Is Gray’s Anatomy’s Parkinson’s ‘Remedy’ Actual?

It’s common for TV to fast-track medical innovation. Take the present season of Gray’s Anatomy, which featured a significant storyline a few “treatment” for Parkinson’s illness. The drama collection adopted a workforce of researchers and docs as they used a groundbreaking surgical process utilizing skin-derived stem cells.

In actual life, regardless of many years of analysis and big good points in technical data round stem cell therapies for Parkinson’s illness, these remedies stay out of attain for most individuals with the illness. Parkinson’s is a mind dysfunction that worsens over time and causes the loss of life of sure nerve cells that usually produce dopamine, which helps coordinate muscle motion. Probably the most generally used surgical remedy for Parkinson’s is deep mind stimulation, which delivers electrical pulses to mind areas affecting motor signs, reminiscent of tremors and rigidity.

Nonetheless, given the stakes of this persistent progressive neurological illness dealing with about 1 million People, it’s value unpacking simply how far-fetched the Hollywood depiction is – or isn’t.

A TV-Prepared Stem Cell Breakthrough

On the present, docs take stem cells from a pores and skin biopsy of a personality with Parkinson’s illness and, “via a fancy course of,” rework these cells into dopamine-producing cells. Folks with Parkinson’s sometimes have low dopamine ranges within the putamen, part of the mind concerned in motion. By injecting new dopamine-producing cells into the character’s forebrain, the place the putamen is discovered, the docs goal to spice up dopamine ranges.

The process kicks off with a CT scan, which provides the surgical workforce pictures of what’s described as “an interactive 3D roadmap” of the character’s mind. After just a few extra fast steps – together with drilling of burr holes to forestall stress from build up within the mind – a robotic arm brings a hole needle into place. A researcher then removes the stem cells from a cooler and examines them beneath a microscope to verify that sufficient cells are alive. Lastly, the cells are injected into the character’s forebrain, beginning with one aspect after which shifting to the opposite.

A lot of what’s depicted on the present is practical – if simplified and futuristic – in keeping with Willard Kasoff, MD, an affiliate professor of neurosurgery on the Lewis Katz College of Drugs at Temple College and director of stereotactic and purposeful neurosurgery at Temple College Hospital.

“It is not science fiction, however it’s a future present,” he says.

The Actuality of Stem Cell Remedies for Parkinson’s Illness

There have been a number of thrilling stem cell improvements focusing on Parkinson’s lately that, on the floor, are harking back to Gray’s Anatomy’s televised “treatment.”

In 2017 and 2018, as an illustration, docs reprogrammed pores and skin cells taken from an individual with Parkinson’s to create “substitute dopamine neurons,” which obtained implanted into the individual’s mind. Extra just lately, a medical trial concerned injecting stem cells into the brains of individuals with Parkinson’s as a way to restore their dopamine ranges, full with a GPS-like mind scan displaying neurosurgeons the place to inject the cells. Upcoming medical trials may even use Parkinson’s sufferers’ pores and skin cells to provide substitute dopamine neurons for transplantation.

However such remedies received’t essentially be extensively accessible anytime quickly, in keeping with Kasoff. “Cell transplantation is extremely troublesome and complex,” he says. “It has been labored on for many years, and it is nonetheless early, early analysis trials. So even that form of remedy is probably going years and years away.”

Among the therapies depend on genetic engineering to transform stem cells into neural progenitor cells, which may develop into varied cell sorts discovered within the mind – a course of referred to as differentiating. Neurosurgeons can even direct how neural progenitor cells change, reminiscent of guiding them to grow to be dopamine neurons. The hope is that when these cells are transplanted into the mind, they’ll “determine what to do, or be instructed what to do by the encompassing cells,” says Kasoff.

A Future Remedy?

Even when the trials succeed, they could not symbolize a treatment. As a result of the remedies are directed on the putamen and the substantia nigra (an space the place neuron loss can have an effect on dopamine ranges), they solely tackle motor signs. Parkinson’s illness additionally impacts pondering expertise, stability, and different features all through the physique. Cognitive decline can result in dementia and loss of life.

“The thought that you may treatment Parkinson’s by placing cells within the substantia nigra or the putamen might be not true,” Kasoff says.

Additionally, Parkinson’s is usually considered a illness of 1 cell sort: the dopaminergic cells within the substantia nigra. However in actuality, Kasoff explains, it’s probably a illness with “1000’s of cell sorts,” which makes any potential stem cell-derived treatment extraordinarily advanced. Sort 1 diabetes, alternatively, is a illness of just one cell sort, and new remedies utilizing insulin-producing cells derived from stem cells might quantity to a treatment.

As for Parkinson’s, says Kasoff, “it might be that the subsequent stem cell trial hits the jackpot, after which we’ll be on to the subsequent step.” That would imply determining the place to transplant stem cells for the cognitive and balance-related signs of the illness, as an illustration.

Finally, he says, “the hope is that what occurs on the present is strictly what is going to occur sooner or later sooner or later.”

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