TREATMENT STRATEGIES FOR NEURODEGENERATIVE DISEASES BASED ON TROPHIC FACTORS AND CELL TRANSPLANTATION TECHNIQUES

Treatment strategies based on transfer of genes, molecules, or cells t o the central nervous system are summarized. When neurons are already degenerated, functional compensation can be effected by grafts of syng eneic or allogenic tissue to the target area. This technique is underg oing clinical trials in Parkinson's disease. Before degeneration has o ccurred, it may be possible to rescue ''stressed'' neurons, and stimul ate terminal outgrowth using treatment with neurotrophic factors. Such approaches, with an emphasis on the NGF family of neurotrophins and t heir receptors, are reviewed. Finally, new molecular biology technique s may permit the transfer of genes directly into non-dividing cells of the central nervous system. These three approaches may have a more ge neral applicability, and become important not only in neurodegenerativ e diseases, but also in other afflictions of the nervous system such a s ischemia, stroke and injury.