Cell Therapy for Parkinson's Disease: Only Young Onset Patients Allowed? Reflections about the Results of Recent Clinical Trials with Cell Therapy and the Progression of Parkinson's Disease

Autor: Gurutz Linazasoro
Jazyk: angličtina
Rok vydání: 2006
Předmět:
Zdroj: Cell Transplantation, Vol 15 (2006)
Druh dokumentu: article
ISSN: 0963-6897
1555-3892
00000000
DOI: 10.3727/000000006783981792
Popis: The selection of the best candidates for surgery among Parkinson's disease (PD) patients is a debated topic. This could be particularly important for transplantation studies in which patients with advanced PD and motor complications refractory to conventional pharmacological treatments are usually included. The development of lesions in nondopaminergic structures, which apparently are unaffected by the intervention, could eventually lead to the appearance of disabling, treatment-resistant symptoms. This has been considered as the crucial factor responsible for the outcome of any therapeutic procedure. However, other factors might be involved. It is suggested in this article that the rate of progression of PD and the effects of ageing are more important than the extradopaminergic involvement in the final outcome. Rate of progression of PD is critically related to the power of compensatory mechanisms, which are age related and under the control of still unknown genes. Thus, patients with young onset parkinsonism (YOP), either caused by gene mutations or not, could be the best candidates for surgery because they have a slower disease progression and more competent compensatory mechanisms. On the other hand, this can also explain the appearance of unexpected side effects such as the “runaway” dyskinesias reported following transplantation.
Databáze: Directory of Open Access Journals