Human Placental Extract as a Promising Epidural Therapy for Lumbar Spinal Stenosis: Enhancing Axonal Plasticity and Mitigating Pain and Inflammation in a Rat Model

ABSTRACT Background Epidural injections treat lumbar spinal stenosis (LSS) by targeting localized inflammation and tissue damage. However, current medications such as corticosteroids and local anesthetics often have limited efficacy and significant adverse effects. Methods Human placental extract (H...

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Main Authors: Jin Young Hong, Hyun Kim, Wan‐Jin Jeon, Changhwan Yeo, Junseon Lee, Hyunseong Kim, Yoon Jae Lee, In‐Hyuk Ha
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:JOR Spine
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Online Access:https://doi.org/10.1002/jsp2.70085
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author Jin Young Hong
Hyun Kim
Wan‐Jin Jeon
Changhwan Yeo
Junseon Lee
Hyunseong Kim
Yoon Jae Lee
In‐Hyuk Ha
author_facet Jin Young Hong
Hyun Kim
Wan‐Jin Jeon
Changhwan Yeo
Junseon Lee
Hyunseong Kim
Yoon Jae Lee
In‐Hyuk Ha
author_sort Jin Young Hong
collection DOAJ
description ABSTRACT Background Epidural injections treat lumbar spinal stenosis (LSS) by targeting localized inflammation and tissue damage. However, current medications such as corticosteroids and local anesthetics often have limited efficacy and significant adverse effects. Methods Human placental extract (HPE), with regenerative and anti‐inflammatory properties, was tested for its axon‐promoting and pain‐relieving effects in an in vitro model using dorsal root ganglion neurons exposed to hydrogen peroxide (H2O2). Results Various HPE doses were applied, and 2.5 or 5 mg/mL enhanced cell viability and neurite outgrowth while alleviating the increased expression of pain‐related markers (IB4, CGRP, TRPV1) caused by H2O2 in a dose‐dependent manner. Subsequently, rats with LSS received epidural injections of 10 or 20 mg/kg HPE five times weekly for four weeks. In vivo results showed that repeated HPE injections significantly reduced ED1+ macrophages and altered the expression of M1 (iNOS, TNF‐α, COX‐2) and M2 (Arg1, CD206) macrophage markers. Pain‐related markers (TRPV1, IB4, CGRP, NF200) and genes (Il1rn, Scn9a) were significantly downregulated in 3D dorsal root ganglion tissues. Additionally, the 3D spinal cord exhibited increased serotonergic axons and upregulated expression of genes related to axonal growth and neurotrophic factors (Nefh, Ngf, Bdnf, Gap43). Conclusions Our findings suggest that repeated epidural injections of human placental extract in LSS rats can improve locomotor function. This underscores the potential benefits of human placental extract as an epidural agent, enhancing the recovery process and offering a new and minimally invasive treatment strategy for LSS.
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spelling doaj-art-fda54590dcef4edbabfb5264b873eb122025-08-20T03:28:01ZengWileyJOR Spine2572-11432025-06-0182n/an/a10.1002/jsp2.70085Human Placental Extract as a Promising Epidural Therapy for Lumbar Spinal Stenosis: Enhancing Axonal Plasticity and Mitigating Pain and Inflammation in a Rat ModelJin Young Hong0Hyun Kim1Wan‐Jin Jeon2Changhwan Yeo3Junseon Lee4Hyunseong Kim5Yoon Jae Lee6In‐Hyuk Ha7Jaseng Spine and Joint Research Institute Jaseng Medical Foundation Seoul Republic of KoreaJaseng Spine and Joint Research Institute Jaseng Medical Foundation Seoul Republic of KoreaJaseng Spine and Joint Research Institute Jaseng Medical Foundation Seoul Republic of KoreaJaseng Spine and Joint Research Institute Jaseng Medical Foundation Seoul Republic of KoreaJaseng Spine and Joint Research Institute Jaseng Medical Foundation Seoul Republic of KoreaJaseng Spine and Joint Research Institute Jaseng Medical Foundation Seoul Republic of KoreaJaseng Spine and Joint Research Institute Jaseng Medical Foundation Seoul Republic of KoreaJaseng Spine and Joint Research Institute Jaseng Medical Foundation Seoul Republic of KoreaABSTRACT Background Epidural injections treat lumbar spinal stenosis (LSS) by targeting localized inflammation and tissue damage. However, current medications such as corticosteroids and local anesthetics often have limited efficacy and significant adverse effects. Methods Human placental extract (HPE), with regenerative and anti‐inflammatory properties, was tested for its axon‐promoting and pain‐relieving effects in an in vitro model using dorsal root ganglion neurons exposed to hydrogen peroxide (H2O2). Results Various HPE doses were applied, and 2.5 or 5 mg/mL enhanced cell viability and neurite outgrowth while alleviating the increased expression of pain‐related markers (IB4, CGRP, TRPV1) caused by H2O2 in a dose‐dependent manner. Subsequently, rats with LSS received epidural injections of 10 or 20 mg/kg HPE five times weekly for four weeks. In vivo results showed that repeated HPE injections significantly reduced ED1+ macrophages and altered the expression of M1 (iNOS, TNF‐α, COX‐2) and M2 (Arg1, CD206) macrophage markers. Pain‐related markers (TRPV1, IB4, CGRP, NF200) and genes (Il1rn, Scn9a) were significantly downregulated in 3D dorsal root ganglion tissues. Additionally, the 3D spinal cord exhibited increased serotonergic axons and upregulated expression of genes related to axonal growth and neurotrophic factors (Nefh, Ngf, Bdnf, Gap43). Conclusions Our findings suggest that repeated epidural injections of human placental extract in LSS rats can improve locomotor function. This underscores the potential benefits of human placental extract as an epidural agent, enhancing the recovery process and offering a new and minimally invasive treatment strategy for LSS.https://doi.org/10.1002/jsp2.70085axonal growthhuman placental extractinflammationlumbar spinal stenosisrepetitive epidural injectionsserotonergic axons
spellingShingle Jin Young Hong
Hyun Kim
Wan‐Jin Jeon
Changhwan Yeo
Junseon Lee
Hyunseong Kim
Yoon Jae Lee
In‐Hyuk Ha
Human Placental Extract as a Promising Epidural Therapy for Lumbar Spinal Stenosis: Enhancing Axonal Plasticity and Mitigating Pain and Inflammation in a Rat Model
JOR Spine
axonal growth
human placental extract
inflammation
lumbar spinal stenosis
repetitive epidural injections
serotonergic axons
title Human Placental Extract as a Promising Epidural Therapy for Lumbar Spinal Stenosis: Enhancing Axonal Plasticity and Mitigating Pain and Inflammation in a Rat Model
title_full Human Placental Extract as a Promising Epidural Therapy for Lumbar Spinal Stenosis: Enhancing Axonal Plasticity and Mitigating Pain and Inflammation in a Rat Model
title_fullStr Human Placental Extract as a Promising Epidural Therapy for Lumbar Spinal Stenosis: Enhancing Axonal Plasticity and Mitigating Pain and Inflammation in a Rat Model
title_full_unstemmed Human Placental Extract as a Promising Epidural Therapy for Lumbar Spinal Stenosis: Enhancing Axonal Plasticity and Mitigating Pain and Inflammation in a Rat Model
title_short Human Placental Extract as a Promising Epidural Therapy for Lumbar Spinal Stenosis: Enhancing Axonal Plasticity and Mitigating Pain and Inflammation in a Rat Model
title_sort human placental extract as a promising epidural therapy for lumbar spinal stenosis enhancing axonal plasticity and mitigating pain and inflammation in a rat model
topic axonal growth
human placental extract
inflammation
lumbar spinal stenosis
repetitive epidural injections
serotonergic axons
url https://doi.org/10.1002/jsp2.70085
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