Yin Dali, Valles Francisco E, Fiandaca Massimo S, Forsayeth John, Larson Paul, Starr Phillip, Bankiewicz Krystof S
Department of Neurosurgery, University of California San Francisco, 1855 Folsom Street, San Francisco, CA 94103, United States.
J Neurosci Methods. 2009 Jan 30;176(2):200-5. doi: 10.1016/j.jneumeth.2008.08.027. Epub 2008 Sep 2.
Convection-enhanced delivery (CED) has recently entered the clinic and represents a promising new delivery option for targeted gene therapy in Parkinson's disease (PD). The prime stereotactic target for the majority of recent gene therapy clinical trials has been the human putamen. The stereotactic delivery of therapeutic agents into putamen (or other subcortical structures) via CED remains problematic due to the difficulty in knowing what volume of therapeutic agent to deliver. Preclinical studies in non-human primates (NHP) offer a way to model treatment strategies prior to clinical trials. Understanding more accurately the volumetric differences in striatum, especially putamen, between NHP and humans is essential in predicting convective volume parameters in human clinical trials. In this study, magnetic resonance images (MRI) were obtained for volumetric measurements of striatum (putamen and caudate nucleus) and whole brain from 11 PD patients, 13 aged healthy human subjects, as well as 8 parkinsonian and 30 normal NHP. The human brain is 13-18 times larger than the monkey brain. However, this ratio is significantly smaller for striatum (5.7-6.5), caudate nucleus (4.6-6.6) and putamen (4.4-6.6). Size and species of the monkeys used for this comparative study are responsible for differences in ratios for each structure between monkeys and humans. This volumetric ratio may have important implications in the design of clinical therapies for PD and Huntington's disease and should be considered when local therapies such as gene transfer, local protein administration or cellular replacement are translated based on NHP research.
对流增强递送(CED)最近已进入临床,是帕金森病(PD)靶向基因治疗中一种有前景的新递送选择。近期大多数基因治疗临床试验的主要立体定向靶点是人类壳核。由于难以确定要递送的治疗剂体积,通过CED将治疗剂立体定向递送至壳核(或其他皮质下结构)仍然存在问题。非人灵长类动物(NHP)的临床前研究为在临床试验之前模拟治疗策略提供了一种方法。更准确地了解NHP与人类之间纹状体,尤其是壳核的体积差异,对于预测人类临床试验中的对流体积参数至关重要。在本研究中,获取了11例PD患者、13例老年健康人类受试者以及8只帕金森病NHP和30只正常NHP的磁共振图像(MRI),用于测量纹状体(壳核和尾状核)和全脑的体积。人类大脑比猴脑大13 - 18倍。然而,纹状体(5.7 - 6.5)、尾状核(4.6 - 6.6)和壳核(4.4 - 6.6)的这一比例要小得多。用于该比较研究的猴子的大小和种类导致了猴子与人类之间各结构比例的差异。这种体积比例可能对PD和亨廷顿病的临床治疗设计具有重要意义,并且在基于NHP研究进行基因转移、局部蛋白质给药或细胞替代等局部治疗转化时应予以考虑。