanisms of stem cells in different animal models of neuropathic pain should be explored.