Subramanian T
Department of Neurology, Cleveland Clinic Foundation, OH 44195, USA.
Semin Neurol. 2001;21(1):103-15. doi: 10.1055/s-2001-13125.
Cell transplantation is an experimental therapy for Parkinson's disease (PD) and other movement disorders. Several open-label research trials have shown clinically meaningful improvement in parkinsonian signs and symptoms after striatal transplantation of allogeneic fetal ventral mesencephalic (FVM) tissue. However, ethical concerns, variability in surgical techniques, and reports of unusual late complications in a few patients in a clinical trial have limited the use of allogeneic FVM tissue to a few research centers. Research into alternative cell sources such as porcine FVM and allogeneic retinal pigment epithelial cells has shown promising results in preclinical trials, and they are currently being tested in clinical trials. Novel strategies to improve cell survival and to avoid immune rejection of transplants show promising results in preclinical trials. This article focuses on these recent advances and compares the potential clinical utility of these emerging cell therapies for the treatment of advanced PD.
细胞移植是治疗帕金森病(PD)和其他运动障碍的一种实验性疗法。几项开放标签研究试验表明,在将同种异体胎儿腹侧中脑(FVM)组织纹状体移植后,帕金森病体征和症状有了具有临床意义的改善。然而,伦理问题、手术技术的差异以及一项临床试验中少数患者出现异常晚期并发症的报告,限制了同种异体FVM组织仅在少数研究中心使用。对猪FVM和同种异体视网膜色素上皮细胞等替代细胞来源的研究在临床前试验中显示出了有前景的结果,目前正在临床试验中进行测试。改善细胞存活和避免移植免疫排斥的新策略在临床前试验中显示出了有前景的结果。本文重点关注这些最新进展,并比较这些新兴细胞疗法治疗晚期PD的潜在临床效用。