Treating Parkinson's disease in the 21st century: Can stem cell transplantation compete?

Abstract

The characteristic and selective degeneration of a unique population of cells—the nigrostriatal dopamine (DA) neurons—that occurs in Parkinson’s disease (PD) has made the condition an iconic target for cell replacement therapies. Indeed, transplantation of fetal ventral mesencephalic cells into the DA-deficient striatum was first trialled nearly 30 years ago, at a time when other treatments for the disease were less well developed. Over recent decades standard treatments for PD have advanced, and newer biological therapies are now emerging. In the 21st century, stem cell technology will have to compete alongside other sophisticated treatments, including deep brain stimulation and gene therapies. In this review we examine how stem cell–based transplantation therapies compare with these novel and emerging treatments in the management of this common condition. J. Comp. Neurol. 522:2802–2816, 2014.

Potential of GABA-ergic cell therapy for schizophrenia, neuropathic pain, and Alzheimer׳s and Parkinson׳s diseases

“…In people over 60, PD is the second most common neurodegenerative disease. PD is a progressive and nuanced disease which begins with motor deficits in early stages which then develop into a varied set of symptoms including mood, sleep, and general cognitive dysfunction (Buttery and Barker, 2014). Historically, the treatment for PD has relied strongly upon pharmaceuticals such as dopamine (DA) agonists, with a goal to compensate the depletion of DA concentration in the striatum resulting from the loss or dysfunction of DA-ergic neurons in the substantia nigra of the midbrain.…”

“…Historically, the treatment for PD has relied strongly upon pharmaceuticals such as dopamine (DA) agonists, with a goal to compensate the depletion of DA concentration in the striatum resulting from the loss or dysfunction of DA-ergic neurons in the substantia nigra of the midbrain. Dopaminergic cell grafting has been considered as a good alternative to DA agonist treatment and a plethora of studies in animal models have shown efficacy of these grafts (Buttery and Barker, 2014). Nevertheless, the outcome of DAergic cell grafting in PD patients has been mixed with incidences of side effects (Piccini, 2002), which has prompted greater focus towards alternative therapeutic options (Olanow et al, 2009).…”

Is Parkinson's disease the new cancer?

“…This prion-like spread may explain why Lewy bodies can appear in fetal ventral mesencephalic grafts. 3 Both stem cells and dopaminergic gene therapy seem to replace tonic dopamine supply to the striatum. However, a recent review noted that cell replacement might produce a more physiologically complete delivery of dopamine to the striatum than gene therapies and, in turn, more effectively control motor and non-motor symptoms.…”

“…However, a recent review noted that cell replacement might produce a more physiologically complete delivery of dopamine to the striatum than gene therapies and, in turn, more effectively control motor and non-motor symptoms. 3 Without comparative studies, however, stem cell's superiority remains speculation.…”

“…Indeed, transplantation of fetal ventral mesencephalic cells into the striatum of PD patients began in the late 1980s. 3 Today, these features make PD a tempting target for stem cell and gene therapies.…”