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Gupta N, Henry RG, Kang SM, Strober J, Lim DA, Ryan T, Perry R, Farrell J, Ulman M, Rajalingam R, Gage A, Huhn SL, Barkovich AJ, Rowitch DH. Long-Term Safety, Immunologic Response, and Imaging Outcomes following Neural Stem Cell Transplantation for Pelizaeus-Merzbacher Disease. Stem Cell Reports 2019; 13:254-261. [PMID: 31378671 PMCID: PMC6700500 DOI: 10.1016/j.stemcr.2019.07.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 07/04/2019] [Accepted: 07/05/2019] [Indexed: 01/23/2023] Open
Abstract
Four boys with Pelizaeus-Merzbacher disease, an X-linked leukodystrophy, underwent transplantation with human allogeneic central nervous system stem cells (HuCNS-SC). Subsequently, all subjects were followed for an additional 4 years in this separate follow-up study to evaluate safety, neurologic function, magnetic resonance imaging (MRI) data, and immunologic response. The neurosurgical procedure, immunosuppression, and HuCNS-SC transplantation were well tolerated and all four subjects were alive at the conclusion of the study period. At year 2, all subjects exhibited diffusion MRI changes at the implantation sites as well as in more distant brain regions. There were persistent, increased signal changes in the three patients who were studied up to year 5. Two of four subjects developed donor-specific HLA alloantibodies, demonstrating that neural stem cells can elicit an immune response when injected into the CNS, and suggesting the importance of monitoring immunologic parameters and identifying markers of engraftment in future studies. Neural stem cell transplantation has a safe long-term safety profile Donor-specific alloantibodies develop after stem cell transplantation into the CNS Diffusion MR imaging is a potential surrogate for CNS myelination
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Affiliation(s)
- Nalin Gupta
- Department of Neurological Surgery, University of California San Francisco, 550 16(th) Street, 4(th) Floor, San Francisco, CA 94143-0137, USA; Department of Pediatrics, University of California San Francisco, San Francisco, CA 94143, USA.
| | - Roland G Henry
- Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA; Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA; Bioengineering Graduate Group, University of California San Francisco & Berkeley, San Francisco, CA 94143, USA
| | - Sang-Mo Kang
- Division of Transplantation, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Jonathan Strober
- Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA; Department of Pediatrics, University of California San Francisco, San Francisco, CA 94143, USA
| | - Daniel A Lim
- Department of Neurological Surgery, University of California San Francisco, 550 16(th) Street, 4(th) Floor, San Francisco, CA 94143-0137, USA
| | - Tamara Ryan
- Fetal Treatment Center, University of California San Francisco, San Francisco, CA 94143, USA
| | - Rachel Perry
- Fetal Treatment Center, University of California San Francisco, San Francisco, CA 94143, USA
| | - Jody Farrell
- Fetal Treatment Center, University of California San Francisco, San Francisco, CA 94143, USA
| | - Mary Ulman
- Department of Pediatrics, University of California San Francisco, San Francisco, CA 94143, USA
| | - Raja Rajalingam
- Immunogenetics and Transplantation Laboratory, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | | | | | - A James Barkovich
- Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA; Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA; Department of Pediatrics, University of California San Francisco, San Francisco, CA 94143, USA
| | - David H Rowitch
- Department of Neurological Surgery, University of California San Francisco, 550 16(th) Street, 4(th) Floor, San Francisco, CA 94143-0137, USA; Department of Pediatrics, University of California San Francisco, San Francisco, CA 94143, USA; Department of Paediatrics, University of Cambridge, Cambridge CB2 1TN, UK
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Osorio MJ, Rowitch DH, Tesar P, Wernig M, Windrem MS, Goldman SA. Concise Review: Stem Cell-Based Treatment of Pelizaeus-Merzbacher Disease. Stem Cells 2016; 35:311-315. [PMID: 27882623 DOI: 10.1002/stem.2530] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/13/2016] [Accepted: 06/25/2016] [Indexed: 01/16/2023]
Abstract
Pelizaeus-Merzbacher disease (PMD) is an X-linked disorder caused by mutation in the proteolipid protein-1 (PLP1) gene, which encodes the proteolipid protein of myelinating oligodendroglia. PMD exhibits phenotypic variability that reflects its considerable genotypic heterogeneity, but all forms of the disease result in central hypomyelination, associated in most cases with early neurological dysfunction, progressive deterioration, and ultimately death. PMD may present as a connatal, classic and transitional forms, or as the less severe spastic paraplegia type 2 and PLP-null phenotypes. These disorders are most often associated with duplications of the PLP1 gene, but can also be caused by coding and noncoding point mutations as well as full or partial deletion of the gene. A number of genetically-distinct but phenotypically-similar disorders of hypomyelination exist which, like PMD, lack any effective therapy. Yet as relatively pure CNS hypomyelinating disorders, with limited involvement of the PNS and relatively little attendant neuronal pathology, PMD and similar hypomyelinating disorders are attractive therapeutic targets for neural stem cell and glial progenitor cell transplantation, efforts at which are now underway in a number of research centers. Stem Cells 2017;35:311-315.
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Affiliation(s)
- M Joana Osorio
- Center for Basic and Translational Neuroscience, University of Copenhagen, Copenhagen, Denmark
| | - David H Rowitch
- Departments of Pediatrics and Neurosurgery, UCSF School of Medicine and Broad Center for Regenerative Medicine, San Francisco, California, USA
| | - Paul Tesar
- Department of Genetics and Genome Sciences, Case Western Reserve School of Medicine, Cleveland, Ohio, USA
| | - Marius Wernig
- Institute for Stem Cell Biology and Regenerative Medicine.,Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Martha S Windrem
- Center for Translational Neuromedicine, University of Rochester Medical Center, Rochester, New York, USA
| | - Steven A Goldman
- Center for Basic and Translational Neuroscience, University of Copenhagen, Copenhagen, Denmark.,Center for Translational Neuromedicine, University of Rochester Medical Center, Rochester, New York, USA
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Marteyn A, Baron-Van Evercooren A. Is involvement of inflammation underestimated in Pelizaeus-Merzbacher disease? J Neurosci Res 2016; 94:1572-1578. [PMID: 27661457 DOI: 10.1002/jnr.23931] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 09/02/2016] [Accepted: 09/02/2016] [Indexed: 11/11/2022]
Abstract
Pelizaeus-Merzbacher disease (PMD) is a severe hypomyelinating leukodystrophy resulting from proteolipid protein 1 gene (PLP1) mutations leading to oligodendrocyte loss. While neuroinflammation has recently become a common feature and actor in neurodegenerative diseases, the involvement of inflammation in PMD physiopathology is still highly debated despite evidence for strong astrogliosis and microglial cell activation. Activation of the innate immune system, and more particularly, of microglia and astrocytes, is mostly associated with the deleterious role of neuroinflammation. However, in diseases such as multiple sclerosis, microglia appear beneficial for repair based on their role in myelin debris removal or recruitment and differentiation of oligodendrocyte progenitor cells. In this review, we will discuss recent published data in terms of their relevance to the role of microglia in PMD evolution, and of their impact on the improvement of therapeutic approaches combining immunomodulation and cell therapy to promote optimal recovery. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Antoine Marteyn
- INSERM, U1127, F-75013, Paris, France.,CNRS, UMR 7225, F-75013, Paris, France.,Université Pierre et Marie Curie-Paris 6, UMR_S 1127, F-75013, Paris, France.,Institut du Cerveau et de la Moelle épinière, F-75013, Paris, France
| | - Anne Baron-Van Evercooren
- INSERM, U1127, F-75013, Paris, France. .,CNRS, UMR 7225, F-75013, Paris, France. .,Université Pierre et Marie Curie-Paris 6, UMR_S 1127, F-75013, Paris, France. .,Institut du Cerveau et de la Moelle épinière, F-75013, Paris, France.
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4
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Pouwels PJW, Vanderver A, Bernard G, Wolf NI, Dreha-Kulczewksi SF, Deoni SCL, Bertini E, Kohlschütter A, Richardson W, Ffrench-Constant C, Köhler W, Rowitch D, Barkovich AJ. Hypomyelinating leukodystrophies: translational research progress and prospects. Ann Neurol 2014; 76:5-19. [PMID: 24916848 DOI: 10.1002/ana.24194] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 06/05/2014] [Accepted: 06/05/2014] [Indexed: 12/11/2022]
Abstract
Hypomyelinating leukodystrophies represent a genetically heterogeneous but clinically overlapping group of heritable disorders. Current management approaches in the care of the patient with a hypomyelinating leukodystrophy include use of serial magnetic resonance imaging (MRI) to establish and monitor hypomyelination, molecular diagnostics to determine a specific etiology, and equally importantly, careful attention to neurologic complications over time. Emerging research in oligodendrocyte biology and neuroradiology with bedside applications may result in the possibility of clinical trials in the near term, yet there are significant gaps in knowledge in disease classification, characterization, and outcome measures in this group of disorders. Here we review the biological background of myelination, the clinical and genetic variability in hypomyelinating leukodystrophies, and the insights that can be obtained from current MRI techniques. In addition, we discuss ongoing research approaches to define potential outcome markers for future clinical trials.
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Affiliation(s)
- Petra J W Pouwels
- Department of Physics and Medical Technology, VU University Medical Center and Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
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de la Pena I, Pabon M, Acosta S, Sanberg PR, Tajiri N, Kaneko Y, Borlongan CV. Oligodendrocytes engineered with migratory proteins as effective graft source for cell transplantation in multiple sclerosis. CELL MEDICINE 2014; 6:123-127. [PMID: 24999443 DOI: 10.3727/215517913x674144] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Multiple sclerosis (MS) is characterized by widespread immunomodulatory demyelination of the CNS resulting in nerve cell dysfunction. Accordingly, treatment strategies have been centered on immunodulation and remyelination, with the former primarily focused on reducing the pathology rather than enhancing myelin repair which the latter targets. While conceding to the emerging view of heterogeneity in the pathology of MS, which precludes variations in degree of immune response (i.e., inflammation) and demyelination, the concept of enhancing myelin repair is appealing since it is likely to provide both disease-reducing and disease-inhibiting therapeutic approach to MS. In this regard, we and several others, have proposed that cell replacement therapy is an effective strategy to repair the myelin in MS. Here, we hypothesize that transplantation of mouse bone marrow-derived oligodendrocytes (BMDOs) and BMDOs transfected with Ephrin proteins (BMDO+Ephrin), which are known to enhance cell and axonal migratory capacity, may produce therapeutic benefits in animal models of MS.
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Affiliation(s)
- Ike de la Pena
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair. University of South Florida, Morsani College of Medicine 12901 Bruce B. Downs Blvd., Tampa, FL 33612
| | - Mibel Pabon
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair. University of South Florida, Morsani College of Medicine 12901 Bruce B. Downs Blvd., Tampa, FL 33612
| | - Sandra Acosta
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair. University of South Florida, Morsani College of Medicine 12901 Bruce B. Downs Blvd., Tampa, FL 33612
| | - Paul R Sanberg
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair. University of South Florida, Morsani College of Medicine 12901 Bruce B. Downs Blvd., Tampa, FL 33612
| | - Naoki Tajiri
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair. University of South Florida, Morsani College of Medicine 12901 Bruce B. Downs Blvd., Tampa, FL 33612
| | - Yuji Kaneko
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair. University of South Florida, Morsani College of Medicine 12901 Bruce B. Downs Blvd., Tampa, FL 33612
| | - Cesar V Borlongan
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair. University of South Florida, Morsani College of Medicine 12901 Bruce B. Downs Blvd., Tampa, FL 33612
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Lim JH, McCullen SD, Piedrahita JA, Loboa EG, Olby NJ. Alternating current electric fields of varying frequencies: effects on proliferation and differentiation of porcine neural progenitor cells. Cell Reprogram 2013; 15:405-12. [PMID: 23961767 DOI: 10.1089/cell.2013.0001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Application of sinusoidal electric fields (EFs) has been observed to affect cellular processes, including alignment, proliferation, and differentiation. In the present study, we applied low-frequency alternating current (AC) EFs to porcine neural progenitor cells (pNPCs) and investigated the effects on cell patterning, proliferation, and differentiation. pNPCs were grown directly on interdigitated electrodes (IDEs) localizing the EFs to a region accessible visually for fluorescence-based assays. Cultures of pNPCs were exposed to EFs (1 V/cm) of 1 Hz, 10 Hz, and 50 Hz for 3, 7, and 14 days and compared to control cultures. Immunocytochemistry was performed to evaluate the expression of neural markers. pNPCs grew uniformly with no evidence of alignment to the EFs and no change in cell numbers when compared with controls. Nestin expression was shown in all groups at 3 and 7 days, but not at 14 days. NG2 expression was low in all groups. Co-expression of glial fibrillary acidic protein (GFAP) and TUJ1 was significantly higher in the cultures exposed to 10- and 50-Hz EFs than the controls. In summary, sinusoidal AC EFs via IDEs did not alter the alignment and proliferation of pNPCs, but higher frequency stimulation appeared to delay differentiation into mature astrocytes.
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Affiliation(s)
- Ji-Hey Lim
- 1 Department of Clinical Sciences, North Carolina State University , Raleigh, NC, 27607
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Gupta N, Henry RG, Strober J, Kang SM, Lim DA, Bucci M, Caverzasi E, Gaetano L, Mandelli ML, Ryan T, Perry R, Farrell J, Jeremy RJ, Ulman M, Huhn SL, Barkovich AJ, Rowitch DH. Neural stem cell engraftment and myelination in the human brain. Sci Transl Med 2013; 4:155ra137. [PMID: 23052294 DOI: 10.1126/scitranslmed.3004373] [Citation(s) in RCA: 204] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Pelizaeus-Merzbacher disease (PMD) is a rare leukodystrophy caused by mutation of the proteolipid protein 1 gene. Defective oligodendrocytes in PMD fail to myelinate axons, causing global neurological dysfunction. Human central nervous system stem cells (HuCNS-SCs) can develop into oligodendrocytes and confer structurally normal myelin when transplanted into a hypomyelinating mouse model. A 1-year, open-label phase-1 study was undertaken to evaluate safety and to detect evidence of myelin formation after HuCNS-SC transplantation. Allogeneic HuCNS-SCs were surgically implanted into the frontal lobe white matter in four male subjects with an early-onset severe form of PMD. Immunosuppression was administered for 9 months. Serial neurological evaluations, developmental assessments, and cranial magnetic resonance imaging (MRI) and MR spectroscopy, including high-angular resolution diffusion tensor imaging (DTI), were performed at baseline and after transplantation. The neurosurgical procedure, immunosuppression regimen, and HuCNS-SC transplantation were well tolerated. Modest gains in neurological function were observed in three of the four subjects. No clinical or radiological adverse effects were directly attributed to the donor cells. Reduced T1 and T2 relaxation times were observed in the regions of transplantation 9 months after the procedure in the three subjects. Normalized DTI showed increasing fractional anisotropy and reduced radial diffusivity, consistent with myelination, in the region of transplantation compared to control white matter regions remote to the transplant sites. These phase 1 findings indicate a favorable safety profile for HuCNS-SCs in subjects with PMD. The MRI results suggest durable cell engraftment and donor-derived myelin in the transplanted host white matter.
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Affiliation(s)
- Nalin Gupta
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA 94143, USA
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Lee YS, Arinzeh TL. The influence of piezoelectric scaffolds on neural differentiation of human neural stem/progenitor cells. Tissue Eng Part A 2012; 18:2063-72. [PMID: 22646285 DOI: 10.1089/ten.tea.2011.0540] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Human neural stem/progenitor cells (hNSCs/NPCs) are a promising cell source for neural tissue engineering because of their ability to differentiate into various neural lineages. In this study, hNSC/NPC differentiation was evaluated on piezoelectric, fibrous scaffolds. These smart materials have an intrinsic material property where transient electric potential can be generated in the material upon minute mechanical deformation. hNSCs/NPCs cultured on the scaffolds and films differentiated into β-III tubulin-positive cells, a neuronal cell marker, with or without the presence of inductive factors. In contrast, hNSCs/NPCs cultured on laminin-coated plates were predominantly nestin positive, a NSC marker, in the control medium. Gene expression results suggest that the scaffolds may have promoted the formation of mature neural cells exhibiting neuron-like characteristics. hNSCs/NPCs differentiated mostly into β-III tubulin-positive cells and had the greatest average neurite length on micron-sized, annealed (more piezoelectric), aligned scaffolds, demonstrating their potential for neural tissue-engineering applications.
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Affiliation(s)
- Yee-Shuan Lee
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102-1982, USA
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Huang JK, Franklin RJM. Current status of myelin replacement therapies in multiple sclerosis. PROGRESS IN BRAIN RESEARCH 2012. [PMID: 23186717 DOI: 10.1016/b978-0-444-59544-7.00011-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Multiple sclerosis is an autoimmune disease of the human central nervous system characterized by immune-mediated myelin and axonal damage, and chronic axonal loss attributable to the absence of myelin sheaths. There are two aspects to the treatment of MS-first, the prevention of damage by suppressing the maladaptive immune system, and second, the long-term preservation of axons by the promotion of remyelination, a regenerative process in which new axons are restored to demyelinated axons. Medicine has made significant progress in the first of these in recent years-there is an increasing number of ever more effective disease-modifying immunomodulatory interventions. However, there are currently no widely used regenerative therapies in MS. Conceptually, there are two approaches to remyelination therapy-transplantation of myelinogenic cells and promotion of endogenous remyelination mediated by myelinogenic cells present within the diseased tissue. In this chapter, in addition to describing why remyelination therapies are important, we review both these approaches, outlining their current status and future developments.
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Affiliation(s)
- Jeffrey K Huang
- Wellcome Trust and MRC, Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK.
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Duncan ID, Kondo Y, Zhang SC. The myelin mutants as models to study myelin repair in the leukodystrophies. Neurotherapeutics 2011; 8:607-24. [PMID: 21979830 PMCID: PMC3250297 DOI: 10.1007/s13311-011-0080-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The leukodystrophies are rare and serious genetic disorders of the central nervous system that primarily affect children who frequently die early in life or have significantly delayed motor and mental milestones that result in long-term disability. Although with some of these disorders, early intervention with bone marrow or cord blood transplantation has been proven useful, it has not yet been determined that such therapies promote myelin repair of the central nervous system. Research on experimental therapies aimed at myelin repair is aided by the ability to test cell replacement strategies in genetic models in which the mutations and neuropathology match the human disorder. Thus, models exist of Pelizaeus-Merzbacher disease and the lysosomal storage disorder, Krabbe disease, which reflect the clinical and pathological course of the human disorders. Collectively, animals with mutations in myelin genes are called the myelin mutants, and they include rodent models such as the shiverer mouse that have been extensively used to study myelination by exogenous cell transplantation. These studies have encompassed many permutations of the age of the recipient, type of transplanted cell, site of engraftment, and so forth, and they offer hope that the scaling up of myelin produced by transplanted cells will have clinical significance in treating patients. Here we review these models and discuss their relative importance and use in such translational approaches. We discuss how grafts are identified and functional outcomes are measured. Finally, we briefly discuss the cells that have been successfully transplanted, which may be used in future clinical trials.
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Affiliation(s)
- Ian D Duncan
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA.
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11
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Myelin Restoration: Progress and Prospects for Human Cell Replacement Therapies. Arch Immunol Ther Exp (Warsz) 2011; 59:179-93. [DOI: 10.1007/s00005-011-0120-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Accepted: 11/17/2010] [Indexed: 12/12/2022]
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Abstract
There is a great need for pharmacological approaches to enhance neural progenitor cell (NPC) function particularly in neuroinflammatory diseases with failed neuroregeneration. In diseases such as multiple sclerosis and stroke, T-cell infiltration occurs in periventricular zones where NPCs are located and is associated with irreversible neuronal loss. We studied the effect of T-cell activation on NPC functions. NPC proliferation and neuronal differentiation were impaired by granzyme B (GrB) released by the T-cells. GrB mediated its effects by the activation of a Gi-protein-coupled receptor leading to decreased intracellular levels of cAMP and subsequent expression of the voltage-dependent potassium channel, Kv1.3. Importantly, blocking channel activity with margatoxin or blocking its expression reversed the inhibitory effects of GrB on NPCs. We have thus identified a novel pathway in neurogenesis. The increased expression of Kv1.3 in pathological conditions makes it a novel target for promoting neurorestoration.
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Current World Literature. Curr Opin Neurol 2009; 22:321-9. [DOI: 10.1097/wco.0b013e32832cf9cb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lederer CW, Santama N. Neural stem cells: mechanisms of fate specification and nuclear reprogramming in regenerative medicine. Biotechnol J 2009; 3:1521-38. [PMID: 19072908 DOI: 10.1002/biot.200800193] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Recently, intense interest in the potential use of neural stem cells (NSC) in the clinical therapy of brain disease and injury has resulted in rapid progress in research on the properties of NSC, their innate and directed differentiation potential and the induced reprogramming of differentiated somatic cells to revert to a pluripotent NSC-like state. The aim of this review is to give an overview of our current operational definitions of the NSC lineage, the growing understanding of extrinsic and intrinsic mechanisms, including heritable but reversible epigenetic chromatin modifications that regulate the maintenance and differentiation of NSC in vivo, and to emphasize ground-breaking efforts of cellular reprogramming with the view to generating patient-specific stem cells for cell replacement therapy. This is set against a summary of current practical procedures for the isolation, research and application of NSC, and of the state of the art in NSC-based regenerative medicine of the nervous system. Both provide the backdrop for the translation of recent findings into innovative clinical applications, with the hope of increasing the safety, efficiency and ethical acceptability of NSC-based therapies in the near future.
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