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Parkinson's disease: interpretations of transplantation study are erroneous

Nature Neuroscience volume 4, page 553 (2001)Cite this article

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The recent publication by Freed and colleagues1 of the first double-blind trial of fetal transplantation for Parkinson's disease (PD) has generated controversy in both the scientific and popular press. The results have been widely interpreted as disappointing, but we believe that many of the criticisms are misplaced. Here we present a meta-analysis of several published studies, from which we conclude that the results are in fact quite promising. We also suggest a plausible explanation for the side effects that were seen in the Freed study.

Freed and colleagues1 reported that 15% of their patients developed dyskinesias, whereas several other exploratory studies, in a total of about 30 patients, have shown significant clinical benefits of transplantation with no such side effects5,6,7,8. This may be a consequence of the technique used by Freed and colleagues, which differs from the other studies in many respects. For example, Freed and colleagues used a transcallosal surgical approach, and administered L-DOPA throughout the period of transplant growth. Moreover, they used a different procedure to prepare their cells. Some studies3,4,5,6,7 used either small tissue fragments or suspensions of cells that had been freshly dissociated using proteolytic enzymes. In contrast, the so-called 'noodle' cell preparation technique used in the Freed study includes a cell culture step that was requested by NIH reviewers to provide a measurement of dopamine production before implantation. The culture conditions might alter the cells and/or select for particular cell types, leading to a population that differs from that obtained with freshly dissociated preparations.

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Figure 1: Results from Freed et al. (ref. 1 and C. Freed, personal communication) compared with previous transplantation studies.

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Authors and Affiliations

  1. Neuroregeneration Laboratory, McLean Hospital/Harvard Medical School, Belmont, 02178-9106, Massachusetts, USA

    Ole Isacson, Lars Bjorklund & Rosario Sanchez Pernaute

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  1. Ole Isacson
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  2. Lars Bjorklund
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  3. Rosario Sanchez Pernaute
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Isacson, O., Bjorklund, L. & Pernaute, R. Parkinson's disease: interpretations of transplantation study are erroneous. Nat Neurosci 4, 553 (2001). https://doi.org/10.1038/88362

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