Stammzelltherapie neurologischer Erkrankungen

Zusammenfassung

Der Einsatz von Stammzellen hat sich als attraktive Strategie zum Ersatz verloren gegangener Zell- und Gewebefunktionen erwiesen. Stammzelltherapie gehört in vielen Fachgebieten mittlerweile zum klinischen Alltag. Die Komplexität des Gewebes im zentralen Nervensystem (ZNS) beschränkt die therapeutischen Anstrengungen bisher häufig auf die Rekonstitution umschriebener, gut bekannter Neurotransmitterdefizite, wie beispielsweise die Rekonstitution des nigro-striatalen Systems beim idiopathischen Parkinsonsyndrom. Die Entwicklung der letzten Jahre erbrachten allerdings neben der klassischen Zellersatztherapie verschiedene Möglichkeiten und Alternativen einer Stammzelltherapie verschiedenster neurologischer Erkrankungen, wie z. B. der Einsatz neuraler Stammzellen als Neuroprotektiva oder auch als Vektoren für den Transfer von Genen. Durch den Nachweis von neuralen Stammzellen auch im adulten Gehirn stellt sich zudem die Frage nach deren physiologischer und pathophysiologischer Rolle im Laufe des Lebens sowie deren Potenzial zur endogenen Regeneration. Die Kultivierung dieser Zellen hat darüber hinaus das Ziel, Mechanismen der neuronalen Degeneration und Regeneration zu studieren und daraus Therapiemöglichkeiten abzuleiten, wie z. B. die Stimulation endogener Stammzellen durch Medikamente. In dieser Arbeit möchten wir verschiedene Strategien der Nutzung von Stammzellen zur Therapie der häufigsten neurologischen Erkrankungen vorstellen und deren mögliche klinische Anwendung kritisch diskutieren.

Abstract

The use of stem cells has proven to be an attractive strategy for restoring lost cell or tissue functions. Stem cell therapy is nowadays routinely used in many clinical applications. The complexity of the tissue in the central nervous system, however, often limits the use of stem cells as yet for reconstructions of defined well-known neurotransmitter deficits, for example the reconstitution of the nigro-striatal system in Parkinson's disease. The ongoing developments during the recent years have shown alternative applications of stem cells in neurological diseases, for example, the use of neural stem cells as neuroprotective agents or as vectors for transferring genes of interest. Due to the discovery of neural stem cell also in the adult brain, the questions concerning their role in physiological and pathophysiological conditions as well as their potential for endogenous regeneration have to be further investigated. The cultivation and characterisation of these cells is aimed to improve our understanding of the mechanisms of neuronal degeneration and regeneration and could help in the development of therapeutic strategies such as, for example, the stimulation of endogenous stem cells by pharmacological compounds. In this review we present different strategies for the use of stem cells to treat various acute and chronic neurological diseases and discuss possible clinical applications.

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