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基于多能干细胞的帕金森病治疗:现状与展望。

Pluripotent stem cell-based therapy for Parkinson's disease: Current status and future prospects.

机构信息

Department of Psychiatry, McLean Hospital, Harvard Medical School, United States; Laboratory for Translational Research on Neurodegeneration, 115 Mill Street, Belmont, MA, 02478, United States; Program for Neuropsychiatric Research, 115 Mill Street, Belmont, MA, 02478, United States.

Department of Psychiatry, McLean Hospital, Harvard Medical School, United States; Molecular Neurobiology Laboratory, Program in Neuroscience and Harvard Stem Cell Institute, McLean Hospital, Harvard Medical School, 115 Mill Street, Belmont, MA, 02478, United States.

出版信息

Prog Neurobiol. 2018 Sep;168:1-20. doi: 10.1016/j.pneurobio.2018.04.005. Epub 2018 Apr 11.

Abstract

Parkinson's disease (PD) is one of the most common neurodegenerative disorders, which affects about 0.3% of the general population. As the population in the developed world ages, this creates an escalating burden on society both in economic terms and in quality of life for these patients and for the families that support them. Although currently available pharmacological or surgical treatments may significantly improve the quality of life of many patients with PD, these are symptomatic treatments that do not slow or stop the progressive course of the disease. Because motor impairments in PD largely result from loss of midbrain dopamine neurons in the substantia nigra pars compacta, PD has long been considered to be one of the most promising target diseases for cell-based therapy. Indeed, numerous clinical and preclinical studies using fetal cell transplantation have provided proof of concept that cell replacement therapy may be a viable therapeutic approach for PD. However, the use of human fetal cells as a standardized therapeutic regimen has been fraught with fundamental ethical, practical, and clinical issues, prompting scientists to explore alternative cell sources. Based on groundbreaking establishments of human embryonic stem cells and induced pluripotent stem cells, these human pluripotent stem cells have been the subject of extensive research, leading to tremendous advancement in our understanding of these novel classes of stem cells and promising great potential for regenerative medicine. In this review, we discuss the prospects and challenges of human pluripotent stem cell-based cell therapy for PD.

摘要

帕金森病(PD)是最常见的神经退行性疾病之一,影响大约 0.3%的普通人群。随着发达世界人口老龄化,这给社会带来了经济和生活质量两方面的负担,不仅影响患者,也影响支持他们的家庭。尽管目前可用的药物或手术治疗可能显著改善许多 PD 患者的生活质量,但这些治疗方法只是对症治疗,不能减缓或阻止疾病的进展。由于 PD 中的运动障碍主要是由于中脑黑质致密部的多巴胺神经元丧失引起的,因此 PD 长期以来一直被认为是细胞治疗最有希望的目标疾病之一。事实上,许多使用胎儿细胞移植的临床和临床前研究已经提供了概念验证,即细胞替代疗法可能是 PD 的一种可行治疗方法。然而,将人胎儿细胞作为标准化治疗方案使用存在根本的伦理、实际和临床问题,促使科学家探索替代细胞来源。基于人类胚胎干细胞和诱导多能干细胞的开创性建立,这些人类多能干细胞已经成为广泛研究的主题,极大地促进了我们对这些新型干细胞的理解,并为再生医学带来了巨大的潜力。在这篇综述中,我们讨论了基于人类多能干细胞的细胞治疗 PD 的前景和挑战。

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