Disciplina de Neurologia Experimental, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Stem Cell Rev Rep. 2011 Nov;7(4):1006-17. doi: 10.1007/s12015-011-9256-4.
Pre-clinical studies have supported the use of mesenchymal stem cells (MSC) to treat highly prevalent neurodegenerative diseases such as Parkinson's disease (PD) but preliminary trials have reported controversial results. In a rat model of PD induced by MPTP neurotoxin, we first observed a significant bilateral preservation of dopaminergic neurons in the substantia nigra and prevention of motor deficits typically observed in PD such as hypokinesia, catalepsy, and bradykinesia, following intracerebral administration of human umbilical cord-derived MSC (UC-MSC) early after MPTP injury. However, surprisingly, administration of fibroblasts, mesenchymal cells without stem cell properties, as a xenotransplantation control was highly detrimental, causing significant neurodegeneration and motor dysfunction independently of MPTP. This observation prompted us to further investigate the consequences of transplanting a MSC preparation contaminated with fibroblasts, a plausible circumstance in cell therapy since both cell types display similar immunophenotype and can be manipulated in vitro under the same conditions. Here we show for the first time, using the same experimental model and protocol, that transplantation of UC-MSC induced potent neuroprotection in the brain resulting in clinical benefit. However, co-transplantation of UC-MSC with fibroblasts reverted therapeutic efficacy and caused opposite damaging effects, significantly exacerbating neurodegeneration and motor deficits in MPTP-exposed rats. Besides providing a rationale for testing UC-MSC transplantation in early phases of PD aiming at delaying disease progression, our pre-clinical study suggests that fibroblasts may be common cell contaminants affecting purity of MSC preparations and clinical outcome in stem cell therapy protocols, which might also explain discrepant clinical results.
临床前研究支持使用间充质干细胞(MSC)来治疗帕金森病(PD)等高发神经退行性疾病,但初步试验报告的结果存在争议。在 MPTP 神经毒素诱导的 PD 大鼠模型中,我们首先观察到,在 MPTP 损伤后早期向脑内给予人脐带来源的 MSC(UC-MSC)后,黑质中多巴胺能神经元出现显著的双侧保留,并预防了 PD 中通常观察到的运动缺陷,如运动减少、僵住和运动迟缓。然而,令人惊讶的是,作为异种移植对照的成纤维细胞(没有干细胞特性的间充质细胞)给药具有高度的危害性,导致明显的神经退行性变和运动功能障碍,而与 MPTP 无关。这一观察结果促使我们进一步研究移植含有成纤维细胞的 MSC 制剂的后果,这在细胞治疗中是一种合理的情况,因为这两种细胞类型具有相似的免疫表型,并且可以在相同的条件下进行体外操作。在这里,我们首次使用相同的实验模型和方案表明,UC-MSC 的移植诱导了大脑中的强大神经保护作用,从而带来了临床益处。然而,UC-MSC 与成纤维细胞的共移植逆转了治疗效果,并导致相反的损伤作用,显著加重了 MPTP 暴露大鼠的神经退行性变和运动缺陷。除了为在 PD 的早期阶段测试 UC-MSC 移植以延迟疾病进展提供了依据外,我们的临床前研究还表明,成纤维细胞可能是常见的细胞污染物,影响 MSC 制剂的纯度和干细胞治疗方案的临床结果,这也可能解释了不一致的临床结果。