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Parkinson's Approach With Stem Cells A Promising First Step
University of Rochester Medical Center
December 1, 2006
Brain cells derived from human embryonic stem cells improved the condition
of rats with Parkinson's-like symptoms dramatically, but the treatment
caused a significant problem - the appearance of brain tumors - that
scientists are now working to solve. The study is featured on the cover of
the November issue of Nature Medicine.

The work was reported by neurologist Steven Goldman, M.D., Ph.D., professor
of Neurology at the University of Rochester Medical Center and chief of its
Division of Cell and Gene Therapy, and Neeta Roy, Ph.D., assistant professor
of Neurology at Cornell's Weill Medical College.

"The results are a real cause for optimism," said Goldman. "These animals
with severe Parkinson's symptoms had a dramatically improved outcome after
treatment. Now we have a new problem to work on, how to achieve the same
benefit without creating tumors. But we expect to be able to solve this
problem within the next year or two, using new approaches to cell sorting
that we've been developing."

"All in all, this is the way medical discoveries move forward: One step at a
time."

Goldman has spent much of his career creating ways to isolate stem cells,
discovering the molecular signals that help determine what specific types of
cells they become, and then re-creating those signals to direct the cells'
development. It's the versatility of stem cells that make them so
attractive. If scientists like Goldman are successful directing their
development, such cells could provide a ready source of cells custom made to
treat a given disease - for instance, myelin-producing cells for multiple
sclerosis, or the specific types of cells that die in patients with
Parkinson's or Huntington's diseases.

In the experiment reported in Nature Medicine, Goldman, Roy and colleagues
set out to grow brain cells called neurons that produce dopamine, a crucial
brain chemical lacking in patients with Parkinson's. They began by isolating
human embryonic stem cells, then using genes such as "sonic hedgehog" and
fibroblast growth factor 8 that make chemicals in the normal brain
environment. Such signals are the body's natural way of directing stem cells
to develop into the specific cells needed.

Past attempts at using stems cells to make this type of neuron had achieved
modest success, but only relatively small numbers could be produced in
tissue culture. To improve upon this, Roy and Goldman attempted to re-create
the natural environment of the developing brain as much as possible, so it
would seem to the stem cells that they were developing in the part of the
brain where dopamine neurons are normally made. The team did so by raising
the cells together with brain cells known as astrocytes, which had come from
the same brain region. These cells have long been known to play a crucial
role nourishing neurons.

The result was that more than two-thirds of the stem cells developed into
precisely the type of cell needed to treat Parkinson's disease -
dopamine-producing neurons. That percentage is far higher than any previous
experiment had achieved.

The team then injected the cells into the brains of rats with Parkinson's-like
symptoms, and watched for 10 weeks. While rats with the disorder walked in
circles when prompted to move, as if they were chasing their tails, rats
transplanted with the new cells recovered normal function and eventually
stopped walking in circles. By eight weeks after treatment, the tail-chasing
behavior ended completely, and they were walking and running normally.

Yet when the brains of the animals were examined, the team found tumors
within the brain grafts. Goldman said the tumors sprang from stem cells that
had started on the road to becoming neurons, but then stalled in their
development and grew out of control. The team is working on ways to filter
out those cells, to reap the benefits while avoiding the side effects of the
approach.

"The appearance of tumors was disappointing, but not surprising," said
Goldman. "The goals of this experiment were to create a population of cells
that had many more dopamine neurons than previous attempts yielded, and to
measure whether a group of cells with so many of these neurons would yield
real-life benefits in terms of behavior. We accomplished both tasks. The
cells improved the disease symptoms dramatically, beyond what we expected.

"In this first attempt of the technology, we did not attempt to try to
absolutely purify the cell population that was transplanted - thus the brain
tumors. The experiment confirmed that we need to have an absolutely pure
cell population, and we are working on ways to do that."

The work was supported by the National Institute of Neurological Disorders
and Stroke, and the Michael J. Fox Foundation. Other authors of the paper,
all at Cornell, are Carine Cleren, Shashi Singh, Lichuan Yang, and M. Flint
Beal.

For more media inquiries, contact:

Tom Rickey
(585) 275-7954
[log in to unmask]

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