Abstract
Despite the progressive advances, current standards of treatments for peripheral nerve injury do not guarantee complete recovery. Thus, alternative therapeutic interventions should be considered. Complementary and alternative medicines (CAMs) are widely explored for their therapeutic value, but their potential use in peripheral nerve regeneration is underappreciated. The present systematic review, designed according to guidelines of Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols, aims to present and discuss the current literature on the neuroregenerative potential of CAMs, focusing on plants or herbs, mushrooms, decoctions, and their respective natural products. The available literature on CAMs associated with peripheral nerve regeneration published up to 2020 were retrieved from PubMed, Scopus, and Web of Science. According to current literature, the neuroregenerative potential of Achyranthes bidentata, Astragalus membranaceus, Curcuma longa, Panax ginseng, and Hericium erinaceus are the most widely studied. Various CAMs enhanced proliferation and migration of Schwann cells in vitro, primarily through activation of MAPK pathway and FGF-2 signaling, respectively. Animal studies demonstrated the ability of CAMs to promote peripheral nerve regeneration and functional recovery, which are partially associated with modulations of neurotrophic factors, pro-inflammatory cytokines, and anti-apoptotic signaling. This systematic review provides evidence for the potential use of CAMs in the management of peripheral nerve injury.
Highlights
This article is an open access articlePeripheral nerve injury (PNI) can result in partial or total loss of motor, sensory and autonomic functions at denervated regions, leading to temporary or life-long disability [1].In addition to reduced quality of life, functional deficits from PNI have a substantial economic impact on the affected individuals [2]
This review presents current research findings and evaluates the role of Complementary and alternative medicines (CAMs), focusing on plants or herbs, mushrooms, and decoctions, as well as their natural products (NPs), in peripheral nerve regeneration, to highlight their therapeutic potential for the management of PNI
Together with other records identified by other means, reremaining articles were screened based on the eligibility criteria, resulting in 289the addimaining articles were screened based on the eligibility criteria, resulting in additional tional records being excluded, leaving 56 records remaining and their findings being inrecords being excluded, leaving 56 records remaining and their findings being included cluded in the qualitative synthesis (Figure 1)
Summary
Peripheral nerve injury (PNI) can result in partial or total loss of motor, sensory and autonomic functions at denervated regions, leading to temporary or life-long disability [1]. In addition to reduced quality of life, functional deficits from PNI have a substantial economic impact on the affected individuals [2]. A recent study found that, over nine years (from 2009 to 2018), more than 550,000 individuals were afflicted by PNI in the United distributed under the terms and conditions of the Creative Commons. The incidence rate has more than doubled throughout that period of time [3]. Such injuries are primarily due to vehicular and traumatic accidents, lacerations, and iatrogenic causes [4,5,6]
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