Cova Lidia, Silani Vincenzo
Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milano, Italy;
Stem Cells Cloning. 2010 Oct 27;3:145-56. doi: 10.2147/SCCAA.S8662.
Neurodegenerative diseases are a growing public health challenge, and amyotrophic lateral sclerosis (ALS) remains a fatal incurable disease. The advent of stem cell therapy has opened new horizons for both researchers and ALS patients, desperately looking for a treatment. ALS must be considered a systemic disease affecting many cell phenotypes besides motor neurons, even outside the central nervous system. Cell replacement therapy needs to address the specific neurobiological issues of ALS to safely and efficiently reach clinical settings. Moreover, the enormous potential of induced pluripotent cells directly derived from patients for modeling and understanding the pathological mechanisms, in correlation with the discoveries of new genes and animal models, provides new opportunities that need to be integrated with previously described transplantation strategies. Finally, a careful evaluation of preclinical data in conjunction with wary patient choice in clinical trials needs to be established in order to generate meaningful results.
神经退行性疾病对公共卫生构成了日益严峻的挑战,而肌萎缩侧索硬化症(ALS)仍然是一种致命的不治之症。干细胞疗法的出现为研究人员和急切寻求治疗方法的ALS患者开辟了新的前景。ALS必须被视为一种全身性疾病,它不仅会影响运动神经元,甚至会影响中枢神经系统以外的许多细胞表型。细胞替代疗法需要解决ALS的特定神经生物学问题,以便安全有效地应用于临床。此外,直接从患者身上获取的诱导多能细胞在与新基因和动物模型的发现相关联时,对于模拟和理解病理机制具有巨大潜力,这提供了新的机会,需要与之前描述的移植策略相结合。最后,为了产生有意义的结果,需要在临床试验中对临床前数据进行仔细评估,并谨慎选择患者。