Abstracts 13th Meeting of the Network of European CNS Transplantation and Restoration (NECTAR)
Abstract:CURRENT STATUS AND FUTURE OF TRANSPLANTATION OF PRIMARY FETAL DOPAMINE NEURONS IN PARKINSON'S DISEASE
Abstract 1-01 The Lund Experience
Section of Restorative Neurology, Wallenberg Neuroscience Center, University Hospital, Lund, Sweden
Our open-label clinical studies with intrastriatal transplants of embryonic mesencephalic tissue in 18 patients with Parkinson’s disease (PD) provide proof-of-principle for the cell replacement strategy in this disorder. The grafted dopaminergic neurons can survive, restore regulated dopamine (DA) release and movement-related frontal cortical activation, and give rise to significant symptomatic relief. In the most successful cases, patients have been able to withdraw L-dopa treatment after transplantation and resume an independent life. However, there are currently several problems linked to the use of primary embryonic tissue: First, the lack of sufficient amounts of tissue for transplantation in more than a few patients. Second, the variability of the functional outcome with some patients showing major improvement whereas others exhibit only modest, if any, clinical benefit. This lack of consistent efficacy is probably due to several factors such as variation in the viability and composition of the graft tissue, but also issues related to patient selection and optimal graft placement. Third, although most likely not due to overgrowth of the dopaminergic graft, it is clear that dyskinesias can occur after implantation of human embryonic tissue. We must understand the underlying mechanisms and be able to avoid this adverse effect. To conclude, neural transplantation is still at an experimental stage in PD. Several scientific problems must be addressed before this approach should be further tested in patients.
Document Type: Abstract
Publication date: January 1, 2003
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