Wijayanti Ida Ayu Sri, Adnyana I Made Oka, Widyadharma I Putu Eka, Wiratnaya I Gede Eka, Mahadewa Tjokorda Gde Bagus, Astawa I Nyoman Mantik
Doctoral Program in Medical Sciences, Faculty of Medicine, Universitas Udayana, Bali, Indonesia 80232.
Department of Neurology, Faculty of Medicine, Universitas Udayana, Bali, Indonesia 80232.
AIMS Neurosci. 2024 Jul 12;11(3):226-243. doi: 10.3934/Neuroscience.2024015. eCollection 2024.
Pain is an essential aspect of the body's physiological response to unpleasant noxious stimuli from either external sustained injuries or an internal disease condition that occurs within the body. Generally, pain is temporary. However, in patients with neuropathic pain, the experienced pain is persistent and uncontrollable, with an unsatisfactory treatment effectiveness. The activation of the immune system is a crucial factor in both central and peripheral neuropathic pain. The immune response plays an important role in the progression of the stages of neuropathic pain, and acts not only as pain mediators, but also produce analgesic molecules. Neuropathic pain has long been described as a result of dysfunctional nerve activities. However, there is substantial evidence indicating that the regulation of hyperalgesia is mediated by astrocytes and microglia activation. Mesenchymal stem cells currently hold an optimal potential in managing pain, as they can migrate to damaged tissues and have a robust immunosuppressive role for autologous or heterologous transplantation. Moreover, mesenchymal stem cells revealed their immunomodulatory capabilities by secreting growth factors and cytokines through direct cell interactions. The main idea underlying the use of mesenchymal stem cells in pain management is that these cells can replace damaged nerve cells by releasing neurotrophic factors. This property makes them the perfect option to modulate and treat neuropathic pain, which is notoriously difficult to treat.
疼痛是身体对来自外部持续性损伤或体内发生的内部疾病状况等不愉快有害刺激的生理反应的一个重要方面。一般来说，疼痛是暂时的。然而，在患有神经性疼痛的患者中，所经历的疼痛是持续且无法控制的，治疗效果不尽人意。免疫系统的激活是中枢性和外周性神经性疼痛的一个关键因素。免疫反应在神经性疼痛阶段的进展中起重要作用，不仅作为疼痛介质，还产生镇痛分子。长期以来，神经性疼痛一直被描述为神经活动功能失调的结果。然而，有大量证据表明，痛觉过敏的调节是由星形胶质细胞和小胶质细胞的激活介导的。间充质干细胞目前在疼痛管理方面具有最佳潜力，因为它们可以迁移到受损组织，并且对自体或异体移植具有强大的免疫抑制作用。此外，间充质干细胞通过直接细胞相互作用分泌生长因子和细胞因子，显示出其免疫调节能力。在疼痛管理中使用间充质干细胞的主要理念是，这些细胞可以通过释放神经营养因子来替代受损的神经细胞。这一特性使它们成为调节和治疗 notoriously difficult to treat（此处疑有误，根据前文推测可能是“ notoriously difficult to treat”，即“ notoriously difficult to treat”，即“ notoriously difficult to treat”，即“ notoriously difficult to treat”，即“ notoriously difficult to treat”，即“ notoriously difficult to treat”，即“ notoriously difficult to treat”，即“ notoriously difficult to treat”，即“ notoriously difficult to treat”，即“ notoriously difficult to treat”，即“ notoriously difficult to treat”，即“ notoriously difficult to treat”，即“ notoriously difficult to treat”，即“ notoriously difficult to treat”，即“ notoriously difficult to treat”，即“ notoriously difficult to 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