Freeman T B
Division of Neurosurgery, University of South Florida, Tampa 33606, USA.
Exp Neurol. 1997 Mar;144(1):47-50. doi: 10.1006/exnr.1996.6387.
The efficacy of fetal tissue transplants in the treatment of Parkinson's disease has been demonstrated preliminarily. However, results are short term, and have not been confirmed in prospective randomized controlled trials. Furthermore, although patients are improved, they remain severely disabled. There are several problems with the widespread clinical use of fetal tissue that make the use of molecular biological strategies more compelling. Several conceptual problems are shared by both fetal and molecular biological neuroreconstruction strategies. It is necessary to characterize the "dose" of the transplanted therapeutic agent as well as its volume of distribution. The symptoms that may improve following neuronal reconstruction are likely to be directly related to the somatotopic localization of the transplants; the duration of benefit should be long enough to be relevant in a chronic disease such as Parkinson's disease. Operative therapies that utilize gene therapy or other reconstructive neurosurgical techniques are likely to require novel clinical trial designs to demonstrate their efficacy.
胎儿组织移植治疗帕金森病的疗效已得到初步证实。然而，结果是短期的，尚未在前瞻性随机对照试验中得到证实。此外，尽管患者有所改善，但仍严重残疾。胎儿组织广泛临床应用存在若干问题，这使得分子生物学策略的应用更具吸引力。胎儿和分子生物学神经重建策略都存在几个概念性问题。有必要确定移植治疗剂的“剂量”及其分布体积。神经元重建后可能改善的症状可能与移植的躯体定位直接相关；受益持续时间应足够长，以对帕金森病等慢性疾病有意义。利用基因治疗或其他重建性神经外科技术的手术疗法可能需要新颖的临床试验设计来证明其疗效。
