We report the implantation of patient-derived midbrain dopaminergic progenitor cells, differentiated in vitro from autologous induced pluripotent stem cells (iPSCs), in a patient with idiopathic Parkinson’s disease. The patient-specific progenitor cells were produced under Good Manufacturing Practice conditions and characterized as having the phenotypic properties of substantia nigra pars compacta neurons; testing in a humanized mouse model (involving peripheral-blood mononuclear cells) indicated an absence of immunogenicity to these cells. The cells were implanted into the putamen (left hemisphere followed by right hemisphere, 6 months apart) of a patient with Parkinson’s disease, without the need for immunosuppression. Positron-emission tomography with the use of fluorine-18-L-dihydroxyphenylalanine suggested graft survival. Clinical measures of symptoms of Parkinson’s disease after surgery stabilized or improved at 18 to 24 months after implantation. (Funded by the National Institutes of Health and others.)

Extracellular vesicles (EVs) derived from stem cells have shown therapeutic potential in various diseases, but their use in treating neurological disorders remains limited. In this study, we observed neurotoxic activation of reactive astrocytes and lipoapoptosis pathways in both mice and patients with intracerebral hemorrhage (ICH) and found that EVs derived from neural stem cells (EVs-NSC) could suppress this activation. Using loss- and gain-of-function approaches, we identified interferon-β (IFNβ) as a key regulator in neurotoxic activation of astrocytes. In addition, we demonstrated that the microRNA (miRNA) miR-124-3p within EVs-NSC degrades IFNβ mRNA and inhibits ELOVL1 expression via miRNA-coding sequence (CDS) and miRNA-3' UTR binding mechanisms, respectively. This dual action likely reduces astrocyte neurotoxicity by lowering saturated lipid secretion. These mechanisms enable EVs-NSC or miR-124-3p overexpression to inhibit astrocyte neurotoxicity, reduce neural damage, and promote recovery in ICH models, offering strategies for treating neurological disorders by targeting neurotoxic reactive astrocytes.

Parkinson’s disease (PD) is characterized by the selective death of substantia nigra pars compacta (SNpc) dopaminergic neurons and includes both motor and non-motor symptoms. While numerous models exist for the study of typical PD motor deficits, fewer exist for non-motor symptoms. Previous studies have shown that a Pitx3^−/− mouse model (aphakia or ak mouse) has specific developmental failure of the dopaminergic neuron population in the SNpc and that it can be used for the study of PD-related gross motor dysfunction as well as cognitive functional deficits. It remains unclear whether the aphakia mouse, both male and female, might also be used to model fine motor deficits and for additional studies of non-motor deficits associated with PD. Here, using an extensive battery of behavioral tests, we demonstrate that the aphakia mouse shows both gross and fine motor functional deficits compared with control mice. Furthermore, aphakia mice show deficits of olfactory function in buried pellet, odor discrimination and odor habituation/dishabituation tests. We also found that aphakia mice suffer from gastrointestinal dysfunction (e.g., longer whole gut transit time and colon motility deficits), suggesting that the mutation also affects function of the gut-brain axis in this animal model. Moreover, our data demonstrate that in the aphakia mouse, L-DOPA, the gold standard PD medication, can rescue both gross and fine motor function deficits but neither olfactory nor gastrointestinal symptoms, a pattern much like that seen in PD patients. Altogether, this suggests that the aphakia mouse is a suitable model for fine motor, olfactory and gastrointestinal behavioral studies of PD as well as for the development of novel disease-modifying therapeutics. Significance statement: While several animal models are available to study the major motor symptoms of PD, there are fewer that replicate non-motor symptoms, which constitute a major source of morbidity for patients. Moreover, available models often require manipulations resulting in sudden massive cell loss and inflammation, both of which may interfere with understanding of the direct effects of dopaminergic neuronal loss in the SNpc. We describe a model of congenital SNpc cell deficiency in a Pitx3^−/− mouse and characterize it with a battery of behavioral tests suggesting that it closely mimics non-motor as well as motor symptoms of PD, providing a useful insight into the effects of the nigrostriatal dopamine deficit. Taken together, these data suggest that the ak mouse represents a useful model to study dopaminergic system function for both motor and non-motor symptoms of PD.

Transplantation of midbrain dopaminergic neurons (mDANs) derived from human pluripotent stem cells (hPSCs) represents a promising therapeutic approach for

Stem cell-based therapy for Parkinson’s Disease (PD) is entering an exciting era with many groups competing to reach the goal of safe and practical clinical application. However, the road to this goal is long and beset by challenging obstacles, among which are Good Manufacturing Practice (GMP) standards, scalability, and regulatory requirements for the final cell product. Of paramount importance is the patient safety of the stem cell-derived dopaminergic neurons, such that each stage of the cell therapy implementation process must be scrutinized for potential safety concerns before introduction to the clinic can be contemplated. In this chapter, we will critically consider the safety regulations and safety strategies of stem cell-based therapy for PD, emphasizing the principal requirements necessary for this new therapeutic approach to benefit PD patients. We will introduce the current safety challenges and the connections between these safety issues and the special characteristics of neural stem cells. In addition, we will summarize the safety standards for stem cell-based therapy currently adopted by leading cell therapy groups and international regulations. Both in vitro and in vivo safety assessment methods will be discussed as they relate to the implementation of these standards. Finally, we will speculate on strategies for further enhancing the safety of stem cell-based therapy for PD.