A review in the Journal of Stem Cell Research & Therapy has summarized an array of studies that demonstrate that a specific type of stem cell – the mesenchymal stem cell – may be beneficial as a therapeutic approach to chronic pain. The authors point to the huge burden of chronic pain. It is estimated that more than 115 people suffer from the condition, which is more than those who suffer from diabetes, stroke, cancer, and coronary heart disease combined.
Chronic pain is also associated with significant losses in productivity. Given how extreme the burden of chronic pain has become, the National Institute of Medicine has suggested that finding effective ways to alleviate chronic pain should become a priority for the nation.
Regenerative medicine has offered an effective way to treat a variety of injuries and diseases, including some that are related to chronic pain. As the term “regenerative medicine” implies, much of the research into the clinical effects of stem cells have shown that they lead to beneficial outcomes by regenerating damaged tissue by replacing that tissue with new cells.
This new review looks at the potential of mesenchymal stem cells to specifically improve chronic pain through the ability of the cells to suppress inflammation. Given that inflammation is a common characteristic of conditions associated with chronic pain, a strategy that addresses this phenomenon could represent an effective way to help those with chronic pain that comes from things like degenerative disc disease and osteoarthritis.
The current approaches to chronic pain are limited in their ability to reduce or control pain, so there is a great need to develop more effective therapies. Research thus far into the potential impact of mesenchymal stem cells on chronic pain has provided promising results regarding effectiveness and safety. Specifically, these stem cells have not been associated with adverse side effects, they lead to the development and growth of healthy tissue, and they appear to provide pain relief. Future research will help to clarify the mechanisms by which mesenchymal stem cells may confer their benefits to those with chronic pain and provide new insights into how can best use these cells to help chronic pain sufferers.
Reference: Waterman, R.S. & Betancourt, A.M. (2011). Treating chronic pain with mesenchymal stem cells: A therapeutic approach worthy of continued investigation. Journal of Stem Cell Research & Therapy, S2, 1-5.
Osteoarthritis is the most common form of arthritis. In fact, when people casually use the term “arthritis” or think of the arthritis of old-age, they are usually talking about osteoarthritis. People with arthritis experience many symptoms in and around the affected joints including pain and swelling. The affected joints may become unstable or “give out.” At the same time, people who suffer from osteoarthritis may not be able to move their joints fully or smoothly. Commonly people feel that their joints are “stiff.”
Early in osteoarthritis, the pain may just occur occasionally. Perhaps, the person feels sharp pain when moving a certain way. In later stages of osteoarthritis, the affected joints constantly ache, and moving the joint becomes intensely painful.
Nonsteroidal anti-inflammatory drugs or NSAIDs can help in some cases, but they become less effective as osteoarthritis becomes more severe. Often people with osteoarthritis must receive injections of anesthetics and steroids into the joints itself. Ultimately, patients often need orthopedic surgery to grind away diseased joint tissue or even replace the joint with the artificial one.
Researchers are searching for ways to reverse osteoarthritis instead of just treating the symptoms. Fortunately, stem cells may offer hope. Doctors have long known that in people with osteoarthritis, the cartilage becomes thin and breaks down. Joint cartilage lubricates the joint, acts as a shock absorber, and helps the joint move smoothly. When cartilage breaks down, the joint becomes stiff, painful, and irritated. As recent research suggests, mesenchymal stem cells may rebuild and restore joint cartilage.
Two scientists, Kristjánsson and Honsawek, recently reviewed the state of the research in this field. They identified eight clinical studies that tested mesenchymal stem cells on patients with varying degrees of osteoarthritis. The clinical trials demonstrated several intriguing findings. Most notably, mesenchymal stem cells were able to promote cartilage regeneration, reduce pain, and improve joint function. The scientists also found that the more stem cells that were injected, the better the outcome. In addition, the beneficial effect of stem cells occurred whether the cells were taken from the patient (autologous stem cells) or from young, healthy donors (allogenic stem cells).
Importantly, patients with mild to moderate osteoarthritis enjoy the greatest apparent benefit from stem cell injections. This suggests that doctors and patients should consider stem cell treatment earlier in the course of osteoarthritis before joints become too damaged and likely require surgery.
Mesenchymal stem cell injection for osteoarthritis has now been tested in at least eight clinical studies including randomized clinical trials, which are the gold standard studies for evaluating treatments in medicine. Research is ongoing and still needed but these results are strongly encouraging. They may offer, for the first time, a way for patients to reverse the changes of osteoarthritis rather than simply treating the symptoms of the disease.
Reference: Kristjánsson et al. (2017). Mesenchymal stem cells for cartilage regeneration in osteoarthritis. World Journal of Orthopedics. 2017 Sep 18; 8(9): 674–680.
Patients usually recover from bone fractures with the right treatment, but sometimes the bone fails to heal because new tissue does not form and connect the broken pieces properly. Delayed union refers to cases where the bone takes longer than usual to heal, and nonunion refers to cases where the bone does not heal. In approximately 5 to 10 percent of cases of a fractured bone, delayed union or nonunion occurs. These conditions are associated with long-term pain and discomfort, and though can be addressed through surgical treatments, these interventions do not always lead to long-term healing.
In recent years, researchers have begun exploring the potential for mesenchymal stem cells to help address these important challenges of delayed union and nonunion. A review of the potential for these stem cells to help in these cases where fractures do not properly heal was recently published in the Journal of Biomedical Materials Research.
Mesenchymal stem cells are helpful in bone healing because they differentiate well and can differentiate into different cell lineages that are all important for bone formation, growth, and maintenance. These cell types include chondrocytes, osteoblasts, myoblasts, and adipocytes.
According to the authors of the review, mesenchymal stem cells can be used in conjunction with extracellular matrix scaffolds and biological adjuvants that promote growth, differentiation, and blood vessel formation, to help in the bone healing process when the delayed union or nonunion occurs. Future research will help to determine the best ways that mesenchymal stem cells can be used in combination with bioengineering strategies to help patients whose bone fractures do not heal or do not heal properly.