Center of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.
Rehabilitation Key Laboratory of Sichuan Province, Sichuan University, Chengdu, China.
Stem Cells Dev. 2020 Nov 15;29(22):1420-1428. doi: 10.1089/scd.2020.0131. Epub 2020 Oct 22.
Neuropathic pain is defined as a lesion or disease of the somatosensory system, currently remaining a challenging condition to treat. Mesenchymal stem cells (MSCs) transplantation is emerging as a promising strategy to alleviate the neuropathic pain conditions induced by peripheral nerve injury. The aim of this systematic review was to assess the efficacy and safety of MSCs transplantation in neuropathic pain induced by peripheral nerve injury in controlled animal studies, and thus to yield evidence-based decision making. Following the PRISMA guidelines, PubMed, Cochrane Central Library, Embase, and CINAHL were searched for preclinical controlled animal studies from the inception to April 16, 2020. Seventeen studies are included in this review. Substantial heterogeneity is observed regarding the animal's species, models of neuropathic pain, regimen of MSCs transplantation, and outcome of measures across the included studies. Both mechanical allodynia and thermal hyperalgesia could be significantly attenuated by transplanted MSCs. The MSCs-elicited analgesic effect is independent of the type of MSCs, time of administration, and route of delivery, and is efficiently enhanced by genetic transfection with fibroblast growth factor, proenkephalin, and glial cell line-derived neurotrophic factor. The migration of MSCs after intrathecal or intravenous injection has been shown to be directed toward the surface of dorsal spinal cord or dorsal root ganglions on the ipsilateral side of injury. No adverse effects have been reported. The accumulating evidence demonstrates the therapeutic effect of MSCs-based cell therapy on prevention and alleviation of the neuropathic pain induced by peripheral nerve injury in rat or mouse models. The robust preclinical studies are deserved to optimize the regimen of MSCs transplantation and to promote the translation of the MSCs-based therapy into clinical studies.
神经病理性疼痛被定义为躯体感觉系统的损伤或疾病,目前仍是一种具有挑战性的治疗病症。间充质干细胞(MSCs)移植作为一种缓解外周神经损伤引起的神经病理性疼痛的有前途的策略正在出现。本系统评价的目的是评估 MSC 移植在控制动物研究中治疗外周神经损伤引起的神经病理性疼痛的疗效和安全性,从而为基于证据的决策提供依据。根据 PRISMA 指南,检索了从创建到 2020 年 4 月 16 日的 PubMed、Cochrane 中央图书馆、Embase 和 CINAHL 中的临床前对照动物研究。本综述纳入了 17 项研究。在纳入的研究中,关于动物的物种、神经病理性疼痛模型、MSCs 移植方案以及测量结果存在很大的异质性。移植的 MSCs 可显著减轻机械性痛觉过敏和热痛觉过敏。MSCs 产生的镇痛作用与 MSCs 的类型、给药时间和给药途径无关,通过转染成纤维细胞生长因子、前啡肽和胶质细胞系源性神经营养因子可有效地增强这种镇痛作用。鞘内或静脉注射后 MSCs 的迁移已被证明是向损伤同侧背根神经节或背根神经节表面定向的。没有不良反应的报道。越来越多的证据表明,基于 MSCs 的细胞治疗对预防和缓解大鼠或小鼠模型中由外周神经损伤引起的神经病理性疼痛具有治疗作用。强有力的临床前研究值得优化 MSCs 移植方案,并促进 MSCs 治疗转化为临床研究。
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