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Cell therapy in Huntington's disease: taking stock of past studies to move the field forward

Bachoud-Levi, Anne-Catherine, Massart, Renaud and Rosser, Anne 2021. Cell therapy in Huntington's disease: taking stock of past studies to move the field forward. Stem Cells 39 (2) , pp. 144-155. 10.1002/stem.3300

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Abstract

Huntington's disease (HD) is a rare inherited neurodegenerative disease that manifests mostly in adulthood with progressive cognitive, behavioral, and motor dysfunction. Neuronal loss occurs predominantly in the striatum but also extends to other brain regions, notably the cortex. Most patients die around 20 years after motor onset, although there is variability in the rate of progression and some phenotypic heterogeneity. The most advanced experimental therapies currently are huntingtin‐lowering strategies, some of which are in stage 3 clinical trials. However, even if these approaches are successful, it is unlikely that they will be applicable to all patients or will completely halt continued loss of neural cells in all cases. On the other hand, cellular therapies have the potential to restore atrophied tissues and may therefore provide an important complementary therapeutic avenue. Pilot studies of fetal cell grafts in the 2000s reported the most dramatic clinical improvements yet achieved for this disease, but subsequent studies have so far failed to identify methodology to reliably reproduce these results. Moving forward, a major challenge will be to generate suitable donor cells from (nonfetal) cell sources, but in parallel there are a host of procedural and trial design issues that will be important for improving reliability of transplants and so urgently need attention. Here, we consider findings that have emerged from clinical transplant studies in HD to date, in particular new findings emerging from the recent multicenter intracerebral transplant HD study, and consider how these data may be used to inform future cell therapy trials.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Biosciences
Neuroscience and Mental Health Research Institute (NMHRI)
Additional Information: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in anymedium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Publisher: AlphaMed Press
ISSN: 1066-5099
Date of First Compliant Deposit: 14 December 2020
Date of Acceptance: 20 October 2020
Last Modified: 03 Feb 2021 12:01
URI: http://orca.cf.ac.uk/id/eprint/137018

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