Dear Listfriends, Dr. Lieberman has requested the following information be passed on: ----------- Research Continues for NeuroCellTM-PD Porcine Fetal Neural Cell For Transplantation for Parkinson’s Disease Genzyme Corporation and Diacrin, Inc. are continuing clinical research for NeuroCellTM-PD (porcine fetal neural cells for transplantation) for the treatment of advanced Parkinson’s disease (PD). The Phase I trial, in which twelve patients received implanted cells on one side of the brain, has followed patients regularly for over two years. Some improvements were noted at twelve months and efficacy data continues to be collected. Dr. Samuel Ellias of Boston University Medical Center presented the two-year clinical results from this trial at the Parkinson’s Study Group meeting last October in Seattle, WA. The study will continue to monitor these patients for a total of five years to measure the safety of the product and any changes in PD symptoms. The enrollment of patients for a Phase II/III trial was completed last August. Enrollment for an open Phase III trial is planned to begin during the first half of the Year 2000. Both studies will evaluate the safety and efficacy of the NeuroCellTM-PD product for periods of twelve months. Parkinson’s disease results from a loss of nerve tissue in the brain. In PD, this nerve damage occurs in areas in the brain that control movement and can result in a variety of debilitating motor symptoms, including tremors, falls, rigidity, slowed movement, and difficulty with speech. NeuroCellTM-PD is an injection of fetal pig neural cells which, when implanted, are intended to replace the function of brain cells lost in the disease process. NeuroCellTM-PD is being studied to determine its effect on reversing or delaying the progression of some of the disabilities caused by Parkinson’s disease. For several decades, the drug L-dopa has been used to treat Parkinson’s patients. By increasing brain levels of dopamine, the brain chemical deficient in PD patients, treatment with L-dopa can result in nearly complete control of symptoms in early-stage patients, but it does not stop progression of the underlying disease. L-dopa begins to lose its effectiveness after six to twelve years of treatment because of the continuing loss of nerve cells in the brain. The drug has also been known to produce serious side effects in some patients. NeuroCellTM-PD is a surgical therapy that may be useful for those patients whose symptoms are no longer adequately controlled by standard anti-parkinson's medications (including L-dopa). A total of 18 patients have been enrolled in a currently blinded Phase II/III double-blind trial of NeuroCellTM-PD transplantation, in which approximately nine patients have received NeuroCellTM-PD cells and the rest underwent imitation surgery. Anti-PD medications such as L-dopa will continue for all of the patients. This trial will evaluate the safety and effectiveness of a higher dose of cells, four times the dose used in the Phase I study, implanted on both sides of the brain. Patients in this study will be followed for twelve months for any changes in their PD symptoms and tested regularly for safety during the study. Enrollment of patients for an open, Phase III clinical trial for NeuroCellTM-PD is planned to begin during the first half the Year 2000. The Phase III study will measure improvements in motor functions and quality of life after the implantation of NeuroCellTM-PD cells into patients with advanced Parkinson’s disease and who continue to receive standard medical therapy, compared with a control group receiving only standard medical therapy. Patients will be evaluated for safety and any changes in their PD symptoms during follow-up visits for twelve months. The NeuroCellTM-PD treatment carries some risks to the patient, including the risks inherent with any minimally invasive brain surgery. In order to prevent the rejection of the pig cells, transplant recipients will be required to take cyclosporine, a drug that suppresses the immune system. The risk of infection with porcine endogenous retrovirus (PERV) or other infectious agents derived from transplanted pig cells is unknown. To date, no patients transplanted with NeuroCellTM-PD cells have tested positive for PERV or any other pig-derived infectious agent. These results are consistent with a recent report that evaluated 160 patients worldwide who had been treated up to 12 years previously with living pig tissue and demonstrated no evidence of PERV infection. (Science 1999; 285:1236). Diacrin, Inc. is developing transplantable cells for the treatment of human diseases that are characterized by cell dysfunction or cell death and for which current therapies are either inadequate or nonexistent. Products under development for the treatment of neurological disorders include: NeuroCell-FE (porcine fetal neural cells for transplantation) for focal epilepsy, porcine neural cells for stroke and intractable pain, and spinal cord cells for spinal cord injury. Also under development are hepatocytes for alcoholic hepatitis and cirrhosis, myoblasts for cardiac disease, and retinal epithelial cells for macular degeneration. Genzyme Corporation is a developer of cell therapies and biological products for the treatment of unmet medical needs. In 1996, Diacrin and Genzyme Corporation, General Division, formed a joint venture, Diacrin/Genzyme LLC, to develop and commercialize NeuroCellä -PD and NeuroCellä -HD (porcine fetal neural cells for transplantation) for the treatment of Parkinson’s and Huntington’s disease, respectively. For more information regarding the NeuroCellä -PD product, call Diacrin/Genzyme at (800) 285-2556 or visit the website: www.genzyme.com/neurocell. -- Kathrynne Holden, MS, RD Medical nutrition therapy for Parkinson's disease Author: "Eat well, stay well with Parkinson's disease" "Parkinson's disease: assessing and managing unique nutrition needs;" "Risk for malnutrition and bone fracture in Parkinson'sdisease," J Nutr Elderly. V18:3;1999. http://www.nutritionucanlivewith.com/