Widner H
Department of Neurology, Lund University, Sweden.
Adv Neurol. 1999;80:641-9.
Neural tissue grafting can be highly effective and constitutes a potentially curative approach for progressive neurodegenerative disorders such as PD. Virtually all signs and symptoms of PD have been shown to improve after grafting but not necessarily simultaneously in one patient. Several technical aspects require improvement before widespread use of neural tissue implants can be recommended. These include better definition of donor tissue in terms of infectious risks, the need and duration of immunosuppressive treatment, and the minimal amount of tissue needed for definite benefit. Somatotropism within the basal ganglia system (with specific targeted grafts) aimed at relieving certain symptoms need to be elucidated experimentally. Interaction with the underlying disease process is also important to consider, and the role of intracerebral grafts in differing patterns of parkinsonism needs to be addressed. Grafting is potentially a very powerful therapeutic approach that may evolve to be the ideal treatment for patients with young-onset disease who, when starting to experience fluctuations, may have a life expectancy of 25 years with the disease. For these patients, grafting is likely to be both effective and long-lasting. For these patients, it is likely to become an efficient and also economically sound treatment for the patients and society. Provided that the transplantation procedure is performed judiciously and with strict adherence to basic principles defined from animal and human experimentation, more patients are likely to benefit from the procedure.
神经组织移植可能非常有效，对于帕金森病等进行性神经退行性疾病而言，是一种潜在的治愈方法。实际上，帕金森病的所有体征和症状在移植后都已显示有所改善，但不一定在同一名患者身上同时出现。在推荐广泛使用神经组织植入物之前，有几个技术方面需要改进。这些方面包括根据感染风险更好地定义供体组织、免疫抑制治疗的必要性和持续时间，以及获得明确疗效所需的最少组织量。旨在缓解某些症状的基底神经节系统内的生长激素释放作用（采用特定的靶向移植）需要通过实验加以阐明。与潜在疾病进程的相互作用也很重要，需要探讨脑内移植在不同帕金森病模式中的作用。移植可能是一种非常有效的治疗方法，对于年轻发病的患者，当开始出现病情波动时，预期寿命可能还有25年，移植可能会演变成理想的治疗方法。对于这些患者，移植可能既有效又持久。对于这些患者，它可能会成为对患者和社会而言既高效又经济合理的治疗方法。只要移植手术审慎进行，并严格遵循从动物和人体实验中确定的基本原则，更多患者可能会从该手术中受益。
