Unravelling the Parkinson's puzzle, from medications and surgery to stem cells and genes: a comprehensive review of current and future management strategies.
Krishnapriya ChandrababuVineeth RadhakrishnanA S AnjanaRahul RajanUnnikrishnan SivanSyam KrishnanP S Baby ChakrapaniPublished in: Experimental brain research (2023)
Parkinson's disease (PD) is a neurodegenerative disorder, prevalent in the elderly population. Neuropathological hallmarks of PD include loss of dopaminergic cells in the nigro-striatal pathway and deposition of alpha-synuclein protein in the neurons and synaptic terminals, which lead to a complex presentation of motor and non-motor symptoms. This review focuses on various aspects of PD, from clinical diagnosis to currently accepted treatment options, such as pharmacological management through dopamine replacement and surgical techniques such as deep brain stimulation (DBS). The review discusses in detail the potential of emerging stem cell-based therapies and gene therapies to be adopted as a cure, in contrast to the present symptomatic treatment in PD. The potential sources of stem cells for autologous and allogeneic stem cell therapy have been discussed, along with the progress evaluation of pre-clinical and clinical trials. Even though recent techniques hold great potential to improve the lives of PD patients, we present the importance of addressing the safety, efficacy, ethical, cost, and regulatory concerns before scaling them to clinical use.
Keyphrases
- stem cells
- cell therapy
- deep brain stimulation
- parkinson disease
- clinical trial
- end stage renal disease
- minimally invasive
- genome wide
- bone marrow
- ejection fraction
- magnetic resonance
- mesenchymal stem cells
- gene expression
- randomized controlled trial
- obsessive compulsive disorder
- genome wide identification
- peritoneal dialysis
- dna methylation
- newly diagnosed
- induced apoptosis
- physical activity
- study protocol
- magnetic resonance imaging
- high dose
- acute coronary syndrome
- case report
- decision making
- transcription factor
- open label
- spinal cord injury
- depressive symptoms
- phase ii
- percutaneous coronary intervention
- replacement therapy
- patient reported outcomes
- double blind