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Designing stem-cell-based dopamine cell replacement trials for Parkinson's disease.

Authors
  • Barker, Roger A1, 2
  • 1 John van Geest Centre for Brain Repair, Department of Clinical Neurosciences and WT-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK. [email protected]
  • 2 John van Geest Centre for Brain Repair, Cambridge University, Cambridge, UK. [email protected]
Type
Published Article
Journal
Nature medicine
Publication Date
Jul 01, 2019
Volume
25
Issue
7
Pages
1045–1053
Identifiers
DOI: 10.1038/s41591-019-0507-2
PMID: 31263283
Source
Medline
Language
English
License
Unknown

Abstract

Clinical studies of Parkinson's disease (PD) using a dopamine cell replacment strategy have been tried for more than 30 years. The outcomes following transplantation of human fetal ventral mesencephalic tissue (hfVM) have been variable, with some patients coming off their anti-PD treatment for many years and others not responding and/or developing significant side effects, including graft-induced dyskinesia. This led to a re-appraisal of the best way to do such trials, which resulted in a new European-Union-funded allograft trial with fetal dopamine cells across several centers in Europe. This new trial, TRANSEURO ( NCT01898390 ), is an open-label study in which some individuals in a large observational cohort of patients with mild PD who were undergoing identical assessments were randomly selected to receive transplants of hfVM. The TRANSEURO trial is currently ongoing as researchers have completed both recruitment into a large multicenter observational study of younger onset early-stage PD and transplantation of hfVM in 11 patients. While completion of TRANSEURO is not expected until 2021, we feel that sharing the rationale for the design of TRANSEURO, along with the lessons we have learned along the way, can help inform researchers and facilitate planning of transplants of dopamine-producing cells derived from human pluripotent stem cells for future clinical trials.

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