Molecular Neurobiology Laboratory, Department of Psychiatry and McLean Hospital, Harvard Medical School, Belmont, MA, USA.
Program in Neuroscience, Harvard Medical School, Belmont, MA, USA.
Nature. 2023 Jul;619(7970):606-615. doi: 10.1038/s41586-023-06300-4. Epub 2023 Jul 12.
The specific loss of midbrain dopamine neurons (mDANs) causes major motor dysfunction in Parkinson's disease, which makes cell replacement a promising therapeutic approach. However, poor survival of grafted mDANs remains an obstacle to successful clinical outcomes. Here we show that the surgical procedure itself (referred to here as 'needle trauma') triggers a profound host response that is characterized by acute neuroinflammation, robust infiltration of peripheral immune cells and brain cell death. When midbrain dopamine (mDA) cells derived from human induced pluripotent stem (iPS) cells were transplanted into the rodent striatum, less than 10% of implanted tyrosine hydroxylase (TH) mDANs survived at two weeks after transplantation. By contrast, TH grafted cells mostly survived. Notably, transplantation of autologous regulatory T (T) cells greatly modified the response to needle trauma, suppressing acute neuroinflammation and immune cell infiltration. Furthermore, intra-striatal co-transplantation of T cells and human-iPS-cell-derived mDA cells significantly protected grafted mDANs from needle-trauma-associated death and improved therapeutic outcomes in rodent models of Parkinson's disease with 6-hydroxydopamine lesions. Co-transplantation with T cells also suppressed the undesirable proliferation of TH grafted cells, resulting in more compact grafts with a higher proportion and higher absolute numbers of TH neurons. Together, these data emphasize the importance of the initial inflammatory response to surgical injury in the differential survival of cellular components of the graft, and suggest that co-transplanting autologous T cells effectively reduces the needle-trauma-induced death of mDANs, providing a potential strategy to achieve better clinical outcomes for cell therapy in Parkinson's disease.
中脑多巴胺神经元(mDAN)的特异性丧失导致帕金森病的主要运动功能障碍,这使得细胞替代成为一种有前途的治疗方法。然而,移植的 mDAN 存活率低仍然是成功临床结果的障碍。在这里,我们表明手术本身(这里称为“针道损伤”)会引发深刻的宿主反应,其特征是急性神经炎症、外周免疫细胞和脑细胞的大量浸润和死亡。当源自人诱导多能干细胞(iPS)的中脑多巴胺(mDA)细胞被移植到啮齿动物纹状体时,不到 10%的植入酪氨酸羟化酶(TH)mDAN 在移植后两周存活。相比之下,TH 移植细胞大多存活。值得注意的是,自体调节性 T(T)细胞的移植极大地改变了对针道损伤的反应,抑制了急性神经炎症和免疫细胞浸润。此外,T 细胞和人 iPS 细胞衍生的 mDA 细胞的纹状体内共移植显著保护了移植的 mDAN 免受针道损伤相关死亡,并改善了 6-羟多巴胺损伤的帕金森病啮齿动物模型的治疗结果。与 T 细胞共移植还抑制了 TH 移植细胞的不期望增殖,导致移植体更紧凑,TH 神经元的比例和绝对数量更高。总之,这些数据强调了手术损伤初始炎症反应对移植物细胞成分存活的差异的重要性,并表明共移植自体 T 细胞可有效减少 mDAN 因针道损伤引起的死亡,为帕金森病细胞治疗提供了更好的临床结果的潜在策略。