Parkinson's Disease Cell Transplantation Therapy: A New Dawn With Pluripotent Stem Cell–Based Therapy

IF 4.6 3区 医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY
Etsuro Nakanishi, Hodaka Yamakado, Nobukatsu Sawamoto, Jun Takahashi, Ryosuke Takahashi
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Abstract

Parkinson's disease (PD), a prevalent neurodegenerative disorder, is characterized by progressive loss of dopaminergic neurons in the midbrain. While dopamine replacement therapy effectively manages early symptoms, its long-term use leads to motor complications, highlighting the urgent need for treatments that directly address the underlying pathological changes. Cell transplantation, which aims to replace the lost dopaminergic neurons, has emerged as a promising approach. Early attempts using fetal ventral mesencephalic (fVM) tissue showed proof-of-concept, with some patients experiencing long-term motor improvement. However, these trials have been hampered by inconsistent results, graft-induced dyskinesia (GID), and significant ethical and logistical issues related to tissue supply. These challenges have shifted the focus to pluripotent stem cells (PSCs), including human-induced pluripotent stem cells (iPSCs) and embryonic stem cells (ESCs), which offer a stable, ethically sound, and scalable source of high-quality cells. Recent clinical trials using PSCs suggest a turning point. All reported clinical trials demonstrated the safety and feasibility of this approach. The need for long-term safety and efficacy data, patient stratification, and techniques to improve graft survival are key areas of future research. Nevertheless, recent clinical trial successes suggest that cell transplantation is moving beyond symptomatic relief to become a truly restorative therapy for PD.

Abstract Image

帕金森氏病细胞移植治疗:多能干细胞治疗的新曙光
帕金森病(PD)是一种常见的神经退行性疾病,其特征是中脑多巴胺能神经元的进行性丧失。虽然多巴胺替代疗法可以有效地控制早期症状,但长期使用会导致运动并发症,因此迫切需要直接解决潜在病理变化的治疗方法。细胞移植,旨在取代失去的多巴胺能神经元,已经成为一种很有前途的方法。早期使用胎儿腹侧中脑(fVM)组织的尝试证明了这一概念,一些患者经历了长期的运动改善。然而,这些试验受到不一致的结果、移植物诱导的运动障碍(GID)以及与组织供应相关的重大伦理和后勤问题的阻碍。这些挑战已经将焦点转移到多能干细胞(PSCs),包括人类诱导的多能干细胞(iPSCs)和胚胎干细胞(ESCs),它们提供了稳定的、合乎伦理的、可扩展的高质量细胞来源。最近使用psc的临床试验表明这是一个转折点。所有报道的临床试验都证明了这种方法的安全性和可行性。对长期安全性和有效性数据、患者分层和提高移植物存活率的技术的需求是未来研究的关键领域。然而,最近的临床试验成功表明,细胞移植正在超越症状缓解,成为帕金森病的真正恢复性治疗。
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来源期刊
Journal of Neurochemistry
Journal of Neurochemistry 医学-神经科学
CiteScore
9.30
自引率
2.10%
发文量
181
审稿时长
2.2 months
期刊介绍: Journal of Neurochemistry focuses on molecular, cellular and biochemical aspects of the nervous system, the pathogenesis of neurological disorders and the development of disease specific biomarkers. It is devoted to the prompt publication of original findings of the highest scientific priority and value that provide novel mechanistic insights, represent a clear advance over previous studies and have the potential to generate exciting future research.
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