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Muramatsu SI, Fujimoto KI, Kato S, Mizukami H, Asari S, Ikeguchi K, Kawakami 
T, Urabe M, Kume A, Sato T, Watanabe E, Ozawa K, Nakano I.

Division of Neurology, Department of Medicine, Jichi Medical University, 
Tochigi, Japan.
Abstract

Gene transfer of dopamine-synthesizing enzymes into the striatal neurons has 
led to behavioral recovery in animal models of Parkinson's disease (PD). We 
evaluated the safety, tolerability, and potential efficacy of adeno-associated 
virus (AAV) vector-mediated gene delivery of aromatic L-amino acid 
decarboxylase (AADC) into the putamen of PD patients. Six PD patients were 
evaluated at baseline and at 6 months, using multiple measures, including the 
Unified Parkinson's Disease Rating Scale (UPDRS), motor state diaries, and 
positron emission tomography (PET) with 6-[(18)F]fluoro-L-m-tyrosine (FMT), a 
tracer for AADC. The short-duration response to levodopa was measured in three 
patients. The procedure was well tolerated. Six months after surgery, motor 
functions in the OFF-medication state improved an average of 46% based on the 
UPDRS scores, without apparent changes in the short-duration response to 
levodopa. PET revealed a 56% increase in FMT activity, which persisted up to 
96 weeks. Our findings provide class IV evidence regarding the safety and 
efficacy of AADC gene therapy and warrant further evaluation in a randomized, 
controlled, phase 2 setting.

PMID: 20606642 [PubMed - as supplied by publisher]

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