Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Cell Transplant. 2013;22(4):639-52. doi: 10.3727/096368912X655082. Epub 2012 Oct 31.
Parkinson's disease (PD) is a common neurodegenerative disease and typically presents with tremor, rigidity, bradykinesia, and postural instability. The hallmark pathological features of PD are loss of dopaminergic neurons in the substantia nigra (SN) and the presence of neuronal intracellular Lewy body (LB) inclusions. In general, PD is sporadic; however, familial PD, while uncommon, can be inherited in an autosomal dominant (AD) or autosomal recessive (AR) manner. The molecular investigations of proteins encoded by PD-linked genes have clarified that ADPD is associated with α-synuclein and LRRK2, while ARPD is linked to Parkin, PINK1, DJ1, and ATP13A2. Understanding these genes can bring insights into this disease and create possible genetic tests for early diagnosis. Long-term pharmacological treatment is so far disappointing, probably due to unwanted complications and decreasing drug efficacy. Several strategies have been proposed and tested as alternatives for PD. Cellular transplantation of dopamine-secreting stem cells opens the door to new therapeutic avenues for restoration of the functions of degenerative and/or damaged neurons in PD.
帕金森病(PD)是一种常见的神经退行性疾病,通常表现为震颤、僵硬、运动迟缓以及姿势不稳。PD 的标志性病理特征是黑质(SN)中多巴胺能神经元的丧失和神经元内路易小体(LB)包涵体的存在。一般来说,PD 是散发性的;然而,家族性 PD 虽然不常见,但可以以常染色体显性(AD)或常染色体隐性(AR)方式遗传。对 PD 相关基因编码蛋白的分子研究已经阐明,ADPD 与α-突触核蛋白和 LRRK2 有关,而 ARPD 与 Parkin、PINK1、DJ1 和 ATP13A2 有关。了解这些基因可以深入了解这种疾病,并为早期诊断创造可能的基因检测方法。到目前为止,长期的药物治疗效果令人失望,可能是由于出现了不必要的并发症和药物疗效下降。已经提出了几种策略作为 PD 的替代治疗方法并进行了测试。多巴胺能分泌干细胞的细胞移植为恢复 PD 中退行性和/或受损神经元的功能开辟了新的治疗途径。