Managing chronic pain using bone marrow stromal stem cells
Chronic pain is a growing epidemic, affecting well over one-fifth of Americans. As a result, chronic pain management costs the US over $600 billion in treatments and lost productivity. Chronic pain is typically managed with therapies that promote only transient beneficial effects (e.g. NSAIDs, muscle relaxers, opioids). Consequently, these modalities require repeated dosing and often lead to major organ damage. Additionally, many of these medications are habit-forming, which takes an additional toll on the economy. Therefore, most clinicians agree that a successful pain management regimen is one that can render prolonged therapeutic benefits without addictive potential.
Dr. Ru-Rong Ji and colleagues have discovered a novel way to durably treat chronic pain using bone marrow-derived stromal stem cells (BMSCs). Using several mouse models of neuropathic pain, their studies demonstrated that affected mice treated intrathecally with BMSCs experienced a significant increase in pain tolerance within the first 24 hours following treatment; in some cases, pain tolerance was almost completely restored to baseline levels. Furthermore, this therapy was effective at ameliorating chemotherapy-induced peripheral neuropathy – a common complication of several chemotherapeutics, such as Paclitaxel. The pain-tolerizing effect of BMSCs is mediated by the multifunctional cytokine TGF-β1; however, unlike treatment with TGF-β1 protein alone, pain modulation with BMSCs persisted over a several week observation period. These findings offer a novel and powerful strategy for treating chronic neuropathic pain and have encouraging implications for pain management.
Most pain management therapies produce only transient effects. Injected BMSCs have been shown to engraft and persist around damaged nervous tissue, affording long-term treatment benefits. Additionally, there is likely no habit-forming potential of BMSC therapy.