Regenerative medicine for neuropathic pain: physiology, ultrasound and therapies with a focus on alpha-2-macroglobulin.

The currently available drugs to treat neuropathic pain do not provide adequate pain management. As such, other treatments including stem cells, platelet-rich plasma and plasma-derived molecules such as alpha-2 macroglobulin (A2M) are being explored because they show promising potential for neuropathic pain. The various mechanisms and immunomodulatory effects could be a desirable approach in targeting neuropathic pain. This review indicates that A2M can be highly efficacious due to its conformational change during activation and specificity of action on various cytokines. Its ability to reduce neuropathic pain can further the future of neuropathic intervention. However, there is a lack of robust clinical studies and thus further research is needed to verify and expand the understanding of its therapeutic effects. The currently available drugs to treat neuropathic pain do not provide adequate pain control. As such, other various regenerative treatments modalities are being explored because they show promising potential for neuropathic pain. The various mechanisms and immunity-focused effects could be a desirable approach in targeting neuropathic pain. This review indicates that alpha-2 macroglobulin, a specific plasma derived molecule, can be highly effective due to its shape change during activation and highly specific action on various proteins. Its ability to reduce neuropathic pain can further the future of neuropathic intervention. However, there is a lack of robust clinical studies and thus further research is needed to verify and expand the understanding of its therapeutic effects.