Evaluation of Platelet-Rich Plasma Therapy for Peripheral Nerve Regeneration: A Critical Review of Literature

From the Department of Hand Surgery, China-Japan Union Hospital of Jilin University, Changchun, China

Peripheral nerve injury (PNI) is a common disease in clinic, and the regeneration process of peripheral nerve tissue is slow, and patients with PNI often suffer from the loss of nerve function. At present, related research on the mechanism of peripheral nerve regeneration has become a hot spot, and scholars are also seeking a method that can accelerate the regeneration of peripheral nerve. Platelet-rich plasma (PRP) is a platelet concentrate extracted from autologous blood by centrifugation, which is a kind of bioactive substance. High concentration of platelets can release a variety of growth factors after activation, and can promote the proliferation and differentiation of tissue cells, which can accelerate the process of tissue regeneration. The application of PRP comes from the body, there is no immune rejection reaction, it can promote tissue regeneration with less cost, it is,therefore, widely used in various clinical fields. At present, there are relatively few studies on the application of PRP to peripheral nerve regeneration. This article summarizes the literature in recent years to illustrate the effect of PRP on peripheral nerve regeneration from mechanism to clinical application, and prospects for the application of PRP to peripheral nerve.

Introduction

Peripheral nerve injury is a common nervous system condition associated with a high disability rate. Currently, the best treatment for nerve injury is restoring nerve continuity through microsurgical tension-free anastomosis or autogenous nerve transplantation. This treatment approach does not improve slow nerve regeneration and incomplete postoperative functional recovery. Thus, regeneration and repair of peripheral nerve injury is the focus of intense research.

Although injured nerve can be reconstructed the continuity, this, however, does not create a suitable microenvironment of nerve regeneration (Fowler et al., 2015). Platelet rich plasma (PRP) is a concentration of autologous platelets that releases various growth factors, hence promoting tissue regeneration. PRP has many applications. For example, in stomatology, a randomized controlled clinical trial showed that PRP and its derivatives prevent alveolar bone atrophy and enhance alveolar tissue regeneration (Ucak Turer et al., 2020). A multicenter, double-blind, randomized controlled trial in foot and ankle surgery showed that PRP injection outperforms traditional glucocorticoid injection in plantar aponeurosis treatment (Peerbooms et al., 2019). In sports medicine, a double-blind randomized control study showed that PRP injection can effectively improve healing of old meniscus injury (Kaminski et al., 2019). In chronic sports injury treatment, it is reported that pain relief and functional recovery of lateral humeral epicondylitis (tennis elbow) patients receiving PRP are better relative to controls (Mishra et al., 2014Merolla et al., 2017). In joint surgery, local PRP injection effectively relieves pain in patients with knee joint osteoarthritis, promoting functional recovery and its effects are superior to traditional hyaluronic acid (Duymus et al., 2017Lisi et al., 2018). In ophthalmology, PRP can be used to treat secretory dry eye (García-Conca et al., 2019). PRP is also reported to significantly accelerate wound healing (Mohamadi et al., 2019Zhang et al., 2019). PRP applications are summarized in Table 1.

Table 1

www.frontiersin.orgTABLE 1. Summary of clinical application of PRP.

In conclusion, decades of clinical practice show that PRP promotes tissue repair and regeneration. Moreover, this approach does not need special equipment and training, and is cost effective, making it of great value in regenerative medicine (Etulain, 2018). Here, we comprehensively review the effects of PRP on peripheral nerve regeneration, the mechanisms underlying PRP promotion of peripheral nerve regeneration, and PRP clinical applications for peripheral nerve regeneration.

For the entire article, please click on the link below, or to learn more about this PRP treatment, visit: www.stemcellmia.com

https://www.frontiersin.org/articles/10.3389/fbioe.2022.808248/full

 

Fighting Neuropathic Pain — Stem Cell Research Points to New Treatments for a Debilitating Condition

 

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By Mark D. Coggins, PharmD, BCGP, FASCP
Today’s Geriatric Medicine
Vol. 13 No. 2 P. 14

Neuropathic pain (NP) is a common and difficult-to-treat symptom of nerve damage. Patients suffering from this chronic pain condition are at risk of incurring increased health care expenditures and experiencing significant reductions in quality of life. Patients with NP often report job loss or significant changes to their careers, limited social interactions, decreased quality time with family, and feelings of hopelessness and depression due to their disease.1 Furthermore, current treatment approaches for NP, which focus on symptom management, are frequently inadequate.

Advancements in stem cell research are promising and may lead to new treatment modalities for NP.

NP Symptoms
NP symptoms are frequently described as burning, electric, tingling, and shooting. Hallmarks of NP include allodynia (pain resulting from a stimulus that normally does not elicit a painful response) and hyperalgesia (greater pain than normally would be expected from a painful stimulus).

Symptoms of neuropathy range from mild to disabling and may include a loss of reflexes, problems feeling pain, changes in temperature, numbness and tingling, and pain that is often worse at night.2 Symptoms are often sudden and unpredictable and follow different patterns that vary over a period of days, weeks, or years.1,2

Causes/Types
Approximately 30% of cases of neuropathy are the result of diabetes, and about 60% to 70% of people with diabetes have mild to severe forms of damage to sensory, motor, and autonomic nerves that cause such symptoms as numb, tingling, or burning feet; one-sided bands of pain; and numbness and weakness on the trunk or pelvis.2

More than 100 types of neuropathy have been identified, each with its own characteristic set of symptoms and prognosis.2 Causes of NP include chronic medical conditions (eg, diabetes), physical injury (eg, fractures, spinal cord injury), alcoholism, amputation (resulting in phantom pain), use of some chemotherapeutic agents (eg, Cisplatin, Vincristine), radiation therapy, trigeminal neuralgia, infections (eg, shingles, HIV), central nervous system disorders (eg, Parkinson’s disease, multiple sclerosis), kidney and liver disorders, nutritional deficiencies and imbalances (eg, B12 deficiency, excess B6), autoimmune disorders (eg, Guillain-Barré syndrome, rheumatoid arthritis, lupus), and some cancers/tumors. In some cases, NP is idiopathic.1-3

Available Treatments
Existing treatments and approaches to NP focus on palliative management of symptoms. There are no drugs available that can restore nerve function. The management of NP is challenging, as this type of pain is frequently refractory to existing treatments.4 It’s been reported that in clinical trials, no more than one-half of patients with NP experience clinically meaningful pain relief.3 Similarly, several studies of individuals with NP living in the community have shown patients on average experience pain of moderate severity despite taking prescribed medications for their pain.4

Medications commonly used include analgesics such as opioids (eg morphine, methadone, tramadol) and over-the-counter pain medications (eg, NSAIDs), antidepressants (eg, amitriptyline, nortriptyline, venlafaxine, duloxetine), anticonvulsants (eg, gabapentin, pregabalin), muscle relaxers (eg, cyclobenzaprine), and topical agents such as lidocaine creams or patches. In addition to medications, nondrug therapies and lifestyle modifications such as exercise, physical therapy, acupuncture, and limiting physical activity may also be utilized to manage symptoms.

Stem Cells
Stem cell transplantation has the potential to repair, restore, replace, and regenerate cells, and may be able to treat a number of different medical conditions and diseases. Research increasingly is evaluating the use of stem cells for the treatment of NP. Unlike existing treatments that focus only on symptom management, stem cell transplantation may be able to replace damaged nerve cells, possibly offering a cure.

Stem cells, sometimes referred to as “master cells,” are the foundation for every organ and tissue in the human body. These include embryonic stem cells and tissue-specific adult stem cells. Due to the ethical issues associated with the use of embryonic stem cells, most of the research being done involves the use of adult stem cells. Regardless of the type used, stem cells have the unique ability to self-renew (make copies of themselves) and differentiate (develop into more specialized cells).

Stem cells can be transplanted in a number of different ways, including local delivery, intrathecal or intracerebroventricular administration, IV injection, intranasal delivery, and endogenous mobilization by drugs for chronic intractable pain treatment.

In early research, it had been thought that stem cells would need to be administered intrathecally to reduce pain as IV administration appeared to result in the stem cells becoming trapped in the lungs, preventing their migration to the site of injury. However, more recent evidence suggests this lung trapping effect may be transient.

For the entire article, please click on the link below:

https://www.todaysgeriatricmedicine.com/archive/MA20p14.shtml

 

Stem Cell Therapy for Neuropathy: Take Your Pain Away

As the body ages, it’s only natural that some of its processes should break down. This is often due to the fact that nerves in our extremities grow less sensitive over time, transmitting messages to the brain more slowly and feeling less acutely – a condition known as peripheral neuropathy or simply neuropathy.

While some of that is normal, especially in the golden years, neuropathy often manifests in people much too young – in their 30s, 40s, or 50s – as a result of a disease such as diabetes or autoimmune issues. Unfortunately, the condition can significantly hamper your quality of life, making mobility difficult and limiting everyday activities.

The good news? Neuropathy may have a cure, or at least a solid treatment, on the horizon. Stem cells show great promise for a wide variety of conditions, and nerve damage is the latest of these. To see how it can help, it’s important to understand what stem cell treatment is, what neuropathy is and how it could potentially be remedied.

For the entire article, please click the link below:

Stem Cell Therapy for Neuropathy: Take Your Pain Away

 

New Insights into Stem Cell Therapy in 2019 by Ingrid Machado / Stem Cell Miami CEO

 

Ingrid Machado / CEO Stem Cell Miami

The other day a friend asked me what my New Year’s resolution was.  When I told her “communicate better,” she gave me the kind of look that says “There are SO many other things you should be working on!”

I can’t blame my friend—she has the kind of profession that everyone understands.  At parties, when people ask her what she does, she says she’s a lawyer and the questions stop there.  Me?  I tell people I work with stem cells and they follow me for the rest of the evening asking questions.  Don’t get me wrong, I don’t mind the questions.  It’s just that I keep assuming that people know about my field when, in reality, there’s a tremendous amount of misinformation that people have to sort through.

Anyway, I’m writing this on New Year’s Day and I need to get to work on my resolution, so let’s take a few minutes to go over what stem cells are, what they can and cannot do, and what treatments are available.  First of all, stem cells are just a special type of cell that can transform itself into a different type of cell.  In embryos, stem cells become the various cells that make up the body; in adults, stem cells take care of the damage repair and cell turnover that keeps us going.

(more…)

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