COMMENTARY: Neural Transplantation in the New Millenium
Abstract:Neural transplantation in the central nervous system has been established as an efficacious therapy in animal models of neurological disorders. Over the last two decades, we have witnessed the transfer of such therapy from the laboratory to the clinic. In recent years, modest to excellent clinical improvements have been noted in transplanted Parkinson's disease patients, which are in stark contrast to the early clinical trials with autologous adrenal chromaffin cell grafts. Owing in part to carefully planned and designed clinical trials (i.e., adding of placebo controls), the impetus for proceeding with clinical neural transplantation therapy can be equally attributed to rigorous laboratory studies that are focused on optimizing the therapeutic outcomes by refinement of existing and/or developing new transplantation procedures. Increasing the viability of donor cells prior to and after grafting remains a main obstacle for successful transplantation. However, recent laboratory data offer possible solutions. For example, better hibernation media and cryopreservation techniques have now been made available, which demonstrate increased viability of donor cells, as well as graft survival. Whereas modulating the host immune system continues to occupy center stage as a major target for enhancing graft survival, long-term positive results with immunoisolation therapy (i.e., encapsulation of cells) suggest its larger role especially in xenotransplantation. In parallel, a high breed of immunosuppressants has been introduced as potentially better immunomodualtors, and may even serve as neuroprotectants. Neurotrophic factors alone or as adjunct to cell grafts have reached clinical investigations. New technology in cell sorting designed to provide homogenous cell populations has also shown feasibility in transplantation studies. Of course, we cannot ignore the landmark entry of nonfetal primary cells as alternative graft sources, specifically stem cells derived from bone marrow and umbilical cord. The yardstick for evaluating these new cell types as safe and efficacious graft sources undoubtedly will be measured by the same high standards used for fetal neural transplantation.
Document Type: Miscellaneous
Affiliations: *Department of Neurology and Institute of Molecular Medicine and Genetics, Medical College of Georgia; Research and Affiliations Service Line, Veterans Administration Medical Center, Augusta, GA 30912-3200
Publication date: January 1, 2002
- Cell Transplantation publishes original, peer-reviewed research and review articles on the subject of cell transplantation and its application to human diseases. To ensure high-quality contributions from all areas of transplantation, separate section editors and editorial boards have been established. Articles deal with a wide range of topics including physiological, medical, preclinical, tissue engineering, and device-oriented aspects of transplantation of nervous system, endocrine, growth factor-secreting, bone marrow, epithelial, endothelial, and genetically engineered cells, among others. Basic clinical studies and immunological research papers are also featured. To provide complete coverage of this revolutionary field, Cell Transplantation will report on relevant technological advances, and ethical and regulatory considerations of cell transplants. Cell Transplantation is now an Open Access journal starting with volume 18 in 2009, and therefore there will be an inexpensive publication charge, which is dependent on the number of pages, in addition to the charge for color figures. This will allow work to be disseminated to a wider audience and also entitle the corresponding author to a free PDF, as well as prepublication of an unedited version of the manuscript.