Role of cell therapy in Parkinson disease.
(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:
https://lup.lub.lu.se/record/134947
- author
- Lindvall, Olle LU and Hagell, Peter LU
- organization
- publishing date
- 2002
- 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
- 2016-04-01 15:37:14
- date last changed
- 2022-01-28 06:16:31
@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}},
keywords = {{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.}},
url = {{http://www.aans.org/education/journal/neurosurgical/nov02/13-5-2.pdf}},
volume = {{13}},
year = {{2002}},
}