Regenerative Medicine Strategies Offer Novel Hope for Refractory Craniofacial and Corneal Neuropathic Pain

Craniofacial and corneal neuropathic pain are debilitating conditions often resistant to conventional treatments, significantly impairing patient quality of life. These pains stem from damage to corneal sensory nerves or dysfunction within trigeminal and cervical sensory pathways. Existing pharmacological interventions primarily offer symptomatic relief by modulating nerve signaling, failing to address the underlying pathology of damaged nerves, dysregulated immune responses, and maladaptive central processing. Regenerative medicine offers a paradigm shift, aiming to repair tissue and restore normal nerve structure and function at the source of the pain.

This comprehensive review synthesizes current literature on regenerative medicine approaches for craniofacial and corneal neuropathic pain. It systematically examines various strategies, including autologous biologics like platelet-rich plasma (PRP) and serum tears, mesenchymal stem cells (MSCs) and their derivatives, extracellular vesicles, and neurotrophic peptides. The review evaluates their proposed mechanisms of action and potential to promote nerve regeneration, modulate immune responses, and restore normal tissue function, moving beyond traditional symptom management.

The review highlights that regenerative medicine offers a promising shift from merely managing symptoms to actively repairing the root causes of neuropathic pain. It identifies several key strategies: autologous biologics such as platelet-rich plasma (PRP) and serum tears are discussed for their rich content of growth factors that support nerve healing. Mesenchymal stem cells (MSCs) and their derivatives are presented as potent agents for immunomodulation and tissue regeneration, capable of promoting nerve repair and reducing inflammation. Extracellular vesicles are also noted for their therapeutic potential. Neurotrophic peptides are emphasized for their ability to restore normal nerve structure and function.

The synthesis underscores that these regenerative approaches collectively target damaged sensory nerves, dysregulated immune responses, and maladaptive central processing, aiming for fundamental pain alleviation.