Stem Cell Therapy for Peripheral Neuropathy

Answer: Yes in many cases. Most studies show evaluating pain show improvement. This includes diabetic and non-diabetic cases. While many studies show the effectiveness of stem cells for neuropathic pain in animals, human studies much fewer. Expect many advancements in the next few years.

Answer: Yes in many cases. The situation is similar to that with pain. Studies do show improvement, but the ideal way to collect and deliver the stem cells is still being determined.

Answer: Yes in many cases. Patients with neuropathy often have balance problems. Stem cells appear to do help much of the time.

Answer: Yes in many cases. Nerve regeneration is seen in many animal studies and a few human studies. Again, the ideal ways to collect and deliver the stem cells are still being determined.

Answer: Most commonly, peripheral neuropathy begins as a loss of sensation or burning in the feet or hands. This tends to be fairly equal in both hands and feet. Weakness may be associated in some cases. The exact pattern by which the disease develops is determined by the underlying cause. The most common causes of peripheral neuropathy are:

1. Diabetes mellitus. This is the most common cause. Peripheral neuropathy is common in people with diabetes. Burning, Tingling, and Pain
2. Other systemic. This includes vitamin deficiencies, hypothyroidism, HIV infection, and others.
3. Autoimmune. This category includes Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) and Guillain-Barré syndrome.
4. Toxic. The most common toxin is alcohol. Chemotherapy and lead exposure along with others are also in this category.
5. Hereditary.
6. Environmental. This is most commonly from injuries such as repeated vibrations or severe hypothermia.
7. Idiopathic. This means the cause is unknown. Many cases fit into this category.

Most of these disorders affect the sensory nerves causing loss of sensation and frequent pain or discomfort. Many of them, especially the autoimmune peripheral neuropathies, also affect motor function. Symptoms can vary from very mild (often diagnosed by accident while looking for other disorders) to severe and debilitating. For more information see: https://www.ninds.nih.gov/health-information/disorders/peripheral-neuropathy

Answer: When possible, like with diabetes or vitamin deficiencies, treatment begins with treating the underlying cause of the peripheral neuropathy. Removing toxins such as alcohol or environmental factors like repeated vibration can also be instrumental in these disorders. Patients with autoimmune neuropathy are sometimes treated with aggressive therapies such as:

1. Intravenous immune globulin.
2. Plasma exchange.
3. High dose steroids (glucocorticoids).

Other treatments are directed toward helping the symptoms and avoiding complications. Several medications are used to help with the pain and discomfort:

1. Gabapentin and other anti-epilepsy drugs like carbamazepine and topiramate.
2. Tricyclic antidepressant drugs like amitriptyline desipramine.
3. Pain medications like tramadol or ibuprofen.

Physical therapy is also very important to train in walking and balance assistance. Proper training and maintenance of routine foot inspection are essential to prevent or intervene early with foot and leg ulcers. If you are a person doing well using these options, this might not be the right time to consider adult stem cell treatment. However, if you are not doing well with the current treatment, you may wish to consider adult stem cell treatment. For more information on the treatment of peripheral neuropathy please see: https://www.webmd.com/brain/understanding-peripheral-neuropathy-treatment

Answer: Stem cells are special cells in our bodies that have two important characteristics:

1. Stem cells have the ability to replicate. In other words, they can make new copies of themselves. Because of this ability, an infinite number of copies can be made from the same cell.
2. Stem cells also have the ability to become other types of cells. A good example of this is that research labs have used fat-derived stem cells to make cartilage muscle, skin, and bone cells. This ability means that in theory the transformed can make an infinite number of the new cell type. See our blogs What are Stem Cells? and Understanding Adipose-Derived Stem Cells

Stem cells can come from a number of sources including embryos, umbilical cord blood, and adult cells. Adult stem cells come from adult individuals, not embryos or umbilical cord blood. Stem cells obtained from mature adult tissues are referred to as adult stem cells. Adult stem cells are believed to have the potential to become any type of cell. The two most commonly used sources of adult stem cells are fat and bone marrow. Adult stem cells from fat are called adipose-derived adult stem cells. For most purposes, stem cells from fat are easier to obtain and more abundant than from other tissues.

Answer: Harvesting adult stem cells from fat is very safe. The procedure has little discomfort and a fairly easy recovery. First, an area such as the stomach or leg is picked to remove the fat. We then take you to the procedure room and sterilize the area. A local anesthetic is then injected into the area. Fat is suctioned using a special syringe and cannula. Typically we suction about 50 ml (about 1 1.2 oz.) of fat. Swelling and bruising are common following the procedure at the harvest site. Swelling and bruising typically resolve within 2-3 weeks after the procedure. Most patients receive a prescription for pain medications for use as needed. We give a dose of antibiotics before the procedure but no antibiotics are needed afterward. Nest we take the harvested cells and use a centrifuge and incubator to do some simple processing. The processing isolates the adult stem cells from the other fat cells. The final product is called Stromal Vascular Fraction (SVF). We typically get 100 million cells or even more (counts may vary). SVF also contains a large amount of growth factors. Growth factors are chemical “text messages” our cells use to communicate with each other. After we have obtained the SVF, the next step is to deploy the SVF for your peripheral neuropathy.

Answer: Once the process of removing adult stem cells/SVF from fat is complete, we then deploy them for peripheral neuropathy. All types of peripheral neuropathy are treated with IV deployment. For the autoimmune peripheral neuropathies, IV mannitol is often given before the cells to help prepare for cell delivery, with the aim of helping cells reach the nervous system. We know that the damaged areas are releasing growth factors. These growth factors attract the adult stem cells/SVF to the area of the injury or disease activity. In treating the non-autoimmune peripheral neuropathies we also deploy the adult stem cells/SVF into the soft tissue around the area of nerve involvement. We use a small needle and inject the adult stem cells/SVF about 1 centimeter deep every few centimeters in the areas of the involved nerves.

Answer: Many patients report improvement, and results vary. Based on our patient outcomes (Innovations Stem Cell Center’s own patient-reported data, not a published clinical study), over 50% of our peripheral neuropathy patients respond. How a patient responds can depend on the cause of the neuropathy (for example diabetic, idiopathic, autoimmune or toxic), how long it has been present, and overall health. When patients notice changes, they usually begin within a few weeks to months. Some patients have a second treatment, typically 3 to 12 months after the first, depending on their response. Individual results vary, and no specific result can be promised.

Answer: Many researchers see potential for stem cells in peripheral neuropathy. Which type of stem cells to use (embryonic, bone marrow, or fat derived) and how to use them is heavily researched and debated. Adult stem cells have a good chance of becoming the treatment of choice because of their safety, availability, and lack of controversy. It is likely that in the future, we will see further preparation done to the adult stem cells/SVF in order to prepare them to more readily become neurons. Research in this area is ongoing.