Rosenfeld J V, Kilpatrick T J, Bartlett P F
Neurosurgery Department, Monash Medical Centre, Clayton, Vic, Australia.
Aust N Z J Med. 1991 Aug;21(4):477-84. doi: 10.1111/j.1445-5994.1991.tb01357.x.
The medical treatment of severe Parkinson's disease is presently problematical and neural transplantation has been proposed as an additional therapy. While functional improvement in animal models of Parkinson's disease has been reported following neural grafting, the treatment of human Parkinsonian patients by adrenal medulla autografting into the neostriatum has produced little clinical improvement overall, and is associated with significant morbidity. Although recent grafting of human foetal dopaminergic neurons has shown more promise, many of the case reports lack rigorous assessment and long term follow-up. Further laboratory experimentation in animal models, particularly primates, to ascertain the mechanism of action of the grafts, the optimal sites for grafting, and the immunological responses to grafting, is essential. The future success of neural transplantation for Parkinson's disease may depend on the development of novel strategies such as the use of growth factors to aid cell survival, regulate neurotransmitter levels and promote connectivity. However, at present, the clinical application of neural transplantation for Parkinson's disease is premature.
重度帕金森病的医学治疗目前存在问题，神经移植已被提议作为一种辅助治疗方法。虽然在帕金森病动物模型中，神经移植后已有功能改善的报道，但将肾上腺髓质自体移植到新纹状体来治疗人类帕金森病患者，总体上临床改善甚微，且伴有显著的发病率。尽管最近移植人类胎儿多巴胺能神经元显示出更大的前景，但许多病例报告缺乏严格评估和长期随访。在动物模型，尤其是灵长类动物中进行进一步的实验室实验，以确定移植的作用机制、最佳移植部位以及对移植的免疫反应，至关重要。帕金森病神经移植未来的成功可能取决于新策略的开发，如使用生长因子来帮助细胞存活、调节神经递质水平并促进连接。然而，目前帕金森病神经移植的临床应用尚不成熟。
