Replacing Dopamine Neurons in Parkinson's Disease: How did it happen?

The efforts to develop a dopamine cell replacement therapy for Parkinson's disease have spanned over more than three decades. Based on almost 10 years of transplantation studies in animal models, the first patients receiving grafts of fetal-derived dopamine neuroblasts were operated in Lund in 1987. Over the following two decades, a total of 18 patients were transplanted and followed closely by our team with mixed but also very encouraging results. In this article we tell the story of how the preclinical and clinical transplantation program in Lund evolved. We recall the excitement when we obtained the first evidence for survival and function of transplanted neurons in the diseased human brain. We also remember the setbacks that we have experienced during these 30 years and discuss the very interesting developments that are now taking place in this exciting field.

[Importance of the brain in body-soul discussion from the history of medicine perspective]. / Der Stellenwert des Gehirns in der Leib-Seele-Diskussion aus medizinisch-historischer Perspektive.

Since the earliest time medicine has considered our intellectual-psychic abilities in relationship to organs and substrata. Originally blood and its presumptive production resp. depot organs liver and heart acted as soul carriers. Gradually the brain obtained superiority in the body-soul-discussion and during the course of development nearly any structure of the brain was taken into consideration as seat of the soul and the sensorium commune. In the meantime the unity of body and soul never has been controversial among the former medical authors. Since the central nervous system took place of the blood vascular system already at an early time it follows that the brain equally in past and present passed for the material form of our intellectual-psychic abilities. It is true, today we renounce to speak in the body-soul-discussion of single structures of the brain--this has been done intensively and extensively for us by the searchers in former times--, but we still follow the old localisation concept perceiving in the brain and its estimated hundred milliards of nerve cells the unimaginable complex organ that offers the substratum for our intellectual-psychic abilities. Much is not yet realized. But: The genetic material was up to the present a "black box". Today light is fallen in. The efforts concerning this light incidence into the "black box" of the brain must be continued in favour of a successful restorative neurotransplantation.

Stereotactic neural transplantation.

In this keynote address, the author presents state-of-the-art information on the current status of the transplantation of fetal tissue for the treatment of movement disorders. Drawing on the experience in his own studies and elaborating upon the work reported by others, he outlines specific techniques and protocols and summarizes early findings.

A successful transplant of embryonic adrenal tissue in a patient with Addison's disease.

Well documented reports of the successful transplantation of human adrenal cortical tissue cannot be found in the literature. In 1951 we achieved the successful transplantation of human embryonic adrenal gland (cortical tissue) in a patient with symptomatic adrenal insufficiency (Addison's disease), apparently the first instance of histologically documented successful homografting of human adrenal cortex. Because of its historical pertinence, the authors, many years later, herein report on this case, which appeared in the senior author's medical thesis. The report must be viewed in the context of the existing clinical knowledge and technology available 40 years ago.

Neural transplantation: an historical perspective.

Literature on transplantation of neural and nonneural tissues into the brains of host animals is reviewed in the perspective of various issues. The two dominant issues determining this research were elucidation of embryological processes underlying the development of the nervous system and regeneration in the host brain. A comprehensive review of studies on regeneration in the central nervous system (CNS), using this technique of transplantation, indicates that regeneration of axonal fibers is small in magnitude and extent, and that it is more directly related to the trauma caused to the brain than to any other variable. This literature review attempts to provide a perspective to the contemporary research on neural transplantation and on regeneration in the CNS.