[paula_w]

Annals of Neurology [2009] 66 (5) : 591-596 (Olanow CW, Kordower JH, Lang AE,
Obeso JA.) Complete abstract

excerpt from the conclusion....what a surprise [she says dryly]. And that was our only issue for 10{?} years. support it or be called a radical right religious fanatic and not worth even listening to. the world is starting to really **** me off. i'm in a "mood" now peg if you are reading this. But with good reason. Some of us knew inside that it wasn't natural and went against our "gut" and beliefs to try to believe that it was ok. in a sense, i sold out. I will not do that again for any theory or politically correct bs.....afraid to ask...but are they talking about cell implants or does that also include growth factors?....paula

begin excerpt:

The failure of dopaminergic cell-based therapies to achieve efficacy in double blind clinical trials, the development of unanticipated and occasionally disabling side effects, evidence that implanted cells themselves can develop the pathological changes of PD, and the likelihood that these treatments will not address the nondopaminergic features of the disease do not bode well for the near-term future of cell-based therapies as a clinically meaningful treatment for the majority of patients with PD. For the present, it would seem that greater opportunities for more effective therapies in PD would derive from better understanding of the etiology and pathogenesis of the disease and the development of neuroprotective therapies that might slow or stop disease progression."

[pegleg]

Could you post the link to this abstract, please? I don't think this is good news either, but I need to read it. Why? Because if they are insinuating in any way that dopamine replacement iisn't the way to go, thenthey have to replace the concept of this past 40+ years of making that the gold standard of treatment!

Peg GRRRR!

[pegleg]

I found another abstract of th is same publication, which is as follows:


Ann Neurol. 2009 Jun 18;66(5):591-596. [Epub ahead of print]

Dopaminergic transplantation for parkinson's disease: Current status and future prospects.
Olanow CW, Kordower JH, Lang AE, Obeso JA.

Department of Neurology, Mount Sinai School of Medicine, New York, NY.

Cell-based therapies that involve transplantation into the striatum of dopaminergic cells have attracted considerable interest as possible treatments for Parkinson's disease (PD). However, all double-blind, sham-controlled, studies have failed to meet their primary endpoints, and transplantation of dopamine cells derived from the fetal mesencephalon is associated with a potentially disabling form of dyskinesia that persists even after withdrawal of levodopa (off-medication dyskinesia). In addition, disability in advanced patients primarily results from features such as gait dysfunction, freezing, falling, and dementia, which are likely due to nondopaminergic pathology. These features are not adequately controlled with dopaminergic therapies and are thus unlikely to respond to dopaminergic grafts. More recently, implanted dopamine neurons have been found to contain Lewy bodies, suggesting that they are dysfunctional and may have been affected by the PD pathological process. Collectively, these findings do not bode well for the short-term future of cell-based dopaminergic therapies in PD. Ann Neurol 2009;66:591-596.

PMID: 19938101 [PubMed - as supplied by publisher]


I need to point out (if you didn't already know), that when some of these guys find a way to "trash" other therapies to make what they are doing look good, they'll do it every time. Surely, this is not the case here. Hmmm? But alas, I recognize some of these scientists' names, and it sure looks suspicious of such defamation.

We (science) have yet to prove that altering one's genetic system (aka gene therapy) is the way to go either. I have this mission to tell the world this about research: SHUT NO DOORS ON POSSIBLE THERAPIES! Now, why would I claim so bold a statement? BECAUSE WE HAVEN'T EVEN COME UP WITH A WAY TO POSITIVELY IDENTIFY THAT A PERSON EVEN HAS PARKINSON'S!

I guess what I'm really trying to say is WHO ARE THESE RESEARCHERS TO PROCLAIM THAT DOPAMINERGIC CELL REPLACEMENT IS OUT OF THE RUNNING?

[Conductor71]

Originally Posted by paula_w

Annals of Neurology [2009] 66 (5) : 591-596 (Olanow CW, Kordower JH, Lang AE,
Obeso JA.) Complete abstract

excerpt from the conclusion....what a surprise [she says dryly]. And that was our only issue for 10{?} years. support it or be called a radical right religious fanatic and not worth even listening to. the world is starting to really **** me off. i'm in a "mood" now peg if you are reading this. But with good reason. Some of us knew inside that it wasn't natural and went against our "gut" and beliefs to try to believe that it was ok. in a sense, i sold out. I will not do that again for any theory or politically correct bs.....afraid to ask...but are they talking about cell implants or does that also include growth factors?....paula

begin excerpt:

The failure of dopaminergic cell-based therapies to achieve efficacy in double blind clinical trials, the development of unanticipated and occasionally disabling side effects, evidence that implanted cells themselves can develop the pathological changes of PD, and the likelihood that these treatments will not address the nondopaminergic features of the disease do not bode well for the near-term future of cell-based therapies as a clinically meaningful treatment for the majority of patients with PD. For the present, it would seem that greater opportunities for more effective therapies in PD would derive from better understanding of the etiology and pathogenesis of the disease and the development of neuroprotective therapies that might slow or stop disease progression."

Paula,

I share your frustation, but I didn't necessarily see this is a bad thing. I think in a weird way it is beneficial to us? Instead of focusing so much energy on dopaminergic cells when so little is understood in how to really control them leaves us running in place. We really need to start focusing on etiologies and epidemiology to figure out why we getting PD in the first place - I think by better understanding what goes afoul in our neurotramsitter pathways- get to know where the break down originates and why- will lead to increased avenues of therapy as they look past just the role of dopamine. Glutamate receptors, for example, show promise. If they get a handle on why we go 'rogue' in the first place...this could lead to bigger discoveries and treatment pathways. That's my take on it at least, and I guess tonight I am a regular Pollyanna!

Laura

[paula_w]

That's a very good question Peg.

Is this a new fact being pre- licensed.. er..shared? is there a king of pd? does he get to pick what is researched?

paula

[paula_w]

Laura,

cell implants are too risky for many reasons[IMHO]. There were so many offfensive comments over that topic---------

i don't disagree with you laura..don't want to place a priority on what isn't working.

paula

[lurkingforacure]

I read this to mean essentially embryonic cells which we already know and have known for years have all kinds of problems our own adult stem cells do not. If this article is implying that autologous stem cell therapies should be shut out, I completely disagree. Look at Dennis Turner, and that guy on the PBS show who got his own cells implanted in Canada....true, those new cells may ultimately become infected with PD, whatever we find it to be, but it did buy those guys many good, good years of better health than they would have had on the same old, same old drug regime. And those are just two.

I want the choice to have stem cells as a treatment, if for nothing else than to buy time, since it is more than clear that the drug companies are in no hurry to help us.

[reverett123]

Who would stand to gain or lose money if a cellular approach should succeed? The hospitals would gain a little from the procedure. The pharmas ould lose a fortune as we fled. Now, look at the names on that paper. Anyone there who might be in Big Pharma's pocket?

[paula_w]

reminder that this was already posted a few days ago..

http://neurotalk.psychcentral.com/thread109155.html

paula

[girija]

Hi All,
I have been away from the forum for a couple of months and catching up today. Here I go giving my 2 cents worth on this abstract!

Since its an abstract from the Annals, it is a comprehensive survey of whats been going on in the field and their abstract seems to say that the current mode of treatments have not worked well. I think it is an accurate statement. Unless one reads the article its hard to say more than that.

As far as the stem cell therapies (wherever they are derived from) go, they are temporary till we know what causes neuronal cell death......thats one reason for many to be not so enthusiastic about this type of treatment.
I wish people who benefited from these therapies in India, China or Germany come forward to share their experiences,

However, a combination of gene therapy with a growth factor and an anti-inflammatory/anti-apoptotic molecule and stemcells could give us what we are looking for.
The million $$ question is how soon and when? I dont think anyone has an answer for it. So its neither good nor bad new IMHO. Its the same old news and I understand the frustration.

girija