Brain Advance Access originally published online on March 26, 2004
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Brain, Vol. 127, No. 6, 1219-1228, 2004
© 2004 Guarantors of Brain
doi: 10.1093/brain/awh145
Integrating fetal neural transplants into a therapeutic strategy: the example of Huntingtons disease
1 INSERM U 421, Faculté de Médecine, 2 Service de Neurologie, CHU Henri-Mondor, Créteil and 3 CEA-CNRS URA 2210, Unité dImagerie Isotopique, Biochimique et Pharmacologique UI2BP and ImaGene program, Service Hospitalier Frédéric Joliot, Orsay, France
Correspondence to: Marc Peschanski, INSERM U 421, Faculté de Médecine, 94010 Créteil cedex, France. E-mail: Peschanski{at}im3.inserm.fr
Fetal neural transplants have become clinically relevant over the past 15 years for two major neurodegenerative diseases, namely Parkinsons disease and Huntingtons disease. It is therefore timely to consider how this neurosurgical procedure can integrate the therapeutic armamentarium, what can be expected of it, and what cannot. We use here the example of Huntingtons disease to show what fetal neural transplants may uniquely offer for that disease. Up to very recent times, Huntingtons disease has been one special example of those neurodegenerative diseases against which neurologists feel totally helpless. This has all changed today and, although results are essentially still to come, one can foresee the mobilization of very large scientific and medical forces against this disease, with definite steps forward in terms of physiopathology and a better view of the therapeutic challenges. While defining the role that fetal neural transplantation may play in meeting these challenges, we also try to show rationales and developments for all types of treatments attempted or suggested so far, as well as their limits and, when relevant, informative failures. The date of writing this review needs to be noted, because the rapid accumulation of data on molecular mechanisms of Huntingtons disease pathogenesis and the increasing numbers of clinical trials do not allow much time for the ink of a review to dry.
Key Words: neurodegenerative diseases; striatum; cell therapy; neuroprotection
Abbreviations: CNTF = ciliary neurotrophic factor
Received October 15, 2003. Revised January 9, 2004. Accepted January 10, 2004.