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用于慢性疼痛管理的干细胞疗法:用途、进展及不良反应综述

Stem Cell Therapy for Chronic Pain Management: Review of Uses, Advances, and Adverse Effects.

作者信息

Chakravarthy Krishnan, Chen Yian, He Cathy, Christo Paul J

机构信息

Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital - Harvard Medical School, Boston, MA; Johns Hopkins Institute for Nanobiotechnology (INBT), Baltimore MD.

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Blaustein Pain Treatment Center, Johns Hopkins Hospital, Baltimore MD.

出版信息

Pain Physician. 2017 May;20(4):293-305.

Abstract

BACKGROUND

This review article outlines the recent advances, uses, and adverse effects of cell-based therapy for chronic pain management. Cell based therapies are gaining increasing ground as novel treatment modalities for a variety of pain pathologies that include, but are not limited to, neuropathic pain and degenerative disc disease. As these treatment modalities become more common practice, we have focused our review to provide pain practitioners and other practicing physicians an understanding of the technology and to summarize key clinical data and existing clinical trials that are being pursued by clinical investigators worldwide.

OBJECTIVE

Review of stem cell technology and applications in pain management.

STUDY DESIGN

Narrative review.

METHODS

The Pubmed NCBI and EMBASE databases was utilized to review published reports of clinical studies reported from 2000 to 2015, and ClinicalTrials.gov (www.clinicaltrials.gov/ct2/search) search function was used to document ongoing clinical trials [keywords: "chronic pain," "disc pain," "cell therapy," "osteoarthritis," "neuropathic," "stem cell"] currently active and recruiting patients.

RESULTS

Articles were screened by title, abstract, and full article review. They were then analyzed by specific clinical indications and appropriate data were presented based on critical analysis of those articles.

LIMITATIONS

More studies looking at the systematic use of stem cells in pain management will be required to draw conclusions about the benefits of the technology.

CONCLUSION

Though the data from existing studies look promising for the use of stem cells as a novel therapeutic strategy for discogenic pain, neuropathic pain, and osteoarthritis, additional clinical studies will be needed to validate the benefit of the technology for clinical use. However, we hope that this narrative review will help guide pain physicians in making informed decisions for their patients about the potential of cell-based therapy for treating chronic pain conditions.

摘要

背景

这篇综述文章概述了基于细胞的疗法在慢性疼痛管理中的最新进展、用途及不良反应。基于细胞的疗法作为多种疼痛病症(包括但不限于神经性疼痛和椎间盘退变疾病)的新型治疗方式,正逐渐获得更多认可。随着这些治疗方式越来越普遍,我们的综述旨在让疼痛科医生和其他执业医师了解这项技术,并总结全球临床研究人员正在进行的关键临床数据和现有临床试验。

目的

综述干细胞技术及其在疼痛管理中的应用。

研究设计

叙述性综述。

方法

利用PubMed NCBI和EMBASE数据库检索2000年至2015年发表的临床研究报告,并使用ClinicalTrials.gov(www.clinicaltrials.gov/ct2/search)的搜索功能记录当前正在进行且招募患者的临床试验[关键词:“慢性疼痛”“椎间盘疼痛”“细胞疗法”“骨关节炎”“神经性”“干细胞”]。

结果

通过标题、摘要和全文评审对文章进行筛选。然后根据具体临床适应症进行分析,并基于对这些文章的批判性分析呈现适当的数据。

局限性

需要更多关于干细胞在疼痛管理中系统应用的研究,才能就该技术的益处得出结论。

结论

尽管现有研究的数据显示,干细胞作为治疗椎间盘源性疼痛、神经性疼痛和骨关节炎的新型治疗策略很有前景,但仍需要更多临床研究来验证该技术在临床应用中的益处。然而,我们希望这篇叙述性综述将有助于指导疼痛科医生为患者做出明智的决策,了解基于细胞的疗法治疗慢性疼痛病症的潜力。

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