Regenerative Medicine Targeting of Neuro-immune Interactions & Neuroinflammation

Regenerative Medicine Targeting of Neuro-immune Interactions & Neuroinflammation: 

Promoting Restorative Adaptations of Detrimental Responses

Outcomes

Learners completing this activity routinely report improved abilities in:

• Implementing a multi-modality approach to chronic pain management 
• Influencing disease processes through neuroimmune modulation
• Targeting pain and not undertreating
• Considering neuroimmune interactions in nociceptive sensitization
• Implementing regenerative therapies into their practice
• Understanding of pathophysiology for regenerative treatments
• Educating staff and patients about regenerative medicine

Learning Objectives

As a result of participating in this activity, learners will be better able to:

• Apply a greater understanding of neuroimmune interactions to address neuropathic pain
• Influence disease process through neuroimmune modulation

Abstract

Regenerative pain medicine is rapidly emerging as a field within pain medicine and orthopedics^1,2. It is increasingly appreciated that common analgesic mechanisms for these treatments depend on neuroimmune modulation. In this lecture, we briefly review the mechanisms of state-of-the-art pain therapies^3-5, discuss recent progress in mechanistic understanding of nociceptive sensitization in chronic pain with a focus on neuroimmune modulation, and describe the rationale of evidence-based regenerative medicine in pain management¹.

Outline

• Overview of the mechanisms of state-of-the-art pain therapies
• Describe new mechanistic understanding of nociceptive sensitization through neuroimmune interactions
• Describe the need for new and innovative therapies for pain and promising treatments on the horizon
• Describe the current understanding of the mechanisms of regenerative medicine and its preclinical and clinical evidence.

Desirable Physician Attributes

• Medical Knowledge [ACGME/ABMS]  about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care
  
• Employ Evidenced-based Practice [IOM] Integrate best research with clinical expertise and patient values for optimum care, and participate in learning and research activities to the extent feasible
• Patient Care [ACGME/ABMS]  Provide care that is compassionate, appropriate and effective for the treatment of health problems and the promotion of health

Pain management domains and core competencies

• 1. Multidimensional nature of pain: What is pain?
  • 1.2: Present theories and science for understanding pain
  • 1.3: Define terminology for describing pain and associated conditions

• 3. Management of pain: How is pain relieved?
  • 3.2: Identify pain treatment options that can be accessed in a comprehensive pain management plan
  • 3.4: Develop a pain treatment plan based on benefits and risks of available treatments

Accreditation & Designation

Release date: This activity was released 8/15/2020.

Termination date: The content of this activity remains eligible for CME Credit until 8/14/2023, unless reviewed or amended prior to this date.

Neurovations Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Neurovations Education designates this other activity (blended learning) for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This activity includes discussions and explorations of new and evolving topics. Such inclusion includes adequate justifications of statements based upon current science, evidence and clinical reasoning.

Disclosure of Financial Relationships

Neither the speaker, peer reviewers nor any other person with control of, or responsibility for, the development, management, presentation or evaluation of the CME activity has, or has had within the past 12 months, any relevant financial relationships to disclose. This includes any relationships of an involved person's spouse/partner.

Additional Reading

1. Buchheit T, Huh Y, Maixner W, Cheng J, Ji RR: Neuroimmune modulation of pain and regenerative pain medicine. J Clin Invest 2020; 130: 2164-2176
2. Li F, Liu L, Cheng K, Chen Z, Cheng J: The Use of Stem Cell Therapy to Reverse Opioid Tolerance. Clin Pharmacol Ther 2018; 103: 971-974
3. Hua Z, Liu L, Shen J, Cheng K, Liu A, Yang J, Wang L, Qu T, Yang H, Li Y, Wu H, Narouze J, Yin Y, Cheng J: Mesenchymal Stem Cells Reversed Morphine Tolerance and Opioid-induced Hyperalgesia. Sci Rep 2016; 6: 32096
4. Liu LP, Hua Z, Shen J, Yin Y, Yang J, Cheng K, Liu AJ, Wang LN, Cheng JG: Comparative Efficacy of Multiple Variables of Mesenchymal Stem Cell Transplantation for the Treatment of Neuropathic Pain in Rats. Military Medicine 2017; 182: 175-184
5. Cheng J: State of the Art, Challenges, and Opportunities for Pain Medicine. Pain Med 2018; 19: 1109-1111