Advances in stem cell treatment for sciatic nerve injury

ABSTRACT

Introduction: The sciatic nerve is one of the peripheral nerves that is most prone to injuries. After injury, the connection between the nervous system and the distal organs is disrupted, and delayed treatment results in distal organ atrophy and total disability. Regardless of great advances in the fields of neurosurgery, biological sciences, and regenerative medicine, total functional recovery is yet to be achieved.

Areas covered: Cell-based therapy for the treatment of peripheral nerve injuries (PNIs) has brought a new perspective to the field of regenerative medicine. Having the ability to differentiate into neural and glial cells, stem cells enhance neural regeneration after PNIs. Augmenting axonal regeneration, remyelination, and muscle mass preservation are the main mechanisms underlying stem cells’ beneficial effects on neural regeneration.

Expert opinion: Despite the usefulness of employing stem cells for the treatment of PNIs in pre-clinical settings, further assessments are still needed in order to translate this approach into clinical settings. Mesenchymal stem cells, especially adipose-derived stem cells, with the ability of autologous transplantation, as well as easy harvesting procedures, are speculated to be the most promising source to be used in the treatment of PNIs.

KEYWORDS:

• Stem cells
• sciatic nerve
• peripheral nerve injury
• regenerative medicine

Article highlights

• The gold standard treatment of PNIs is still autologous nerve grafting, which due to its own limitations is the main challenge in the field of regenerative medicine.

• Alternative approaches such as cell-based therapies made it easier for scientists, to enhance neural regeneration, after an injury in animal models. However, it seems more difficult to achieve near-to-complete functional recovery in clinical practice.

• Stem cells derived from different sources can serve as an adjunct therapy to common practices of surgical nerve repair, as they differentiate into both neural and glial cells, stimulate neurotrophic properties, and by that means, modulate myelination and axonal regeneration.

• It is necessary to conduct follow up studies to recognize the desirable cell source, which we believe is the adipose tissue, set the ideal number and method of cell delivery, and guide the cells toward desirable fates, in order to eliminate side effects and improve sensory and motor functions.

• To gain far better results, adjuvant therapy should be employed. Combination of cell-based therapies along with rehabilitation and/or pharmacotherapy leads to optimal functional recovery.

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Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.