胶质细胞源性神经营养因子的封装细胞生物递送:帕金森病神经保护和神经再生的一种新临床策略?
Encapsulated cell biodelivery of GDNF: a novel clinical strategy for neuroprotection and neuroregeneration in Parkinson's disease?
作者信息
Lindvall Olle, Wahlberg Lars U
机构信息
Laboratory of Neurogenesis and Cell Therapy, Section of Restorative Neurology, Wallenberg Neuroscience Center, University Hospital, SE-221 84, Lund, Sweden.
出版信息
Exp Neurol. 2008 Jan;209(1):82-8. doi: 10.1016/j.expneurol.2007.08.019. Epub 2007 Sep 14.
The main pathology underlying disease symptoms in Parkinson's disease (PD) is a progressive degeneration of nigrostriatal dopamine (DA) neurons. No effective disease-modifying treatment currently exists. Glial cell line-derived neurotrophic factor (GDNF) has neuroprotective and neuroregenerative effects and it enhances dopaminergic function in animal models of PD. These findings raise the possibility that intrastriatal administration of GDNF might be developed into a new clinical strategy for functional preservation and restoration also in PD patients. Gene therapy is a novel tool to increase local levels of GDNF. Transplantation of encapsulated, GDNF-secreting cells is one strategy for ex vivo cell-based gene delivery which has the advantage to allow for removal of the cells if untoward effects occur. Here we summarize studies with such cells in animals, and discuss the results from previous trials with GDNF in PD patients and their implications for the further development of neuroprotective/neuroregenerative therapies. Finally, we describe the different scientific and regulatory issues that need to be addressed in order to reach the clinic and start the first trial in patients.
帕金森病(PD)症状背后的主要病理是黑质纹状体多巴胺(DA)神经元的进行性退化。目前尚无有效的疾病修饰治疗方法。胶质细胞源性神经营养因子(GDNF)具有神经保护和神经再生作用,并能增强PD动物模型中的多巴胺能功能。这些发现增加了这样一种可能性,即纹状体内给予GDNF可能会发展成为一种新的临床策略,用于PD患者的功能保存和恢复。基因治疗是一种增加GDNF局部水平的新工具。移植封装的、分泌GDNF的细胞是一种基于细胞的离体基因递送策略,其优点是如果出现不良影响,可以将细胞移除。在这里,我们总结了在动物中使用此类细胞的研究,并讨论了先前在PD患者中使用GDNF进行试验的结果及其对神经保护/神经再生疗法进一步发展的意义。最后,我们描述了为进入临床并开始首例患者试验而需要解决的不同科学和监管问题。