末梢神経再生における細胞移植とリハビリテーション

抄録

Autograft is a gold standard for regeneration after peripheral nerve defect but leads to donor-site dysfunction. Cell transplantation offers an alternative treatment for peripheral nerve injuries. Rehabilitation, such as ultrasound stimulation and exercise, could accelerate peripheral nerve regeneration. Therefore, a combination of rehabilitation and cell transplantation is expected to be a new strategy for peripheral nerve regeneration. In this paper, we review studies that describe rehabilitation after cell transplantation in animal models of peripheral nerve injuries. Ten studies on the combination of cell transplantation and rehabilitation were identified from PubMed. They transplanted Schwann or stem cells and conducted physical or exercise therapies as methods of rehabilitation. Either cell transplantation or rehabilitation could increase neurotrophic factors and promote nerve regeneration and functional recovery, which are better enhanced by their combination. However, there are some limitations. Compared with autograft, the effect of combination therapy is inadequate. Furthermore, differentiation of stem cells into Schwann cells is insufficient in vivo. For further advances of cell therapy to facilitate peripheral nerve regeneration, a study on optimal intensities of rehabilitation is required.