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  4. Transplantation of olfactory ensheathing cells on functional recovery and neuropathic pain after spinal cord injury; systematic review and meta-analysis

Transplantation of olfactory ensheathing cells on functional recovery and neuropathic pain after spinal cord injury; systematic review and meta-analysis

Scientific Reports, 2018 · DOI: 10.1038/s41598-017-18754-4 · Published: January 10, 2018

Spinal Cord InjuryRegenerative MedicineResearch Methodology & Design

Simple Explanation

This study investigates the effectiveness of transplanting olfactory ensheathing cells (OECs) to help with motor function and neuropathic pain in animal models of spinal cord injury (SCI). The authors reviewed existing research on this topic. The research showed that OEC transplantation significantly improved functional recovery in SCI animal models, especially in thoracic injuries and with allogeneic transplants. However, it didn't improve hyperalgesia and allodynia, and may worsen hyperalgesia over time. The authors highlight that while OEC transplantation can improve motor function after SCI, it might not alleviate all types of pain and could even worsen certain pain conditions like hyperalgesia, necessitating further research.

Study Duration
Not specified
Participants
933 animals (control group = 464, treatment group = 469)
Evidence Level
Level 1: Meta-Analysis and Systematic Review

Key Findings

  • 1
    OEC transplantation significantly improves functional recovery post-SCI in animal models.
  • 2
    The efficacy of OEC transplantation is higher in thoracic injuries and allogeneic transplants.
  • 3
    OEC transplantation does not affect allodynia and might lead to relative aggravation of hyperalgesia.

Research Summary

This meta-analysis evaluated the effects of OEC transplantation on neuropathic pain for the first time, finding that longer follow-up periods were associated with reports of OEC transplantation negatively affecting neuropathic pain post-SCI. The study found that OEC transplantation significantly improves motor function recovery in animals’ post-SCI and the observed efficacy was affected by the treatment protocol. The meta-analysis concludes that OEC transplantation improves motor function after SCI but may aggravate hyperalgesia. Further studies are needed to identify patient subgroups that benefit most from this treatment.

Practical Implications

Treatment strategy

OEC transplantation can be considered as a potential treatment to improve motor function recovery after SCI.

Personalized application

The effects of OEC transplantation should be interpreted with caution since the treatment may not be beneficial in every setting and further investigations are required to determine the subgroups of patients and the specific settings that benefit the most from this treatment.

Pain management

Neuropathic pain should be carefully monitored in patients undergoing OEC transplantation for SCI, particularly with longer follow-up periods, given the potential for aggravation of hyperalgesia.

Study Limitations

  • 1
    Significant heterogeneity was observed in evaluation of motor function recovery.
  • 2
    Not blinding the researchers in some of the included studies might have subjected results to bias.
  • 3
    Purity of transplanted OECs varied, with limited evidence provided for 'high purity' claims.

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