Preclinical Parkinson's Research Program, Wisconsin National Primate Research Center, University of Wisconsin, Madison, Wisconsin 53715, USA.
Antioxid Redox Signal. 2009 Sep;11(9):2189-208. doi: 10.1089/ars.2009.2654.
Parkinson's disease (PD) researchers have pioneered the use of cell-based therapies (CBTs) in the central nervous system. CBTs for PD were originally envisioned as a way to replace the dopaminergic nigral neurons lost with the disease. Several sources of catecholaminergic cells, including autografts of adrenal medulla and allografts or xenografts of mesencephalic fetal tissue, were successfully assessed in animal models, but their clinical translation has yielded poor results and much controversy. Recent breakthroughs on cell biology are helping to develop novel cell lines that could be used for regenerative medicine. Their future successful clinical application depends on identifying and solving the problems encountered in previous CBTs trials. In this review, we critically analyze past CBTs' clinical translation, the impact of the host in graft survival, and the role of preclinical studies and emerging new cell lines. We propose that the prediction of clinical results from preclinical studies requires experimental designs that allow blind data acquisition and statistical analysis, assessment of the therapy in models that parallel clinical conditions, looking for sources of complications or side effects, and limiting optimism bias when reporting outcomes.
帕金森病(PD)研究人员率先在中枢神经系统中使用基于细胞的疗法(CBT)。最初设想 PD 的 CBT 是一种替代疾病导致的多巴胺能黑质神经元的方法。包括肾上腺髓质自体移植物和中脑胎组织同种异体或异种移植物在内的几种儿茶酚胺能细胞来源,在动物模型中得到了成功评估,但它们的临床转化效果不佳,引起了很大争议。细胞生物学的最新突破正在帮助开发新的细胞系,这些细胞系可用于再生医学。它们未来的临床成功应用取决于能否解决之前 CBT 试验中遇到的问题。在这篇综述中,我们批判性地分析了过去 CBT 的临床转化、宿主对移植物存活的影响,以及临床前研究和新兴的新细胞系的作用。我们提出,从临床前研究预测临床结果需要实验设计,允许进行盲数据采集和统计分析,在与临床情况相似的模型中评估治疗效果,寻找并发症或副作用的来源,并在报告结果时限制乐观偏见。