Review of the history and current status of cell-transplant approaches for the management of neuropathic pain

Abstract

Treatment of sensory neuropathies, whether inherited or caused by trauma, the progress of diabetes, or other disease states, are among the most difficult problems in modern clinical practice. Cell therapy to release antinociceptive agents near the injured spinal cord would be the logical next step in the development of treatment modalities. But few clinical trials, especially for chronic pain, have tested the transplant of cells or a cell line to treat human disease. The history of the research and development of useful cell-transplant-based approaches offers an understanding of the advantages and problems associated with these technologies, but as an adjuvant or replacement for current pharmacological treatments, cell therapy is a likely near future clinical tool for improved health care.

Figure 1

Model of lumbar subarachnoid injection of human neurons near the human spinal cord. MRI image of the human spinal cord (a) with a lumbar puncture of the subarachnoid space adjacent to the cord (b), and injection of cells, such as the GABAergic human neuronal hNT2.17 cells (c) for pain relief, as delivered by syringe (d). A similar technique has been used in all pre-clinical animal experiments and clinical studies with human chromaffin cell injections for pain.