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pISSN 2005-9159
eISSN 2093-0569

Experimental Research Article

Korean J Pain 2022; 35(1): 43-58

Published online January 1, 2022 https://doi.org/10.3344/kjp.2022.35.1.43

Copyright © The Korean Pain Society.

The efficacy of GABAergic precursor cells transplantation in alleviating neuropathic pain in animal models: a systematic review and meta-analysis

Shaghayegh Askarian-Amiri1 , Solmaz Nasseri Maleki2 , Seyedeh Niloufar Rafiei Alavi2 , Arian Madani Neishaboori2 , Amirmohammad Toloui2 , Mohammed I. M. Gubari3 , Arash Sarveazad4,5 , Mostafa Hosseini6,7 , Mahmoud Yousefifard2

1Institute de Biologie Structurale (IBS), Grenoble Alpes University, CEA, CNRS, Grenoble, France
2Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
3Department of Family and Community Medicine, College of Medicine, University of Sulaimani, Sulaimani, Iraq
4Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
5Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
6Pediatric Chronic Kidney Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
7Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Correspondence to:Mahmoud Yousefifard
Physiology Research Center, Iran University of Medical Sciences, Hemmat Highway, P.O Box: 14665-354, Tehran 1449614535, Iran
Tel: +982186704771
Fax: +982186704771
E-mail: yousefifard.m@iums.ac.ir

Mostafa Hosseini
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Poursina Ave, Tehran 1417613151, Iran
Tel: +982188989125
Fax: +982188989127
E-mail: mhossein110@yahoo.com

Handling Editor: Hyun Kang

Received: August 3, 2021; Revised: October 14, 2021; Accepted: October 14, 2021

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Current therapies are quite unsuccessful in the management of neuropathic pain. Therefore, considering the inhibitory characteristics of GABA mediators, the present systematic review and meta-analysis aimed to determine the efficacy of GABAergic neural precursor cells on neuropathic pain management.
Methods: Search was conducted on Medline, Embase, Scopus, and Web of Science databases. A search strategy was designed based on the keywords related to GABAergic cells combined with neuropathic pain. The outcomes were allodynia and hyperalgesia. The results were reported as a pooled standardized mean difference (SMD) with a 95% confidence interval (95% CI).
Results: Data of 13 studies were analyzed in the present meta-analysis. The results showed that administration of GABAergic cells improved allodynia (SMD = 1.79; 95% CI: 0.87, 271; P < 0.001) and hyperalgesia (SMD = 1.29; 95% CI: 0.26, 2.32; P = 0.019). Moreover, the analyses demonstrated that the efficacy of GABAergic cells in the management of allodynia and hyperalgesia is only observed in rats. Also, only genetically modified cells are effective in improving both of allodynia, and hyperalgesia.
Conclusions: A moderate level of pre-clinical evidence showed that transplantation of genetically-modified GABAergic cells is effective in the management of neuropathic pain. However, it seems that the transplantation efficacy of these cells is only statistically significant in improving pain symptoms in rats. Hence, caution should be exercised regarding the generalizability and the translation of the findings from rats and mice studies to large animal studies and clinical trials.

Keywords: Bibliometrics, Cell Engineering, Chronic Pain, GABAergic Neurons, Gamma-Aminobutyric Acid, Hyperalgesia, Neural Stem Cells, Neuralgia, Pain Management, Spinal Cord Injuries.