Safety and Tolerability Assessment of Intrastriatal Neural Allografts in Five Patients with Huntington's Disease
Identifieur interne : 001D15 ( Main/Curation ); précédent : 001D14; suivant : 001D16Safety and Tolerability Assessment of Intrastriatal Neural Allografts in Five Patients with Huntington's Disease
Auteurs : A.-C. Bachoud-Lévi [France] ; C. Bourdet [France] ; P. Brugières [France] ; J.-P. Nguyen [France] ; T. Grandmougin [France] ; B. Haddad [France] ; R. Jény [France] ; P. Bartolomeo [France] ; M.-F. Boissé [France] ; G. Dalla Barba [France] ; J.-D. Degos [France] ; A.-M. Ergis [France] ; J.-P. Lefaucheur [France] ; F. Lisovoski [France] ; E. Pailhous [France] ; P. Rémy [France] ; S. Palfi [France] ; G. L. Defer [France] ; P. Cesaro [France] ; P. Hantraye [France] ; M. Peschanski [France]Source :
- Experimental Neurology [ 0014-4886 ] ; 1999.
English descriptors
Abstract
This study describes issues related to the safety and tolerability of fetal striatal neural allografts as assessed in five patients with Huntington's disease. Huntington's disease (HD) is characterized by motor, cognitive, and behavioral disturbances. The latter include psychological disturbances and, as a consequence, we took particular care to analyze behavioral changes, in addition to the usual “safety” follow-up. We conducted multidisciplinary follow-up at least 2 years before and 1 year after grafting. Psychological care extended to close relatives. The grafting procedure itself was altogether safe and uneventful, and there were no apparent clinical deleterious effects for 1 year. The immunosuppressive treatment, however, was complicated by various problems (irregular compliance, errors of handling, side effects). Direct psychological consequences of the transplantation procedure were rare and not worrisome, although mood alteration requiring treatment was observed in one patient. Indirectly, however, the procedure required patients and relatives to accept constraints that tended to complicate familial situations already marred by aggressivity and depression. All patients and close relatives expressed major expectations, in spite of our strong and repeated cautioning. It is clearly important to be aware of these particular conditions since they may eventually translate into psychological difficulties in coping with the long-term clinical outcome of the procedure, if not beneficial. Despite an overall good tolerance, therefore, this follow-up calls for caution regarding the involvement of HD patients in experimental surgical protocols.
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DOI: 10.1006/exnr.1999.7239
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Hantraye</name><affiliation wicri:level="1"><mods:affiliation>CEA, CNRS URA 2210, SHFJ, 91406, Orsay, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>CEA, CNRS URA 2210, SHFJ, 91406, Orsay</wicri:regionArea></affiliation></author><author><name sortKey="Peschanski, M" sort="Peschanski, M" uniqKey="Peschanski M" first="M." last="Peschanski">M. Peschanski</name><affiliation wicri:level="1"><mods:affiliation>Faculté de Médecine, INSERM U. 421/IM3, 94010, Créteil, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Faculté de Médecine, INSERM U. 421/IM3, 94010, Créteil</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:D64682DFDD7E38D56E3B9F94E88EDC0FA406447E</idno><date when="2000" year="2000">2000</date><idno type="doi">10.1006/exnr.1999.7239</idno><idno type="url">https://api.istex.fr/document/D64682DFDD7E38D56E3B9F94E88EDC0FA406447E/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">002012</idno><idno type="wicri:Area/Main/Curation">001D15</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Safety and Tolerability Assessment of Intrastriatal Neural Allografts in Five Patients with Huntington's Disease</title><author><name sortKey="Bachoud Levi, A C" sort="Bachoud Levi, A C" uniqKey="Bachoud Levi A" first="A.-C." last="Bachoud-Lévi">A.-C. Bachoud-Lévi</name><affiliation wicri:level="1"><mods:affiliation>Faculté de Médecine, INSERM U. 421/IM3, 94010, Créteil, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Faculté de Médecine, INSERM U. 421/IM3, 94010, Créteil</wicri:regionArea></affiliation></author><author><name sortKey="Bourdet, C" sort="Bourdet, C" uniqKey="Bourdet C" first="C." last="Bourdet">C. Bourdet</name><affiliation wicri:level="1"><mods:affiliation>Service de Psychiatrie, Hôpital Albert Chenevier-AP/HP, 94010, Créteil, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Psychiatrie, Hôpital Albert Chenevier-AP/HP, 94010, Créteil</wicri:regionArea></affiliation></author><author><name sortKey="Brugieres, P" sort="Brugieres, P" uniqKey="Brugieres P" first="P." last="Brugières">P. Brugières</name><affiliation wicri:level="1"><mods:affiliation>Service de Neuroradiologie, CHU Henri Mondor-AP/HP, 94010, Créteil, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Neuroradiologie, CHU Henri Mondor-AP/HP, 94010, Créteil</wicri:regionArea></affiliation></author><author><name sortKey="Nguyen, J P" sort="Nguyen, J P" uniqKey="Nguyen J" first="J.-P." last="Nguyen">J.-P. Nguyen</name><affiliation wicri:level="1"><mods:affiliation>Service de Neurochirurgie, CHU Henri Mondor-AP/HP, 94010, Créteil, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Neurochirurgie, CHU Henri Mondor-AP/HP, 94010, Créteil</wicri:regionArea></affiliation></author><author><name sortKey="Grandmougin, T" sort="Grandmougin, T" uniqKey="Grandmougin T" first="T." last="Grandmougin">T. Grandmougin</name><affiliation wicri:level="1"><mods:affiliation>Service de Psychiatrie, Hôpital Albert Chenevier-AP/HP, 94010, Créteil, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Psychiatrie, Hôpital Albert Chenevier-AP/HP, 94010, Créteil</wicri:regionArea></affiliation></author><author><name sortKey="Haddad, B" sort="Haddad, B" uniqKey="Haddad B" first="B." last="Haddad">B. Haddad</name><affiliation wicri:level="1"><mods:affiliation>Service de Gynécologie, Centre Hospitalier Intercommunal de Créteil, 94010, Créteil, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Gynécologie, Centre Hospitalier Intercommunal de Créteil, 94010, Créteil</wicri:regionArea></affiliation></author><author><name sortKey="Jeny, R" sort="Jeny, R" uniqKey="Jeny R" first="R." last="Jény">R. Jény</name><affiliation wicri:level="1"><mods:affiliation>Service de Gynécologie, Hôpital Esquirol, 94 Saint-Maurice, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Gynécologie, Hôpital Esquirol, 94 Saint-Maurice</wicri:regionArea></affiliation></author><author><name sortKey="Bartolomeo, P" sort="Bartolomeo, P" uniqKey="Bartolomeo P" first="P." last="Bartolomeo">P. Bartolomeo</name><affiliation wicri:level="1"><mods:affiliation>Service de Neurologie, CHU Henri Mondor-AP/HP, 94010, Créteil, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Neurologie, CHU Henri Mondor-AP/HP, 94010, Créteil</wicri:regionArea></affiliation></author><author><name sortKey="Boisse, M F" sort="Boisse, M F" uniqKey="Boisse M" first="M.-F." last="Boissé">M.-F. Boissé</name><affiliation wicri:level="1"><mods:affiliation>Service de Neurologie, CHU Henri Mondor-AP/HP, 94010, Créteil, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Neurologie, CHU Henri Mondor-AP/HP, 94010, Créteil</wicri:regionArea></affiliation></author><author><name sortKey="Barba, G Dalla" sort="Barba, G Dalla" uniqKey="Barba G" first="G. Dalla" last="Barba">G. Dalla Barba</name><affiliation wicri:level="1"><mods:affiliation>Service de Neurologie, CHU Henri Mondor-AP/HP, 94010, Créteil, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Neurologie, CHU Henri Mondor-AP/HP, 94010, Créteil</wicri:regionArea></affiliation></author><author><name sortKey="Degos, J D" sort="Degos, J D" uniqKey="Degos J" first="J.-D." last="Degos">J.-D. Degos</name><affiliation wicri:level="1"><mods:affiliation>Service de Neurologie, CHU Henri Mondor-AP/HP, 94010, Créteil, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Neurologie, CHU Henri Mondor-AP/HP, 94010, Créteil</wicri:regionArea></affiliation></author><author><name sortKey="Ergis, A M" sort="Ergis, A M" uniqKey="Ergis A" first="A.-M." last="Ergis">A.-M. Ergis</name><affiliation wicri:level="1"><mods:affiliation>Service de Neurologie, CHU Henri Mondor-AP/HP, 94010, Créteil, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Neurologie, CHU Henri Mondor-AP/HP, 94010, Créteil</wicri:regionArea></affiliation></author><author><name sortKey="Lefaucheur, J P" sort="Lefaucheur, J P" uniqKey="Lefaucheur J" first="J.-P." last="Lefaucheur">J.-P. Lefaucheur</name><affiliation wicri:level="1"><mods:affiliation>Service de Physiologie–Explorations Fonctionnelles, CHU Henri Mondor-AP/HP, 94010, Créteil, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Physiologie–Explorations Fonctionnelles, CHU Henri Mondor-AP/HP, 94010, Créteil</wicri:regionArea></affiliation></author><author><name sortKey="Lisovoski, F" sort="Lisovoski, F" uniqKey="Lisovoski F" first="F." last="Lisovoski">F. Lisovoski</name><affiliation wicri:level="1"><mods:affiliation>Faculté de Médecine, INSERM U. 421/IM3, 94010, Créteil, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Faculté de Médecine, INSERM U. 421/IM3, 94010, Créteil</wicri:regionArea></affiliation></author><author><name sortKey="Pailhous, E" sort="Pailhous, E" uniqKey="Pailhous E" first="E." last="Pailhous">E. Pailhous</name><affiliation wicri:level="1"><mods:affiliation>Service de Psychiatrie, Hôpital Albert Chenevier-AP/HP, 94010, Créteil, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Psychiatrie, Hôpital Albert Chenevier-AP/HP, 94010, Créteil</wicri:regionArea></affiliation></author><author><name sortKey="Remy, P" sort="Remy, P" uniqKey="Remy P" first="P." last="Rémy">P. Rémy</name><affiliation wicri:level="1"><mods:affiliation>Service de Neurologie, CHU Henri Mondor-AP/HP, 94010, Créteil, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Neurologie, CHU Henri Mondor-AP/HP, 94010, Créteil</wicri:regionArea></affiliation></author><author><name sortKey="Palfi, S" sort="Palfi, S" uniqKey="Palfi S" first="S." last="Palfi">S. Palfi</name><affiliation wicri:level="1"><mods:affiliation>CEA, CNRS URA 2210, SHFJ, 91406, Orsay, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>CEA, CNRS URA 2210, SHFJ, 91406, Orsay</wicri:regionArea></affiliation></author><author><name sortKey="Defer, G L" sort="Defer, G L" uniqKey="Defer G" first="G. L." last="Defer">G. L. Defer</name><affiliation wicri:level="1"><mods:affiliation>Service de Neurologie, CHU Côte de Nâcre, 14000, Caen, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Neurologie, CHU Côte de Nâcre, 14000, Caen</wicri:regionArea></affiliation></author><author><name sortKey="Cesaro, P" sort="Cesaro, P" uniqKey="Cesaro P" first="P." last="Cesaro">P. Cesaro</name><affiliation wicri:level="1"><mods:affiliation>Faculté de Médecine, INSERM U. 421/IM3, 94010, Créteil, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Faculté de Médecine, INSERM U. 421/IM3, 94010, Créteil</wicri:regionArea></affiliation></author><author><name sortKey="Hantraye, P" sort="Hantraye, P" uniqKey="Hantraye P" first="P." last="Hantraye">P. Hantraye</name><affiliation wicri:level="1"><mods:affiliation>CEA, CNRS URA 2210, SHFJ, 91406, Orsay, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>CEA, CNRS URA 2210, SHFJ, 91406, Orsay</wicri:regionArea></affiliation></author><author><name sortKey="Peschanski, M" sort="Peschanski, M" uniqKey="Peschanski M" first="M." last="Peschanski">M. Peschanski</name><affiliation wicri:level="1"><mods:affiliation>Faculté de Médecine, INSERM U. 421/IM3, 94010, Créteil, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Faculté de Médecine, INSERM U. 421/IM3, 94010, Créteil</wicri:regionArea></affiliation></author></analytic><monogr></monogr><series><title level="j">Experimental Neurology</title><title level="j" type="abbrev">YEXNR</title><idno type="ISSN">0014-4886</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1999">1999</date><biblScope unit="volume">161</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="194">194</biblScope><biblScope unit="page" to="202">202</biblScope></imprint><idno type="ISSN">0014-4886</idno></series><idno type="istex">D64682DFDD7E38D56E3B9F94E88EDC0FA406447E</idno><idno type="DOI">10.1006/exnr.1999.7239</idno><idno type="PII">S0014-4886(99)97239-4</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0014-4886</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Huntington's disease</term><term>fetal neural transplants.</term><term>safety and tolerability</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">This study describes issues related to the safety and tolerability of fetal striatal neural allografts as assessed in five patients with Huntington's disease. Huntington's disease (HD) is characterized by motor, cognitive, and behavioral disturbances. The latter include psychological disturbances and, as a consequence, we took particular care to analyze behavioral changes, in addition to the usual “safety” follow-up. We conducted multidisciplinary follow-up at least 2 years before and 1 year after grafting. Psychological care extended to close relatives. The grafting procedure itself was altogether safe and uneventful, and there were no apparent clinical deleterious effects for 1 year. The immunosuppressive treatment, however, was complicated by various problems (irregular compliance, errors of handling, side effects). Direct psychological consequences of the transplantation procedure were rare and not worrisome, although mood alteration requiring treatment was observed in one patient. Indirectly, however, the procedure required patients and relatives to accept constraints that tended to complicate familial situations already marred by aggressivity and depression. All patients and close relatives expressed major expectations, in spite of our strong and repeated cautioning. It is clearly important to be aware of these particular conditions since they may eventually translate into psychological difficulties in coping with the long-term clinical outcome of the procedure, if not beneficial. Despite an overall good tolerance, therefore, this follow-up calls for caution regarding the involvement of HD patients in experimental surgical protocols.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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