1
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Maxan A, Mason S, Saint-Pierre M, Smith E, Ho A, Harrower T, Watts C, Tai Y, Pavese N, Savage JC, Tremblay MÈ, Gould P, Rosser AE, Dunnett SB, Piccini P, Barker RA, Cicchetti F. Outcome of cell suspension allografts in a patient with Huntington's disease. Ann Neurol 2018; 84:950-956. [PMID: 30286516 PMCID: PMC6587549 DOI: 10.1002/ana.25354] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 09/27/2018] [Accepted: 09/27/2018] [Indexed: 12/22/2022]
Abstract
For patients with incurable neurodegenerative disorders such as Huntington's (HD) and Parkinson's disease, cell transplantation has been explored as a potential treatment option. Here, we present the first clinicopathological study of a patient with HD in receipt of cell-suspension striatal allografts who took part in the NEST-UK multicenter clinical transplantation trial. Using various immunohistochemical techniques, we found a discrepancy in the survival of grafted projection neurons with respect to grafted interneurons as well as major ongoing inflammatory and immune responses to the grafted tissue with evidence of mutant huntingtin aggregates within the transplant area. Our results indicate that grafts can survive more than a decade post-transplantation, but show compromised survival with inflammation and mutant protein being observed within the transplant site. Ann Neurol 2018;84:950-956.
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Affiliation(s)
- Alexander Maxan
- Centre de Recherche du CHU de Québec (CHUQ), Axe Neurosciences, Québec, QC, Canada
| | - Sarah Mason
- John van Geest Centre for Brain Repair and Department of Clinical Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Martine Saint-Pierre
- Centre de Recherche du CHU de Québec (CHUQ), Axe Neurosciences, Québec, QC, Canada
| | - Emma Smith
- John van Geest Centre for Brain Repair and Department of Clinical Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Aileen Ho
- John van Geest Centre for Brain Repair and Department of Clinical Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Timothy Harrower
- Royal Devon and Exeter Hospital, Barrack Road, Exeter, Devon, United Kingdom
| | - Colin Watts
- John van Geest Centre for Brain Repair and Department of Clinical Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Yen Tai
- John van Geest Centre for Brain Repair and Department of Clinical Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Nicola Pavese
- Department of Medicine, Neurology Imaging Unit, Imperial College London, London, United Kingdom
| | - Julie C Savage
- Centre de Recherche du CHU de Québec (CHUQ), Axe Neurosciences, Québec, QC, Canada.,Département de médecine moléculaire, Université Laval, Québec, QC, Canada
| | - Marie-Ève Tremblay
- Centre de Recherche du CHU de Québec (CHUQ), Axe Neurosciences, Québec, QC, Canada.,Département de médecine moléculaire, Université Laval, Québec, QC, Canada
| | - Peter Gould
- Laboratoire de neuropathology, Hôpital de l'Enfant-Jésus-CHU de Québec, Québec, QC, United Kingdom
| | - Anne E Rosser
- Brain Repair Group and BRAIN unit, Neuroscience and Mental Health Research Institute and School of Biosciences, Cardiff University, Cardiff, United Kingdom
| | - Stephen B Dunnett
- Brain Repair Group and BRAIN unit, Neuroscience and Mental Health Research Institute and School of Biosciences, Cardiff University, Cardiff, United Kingdom
| | - Paola Piccini
- Department of Medicine, Neurology Imaging Unit, Imperial College London, London, United Kingdom
| | - Roger A Barker
- John van Geest Centre for Brain Repair and Department of Clinical Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Francesca Cicchetti
- Centre de Recherche du CHU de Québec (CHUQ), Axe Neurosciences, Québec, QC, Canada.,Département de Psychiatrie & Neurosciences, Université Laval, Québec, QC, Canada
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2
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Dissection and Preparation of Human Primary Fetal Ganglionic Eminence Tissue for Research and Clinical Applications. Methods Mol Biol 2018; 1780:573-583. [PMID: 29856036 DOI: 10.1007/978-1-4939-7825-0_26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Here, we describe detailed dissection and enzymatic dissociation protocols for the ganglionic eminences from the developing human brain to generate viable quasi-single cell suspensions for subsequent use in transplantation or cell culture. These reliable and reproducible protocols can provide tissue for use in the study of the developing human brain, as well as for the preparation of donor cells for transplantation in Huntington's disease (HD). For use in the clinic as a therapy for HD, the translation of these protocols from the research laboratory to the GMP suite is described, including modification to reagents used and appropriate monitoring and tissue release criteria.
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3
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Hadman M, Chiu FC, Lobel D, Borlongan CV. Article Commentary: Standardized Embryonic Tissue Collection and Hibernation Procedures, and MRI-Based Graft Assessment: Advancing Neural Transplantation Therapy for Huntington's Disease. Cell Transplant 2017; 12:677-8. [PMID: 15597511 DOI: 10.3727/000000003108747235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Martin Hadman
- Department of Neurology, Medical College of Georgia and Research and Affiliations Service Line, Augusta VMAC, GA 30912, USA
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4
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Farrington M, Wreghitt TG, Lever AML, Dunnett SB, Rosser AE, Barker RA. Neural Transplantation in Huntington's Disease: The NEST-UK Donor Tissue Microbiological Screening Program and Review of the Literature. Cell Transplant 2017; 15:279-94. [PMID: 16898222 DOI: 10.3727/000000006783981927] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Neural transplantation of human fetal tissue for Huntington's disease (HD) is now entering the clinical arena. The safety of the procedure has now been demonstrated in a number of studies, although the efficacy of such an approach is still being investigated. Stringent but practicable screening of the donor tissue for potential pathogens is an essential prerequisite for successful implementation of any novel transplant program that uses human fetal tissue. In this article we summarize the UK-NEST protocol for the screening of human fetal tissue being grafted to patients with mild to moderate HD. We describe the results of microbiological screening of 87 potential tissue donors in a pilot study, and of the first four donor–recipient patients included in the UK-NEST series. The rationale for the adoption and interpretation of the various tests is described and our methodology is compared with those previously used by other centers. This article therefore presents a comprehensive, logical yet pragmatic screening program that could be employed in any clinical studies that use human fetal tissue for neurotransplantation.
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Affiliation(s)
- M Farrington
- Clinical Microbiology and Public Health Laboratory, Health Protection Agency & Addenbrooke's Hospital, Cambridge, UK.
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5
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Borlongan CV, Yu G, Matsukawa N, Yasuhara T, Hara K, Xu L. Article Commentary: Cell Transplantation: Stem Cells in the Spotlight. Cell Transplant 2017; 14:519-526. [DOI: 10.3727/000000005783982774] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- Cesar V. Borlongan
- Neurology/Insttitute of Molecular Medicind & Genetics/School of Graduate Studies, Medical College of Georgia, Augusta, GA, USA
- Research/Affiliations Service Line, Augusta VAMC, Augusta, GA, USA
| | - Guolong Yu
- Neurology/Insttitute of Molecular Medicind & Genetics/School of Graduate Studies, Medical College of Georgia, Augusta, GA, USA
- Research/Affiliations Service Line, Augusta VAMC, Augusta, GA, USA
| | - Noriyuki Matsukawa
- Neurology/Insttitute of Molecular Medicind & Genetics/School of Graduate Studies, Medical College of Georgia, Augusta, GA, USA
- Research/Affiliations Service Line, Augusta VAMC, Augusta, GA, USA
| | - Takao Yasuhara
- Neurology/Insttitute of Molecular Medicind & Genetics/School of Graduate Studies, Medical College of Georgia, Augusta, GA, USA
- Research/Affiliations Service Line, Augusta VAMC, Augusta, GA, USA
| | - Koichi Hara
- Neurology/Insttitute of Molecular Medicind & Genetics/School of Graduate Studies, Medical College of Georgia, Augusta, GA, USA
- Research/Affiliations Service Line, Augusta VAMC, Augusta, GA, USA
| | - Lin Xu
- Neurology/Insttitute of Molecular Medicind & Genetics/School of Graduate Studies, Medical College of Georgia, Augusta, GA, USA
- Research/Affiliations Service Line, Augusta VAMC, Augusta, GA, USA
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6
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Sanberg PR, Greene-Zavertnik C, Davis CD. Article Commentary: Cell Transplantation: The Regenerative Medicine Journal. A Biennial Analysis of Publications. Cell Transplant 2017; 12:815-825. [DOI: 10.3727/000000003771000165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Paul R. Sanberg
- Center of Excellence for Aging and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd., MDC 78, Tampa, FL 33612
| | - Cathryn Greene-Zavertnik
- Center of Excellence for Aging and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd., MDC 78, Tampa, FL 33612
| | - Cyndy D. Davis
- Center of Excellence for Aging and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd., MDC 78, Tampa, FL 33612
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7
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Li J, He F, Pei M. Chondrogenic priming of human fetal synovium-derived stem cells in an adult stem cell matrix microenvironment. Genes Dis 2015; 2:337-346. [PMID: 30258873 PMCID: PMC6147170 DOI: 10.1016/j.gendis.2015.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 06/29/2015] [Indexed: 02/08/2023] Open
Abstract
Cartilage defects are a challenge to treat clinically due to the avascular nature of cartilage. Low immunogenicity and extensive proliferation and multidifferentiation potential make fetal stem cells a promising source for regenerative medicine. In this study, we aimed to determine whether fetal synovium-derived stem cells (FSDSCs) exhibited replicative senescence and whether expansion on decellularized extracellular matrix (dECM) deposited by adult SDSCs (AECM) promoted FSDSCs' chondrogenic potential. FSDSCs from passage 2 and 9 were compared for chondrogenic potential, using Alcian blue staining for sulfated glycosaminoglycans (GAGs), biochemical analysis for DNA and GAG amounts, and real-time PCR for chondrogenic genes including ACAN and COL2A1. Passage 3 FSDSCs were expanded for one passage on plastic flasks (PL), AECM, or dECM deposited by fetal SDSCs (FECM). During expansion, cell proliferation was evaluated using flow cytometry for proliferation index, stem cell surface markers, and resistance to hydrogen peroxide. During chondrogenic induction, expanded FSDSCs were evaluated for tri-lineage differentiation capacity. We found that cell expansion enhanced FSDSCs' chondrogenic potential at least up to passage 9. Expansion on dECMs promoted FSDSCs' proliferative and survival capacity and adipogenic differentiation but not osteogenic capacity. AECM-primed FSDSCs exhibited an enhanced chondrogenic potential.
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Affiliation(s)
- Jingting Li
- Stem Cell and Tissue Engineering Laboratory, Department of Orthopaedics, West Virginia University, Morgantown, WV 26506, USA.,Division of Exercise Physiology, West Virginia University, Morgantown, WV 26506, USA
| | - Fan He
- Stem Cell and Tissue Engineering Laboratory, Department of Orthopaedics, West Virginia University, Morgantown, WV 26506, USA.,Division of Exercise Physiology, West Virginia University, Morgantown, WV 26506, USA.,Orthopaedic Institute, Soochow University, Suzhou 215007, China
| | - Ming Pei
- Stem Cell and Tissue Engineering Laboratory, Department of Orthopaedics, West Virginia University, Morgantown, WV 26506, USA.,Division of Exercise Physiology, West Virginia University, Morgantown, WV 26506, USA
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8
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Barker RA, Mason SL, Harrower TP, Swain RA, Ho AK, Sahakian BJ, Mathur R, Elneil S, Thornton S, Hurrelbrink C, Armstrong RJ, Tyers P, Smith E, Carpenter A, Piccini P, Tai YF, Brooks DJ, Pavese N, Watts C, Pickard JD, Rosser AE, Dunnett SB. The long-term safety and efficacy of bilateral transplantation of human fetal striatal tissue in patients with mild to moderate Huntington's disease. J Neurol Neurosurg Psychiatry 2013; 84:657-65. [PMID: 23345280 PMCID: PMC3646287 DOI: 10.1136/jnnp-2012-302441] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Huntington's disease (HD) is a fatal autosomal dominant neurodegenerative disease involving progressive motor, cognitive and behavioural decline, leading to death approximately 20 years after motor onset. The disease is characterised pathologically by an early and progressive striatal neuronal cell loss and atrophy, which has provided the rationale for first clinical trials of neural repair using fetal striatal cell transplantation. Between 2000 and 2003, the 'NEST-UK' consortium carried out bilateral striatal transplants of human fetal striatal tissue in five HD patients. This paper describes the long-term follow up over a 3-10-year postoperative period of the patients, grafted and non-grafted, recruited to this cohort using the 'Core assessment program for intracerebral transplantations-HD' assessment protocol. No significant differences were found over time between the patients, grafted and non-grafted, on any subscore of the Unified Huntington's Disease Rating Scale, nor on the Mini Mental State Examination. There was a trend towards a slowing of progression on some timed motor tasks in four of the five patients with transplants, but overall, the trial showed no significant benefit of striatal allografts in comparison with a reference cohort of patients without grafts. Importantly, no significant adverse or placebo effects were seen. Notably, the raclopride positron emission tomography (PET) signal in individuals with transplants, indicated that there was no obvious surviving striatal graft tissue. This study concludes that fetal striatal allografting in HD is safe. While no sustained functional benefit was seen, we conclude that this may relate to the small amount of tissue that was grafted in this safety study compared with other reports of more successful transplants in patients with HD.
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Affiliation(s)
- Roger A Barker
- Cambridge Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
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9
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Precious SV, Rosser AE. Producing striatal phenotypes for transplantation in Huntington's disease. Exp Biol Med (Maywood) 2012; 237:343-51. [PMID: 22490511 DOI: 10.1258/ebm.2011.011359] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Neural transplantation as a therapeutic strategy in neurodegenerative disorders offers to replace cells lost during the disease process, with the potential to reconstruct dysfunctional circuitry, thus alleviating associated disease symptoms. The focal loss of striatal cells, specifically medium-sized spiny neurons (MSN) in Huntington's disease (HD), makes transplantation a therapeutic option. Here, we review the progress made in generating striatal MSN phenotypes for transplantation in HD. We discuss the use of primary fetal tissue as a donor source in both preclinical and clinical studies and assess the options for renewable cell sources. We evaluate progress in directing the differentiation of renewable cells towards a striatal MSN phenotype for HD.
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Affiliation(s)
- Sophie V Precious
- Brain Repair Group, School of Biosciences, Cardiff University, Museum Avenue, Cardiff CF10 3AX, UK.
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10
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Rosser AE, Bachoud-Lévi AC. Clinical trials of neural transplantation in Huntington's disease. PROGRESS IN BRAIN RESEARCH 2012. [PMID: 23195427 DOI: 10.1016/b978-0-444-59575-1.00016-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Clinical neural transplantation in Huntington's disease has moved forward as a series of small studies, which have provided some preliminary proof of principle that neural transplantation can provide benefit. However, to date, such benefits have not been robust, and there are a number of important issues that need to be addressed. These include defining the optimum donor tissue conditions and host characteristics in order to produce reliable benefit in transplant recipients, and whether, and for how long, immunosuppression is needed. Further clinical studies will be required to address these, and other issues, in order to better understand the processes leading to a properly functioning neural graft. Such studies will pave the way for future clinical trials of renewable donor sources, in particular, stem cell-derived neuronal progenitor grafts.
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Affiliation(s)
- Anne E Rosser
- Brain Repair Group, School of Biosciences, Cardiff University, Cardiff, Wales, UK.
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11
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Kelly CM, Precious SV, Torres EM, Harrison AW, Williams D, Scherf C, Weyrauch UM, Lane EL, Allen ND, Penketh R, Amso NN, Kemp PJ, Dunnett SB, Rosser AE. Medical Terminations of Pregnancy: A Viable Source of Tissue for Cell Replacement Therapy for Neurodegenerative Disorders. Cell Transplant 2011; 20:503-13. [DOI: 10.3727/096368910x546580] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
“Proof-of-principle” that cell replacement therapy works for neurodegeneration has been reported, but only using donor cells collected from fetal brain tissue obtained from surgical terminations of pregnancy. Surgical terminations of pregnancy represent an increasingly limited supply of donor cells due to the tendency towards performing medical termination in much of Europe. This imposes a severe constraint on further experimental and clinical cell transplantation research. Therefore, we explore here the feasibility of using medical termination tissue as a donor source. Products of conception were retrieved from surgical terminations over the last 7 years and from medical terminations over the last 2.5 years. The number of collections that yielded fetal tissue, viable brain tissue, and identifiable brain regions (ganglionic eminence, ventral mesencephalon, and neocortex) were recorded. We studied cell viability, cell physiological properties, and differentiation potential both in vitro and following transplantation into the central nervous system of rodent models of neurodegenerative disease. Within equivalent periods, we were able to collect substantially greater numbers of fetal remains from medical than from surgical terminations of pregnancy, and the medical terminations yielded a much higher proportion of identifiable and dissectible brain tissue. Furthermore, we demonstrate that harvested cells retain the capacity to differentiate into neurons with characteristics appropriate to the region from which they are dissected. We show that, contrary to widespread assumption, medical termination of pregnancy-derived fetal brain cells represent a feasible and more readily available source of human fetal tissue for experimental cell transplantation with the potential for use in future clinical trials in human neurodegenerative disease.
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Affiliation(s)
- C. M. Kelly
- Brain Repair Group, School of Biosciences, Cardiff University, Cardiff, UK
| | - S. V. Precious
- Brain Repair Group, School of Biosciences, Cardiff University, Cardiff, UK
| | - E. M. Torres
- Brain Repair Group, School of Biosciences, Cardiff University, Cardiff, UK
| | - A. W. Harrison
- Division of Pathophysiology and Repair, School of Biomedical Sciences, Cardiff University, Cardiff, UK
| | - D. Williams
- Department of Obstetrics and Gynaecology, School of Medicine, Cardiff University, Cardiff, UK
| | - C. Scherf
- Department of Obstetrics and Gynaecology, School of Medicine, Cardiff University, Cardiff, UK
| | - U. M. Weyrauch
- Brain Repair Group, School of Biosciences, Cardiff University, Cardiff, UK
| | - E. L. Lane
- Brain Repair Group, School of Biosciences, Cardiff University, Cardiff, UK
| | - N. D. Allen
- Brain Repair Group, School of Biosciences, Cardiff University, Cardiff, UK
| | - R. Penketh
- Department of Obstetrics and Gynaecology, School of Medicine, Cardiff University, Cardiff, UK
| | - N. N. Amso
- Department of Obstetrics and Gynaecology, School of Medicine, Cardiff University, Cardiff, UK
| | - P. J. Kemp
- Division of Pathophysiology and Repair, School of Biomedical Sciences, Cardiff University, Cardiff, UK
| | - S. B. Dunnett
- Brain Repair Group, School of Biosciences, Cardiff University, Cardiff, UK
| | - A. E. Rosser
- Brain Repair Group, School of Biosciences, Cardiff University, Cardiff, UK
- Departments of Neurology and Genetics, School of Medicine, Cardiff University, Cardiff, UK
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12
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Gallina P, Paganini M, Lombardini L, Saccardi R, Marini M, De Cristofaro MT, Pinzani P, Salvianti F, Crescioli C, Di Rita A, Bucciantini S, Mechi C, Sarchielli E, Moretti M, Piacentini S, Gritti G, Bosi A, Sorbi S, Orlandini G, Vannelli GB, Di Lorenzo N. Development of human striatal anlagen after transplantation in a patient with Huntington's disease. Exp Neurol 2008; 213:241-4. [DOI: 10.1016/j.expneurol.2008.06.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Revised: 06/05/2008] [Accepted: 06/06/2008] [Indexed: 11/28/2022]
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13
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Abstract
Cell transplantation for Huntington's disease has developed over the last decade to clinical application in pilot trials in the USA, France and the UK. Although the procedures are feasible, and under appropriate conditions safe, evidence for efficacy is still limited, which has led to some calls that further development should be discontinued. We review the background of striatal cell transplantation in experimental animal models of Huntington's disease and the rationale for applying similar strategies in the human disease, and we survey the present status of the preliminary studies that have so far been undertaken in patients. When we consider the variety of parameters and principles that remain poorly defined -- such as the optimal source, age, dissection, preparation, implantation, immunoprotection and assessment protocols -- it is not surprising that clinical efficacy is still unreliable. However, since these protocols are all tractable to experimental refinement, we consider that the potential for cell transplantation in Huntington's disease is greater than has yet been realised, and remains a therapeutic strategy worthy of investigation and pursuit.
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14
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Abstract
Huntington's disease is an autosomal dominant genetic disease, which results in progressive neuronal degeneration in the neostriatum and neocortex, and associated functional impairments in motor, cognitive, and psychiatric domains. Although the genetic mutation is identified, involving an abnormal CAG expansion within the htt gene on chromosome 4, the mechanism by which this leads to neuronal cell death and the question of why striatal neurones are targeted both remain unknown. Thus, in addition to the search for molecular and genetic strategies to inhibit development of the disease, we still need to identify effective strategies for cellular repair in affected individuals. Aspects of the human neuropathology can be well modeled by excitotoxic or metabolic lesions in experimental animals, and in transgenic mice carrying the htt mutation, providing the basis for testing alternative therapeutic strategies. The rationale and efficacy of alternative cell therapies are reviewed, including transplantation repair with embryonic striatal tissues, expansion and differentiation of striatal-like cells from stem cells, and in vivo and ex vivo gene therapy for delivery of neuroprotective growth factor molecules. Pilot and experimental clinical trials of several approaches are now also underway, and the alternative strategies are compared.
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Affiliation(s)
- Stephen B Dunnett
- School of Biosciences, Cardiff University, Cardiff CF10 3US, Wales, United Kingdom.
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