Gene therapy for Parkinson's disease: Disease modification by GDNF family of ligands.
Gene transfer is a promising drug delivery method of advanced therapeutic entities for Parkinson's disease. One advantage over conventional therapies, such as peripheral delivery of the dopamine pre-cursor l-DOPA, is site-specific expression of proteins with regenerative, disease-modifying and potentially neuroprotective capacity. Several clinical trials have been performed to test the capacity of glial-cell line derived neurotrophic factor and neurturin to rescue degenerating dopaminergic neurons in the substantia nigra and their axon terminals in the striatum by delivery of these neurotrophic factors either as purified protein or by means of viral vector mediated gene delivery to the brain. Although gene therapy approaches tested so far have been shown to be safe, none met their primary endpoints in phase II clinical trials designed and powered to test the efficacy of the intervention. Within the scope of this review we aim to describe the state-of-the-art in the field, how different technical parameters were translated from pre-clinical studies in non-human primates to clinical trials, and what these trials taught us regarding important factors that may pave the way to the success of gene therapy for the treatment of Parkinson's disease.
Brain Repair and Imaging in Neural Systems (B.R.A.I.N.S) Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden. Electronic address: deniz.kirik@med.lu.se.
Deniz
D
Kirik
Brain Repair and Imaging in Neural Systems (B.R.A.I.N.S) Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden.
Erik
E
Cederfjäll
Faculty of Medicine, University of New South Wales and Neuroscience Research Australia, Sydney, Australia.
Glenda
G
Halliday
Translational Neuroendocrine Research Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden.
Åsa
Å
Petersén
D000818:Animals; D015316:Genetic Therapy; D051100:Glial Cell Line-Derived Neurotrophic Factor / Q000235:genetics / Q000378:metabolism; D006801:Humans; D020734:Parkinsonian Disorders / Q000378:metabolism / Q000628:therapy*
D051100:Glial Cell Line-Derived Neurotrophic Factor
AAV; Adeno-associated virus; Dopamine; GDNF; Neurotrophic factors; Neurturin; Non-human primates; Viral vectors