Effects of Combined Intrathecal Mesenchymal Stem Cells and Schwann Cells Transplantation on Neuropathic Pain in Complete Spinal Cord Injury: A Phase II Randomized Active-Controlled Trial.

IF 3.2 4区 医学 Q3 CELL & TISSUE ENGINEERING
Mohammadhosein Akhlaghpasand, Roozbeh Tavanaei, Maede Hosseinpoor, Reza Heidari, Ida Mohammadi, Mohsen Chamanara, Melika Hosseinpour, Alireza Zali, Reza Mosaed, Saeed Oraee-Yazdani
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引用次数: 0

Abstract

Neuropathic pain is a debilitating complication following spinal cord injury (SCI). Currently, effective treatments for SCI-induced neuropathic pain are highly lacking. This clinical trial aimed to investigate the efficacy of combined intrathecal injection of Schwann cells (SCs) and bone marrow-derived mesenchymal stem cells (BMSCs) in improving SCI-induced neuropathic pain. This study was a parallel-group, randomized, open-label, active-controlled phase II trial with two arms, including treatment and control groups. Patients with complete SCI-induced neuropathic pain in the treatment group received a single combined intrathecal injection of BMSCs and SCs. Study outcome measures were International SCI Pain Basic Data Set (ISCIPBDS) and World Health Organization (WHO) Quality of Life Assessment Instrument (WHOQOL-BREF). A total of 37 (55.2%) and 30 (44.8%) patients in the treatment and control groups were followed up for 6 months, respectively. Significant reductions in mean scores of interference items in the treatment group, including daily activities (P < 0.001), mood (P < 0.001), and sleep (P < 0.001), were found at 6 months after the injection compared with the control one. Similarly, pain frequency (P = 0.002), mean (P = 0.001), and worst (P = 0.001) numeric rating scale (NRS) pain intensity scores showed significant reductions in the treatment group after 6 months compared with the control one. Based on multiple regression analysis controlled for potential confounders, significant associations between changes in all outcome measures over the study period and the treatment group were found. This clinical trial indicated the efficacy of combined cell therapy in improving the neuropathic pain and quality of life in complete SCI patients. Future investigations should evaluate the effects of combination of this strategy with other existing therapies for SCI-induced neuropathic pain. This clinical trial was also registered prospectively at the Iranian Registry of Clinical Trials (IRCT20200502047277N8).

鞘内间充质干细胞和雪旺细胞联合移植对完全性脊髓损伤神经性疼痛的影响:一项II期随机主动对照试验
神经性疼痛是脊髓损伤(SCI)后的一种衰弱性并发症。目前,对sci诱导的神经性疼痛的有效治疗非常缺乏。本临床试验旨在探讨鞘内联合注射雪旺细胞(SCs)和骨髓间充质干细胞(BMSCs)改善sci诱导的神经性疼痛的疗效。这项研究是一项平行组、随机、开放标签、主动控制的II期试验,有两组,包括治疗组和对照组。治疗组完全性sci诱导神经性疼痛患者接受单次鞘内骨髓间充质干细胞和干细胞联合注射。研究结果测量是国际SCI疼痛基础数据集(ISCIPBDS)和世界卫生组织(WHO)生活质量评估工具(WHOQOL-BREF)。治疗组37例(55.2%),对照组30例(44.8%),随访6个月。注射后6个月,治疗组在日常活动(P < 0.001)、情绪(P < 0.001)、睡眠(P < 0.001)等干扰项的平均得分均显著低于对照组。同样,6个月后,治疗组疼痛频率(P = 0.002)、平均(P = 0.001)和最差(P = 0.001)数值评定量表(NRS)疼痛强度评分与对照组相比,治疗组疼痛频率(P = 0.002)、平均(P = 0.001)和最差(P = 0.001)评分均有显著降低。基于控制潜在混杂因素的多元回归分析,发现研究期间所有结果测量值的变化与治疗组之间存在显著关联。该临床试验表明联合细胞治疗在改善完全性脊髓损伤患者神经性疼痛和生活质量方面的疗效。未来的研究应评估该策略与其他现有疗法联合治疗sci诱导的神经性疼痛的效果。该临床试验也在伊朗临床试验登记处(IRCT20200502047277N8)进行了前瞻性注册。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Cell Transplantation
Cell Transplantation 生物-细胞与组织工程
CiteScore
6.00
自引率
3.00%
发文量
97
审稿时长
6 months
期刊介绍: Cell Transplantation, The Regenerative Medicine Journal is an open access, peer reviewed journal that is published 12 times annually. Cell Transplantation is a multi-disciplinary forum for publication of articles on cell transplantation and its applications to human diseases. Articles focus on a myriad of topics including the physiological, medical, pre-clinical, tissue engineering, stem cell, and device-oriented aspects of the nervous, endocrine, cardiovascular, and endothelial systems, as well as genetically engineered cells. Cell Transplantation also reports on relevant technological advances, clinical studies, and regulatory considerations related to the implantation of cells into the body in order to provide complete coverage of the field.
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