Newswise, May 12, 2016 — Researchers at Lund University in
Sweden have used a completely new preclinical technique and analysis of tissue
from patients to show exactly what happens when certain patients with
Parkinson's disease are restored as a result of nerve cell transplants.
They
have also identified what makes many of the transplant patients develop serious
side effects in the form of involuntary movements.
The treatment of Parkinson's disease has improved over the
past few decades. Despite this, the problem of serious side effects remains,
caused by both medication and the transplantation of nerve cells.
Parkinson's disease is associated with a deficit of the nerve
cells that produce the neurotransmitter dopamine in the brain.
One treatment method is to transplant dopamine-producing cells
into the affected part of the brain. Some patients have been completely
restored after such a transplant. Others have experienced side effects,
involuntary movements known as dyskinesias.
The reason why transplanted patients develop dyskinesias,
which is also a common side effect of medication treatment using L-DOPA, has
been unknown up to now.
For several years, the Lund researcher Tomas Björklund and his
colleagues have been working to develop a completely new technique for studying
how the transplanted cells actually function when they are transplanted into a
brain affected by Parkinson's disease.
They have placed an artificial receptor on the surface of
transplanted cells. A specially designed drug activates the receptor, which
controls the cells' release of dopamine. In animal testing they have now shown
that this method can be used to control the transplanted dopamine-producing cells'
activity in the brain. When the dopamine-producing cells are active, the animal
is almost completely restored.
"It is like a remote control for the brain. Using this
new technique, we can now either close down the transplanted cells completely
or increase their activity", states Tomas Björklund.
"Now we can control very closely when and how the cells
function when transplanted into the area of the brain affected by the
disease."
Using this new technique, the researchers have identified the
exact signalling pathway in the nerve cells that causes the involuntary
movements.
This is the chain of events: when the researchers activated
the dopamine-producing cells via a specific receptor, 5-HT6, which is sensitive
to the neurotransmitter serotonin, cyclic AMP increased within the transplanted
cells. This in turn caused an abnormal release of dopamine from the cells,
which ultimately caused dyskinesia among the animals.
"We have now been able to map exactly what it is that
makes nerve cell transplantation effective as a treatment. We have had access
to unique patient material from a patient who has had this type of cell
transplant and have also found a very high level expression of the receptor
that causes the side effects.
"The discovery is important, as in future clinical
treatment using cell transplantation can be carried out with a considerably
reduced risk of side effects, and the effect of the treatment can be
enhanced."
"There are advanced plans in many parts of the world to
carry out new clinical studies with nerve cell transplants from both foetuses
and stem cells against Parkinson's disease, which means that it's now more
relevant than ever to identify the underlying mechanisms in the brain."
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