Hope is rising among patients with Parkinson's disease, thought to number about 160,000 in Japan, following Kyoto University's latest announcement. The university should clearly ascertain the effectiveness of a new treatment utilizing induced pluripotent stem (iPS) cells.
The university has said it will generate cerebral nerve cells, cultivating them from iPS cells that are capable of developing into various types of cells, and then transplant these nerve cells into the brains of Parkinson's disease patients.
Kyoto University Hospital is set to select patients for the experimental treatment, following the approval given to the university's clinical test plan by a government institution. The first surgery involving the new treatment will be carried out as early as this year.
The hospital will eventually treat a total of seven patients with the method, and based on their therapeutic results, it will seek to file an application in 2022, at the earliest, aimed at ensuring such treatments are covered by medical insurance. If the new method is established as a remedy, it will greatly expand the range of options for Parkinson's disease patients.
Parkinson's disease develops as a result of reductions in nerve cells that produce dopamine, a substance that serves as an intracerebral information transmitter. The disease is intractable, and its patients suffer a gradual loss of bodily movements.
Health-care insurance already covers medicines that make up for a lack of dopamine as well as surgical operations in which electrodes are implanted into the brains of patients, thereby making it easier for them to move their bodies. However, no fundamental treatment is available. In many cases, patients find their daily life so difficult that they need nursing care.
Extreme care required
A new remedy for the disease has been earnestly longed for around the world. If Kyoto University's plan comes to fruition, the usefulness of iPS cells, whose technology originates in Japan, will be displayed both at home and abroad.
Since the 1980s in the United States and European countries, attempts have been made to transplant brain cells from babies aborted at an embryonic stage, as a method of treatment using cells. This is because cells at that stage have growth potential and easily take root. In fact, some good results have been reported.
However, many people oppose such utilization of aborted embryos from an ethical point of view, and the technique has not been commonly used.
The use of iPS cells will make it easier to produce cells suited to achieving symptomatic improvement. There are few concerns that the method may raise ethical problems, either. It will also be useful for treating patients on whom medicines have little effect.
Under which conditions can patients see remarkable results? Are there any cases in which no good effect can be expected? The iPS method should be carefully assessed through clinical tests.
It is important to secure the safety of the new treatment. If low-quality iPS cells are mixed with the most suitable ones, they could become cancerous or cause other problems.
Kyoto University will continuously check the intracerebral conditions of patients through radiation diagnosis and other means, and if there is any problem in their conditions, it plans to remove the affected parts by surgery or other means.
Progress is being made in the effort to promote the clinical application of iPS cells in treating such illnesses as cardiac disease. If unexpected trouble cannot be properly dealt with, it could cause delays in other research activities. Japan's iPS technology can be described as its decisive tool for regenerative medicine. Extreme care should be exercised.
(From The Yomiuri Shimbun, Aug. 1, 2018)
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