Affiliations: Department of Stereotactic and Functional Neurosurgery, University of Freiburg Medical Center, Breisacher, Freiburg, Germany | Division of Functional Neurosurgery, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil | Department of Neurosurgery, University of Erlangen, Schwabachanlage, Erlangen, Germany | Laboratory of Clinical Genetics, Department of Pathomorphology, Bydgoszcz, Poland | Department of Microbiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland | Department of General Neurosurgery, University of Freiburg Medical Center, Breisacher, Freiburg, Germany | Division of Functional Neurosurgery, Department of Neurosurgery, Heinrich-Heine-University, Dusseldorf, Germany
Abstract: Purpose: The concept of transplantation of neuronal cells to treat Huntington's and Parkinson's diseases is based on the proven principle that dopaminergic and GABA-ergic progenitor neurons (from the human developing ventral mesencephalon and whole ganglionic eminence) can survive, differentiate and functionally integrate into an allogenic host brain. However, several donor and host-specific variables play a major role in the safety and outcome of this procedure. In this paper, we seek to summarize an updated neural transplantation protocol, based on our institutional experience and many years of collaboration with other neurotransplantation centers. Methods: We present a detailed clinical neurotransplantation protocol for Parkinson's (PD) and Huntington's (HD) diseases with special emphasis in understanding the anatomical relationships of the human fetal tissue that are relevant for selection of the desired cell populations. Results: Two detailed step-wise neurotransplantation protocols are presented, outlining strategies facilitating the avoidance of possible procedure-related complications. Conclusions: In this paper we delineated some crucial technical factors enabling the execution of a safe and effective neural transplantation. The protocols presented here might contribute to further development of the experimental clinical neurotransplantation towards a routine therapeutic procedure.
Keywords: Human fetal neural precursor cells (hFNPCs), neural stem cells (NSC), neural transplantation, ventral mesencephalon (VM), whole ganglionic eminence (WGE), substantia nigra (SN), Parkinson's disease (PD), Huntington's disease (HD), good clinical practice (GCP)
