Skip to main content
Top
Published in: Journal of Translational Medicine 1/2016

Open Access 01-12-2016 | Research

Finding a new therapeutic approach for no-option Parkinsonisms: mesenchymal stromal cells for progressive supranuclear palsy

Authors: Margherita Canesi, Rosaria Giordano, Lorenza Lazzari, Maurizio Isalberti, Ioannis Ugo Isaias, Riccardo Benti, Paolo Rampini, Giorgio Marotta, Aurora Colombo, Emanuele Cereda, Mariangela Dipaola, Tiziana Montemurro, Mariele Viganò, Silvia Budelli, Elisa Montelatici, Cristiana Lavazza, Agostino Cortelezzi, Gianni Pezzoli

Published in: Journal of Translational Medicine | Issue 1/2016

Login to get access

Abstract

Background

The trophic, anti-apoptotic and regenerative effects of bone marrow mesenchymal stromal cells (MSC) may reduce neuronal cell loss in neurodegenerative disorders.

Methods

We used MSC as a novel candidate therapeutic tool in a pilot phase-I study for patients affected by progressive supranuclear palsy (PSP), a rare, severe and no-option form of Parkinsonism. Five patients received the cells by infusion into the cerebral arteries. Effects were assessed using the best available motor function rating scales (UPDRS, Hoehn and Yahr, PSP rating scale), as well as neuropsychological assessments, gait analysis and brain imaging before and after cell administration.

Results

One year after cell infusion, all treated patients were alive, except one, who died 9 months after the infusion for reasons not related to cell administration or to disease progression (accidental fall). In all treated patients motor function rating scales remained stable for at least six-months during the one-year follow-up.

Conclusions

We have demonstrated for the first time that MSC administration is feasible in subjects with PSP. In these patients, in whom deterioration of motor function is invariably rapid, we recorded clinical stabilization for at least 6 months. These encouraging results pave the way to the next randomized, placebo-controlled phase-II study that will definitively provide information on the efficacy of this innovative approach.
Trial registration ClinicalTrials.gov NCT01824121
Literature
1.
go back to reference Bower JH, Maraganore DM, McDonnell SK, Rocca WA. Incidence of progressive supranuclear palsy and multiple system atrophy in Olmsted County, Minnesota, 1976 to 1990. Neurology. 1997;49:1284–8.CrossRefPubMed Bower JH, Maraganore DM, McDonnell SK, Rocca WA. Incidence of progressive supranuclear palsy and multiple system atrophy in Olmsted County, Minnesota, 1976 to 1990. Neurology. 1997;49:1284–8.CrossRefPubMed
2.
go back to reference Schrag A, Ben-Shlomo Y, Quinn NP. Prevalence of progressive supranuclear palsy and multiple system atrophy: a cross-sectional study. Lancet. 1999;354:1771–5.CrossRefPubMed Schrag A, Ben-Shlomo Y, Quinn NP. Prevalence of progressive supranuclear palsy and multiple system atrophy: a cross-sectional study. Lancet. 1999;354:1771–5.CrossRefPubMed
3.
go back to reference Nath U, Ben-Shlomo Y, Thomson RG, et al. The prevalence of progressive supranuclear palsy (Steele–Richardson–Olszewski syndrome) in the UK. Brain. 2001;124:1438–49.CrossRefPubMed Nath U, Ben-Shlomo Y, Thomson RG, et al. The prevalence of progressive supranuclear palsy (Steele–Richardson–Olszewski syndrome) in the UK. Brain. 2001;124:1438–49.CrossRefPubMed
4.
go back to reference Nath U, Ben-Shlomo Y, Thomson RG, Morris HR, Wood NW, Lees AJ, et al. Movement Disorders Society Scientific Issues Committee report: SIC task force appraisal of clinical diagnostic criteria for Parkinsonian disorders. Mov Disord. 2003;18:467–86.CrossRef Nath U, Ben-Shlomo Y, Thomson RG, Morris HR, Wood NW, Lees AJ, et al. Movement Disorders Society Scientific Issues Committee report: SIC task force appraisal of clinical diagnostic criteria for Parkinsonian disorders. Mov Disord. 2003;18:467–86.CrossRef
5.
go back to reference Bensimon G, Ludolph A, Agid Y, Vidailhet M, Payan C, Leigh PN, et al. Riluzole treatment, survival and diagnostic criteria in Parkinson plus disorders: the NNIPPS study. Brain. 2009;132:156–71.CrossRefPubMedPubMedCentral Bensimon G, Ludolph A, Agid Y, Vidailhet M, Payan C, Leigh PN, et al. Riluzole treatment, survival and diagnostic criteria in Parkinson plus disorders: the NNIPPS study. Brain. 2009;132:156–71.CrossRefPubMedPubMedCentral
6.
go back to reference Hauw JJ, Daniel SE, Dickson D, Horoupian DS, Jellinger K, Lantos PL, et al. Preliminary NINDS neuropathologic criteria for Steele–Richardson–Olszewski syndrome (progressive supranuclear palsy). Neurology. 1994;44:2015–9.CrossRefPubMed Hauw JJ, Daniel SE, Dickson D, Horoupian DS, Jellinger K, Lantos PL, et al. Preliminary NINDS neuropathologic criteria for Steele–Richardson–Olszewski syndrome (progressive supranuclear palsy). Neurology. 1994;44:2015–9.CrossRefPubMed
7.
go back to reference Respondek G, Roeber S, Kretzschmar H, Troakes C, Al-Sarraj S, Gelpi E, et al. Accuracy of the National Institute for Neurological Disorders and Stroke/Society for Progressive Supranuclear Palsy and neuroprotection and natural history in Parkinson plus syndromes criteria for the diagnosis of progressive supranuclear palsy. Mov Disord. 2013;28:504–9.CrossRefPubMed Respondek G, Roeber S, Kretzschmar H, Troakes C, Al-Sarraj S, Gelpi E, et al. Accuracy of the National Institute for Neurological Disorders and Stroke/Society for Progressive Supranuclear Palsy and neuroprotection and natural history in Parkinson plus syndromes criteria for the diagnosis of progressive supranuclear palsy. Mov Disord. 2013;28:504–9.CrossRefPubMed
8.
go back to reference Williams DR, Lees AJ. Progressive supranuclear palsy: clinicopathological concepts and diagnostic challenges. Lancet Neurol. 2009;8:270–9.CrossRefPubMed Williams DR, Lees AJ. Progressive supranuclear palsy: clinicopathological concepts and diagnostic challenges. Lancet Neurol. 2009;8:270–9.CrossRefPubMed
9.
go back to reference Burrell JR, Hodges JR, Rowe JB. Cognition in corticobasal syndrome and progressive supranuclear palsy: a review. Mov Disord. 2014;29:684–93.CrossRefPubMed Burrell JR, Hodges JR, Rowe JB. Cognition in corticobasal syndrome and progressive supranuclear palsy: a review. Mov Disord. 2014;29:684–93.CrossRefPubMed
10.
go back to reference Nath U, Ben-Shlomo Y, Thomson RG, Lees AJ, Burn DJ. Clinical features and natural history of progressive supranuclear palsy: a clinical cohort study. Neurology. 2003;60:910–6.CrossRefPubMed Nath U, Ben-Shlomo Y, Thomson RG, Lees AJ, Burn DJ. Clinical features and natural history of progressive supranuclear palsy: a clinical cohort study. Neurology. 2003;60:910–6.CrossRefPubMed
11.
12.
go back to reference Golbe LI, Ohman-Strickland PA. A clinical rating scale for progressive supranuclear palsy. Brain. 2007;130:1552–65.CrossRefPubMed Golbe LI, Ohman-Strickland PA. A clinical rating scale for progressive supranuclear palsy. Brain. 2007;130:1552–65.CrossRefPubMed
13.
go back to reference Burn DJ, Lees AJ. Progressive supranuclear palsy: where are we now? Lancet Neurol. 2002;1:359–69.CrossRefPubMed Burn DJ, Lees AJ. Progressive supranuclear palsy: where are we now? Lancet Neurol. 2002;1:359–69.CrossRefPubMed
14.
go back to reference Papapetropoulos S, Singer C, McCorquodale D, Gonzalez J, Mash DC. Cause, seasonality of death and co-morbidities in progressive supranuclear palsy (PSP). Parkinsonism Relat Disord. 2005;11:459–63.CrossRefPubMed Papapetropoulos S, Singer C, McCorquodale D, Gonzalez J, Mash DC. Cause, seasonality of death and co-morbidities in progressive supranuclear palsy (PSP). Parkinsonism Relat Disord. 2005;11:459–63.CrossRefPubMed
15.
go back to reference Boxer AL, Lang AE, Grossman M, Knopman DS, Miller BL, Schneider LS, et al. Davunetide in patients with progressive supranuclear palsy: a randomised, double-blind, placebo-controlled phase 2/3 trial. Lancet Neurol. 2014;13:676–85.CrossRefPubMedPubMedCentral Boxer AL, Lang AE, Grossman M, Knopman DS, Miller BL, Schneider LS, et al. Davunetide in patients with progressive supranuclear palsy: a randomised, double-blind, placebo-controlled phase 2/3 trial. Lancet Neurol. 2014;13:676–85.CrossRefPubMedPubMedCentral
16.
go back to reference Stamelou M, Reuss A, Pilatus U, Magerkurth J, Niklowitz P, Eggert KM, et al. Short-term effects of coenzyme Q10 in progressive supranuclear palsy: a randomized, placebo-controlled trial. Mov Disord. 2008;23:942–9.CrossRefPubMed Stamelou M, Reuss A, Pilatus U, Magerkurth J, Niklowitz P, Eggert KM, et al. Short-term effects of coenzyme Q10 in progressive supranuclear palsy: a randomized, placebo-controlled trial. Mov Disord. 2008;23:942–9.CrossRefPubMed
17.
go back to reference Cova L, Bossolasco P, Armentero MT, Diana V, Zennaro E, Mellone M, et al. Neuroprotective effects of human mesenchymal stem cells on neural cultures exposed to 6-hydroxydopamine: implications for reparative therapy in Parkinson’s disease. Apoptosis. 2012;17:289–304.CrossRefPubMed Cova L, Bossolasco P, Armentero MT, Diana V, Zennaro E, Mellone M, et al. Neuroprotective effects of human mesenchymal stem cells on neural cultures exposed to 6-hydroxydopamine: implications for reparative therapy in Parkinson’s disease. Apoptosis. 2012;17:289–304.CrossRefPubMed
18.
go back to reference Dominici M, Le Blanc K, Mueller I, Slaper-Cortenbach I, Marini F, Krause D, et al. Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement. Cytotherapy. 2006;8:315–7.CrossRefPubMed Dominici M, Le Blanc K, Mueller I, Slaper-Cortenbach I, Marini F, Krause D, et al. Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement. Cytotherapy. 2006;8:315–7.CrossRefPubMed
19.
go back to reference Horwitz EM, Le Blanc K, Dominici M, Mueller I, Slaper-Cortenbach I, Marini FC, et al. Clarification of the nomenclature for MSC: The International Society for Cellular Therapy position statement. Cytotherapy. 2005;7:393–5.CrossRefPubMed Horwitz EM, Le Blanc K, Dominici M, Mueller I, Slaper-Cortenbach I, Marini FC, et al. Clarification of the nomenclature for MSC: The International Society for Cellular Therapy position statement. Cytotherapy. 2005;7:393–5.CrossRefPubMed
20.
go back to reference Giordano R, Canesi M, Isalberti M, Isaias IU, Montemurro T, Viganò M, et al. Autologous mesenchymal stem cell therapy for progressive supranuclear palsy: translation into a phase I controlled, randomized clinical study. J Transl Med. 2014;12:14.CrossRefPubMedPubMedCentral Giordano R, Canesi M, Isalberti M, Isaias IU, Montemurro T, Viganò M, et al. Autologous mesenchymal stem cell therapy for progressive supranuclear palsy: translation into a phase I controlled, randomized clinical study. J Transl Med. 2014;12:14.CrossRefPubMedPubMedCentral
21.
go back to reference Bossolasco P, Cova L, Calzarossa C, Servida F, Mencacci NE, Onida F, et al. Metalloproteinase alterations in the bone marrow of ALS patients. J Mol Med (Berl). 2010;88:553–64.CrossRef Bossolasco P, Cova L, Calzarossa C, Servida F, Mencacci NE, Onida F, et al. Metalloproteinase alterations in the bone marrow of ALS patients. J Mol Med (Berl). 2010;88:553–64.CrossRef
22.
go back to reference Goetz CG, Tilley BC, Shaftman SR, Stebbins GT, Fahn S, Martinez-Martin P, et al. Movement Disorder Society-sponsored revision of the unified Parkinson’s disease rating scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord. 2008;23:2129–70.CrossRefPubMed Goetz CG, Tilley BC, Shaftman SR, Stebbins GT, Fahn S, Martinez-Martin P, et al. Movement Disorder Society-sponsored revision of the unified Parkinson’s disease rating scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord. 2008;23:2129–70.CrossRefPubMed
23.
go back to reference Goetz CG, Poewe W, Rascol O, Sampaio C, Stebbins GT, Counsell C, et al. Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: status and recommendations. Mov Disord. 2004;19:1020–8.CrossRefPubMed Goetz CG, Poewe W, Rascol O, Sampaio C, Stebbins GT, Counsell C, et al. Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: status and recommendations. Mov Disord. 2004;19:1020–8.CrossRefPubMed
24.
go back to reference Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.CrossRefPubMed Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.CrossRefPubMed
25.
go back to reference Isaias IU, Benti R, Cilia R, Canesi M, Marotta G, Gerundini P, et al. [123I]FP-CIT striatal binding in early Parkinson’s disease patients with tremor vs. akinetic-rigid onset. NeuroReport. 2007;18:1499–502.CrossRefPubMed Isaias IU, Benti R, Cilia R, Canesi M, Marotta G, Gerundini P, et al. [123I]FP-CIT striatal binding in early Parkinson’s disease patients with tremor vs. akinetic-rigid onset. NeuroReport. 2007;18:1499–502.CrossRefPubMed
26.
go back to reference Carpinella I, Crenna P, Calabrese E, Rabuffetti M, Mazzoleni P, Nemni R, et al. Locomotor function in the early stage of Parkinson’s disease. IEEE Trans Neural Syst Rehabil Eng. 2007;15:543–51.CrossRefPubMed Carpinella I, Crenna P, Calabrese E, Rabuffetti M, Mazzoleni P, Nemni R, et al. Locomotor function in the early stage of Parkinson’s disease. IEEE Trans Neural Syst Rehabil Eng. 2007;15:543–51.CrossRefPubMed
27.
go back to reference Winter DA, Patla AE, Frank JS. Assessment of balance control in humans. Med Prog Technol. 1990;16:31–51.PubMed Winter DA, Patla AE, Frank JS. Assessment of balance control in humans. Med Prog Technol. 1990;16:31–51.PubMed
28.
go back to reference Prieto TE, Myklebust JB, Hoffmann RG, Lovett EG, Myklebust BM. Measures of postural steadiness: differences between healthy young and elderly adults. IEEE T Bio-Med Eng. 1996;43:956–66.CrossRef Prieto TE, Myklebust JB, Hoffmann RG, Lovett EG, Myklebust BM. Measures of postural steadiness: differences between healthy young and elderly adults. IEEE T Bio-Med Eng. 1996;43:956–66.CrossRef
29.
go back to reference Duarte M, Zatsiorsky VM. Patterns of center of pressure migration during prolonged unconstrained standing. Mot Control. 1999;3:12–27. Duarte M, Zatsiorsky VM. Patterns of center of pressure migration during prolonged unconstrained standing. Mot Control. 1999;3:12–27.
30.
go back to reference Raymakers JA, Samson MM, Verhaar HJ. The assessment of body sway and the choice of the stability parameters. Gait Posture. 2005;21:48–58.CrossRefPubMed Raymakers JA, Samson MM, Verhaar HJ. The assessment of body sway and the choice of the stability parameters. Gait Posture. 2005;21:48–58.CrossRefPubMed
31.
go back to reference van der Kooij H, van Asseldonk E, van der Helm FC. Comparison of different methods to identify and quantify balance control. J Neurosci Meth. 2005;145:175–203.CrossRef van der Kooij H, van Asseldonk E, van der Helm FC. Comparison of different methods to identify and quantify balance control. J Neurosci Meth. 2005;145:175–203.CrossRef
32.
go back to reference Martin M, Shinberg M, Kuchibhatla M, Ray L, Carollo JJ, Schenkman ML. Gait initiation in community-dwelling adults with Parkinson disease: comparison with older and younger adults without the disease. Phys Ther. 2002;82:566–77.PubMed Martin M, Shinberg M, Kuchibhatla M, Ray L, Carollo JJ, Schenkman ML. Gait initiation in community-dwelling adults with Parkinson disease: comparison with older and younger adults without the disease. Phys Ther. 2002;82:566–77.PubMed
33.
go back to reference Brazzini A, Cantella R, De la Cruz A, Yupanqui J, León C, Jorquiera T, et al. Intraarterial autologous implantation of adult stem cells for patients with Parkinson disease. J Vasc Interv Radiol. 2010;21:443–51.CrossRefPubMed Brazzini A, Cantella R, De la Cruz A, Yupanqui J, León C, Jorquiera T, et al. Intraarterial autologous implantation of adult stem cells for patients with Parkinson disease. J Vasc Interv Radiol. 2010;21:443–51.CrossRefPubMed
34.
go back to reference Hauser RA, Freeman TB, Snow BJ, Nauert M, Gauger L, Kordower JH, et al. Long-term evaluation of bilateral fetal nigral transplantation in Parkinson disease. Arch Neurol. 1999;56:179–87.CrossRefPubMed Hauser RA, Freeman TB, Snow BJ, Nauert M, Gauger L, Kordower JH, et al. Long-term evaluation of bilateral fetal nigral transplantation in Parkinson disease. Arch Neurol. 1999;56:179–87.CrossRefPubMed
35.
go back to reference Amano S, Skinner JW, Lee HK, Stegemöller EL, Hack N, Akbar U, et al. Discriminating features of gait performance in progressive supranuclear palsy. Parkinsonism Relat Disord. 2015;21:888–93.CrossRefPubMed Amano S, Skinner JW, Lee HK, Stegemöller EL, Hack N, Akbar U, et al. Discriminating features of gait performance in progressive supranuclear palsy. Parkinsonism Relat Disord. 2015;21:888–93.CrossRefPubMed
36.
go back to reference Lee PH, Lee JE, Kim HS, Song SK, Lee HS, Nam HS, et al. A randomized trial of mesenchymal stem cells in multiple system atrophy. Ann Neurol. 2012;72:32–40.CrossRefPubMed Lee PH, Lee JE, Kim HS, Song SK, Lee HS, Nam HS, et al. A randomized trial of mesenchymal stem cells in multiple system atrophy. Ann Neurol. 2012;72:32–40.CrossRefPubMed
37.
go back to reference Karlupia N, Manley NC, Prasad K, Schäfer R, Steinberg GK. Intraarterial transplantation of human umbilical cord blood mononuclear cells is more efficacious and safer compared with umbilical cord mesenchymal stromal cells in a rodent stroke model. Stem Cell Res Ther. 2014;5:45–63.CrossRefPubMedPubMedCentral Karlupia N, Manley NC, Prasad K, Schäfer R, Steinberg GK. Intraarterial transplantation of human umbilical cord blood mononuclear cells is more efficacious and safer compared with umbilical cord mesenchymal stromal cells in a rodent stroke model. Stem Cell Res Ther. 2014;5:45–63.CrossRefPubMedPubMedCentral
38.
go back to reference Cui L, Kerkelä E, Bakreen A, Nitzsche F, Andrzejewska A, Nowakowski A. The cerebral embolism evoked by intra-arterial delivery of allogeneic bone marrow mesenchymal stem cells in rats is related to cell dose and infusion velocity. Stem Cell Res Ther. 2015;6:11–9.CrossRefPubMedPubMedCentral Cui L, Kerkelä E, Bakreen A, Nitzsche F, Andrzejewska A, Nowakowski A. The cerebral embolism evoked by intra-arterial delivery of allogeneic bone marrow mesenchymal stem cells in rats is related to cell dose and infusion velocity. Stem Cell Res Ther. 2015;6:11–9.CrossRefPubMedPubMedCentral
39.
go back to reference Janowski M, Lyczek A, Engels C, Xu J, Lukomska B, Bulte JWM, et al. Cell size and velocity of injection are major determinants of the safety of intracarotid stem cell transplantation. J Cereb Blood Flow Metab. 2013;33:921–7.CrossRefPubMedPubMedCentral Janowski M, Lyczek A, Engels C, Xu J, Lukomska B, Bulte JWM, et al. Cell size and velocity of injection are major determinants of the safety of intracarotid stem cell transplantation. J Cereb Blood Flow Metab. 2013;33:921–7.CrossRefPubMedPubMedCentral
Metadata
Title
Finding a new therapeutic approach for no-option Parkinsonisms: mesenchymal stromal cells for progressive supranuclear palsy
Authors
Margherita Canesi
Rosaria Giordano
Lorenza Lazzari
Maurizio Isalberti
Ioannis Ugo Isaias
Riccardo Benti
Paolo Rampini
Giorgio Marotta
Aurora Colombo
Emanuele Cereda
Mariangela Dipaola
Tiziana Montemurro
Mariele Viganò
Silvia Budelli
Elisa Montelatici
Cristiana Lavazza
Agostino Cortelezzi
Gianni Pezzoli
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Journal of Translational Medicine / Issue 1/2016
Electronic ISSN: 1479-5876
DOI
https://doi.org/10.1186/s12967-016-0880-2

Other articles of this Issue 1/2016

Journal of Translational Medicine 1/2016 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.