Shah Siddharth, Mansour Hadeel M, Lucke-Wold Brandon
Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA.
Cells. 2025 Jan 3;14(1):42. doi: 10.3390/cells14010042.
Huntington's disease (HD) is an inherited neurodegenerative disease characterized by uncontrolled movements, emotional disturbances, and progressive cognitive impairment. It is estimated to affect 4.3 to 10.6 per 100,000 people worldwide, and the mean prevalence rate among all published studies, reviews, and genetic HD registries is 5.7 per 100,000. A key feature of HD is the loss of striatal neurons and cortical atrophy. Although there is no cure at present, the discovery of the gene causing HD has brought us into a new DNA era and therapeutic advances for several neurological disorders. PubMed was systematically searched using three search strings: '"Huntington disease" + "stem cell"', '"Huntington disease" + Mesenchymal stromal cell', and '"Huntington disease" + "induced pluripotent stem cell"'. For each string, the search results were categorized based on cell type, and papers that included a clinical analysis were categorized as well. The data were extracted up to 2024. We did not include other databases in our search to have a comparable and systematic review of the literature on the topic. The collected data were analyzed and used for critical interpretation in the present review. Data are presented chronologically as clinical studies were published. Therapeutic strategies based on stem cells have drawn a lot of interest as possible HD therapies. Recent research indicates that NSCs have been the most often utilized stem cell type for treating HD. NSCs have been generated and extracted from a variety of sources, including HD patients' somatic cells and the brain itself. There is strong evidence supporting the transplantation of stem cells or their derivatives in HD animal models, even if stem-cell-based preclinical and clinical trials are still in their early stages. Current treatment only aims at relieving the symptoms rather than treating the pathogenesis of the disease. Although preclinical trials in HD models have shown promise in improving cognitive and motor functions, stem cell therapy still faces many challenges and disadvantages including immunosuppression and immunorejection as well as ethical, technical, and safety concerns. Further research is required for a definitive conclusion.
亨廷顿舞蹈症(HD)是一种遗传性神经退行性疾病,其特征为不受控制的运动、情绪障碍和进行性认知障碍。据估计,全球每10万人中就有4.3至10.6人受其影响,在所有已发表的研究、综述和遗传性HD登记处中,平均患病率为每10万人5.7人。HD的一个关键特征是纹状体神经元丧失和皮质萎缩。尽管目前尚无治愈方法,但导致HD的基因的发现使我们进入了一个新的DNA时代,并为几种神经系统疾病带来了治疗进展。使用三个检索词对PubMed进行了系统检索:“亨廷顿舞蹈症” + “干细胞”、“亨廷顿舞蹈症” + 间充质基质细胞、“亨廷顿舞蹈症” + “诱导多能干细胞”。对于每个检索词,检索结果根据细胞类型进行分类,包含临床分析的论文也进行了分类。数据截至2024年。我们在检索中未纳入其他数据库,以便对该主题的文献进行可比且系统的综述。收集到的数据进行了分析,并用于本综述中的批判性解读。数据按临床研究发表的时间顺序呈现。基于干细胞的治疗策略作为可能的HD治疗方法引起了广泛关注。最近的研究表明,神经干细胞(NSCs)是治疗HD最常用的干细胞类型。NSCs已从多种来源产生和提取,包括HD患者的体细胞和大脑本身。即使基于干细胞的临床前和临床试验仍处于早期阶段,但有强有力的证据支持在HD动物模型中移植干细胞或其衍生物。目前的治疗仅旨在缓解症状,而非治疗疾病的发病机制。尽管HD模型的临床前试验在改善认知和运动功能方面显示出前景,但干细胞治疗仍面临许多挑战和缺点,包括免疫抑制和免疫排斥以及伦理、技术和安全问题。需要进一步研究才能得出明确结论。