Treatment of peripheral nerve disorders | Overview including symptoms and causes

Patients with “peripheral nerve disorders,” which are attributed to various causes, suffer from numbness, pain, and sensory abnormalities, and can have long-term pain and decreased quality of life (QOL) due to the variety of symptoms.
In recent years, stem cell therapy has attracted attention in the field of regenerative medicine. This therapy may offer new solutions that are also applicable to peripheral nerve disorders. In this article, we will review peripheral nerve disorders and explain their symptoms and causes, as well as the mechanism and advantages of stem cell therapy and the actual treatment flow in detail.

What are peripheral nerve disorders?

Peripheral nerve disorders generally refer to conditions in which the nerves branching from the brain or spinal cord (peripheral nerves) sustain damage or become dysfunctional. Typical symptoms include numbness, pain, sensory paralysis, and loss of motor function, which, depending on severity, may seriously interfere with everyday activities. Peripheral nerves are broadly classified into sensory, motor, and autonomic nerves, and damage to a single or multiple peripheral nerves can cause intricately intertwined symptoms–a characteristic of peripheral neuropathy. In particular, symptoms are often concentrated in the distal limbs (hands and feet), while the patient’s condition may vary depending on the affected region and cause. *1

*1 Reference: Tokyo Metropolitan Neurological Hospital

Symptoms of peripheral nerve disorders

The following symptoms are observed in peripheral nerve disorders depending on the type and distribution of the damaged nerves.

• Sensory disturbance
  ・Numbness, tingling pain, and burning sensation occur in the hands and feet.
  ・Hyperesthesia, in which even mild stimulation can cause intense pain, or conversely, anesthesia, a loss of sensation, may develop.
• Movement disorder
  ・Muscular weakness or paralysis may occur, leading to marked motor dysfunction such as gait abnormality and difficulty in grasping things.
  ・Interference with swallowing or speaking occurs.
• Autonomic nervous symptoms
  ・Due to disturbed control of blood pressure, sweating, and urination/bowel movement, dizziness, lightheadedness, frequent urination, and constipation are likely to occur.

The progression and severity of symptoms vary widely among individuals; even if the cause is the same, some may experience severe but localized neural damage, whereas others may experience neural damage that spreads to the entire body. *2
*2 Reference:Saiseikai

Causes of peripheral nerve disorders

Peripheral nerve disorders are caused by several factors, with the following factors being the most representative.

• Diabetes mellitus: Angiopathy due to hyperglycemia interferes with the nutritional supply to the peripheral nerves, making patients susceptible to diabetic neuropathy.
• Drugs
  Drug-induced neuropathy is known to occur, in which drugs including some anticancer agents damage the peripheral nerves, causing numbness and pain.
• Trauma/compression: Fractures, surgery, or prolonged compression posture my cause physical neural damage.
• Autoimmune diseases: In some diseases (such as Guillain-Barré syndrome), nerve sheaths and axons are attacked due to autoimmune dysfunction.
• Infection: Neural damage may be observed after certain viral or bacterial infections, which is attributed to immune responses.
• Inherited: In some cases, genetic predispositions explain the development of peripheral nerve disorders, such as Charcot-Marie-Tooth disease.

As contributing factors such as lifestyle habits, inadequate control of underlying diseases, or external factors are often intertwined, it is important to investigate and address the accurate cause. *3

*3 Reference: Saiseikai

Stem cell therapy as a promising radical treatment for peripheral nerve disorders

Stem cell therapy is currently drawing attention as a therapeutic option for peripheral nerve disorders.

Here, we explain some background behind this therapy.

What is stem cell therapy?

To date, regenerating the damaged nerve itself has been considered difficult. However, stem cell therapy, which is attracting attention as part of regenerative medicine, offers new possibilities for the repair of nerve injury sites and functional recovery. Stem cells are cells with the ability to differentiate into various cells while replicating themselves. They are collected from fat and administered to the affected area after proliferation and differentiation.
This procedure is expected to not only replenish neurons and feeder cells but also suppress inflammation and improve blood flow via cytokine secretion.

Advantages of stem cell therapy

The following advantages are the reasons why stem cell therapy is attracting attention in the context of peripheral nerve disorders.

• Possibility of nerve repair: Stem cells may differentiate into neurons and feeding cells and activate surrounding cells to promote nerve regeneration.
• Various approaches: In addition to alleviating numbness and pain, stem cell therapy improves the tissue environment from various perspectives, such as inflammation control and angiogenesis.
• Reduced risk of side effects: If derived from autologous cells, no rejection or serious adverse reactions will occur.
• Long-term improvement: If neurological function is recovered, it may be possible to slow the progression of symptoms or significantly improve the quality of life.

Reasons why stem cell therapy is effective

In addition to inducing cell proliferation and differentiation, stem cells secrete growth factors and immunoregulatory substances. Thus, suppression of inflammation at the site of damage as well as the switching of surrounding tissue to the regenerative mode can be expected. Since axons and myelin sheaths are often damaged in peripheral nerve disorders, stem cells are believed to support the recovery of sensory and motor functions by helping to rebuild these sites. However, various factors, such as the disease stage and extent of injury, determine whether the nerve function that has been completely lost can be recovered. Indeed, outcomes vary from person to person.

Flow of treatment at the Regenerative Medicine Division of Korokai Medical Corporation

The Regenerative Medicine Division of Korokai Medical Corporation provides stem cell therapy for peripheral nerve disorders by implementing the following process.

• Initial consultation and tests: Patients are asked about their symptoms, course, and past medical history and the site and severity of damage are assessed through tests, such as the nerve conduction test and MRI.
• Stem cell collection and culture: Stem cells are extracted from adipose tissue and cultured to multiply in an environment with thorough quality control.
• Determination of the administration method and frequency: The administration method (e.g., intravenous drip, local injection) and frequency are determined according to the patient’s symptoms and medical history. The treatment schedule is also individually adjusted.
• Administration of stem cells and follow-up: After the administration of stem cells, changes in numbness and pain, degree of motor function recovery, and presence/absence of adverse reactions are monitored over time. The effect may be enhanced by additional administration of stem cells or combination with rehabilitation.

Stem cell therapy as a potential therapeutic option for peripheral nerve disorder

Peripheral nerve disorders greatly impair the quality of life due to numbness, pain, loss of motor function, and other symptoms. Stem cell therapy, which has received attention in recent years, holds promise as a regenerative medicine technique with the potential to repair and regenerate damaged nerves. At the Regenerative Medicine Division of Korokai Medical Corporation, we propose a stem cell treatment plan suitable for the symptoms and conditions of individual patients, aiming for more fundamental improvement of symptoms.

The Regenerative Medicine Division of Korokai Medical Corporation offers stem cell-based regenerative medicine as a medical institution approved by the Ministry of Health, Labour and Welfare. *4

If you are interested in stem cell therapy, please contact our hospital for consultation.
The Regenerative Medicine Division of Korokai Medical Corporation carefully selects evidence-based treatment and provides regenerative medicine according to each individual’s concerns based on new comprehensive treatment strategies. To optimize the results, a combination of oral therapies such as bioidentical hormone replacement therapy or peptide therapy and stem cell therapy may be used according to the patient’s needs.

*4 Source: Ministry of Health, Labour and Welfare

The Regenerative Medicine Division of Korokai Medical Corporation – a stem cell therapy clinic in Tokyo

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[1] Therapeutic Method
The treatment involves harvesting and culturing stem cells from the patient’s adipose tissue, and then injecting them locally to the affected area or administering them via intravenous infusion.
[2] Risk of side effects
At the time of fat collection: Adverse reactions such as internal bleeding, swelling, postoperative infection, postoperative scar, and pain at the injection site may be observed.
At the time of stem cell administration: Adverse reactions such as pain at the injection site, allergic reaction, and pulmonary embolism may be observed.
[3] Contact information
The Regenerative Medicine Division, Korokai Medical Corporation
Precious 18 5F, 4-14-6 Minami-azabu, Minato-ku, Tokyo
TEL:03-6277-4650
[4] Pricing
This treatment is a private therapeutic strategy that is not covered by public health insurance. It will cost about 1.65 million yen including tax (which may vary depending on the diagnosis).
Please consult us for details.
[5] Route of acquisition
Stem cells are cultured at the affiliated CPC.
[6] Presence or absence of devices/drugs approved for the indications in Japan
No approved drugs for the indications are available in Japan.
[7] Safety information in other countries
There are no reports on safety from other countries.
*Significant risks may not have been identified.
[8] The fact that it has not been approved
Drugs used in this treatment have not yet received approval in accordance with the Pharmaceutical and Medical Device Act.
[9] Unapproved drugs/devices
Public aid systems (such as Relief Systems for Adverse Drug Reactions and Infections Acquired through Biological Products) are not applicable to unapproved drugs and devices.
[10] Notification of regenerative medicine provision plans
To perform this treatment, we have submitted the notification of regenerative medicine provision plans to the Ministry of Health, Labour and Welfare in accordance with the Act on the Safety of Regenerative Medicine.
Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3210146
Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3230187
Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3240017
Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3230218