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Published online: 22 October 2006; | doi:10.1038/news061016-16 
Stem-cell treatment for Parkinson's brings mixed results
Almost total relief of symptoms tempered by hints of cancerous side 
effects.
Kerri Smith
 
A rat's movement troubles can be almost completely cured with 
transplants of fresh neurons.
 
The symptoms of Parkinson's disease have been relieved in rats using 
a stem-cell treatment. But a potentially cancerous side effect might 
put the brakes on such therapies for humans.

Parkinson's disease kills off neurons that produce the 
neurotransmitter dopamine, leading to problems with movement and 
balance. Most treatments currently involve replenishing the dopamine 
through drugs. But researchers are keen to develop longer-term 
solutions, using embryonic stem cells to make replacement dopamine 
neurons. 

But it has so far proved difficult to produce enough of the right 
kind of cell; there are several types of dopamine neuron, and only 
some of them will do the job. "Not all dopamine neurons are created 
equal," says Steve Goldman of Cornell University Medical College, New 
York, who leads the study. 

Goldman and his colleagues now report in Nature Medicine1 that they 
have found a way to make the right type — neurons of a part of the 
brain called the substantia nigra, which send signals to cells 
involved in generating movement. 

Grow your own

Goldman and his team took human fetal midbrain tissues, in which 
dopamine cells are made, and extracted glial cells, whose normal role 
is to support and maintain the growth of neurons. They then cultured 
stem cells in this glia-rich environment. 

"What we were really trying to do was to mimic the environment of the 
developing brain to increase the efficiency of dopamine-neuron 
generation, but also to bias the cells towards generating the type of 
dopamine neurons that we wanted," says Goldman.

The technique worked. When the new dopamine neurons were transplanted 
into the brains of rats with the symptoms of Parkinson's disease, the 
animals recovered almost entirely. "The positive results were really 
remarkably strong," Goldman says. "The animals exhibited almost a 
complete restoration of normal function." 

But there could be alarming side effects. Each stem-cell transplant 
also contained cells that had failed to become neurons, and which 
remained undifferentiated. These cells keep dividing, and can turn 
into tumours, says Goldman. (The rats in the study were killed before 
any such tumours developed.)

Small steps

Embryonic stem-cell treatments are known to have this potentially 
killer side effect. To avoid it, the cells will need to be sorted and 
the differentiated ones isolated, says Olle Lindvall, a neurologist 
at University Hospital in Lund, Sweden. Goldman's team is already 
working on this.

It will be several years before clinical trials of stem-cell 
approaches to Parkinson's disease can proceed, says Lindvall.

In the meantime, others are working on using gene therapy to 
stimulate neurons already present in the brain to produce more 
dopamine. This week, an American biotechnology company called 
Neurologix reported successful, preliminary trials of this technique. 
They introduced a harmless virus, equipped with a gene involved in 
the dopamine system, into the brains of patients. All showed an 
improvement of at least 25% in their symptoms. 

But gene therapy too comes with a host of problems, including 
learning how to properly regulate the new genes, and the improvement 
isn't as dramatic as seen with the stem-cell approach. Goldman is 
cautious, but optimistic, about both. "Neither gene therapy nor stem 
cells are ready for primetime," he says.

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