Outside the operating room: unlimited directions in research and beyond.

The anesthesiologist's role often extends beyond the operating room and includes the realm of research. Recently, interest in investigating mesenchymal stem cells (MSCs) as therapy for myriad diseases has grown. MSCs are adult stem cells traditionally found in bone marrow that hone to damaged tissues and contribute to the tissues' repair by secreting chemokines, cytokines, and extracellular matrix proteins. Research has established a connection between the stimulation of specific Toll-like receptors and the immune-modulating responses of human MSCs, which allows for the polarization of MSCs into either a pro-inflammatory or an anti-inflammatory phenotype. It is anticipated that MSC-based therapies polarized into the anti-inflammatory phenotype will treat painful inflammatory diseases, such as diabetic peripheral neuropathy or rheumatoid arthritis. These new cell-based therapies will be another tool for anesthesiologists to employ while treating patients with chronic pain.