Autotransplantation of human carotid body cell aggregates for treatment of Parkinson's disease

被引:69
作者
Arjona, V
Mínguez-Castellanos, A
Montoro, RJ
Ortega, A
Escamilla, F
Toledo-Aral, JJ
Pardal, R
Méndez-Ferrer, S
Martín, JM
Pérez, M
Katati, MJ
Valencia, E
García, T
López-Barneo, J
机构
[1] Hosp Univ Virgen Nieves, Serv Neurocirurg & Neurol, Granada, Spain
[2] Univ Seville, Lab Invest Biomed, Hosp Univ Virgen Rocio, E-41013 Seville, Spain
关键词
autografts; carotid body; clinical outcome; Parkinson's disease; transplantation;
D O I
10.1227/01.NEU.0000073315.88827.72
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
OBJECTIVE: In this study, we assessed the feasibility of autotransplantation of carotid body (CB) cell aggregates into the striatum for the treatment of patients with Parkinson's disease (PD). METHODS: Six patients with advanced PD underwent bilateral autotransplantation of CB cell aggregates into the striatum. They were evaluated clinically preoperatively and for 18 months after surgery according to the recommendations of the Core Assessment Program for Intracerebral Transplantation. RESULTS: No major complications or adverse events resulted from the cell implantation or surgical procedures. During the course of the study, there was no significant aggravation of dyskinesia or decline in cognitive function in any of the patients. Five of the six patients who underwent transplantation manifested a measurable degree of clinical improvement evidence by standardized clinical rating scales for PD. A decrease in the blinded Unified Parkinson's Disease Rating Scale Part III in the "off" state, the main measure of transplant efficacy in our study, was found to be maximal (between 26 and 74 %) at 6 months after surgery. At 1 year, clear reductions in the blinded Unified Parkinson's Disease Rating Scale Part III were maintained in three patients (24, 38, and 52 %, respectively). Modest improvement was seen in two patients (13 and 17 %), and the sole patient and the state of the CB tissue were adversely correlated with clinical improvement after CB autotransplantation. CONCLUSION: This pilot study indicates that CB autograft transplantation is a relatively simple, safe, and viable therapeutical approach for the treatment of patients with advanced PD. More studies are needed to optimize the procedure and to assess its general applicability for the treatment of patients with PD.
引用
收藏
页码:321 / 328
页数:8
相关论文
共 38 条
[1]   FEEDBACK INHIBITION OF CA-2+ CURRENTS BY DOPAMINE IN GLOMUS CELLS OF THE CAROTID-BODY [J].
BENOT, AR ;
LOPEZBARNEO, J .
EUROPEAN JOURNAL OF NEUROSCIENCE, 1990, 2 (09) :809-812
[2]   Dopaminergic neurons protected from degeneration by GDNF gene therapy [J].
ChoiLundberg, DL ;
Lin, Q ;
Chang, YN ;
Chiang, YL ;
Hay, CM ;
Mohajeri, H ;
Davidson, BL ;
Bohn, MC .
SCIENCE, 1997, 275 (5301) :838-841
[3]   Long-term outcome of unilaterally transplanted Parkinsonian patients .1. Clinical approach [J].
Defer, GL ;
Geny, C ;
Ricolfi, F ;
Fenelon, G ;
Monfort, JC ;
Remy, P ;
Villafane, G ;
Jeny, R ;
Samson, Y ;
Keravel, Y ;
Gaston, A ;
Degos, JD ;
Peschanski, M ;
Cesaro, P ;
Nguyen, JP .
BRAIN, 1996, 119 :41-50
[4]   Prospects for new restorative and neuroprotective treatments in Parkinson's disease [J].
Dunnett, SB ;
Björklund, A .
NATURE, 1999, 399 (6738) :A32-A39
[5]   Cellular and functional recovery of Parkinsonian rats after intrastriatal transplantation of carotid body cell aggregates [J].
Espejo, EF ;
Montoro, RJ ;
Armengol, JA ;
López-Barneo, J .
NEURON, 1998, 20 (02) :197-206
[6]   Transplantation of embryonic dopamine neurons for severe Parkinson's disease. [J].
Freed, CR ;
Greene, PE ;
Breeze, RE ;
Tsai, WY ;
DuMouchel, W ;
Kao, R ;
Dillon, S ;
Winfield, H ;
Culver, S ;
Trojanowski, JQ ;
Eidelberg, D ;
Fahn, S .
NEW ENGLAND JOURNAL OF MEDICINE, 2001, 344 (10) :710-719
[7]   SURVIVAL OF IMPLANTED FETAL DOPAMINE CELLS AND NEUROLOGIC IMPROVEMENT 12 TO 46 MONTHS AFTER TRANSPLANTATION FOR PARKINSONS-DISEASE [J].
FREED, CR ;
BREEZE, RE ;
ROSENBERG, NL ;
SCHNECK, SA ;
KRIEK, E ;
QI, JX ;
LONE, T ;
ZHANG, YB ;
SNYDER, JA ;
WELLS, TH ;
RAMIG, LO ;
THOMPSON, L ;
MAZZIOTTA, JC ;
HUANG, SC ;
GRAFTON, ST ;
BROOKS, D ;
SAWLE, G ;
SCHROTER, G ;
ANSARI, AA .
NEW ENGLAND JOURNAL OF MEDICINE, 1992, 327 (22) :1549-1555
[8]   TRANSPLANTATION OF HUMAN FETAL DOPAMINE CELLS FOR PARKINSONS-DISEASE - RESULTS AT 1 YEAR [J].
FREED, CR ;
BREEZE, RE ;
ROSENBERG, NL ;
SCHNECK, SA ;
WELLS, TH ;
BARRETT, JN ;
GRAFTON, ST ;
HUANG, SC ;
EIDELBERG, D ;
ROTTENBERG, DA .
ARCHIVES OF NEUROLOGY, 1990, 47 (05) :505-512
[9]   Functional recovery in parkinsonian monkeys treated with GDNF [J].
Gash, DM ;
Zhang, ZM ;
Ovadia, A ;
Cass, WA ;
Yi, A ;
Simmerman, L ;
Russell, D ;
Martin, D ;
Lapchak, PA ;
Collins, F ;
Hoffer, BJ ;
Gerhardt, GA .
NATURE, 1996, 380 (6571) :252-255
[10]   THE RELEVANCE OF THE LEWY BODY TO THE PATHOGENESIS OF IDIOPATHIC PARKINSONS-DISEASE [J].
GIBB, WRG ;
LEES, AJ .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1988, 51 (06) :745-752