Neural-tube-derived neuroepithelial stem cells: a new transplant resource for Parkinson's disease

Therapeutic function of iPSCs-derived primitive neuroepithelial cells in a rat model of Parkinson's disease

Induced pluripotent stem cells (iPSCs) are a promising unlimited source for cell replacement therapy of neurodegenerative disorders, including Parkinson's disease (PD). In the present study, rat iPSCs-derived primitive neuroepithelial cells (RiPSCs-iNECs) were successfully induced from rat iPSCs (RiPSCs) following two major developmental stages, and could generate neurospheres and differentiated into both neurons and astrocytes in vitro. Then, the RiPSCs-iNECs-GFP⁺ were unilaterally transplanted into the right substantia nigra (SN) of 6-hydroxydopamine-lesioned rat models of PD. The results demonstrated that the grafted RiPSCs-iNECs could survive in parkinsonian rat brain for at least 150 days, and many of them differentiated into tyrosine hydroxylase (TH)-positive cells. Furthermore, the PD model rats grafted with RiPSCs-iNECs exhibited a significant functional recovery from their parkinsonian behavioral defects. Histological studies showed that RiPSCs-iNECs could differentiate into multiple types of neurons including dopaminergic neurons, GFAP, Pax6, FoxA2 and DAT-positive cells, and induced dopaminergic neurons extended dense neurites into the host striatum. Thus, iPSCs derived primitive neuroepithelial cells could be an attractive candidate as a source of donor material for the treatment of PD, but the molecular mechanism needs further clarification.

Acupuncture-Induced Analgesia: The Role of Microglial Inhibition

The last three decades have documented preclinical and clinical data supporting the use of acupuncture in relieving symptoms of many diseases, including allergies, infections, and neurological disorders. The advent of electroacupuncture has not only modernized the practice of acupuncture, but also has improved its efficacy, especially for producing analgesic-like effects. Although the mechanism of action of acupuncture-induced analgesia remains largely unknown, several lines of investigation have implicated modulation of pain processes via brain opioid signaling and neuroimmunoregulatory pathways. Here, we review key findings demonstrating the efficacy and underlying mechanisms of acupuncture-induced analgesia. In particular, we discuss potent analgesic effects of acupuncture via neural pain processes through inhibition of microglial activation. The safe and effective use of acupuncture stands as a nonpharmacological alternative for induction of analgesia, which has direct clinical applications, especially for pain-related diseases.

Rat neurosphere cells protect axotomized rat retinal ganglion cells and facilitate their regeneration

We investigated the ability of a population of rat neural stem and precursor cells derived from rat embryonic spinal cord to protect injured neurons in the rat central nervous system (CNS). The neonatal rat optic pathway was used as a model of CNS injury, whereby retinal ganglion cells (RGCs) were axotomized by lesion of the lateral geniculate nucleus one day after birth. Neural stem and precursor cells derived from expanded neurospheres (NS) were transplanted into the lesion site at the time of injury. Application of Fast Blue tracer dye to the lesion site demonstrated that significant numbers of RGCs survived at 4 and 8 weeks in animals that received a transplant, with an average of 28% survival, though in some individual cases survival was greater than 50%. No RGCs survived in animals that received a lesion alone. Furthermore, labeled RGCs were also observed when Fast Blue was applied to the superior colliculus (SC) at 4 weeks, suggesting that neurosphere cells also facilitated RGC to regenerate to their normal target. Transplanted cells did not migrate or express neural markers after transplantation, and secreted several neurotrophic factors in vitro. We conclude that NS cells can protect injured CNS neurons and promote their regeneration. These effects are not attributable to cell replacement, and may be mediated via secretion of neurotrophic factors. Thus, neuroprotection by stem cell populations may be a more viable approach for treatment of CNS disorders than cell replacement therapy.

Gene therapy in Parkinson's disease: rationale and current status

Parkinson's disease is the second most common age-related neurodegenerative disorder, typified by the progressive loss of substantia nigra pars compacta dopamine neurons and the consequent decrease in the neurotransmitter dopamine. Patients exhibit a range of clinical symptoms, with the most common affecting motor function and including resting tremor, rigidity, akinesia, bradykinesia and postural instability. Current pharmacological interventions are palliative and largely aimed at increasing dopamine levels through increased production and/or inhibition of metabolism of this key neurotransmitter. The gold standard for treatment of both familial and sporadic Parkinson's disease is the peripheral administration of the dopamine precursor, levodopa. However, many patients gradually develop levodopa-induced dyskinesias and motor fluctuations. In addition, dopamine enhancement therapies are most useful when a portion of the nigrostriatal pathway is intact. Consequently, as the number of substantia nigra dopamine neurons and striatal projections decrease, these treatments become less efficacious. Current translational research is focused on the development of novel disease-modifying therapies, including those utilizing gene therapeutic approaches. Herein we present an overview of current gene therapy clinical trials for Parkinson's disease. Employing either recombinant adeno-associated virus type 2 (rAAV2) or lentivirus vectors, these clinical trials are focused on three overarching approaches: augmentation of dopamine levels via increased neurotransmitter production; modulation of the neuronal phenotype; and neuroprotection. The first two therapies discussed in this article focus on increasing dopamine production via direct delivery of genes involved in neurotransmitter synthesis (amino acid decarboxylase, tyrosine hydroxylase and GTP [guanosine triphosphate] cyclohydrolase 1). In an attempt to bypass the degenerating nigrostriatal pathway, a third clinical trial utilizes rAAV2 to deliver glutamic acid decarboxylase to the subthalamic nucleus, converting a subset of excitatory neurons to GABA-producing cells. In contrast, the final clinical trial is aimed at protecting the degenerating nigrostriatum by striatal delivery of rAAV2 harbouring the neuroprotective gene, neurturin. Based on preclinical studies, this gene therapeutic approach is posited to slow disease progression by enhancing neuronal survival. In addition, we discuss the outcome of each clinical trial and discuss the potential rationale for the marginal yet incremental clinical advancements that have thus far been realized for Parkinson's disease gene therapy.

alpha-Synuclein: a therapeutic target for Parkinson's disease?

Parkinson's disease is a progressive age-related neurodegenerative disease with invariant loss of substantia nigra dopamine neurons and striatal projections. This disorder is well known for the associated motoric symptoms including resting tremor and the inability to initiate movement. However, it is now apparent that Parkinson's disease is a multisystem disorder with patients exhibiting symptoms derived from peripheral nervous system and extra-nigral dysfunctions in addition to the prototypical nigrostriatal damage. Although the etiology for sporadic Parkinson's disease is unknown, information gleaned from both familial forms of the disease and animal models places misfolded alpha-synuclein at the forefront. The disease is currently without a cure and most therapies target the motoric symptoms relying on increasing dopamine tone. In this review, the role of alpha-synuclein in disease pathogenesis and as a potential therapeutic target focusing on toxic conformers of this protein is considered. The addition of protofibrillar/oligomer-directed neurotherapeutics to the existing armamentarium may extend the symptom-free stage of Parkinson's disease as well as alleviate pathogenesis.

Dopaminergic differentiation of grafted GFP transgenic neuroepithelial stem cells in the brain of a rat model of Parkinson's disease

Neuroepithelial stem cells (NEPs) possess multipotent potential for self-renewal and neuronal differentiation. Using green fluorescent protein (GFP) positive NEPs, we explored, firstly, the survival and differentiation of grafted NEPs in the host rat and, secondly, whether or not transplantation of NEPs is a feasible therapeutic option for treating Parkinson's disease. NEPs were harvested from the neural tube of enhanced GFP transgenic embryos. In culture, GFP(+) NEPs generated abundant neurospheres and differentiated into both neurons and glia. When stereotaxically transplanted into the 6-hydroxydopamine (6-OHDA)-lesioned striatum of rats, NEPs survived and tyrosine hydroxylase (TH)-positive cells were detected in the graft. Furthermore, these grafted GFP(+) NEPs significantly ameliorated Parkinsonian behavioral symptoms compared with controls which were treated only with normal saline. Our results suggest that transplanted NEPs accomplish dopaminergic differentiation may be used for treating Parkinson's disease.