Can Stem Cells ‘Stem’ the Use of Opioids? Study Shows Great Promise

Stem cell therapy may prevent and even reverse opioid tolerance, according to new Cleveland Clinic research. The newly published findings demonstrate that “this emerging therapeutic strategy has shown promise to impact clinical practice and improve the efficacy and safety of opioid therapy.”

The widespread chronic use of opioids in pain management often lead to opioid tolerance (OT) and worsened pain after starting chronic opioids, an effect known as opioid-induced hyperalgesia (OIH). The amount of opioids prescribed increased by three times from 1999 to 2015 in the U.S., and opioid-related deaths claimed more than 42,000 lives nationwide in 2016.

There is a “need to find new solutions for OT and OIH as part of a national effort to combat chronic pain as a public health issue and the opioid epidemic as a national crisis,” writes the research team.

In preclinical trials, the researchers found that mesenchymal stem cells (MSCs) suppressed neuroinflammation, which had “powerful therapeutic effects on OT and OIH.” The MSC therapy actually prevented and reversed OT and OIH in rats and mice. The research found that using both intrathecal and intravenous transplantations were safe and that “the preventive and therapeutic effects were long-lasting and consistent across different assessment schemes.”

“MSC therapy has enormous potential to profoundly impact clinical practice and improve opioid efficacy and safety,” says principal investigator Jianguo Cheng, MD, PhD, of Cleveland Clinic’s Pain Management Department.

Using stem cell transplantation may allow for a low dose of opioids to be effective in the treatment of pain. Dr. Cheng says he and his team see three reasons that this treatment could be practical: its efficacy, its safety in animal studies, and the ease of clinical application. The team is hoping to get FDA approval and secure funding in order to translate the laboratory findings to clinical trials and applications. The goal, he says, is to be doing clinical trials within the next three years.

The research team published its findings in Journal: Clinical Pharmacology & Therapeutics: http://onlinelibrary.wiley.com/doi/10.1002/cpt.959/full