Immune problems in central nervous system cell therapy |
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Authors: | Roger?A?Barker Email author" target="_blank">H?kan?WidnerEmail author |
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Institution: | 1.Cambridge Center for Brain Repair and Department of Neurology,Cambridge,UK;2.Department of Clinical Neurosciences, Division of Neurology,Lund University Hospital,Lund,Sweden;3.Department of Physiology and Neuroscience, Wallenberg Neuroscience Center,Lund University,Lund,Sweden |
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Abstract: | Transplantation of cells and tissues to the mammalian brain and CNS has revived the interest in the immunological status of
brain and its response to grafted tissue. The previously held view that the brain was an absolute “immunologically privileged
site” allowing indefinite survival without rejection of grafts of cells has proven to be wrong. Thus, the brain should be
regarded as a site where immune responses can occur, albeit in a modified form, and under certain circumstances these are
as vigorous as those seen in other peripheral sites. Clinical cell transplant trials have now been performed in Parkinson’s
disease, Huntington’s disease, demyelinating diseases, retinal disorders, stroke, epilepsy, and even deafness, and normally
are designed as cell replacement strategies, although implantation of genetically modified cells for supplementation of growth
factors has also been tried. In addition, some disorders of the CNS for which cell therapies are being considered have an
immunological basis, such as multiple sclerosis, which further complicates the situation. Embryonic neural tissue allografted
into the CNS of animals and patients with neurodegenerative conditions survives, makes and receives synapses, and ameliorates
behavioral deficits. The use of aborted human tissue is logistically and ethically complicated, which has lead to the search
for alternative sources of cells, including xenogeneic tissue, genetically modified cells, and stem cells, all of which can
and will induce some level of immune reaction. We review some of the immunological factors involved in transplantation of
cells to CNS. |
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