Mesenchymal stem cells’ “garbage bags” at work: Treating radial nerve injury with mesenchymal stem cell-derived exosomes

Table 2 Clinical studies for peripheral nerve injury repair using Schwan cells, stem cells, and their derived exosomes

NCT#	Study title	Conditions	Interventions	Primary outcome	Sponsor	Collaborators
NCT04346680	Intraoperative ADSC administration during nerve release	Neurotmesis of peripheral nerve disorder	ADSC administration	Electrophysiological improvement, improvement in EMG - the appearance of activities in denervated muscles, one year	Mossakowski MRC Polish Academy of Sciences	Centre of Postgraduate Medical Education
NCT03964129	BMAC nerve allograft study	PNI upper limb	Avance nerve graft with autologous BMAC	Comparison of AEs between patients treated with ANG with BMAC and the historical data of nerve repairs with the ANG only. Long-term study - AEs, such as infection, wound dehiscence, neuropathy, carpal tunnel syndrome, bleeding, seroma, and lymphocele, will be recorded and analyzed. AEs will be mapped to a MedDRA-preferred term and system organ classification	Brooke Army Medical Center	Walter Reed National Military Medical Center; Cleveland Clinic Lerner Research Institute
NCT03359330; PKUPH-PNI	Mid-term effect observation of biodegradable conduit small gap tublization repairing PNI	PNIs	Degradable conduit small gap tublization	To observe the mid-term clinical effect of biodegradable conduit small gap tublization on the repair of PNI in multi-center patients and fresh PNIs in the upper extremities	Peking University People’s Hospital	-
NCT05541250	Safety and efficacy of autologous human SCs augmentation in severe peripheral nerve injury	PNIs	Autologous human SC	The primary purpose of this phase I study is to evaluate the safety of injecting one’s SCs along with nerve auto-graft after a severe nerve injury, such as a sciatic nerve or brachial plexus injury	University of Miami, Florida, United States (Recruiting)	-
NCT04654286	Clinical outcomes of HAM and allogeneic MSCs composite augmentation for nerve transfer procedure in brachial plexus injury patients	Brachial plexus neuropathies	Nerve transfer or nerve transfer with HAM-MSC composite wrapping	AROM pre-surgery and 12-month follow-up for shoulder flexion, extension, abduction, adduction, external rotation, and internal rotation using the MRC scale (ranging from 0-5)	Dr. Soetomo General Hospital, Jakarta
Huang et al[19], 2016	A clinical study on the treatment of peripheral nerve injury growth factor of mecobalamin combined with nerve	150 PNI patients	Mecobalamin (0.5 mg, I.V, once a day) combined with NGF (30 mg, I.M injection, once a day) for 3-6 wk	Treatment with mecobalamin combined with NGF improved the sensorimotor evaluation of the curative effect made by the British Medical Research Institute of Neurotrauma Society	Guangxi Basic Science and Technology Plan Project PR China (No.: 20111209)
Civelek et al[20], 2024	Effects of exosomes from mesenchymal stem cells on functional recovery of a patient with total radial nerve injury: A pilot study	One patient with total radial nerve injury	WJ-MSCs derived exosomes	The six-month follow-up based on the BMRC and Mackinnon-Dellon scales showed improved motor (M5, excellent), and sensory functions also showed improvement (S3+, good). These results were achieved without physical therapy. Substantial axonal damage was observed at a ten-week follow-up, but nerve re-innervation was observed by EMG, which also improved significantly during the six-month follow-up	Department of Neurosurgery, University of Health Sciences

ADSCs: Adipose tissue-derived mesenchymal stem cells; AEs: Adverse effects; ANG: Avance nerve graft; AROM: Active range of motion; HAM-MSC: Human amniotic membrane-derived mesenchymal stem cells; BMAC: Bone marrow aspirate concentrate; EMG: Electromyography; MRC: Medical Research Council; MSCs: Mesenchymal stem cells; SCs: Schwan cells; PNI: Peripheral nerve injury; WJ-MSCs: Wharton jelly-derived mesenchymal stem cells; NGF: Nerve growth factor; BMRC: Behavioral Medicine Research Council; ADSC: Adipose-derived stem cell.