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Role of cell therapy in Parkinson disease.

Lindvall, Olle LU and Hagell, Peter LU (2002) In Neurosurgical Focus 13(5).
Abstract
Clinical studies involving intrastriatal transplantation of embryonic mesencephalic tissue in patients with Parkinson

disease (PD) have provided proof-of-principle for the cell replacement strategy in this disorder. The grafted dopaminergic

neurons can reinnervate the denervated striatum, restore regulated dopamine release and movement-related

frontal cortical activation, and produce significant symptomatic relief. In the most successful cases, patients have been

able to withdraw from levodopa treatment after undergoing transplantation and resume an independent life. There are,

however, several problems linked to the use of primary embryonic tissue: 1) lack of sufficient amounts of tissue... (More)
Clinical studies involving intrastriatal transplantation of embryonic mesencephalic tissue in patients with Parkinson

disease (PD) have provided proof-of-principle for the cell replacement strategy in this disorder. The grafted dopaminergic

neurons can reinnervate the denervated striatum, restore regulated dopamine release and movement-related

frontal cortical activation, and produce significant symptomatic relief. In the most successful cases, patients have been

able to withdraw from levodopa treatment after undergoing transplantation and resume an independent life. There are,

however, several problems linked to the use of primary embryonic tissue: 1) lack of sufficient amounts of tissue for

transplantation in a large number of patients; 2) variability of functional outcome (major improvement in some and

modest if any clinical benefit in others); and 3) occurrence of troublesome dyskinesias in a significant proportion of

patients after transplantation. Thus, neural transplantation is still at an experimental stage in the treatment of PD. For

the development of a clinically useful cell therapy we need to define better criteria for patient selection and how graft

placement should be optimized in each individual. Most importantly, we need to generate large numbers of viable

dopamine neurons in preparations that are standardized and quality controlled. Stem cells could be useful as an unlimited

source of dopamine neurons. Thus far, neurons with at least some dopaminergic characteristics have been generated

from stem cells. In most cases, however, their survival after grafting in animals has been poor, and it is also unclear

if they function as normal dopamine neurons. Several scientific issues need to be addressed before stem cell-based therapies

can be tested in PD patients. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Parkinson disease, neural transplantation, stem cell, striatum positron emission tomography, dopamine
in
Neurosurgical Focus
volume
13
issue
5
publisher
American Association of Neurological Surgeons
external identifiers
  • scopus:30344486530
ISSN
1092-0684
language
English
LU publication?
yes
id
31bd356f-e85b-4ad3-9339-1d47b0d4c47d (old id 134947)
alternative location
http://www.aans.org/education/journal/neurosurgical/nov02/13-5-2.pdf
date added to LUP
2007-07-25 10:05:35
date last changed
2017-09-03 04:28:32
@article{31bd356f-e85b-4ad3-9339-1d47b0d4c47d,
  abstract     = {Clinical studies involving intrastriatal transplantation of embryonic mesencephalic tissue in patients with Parkinson<br/><br>
disease (PD) have provided proof-of-principle for the cell replacement strategy in this disorder. The grafted dopaminergic<br/><br>
neurons can reinnervate the denervated striatum, restore regulated dopamine release and movement-related<br/><br>
frontal cortical activation, and produce significant symptomatic relief. In the most successful cases, patients have been<br/><br>
able to withdraw from levodopa treatment after undergoing transplantation and resume an independent life. There are,<br/><br>
however, several problems linked to the use of primary embryonic tissue: 1) lack of sufficient amounts of tissue for<br/><br>
transplantation in a large number of patients; 2) variability of functional outcome (major improvement in some and<br/><br>
modest if any clinical benefit in others); and 3) occurrence of troublesome dyskinesias in a significant proportion of<br/><br>
patients after transplantation. Thus, neural transplantation is still at an experimental stage in the treatment of PD. For<br/><br>
the development of a clinically useful cell therapy we need to define better criteria for patient selection and how graft<br/><br>
placement should be optimized in each individual. Most importantly, we need to generate large numbers of viable<br/><br>
dopamine neurons in preparations that are standardized and quality controlled. Stem cells could be useful as an unlimited<br/><br>
source of dopamine neurons. Thus far, neurons with at least some dopaminergic characteristics have been generated<br/><br>
from stem cells. In most cases, however, their survival after grafting in animals has been poor, and it is also unclear<br/><br>
if they function as normal dopamine neurons. Several scientific issues need to be addressed before stem cell-based therapies<br/><br>
can be tested in PD patients.},
  author       = {Lindvall, Olle and Hagell, Peter},
  issn         = {1092-0684},
  keyword      = {Parkinson disease,neural transplantation,stem cell,striatum positron emission tomography,dopamine},
  language     = {eng},
  number       = {5},
  publisher    = {American Association of Neurological Surgeons},
  series       = {Neurosurgical Focus},
  title        = {Role of cell therapy in Parkinson disease.},
  volume       = {13},
  year         = {2002},
}