Читать книгу Current Concepts in Movement Disorder Management - Группа авторов - Страница 16

Based on the pioneering basic science work of Lindvall and others at the Karolinska Institute, Backlund and colleagues in Stockholm performed the first tissue transplant for Parkinson’s disease using the patient’s own adrenal gland. The procedure was revolutionary in many ways, suggesting that adult adrenal medullary cells could be pushed to transform into dopaminergic neurons that would replace the cells lost in the substantia nigra. Work proceeded on several fronts, with fierce academic debates between scientists urging a “go slow” approach and clinicians urging that the investigational work proceed rapidly. The belief that fetal mesencephalic neurons would be a better graft [20] led to an explosion in a number of centers performing fetal mesencephalic transplants. The technologies existed to precisely place the cells, but the best source and method of infusion was continually contested. Despite being a major scientific news item, the complications of transplantation in frail, advanced Parkinson’s disease patients, especially graft-induced dyskinesias, began to stifle the enthusiasm for cellular therapy. The results seemed inconsistent and debates about the best donor cell and even graft survival led to a gradually waning interest in transplantation. A few centers remained and primarily concentrated on advancing the fields of neural grafts and gene therapy, especially in the treatment of Huntington’s disease.