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静脉注射外泌体在治疗复杂性区域疼痛综合征中的安全性和疗效。

Safety and Efficacy of Intravenous ExoFlo in the Treatment of Complex Regional Pain Syndrome.

机构信息

SC Spine & Sport, Newport Beach, CA; Newport Coast Surgery Center, Newport Beach, CA.

Direct Biologics LLC, Austin, TX.

出版信息

Pain Physician. 2023 Nov;26(7):E851-E857.

Abstract

BACKGROUND

Complex regional pain syndrome (CRPS) is an extremely painful disorder driven primarily by inflammation.

OBJECTIVES

We hypothesized that the immunomodulatory biologic, ExoFloTM, composed of bone marrow mesenchymal stem cell-derived extracellular vesicles, could be safely administered to CRPS patients and alleviate symptoms.

STUDY DESIGN

Ten patients received 2 intravenous (IV) infusions, each containing 15 mL ExoFlo, on day one and day 4. A series of tests were performed at baseline (day 0, prior to infusion), week one, and months one, 3, and 6 after the second infusion.

SETTING

All patients were treated in one of 2 outpatient pain management clinics in Orange County, CA.

METHODS

Testing for clinical improvement included: visual analog scale of pain, brief pain inventory, 36-item short-form questionnaire, range of motion analysis, and jamar dynamometer testing.

RESULTS

No serious adverse events related to ExoFlo treatment occurred. Statistically significant improvements in pain and motion assessments occurred across the patient pool.

LIMITATIONS

This study was limited by its patient number enrolled (10), it lacked a control arm, and one patient who dropped out of the study.

CONCLUSIONS

IV delivery of ExoFlo appears safe in patients with CRPS. In addition, ExoFlo exhibited efficacy in addressing CRPS symptoms. Given the lack of effective and safe treatments available to CRPS patients, these results suggest that further studies are warranted to explore and validate this potential treatment for CRPS.

摘要

背景

复杂性区域疼痛综合征(CRPS)是一种极其疼痛的疾病,主要由炎症驱动。

目的

我们假设免疫调节生物 ExoFloTM,由骨髓间充质干细胞衍生的细胞外囊泡组成,可以安全地给予 CRPS 患者并缓解症状。

研究设计

10 名患者在第 1 天和第 4 天各接受 2 次静脉(IV)输注,每次输注 15 毫升 ExoFlo。在第二次输注前的第 0 天(基线)、第 1 周和第 1、3、6 个月进行了一系列测试。

地点

所有患者均在加利福尼亚州橙县的 2 个门诊疼痛管理诊所之一接受治疗。

方法

测试临床改善的指标包括:疼痛视觉模拟评分、简明疼痛量表、36 项简短健康调查问卷、关节活动度分析和 Jamar 测力计测试。

结果

没有与 ExoFlo 治疗相关的严重不良事件。患者群体的疼痛和运动评估均有显著改善。

局限性

本研究的局限性在于纳入的患者数量(10 名)较少,缺乏对照组,以及一名退出研究的患者。

结论

CRPS 患者静脉输注 ExoFlo 似乎是安全的。此外,ExoFlo 在解决 CRPS 症状方面表现出疗效。鉴于 CRPS 患者缺乏有效和安全的治疗方法,这些结果表明,有必要进一步研究探索和验证这种治疗 CRPS 的潜在方法。

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