Indeed, intracerebral inoculation of brain homogenates derived from old α-synuclein transgenic mice, or injection of synthetic α-synuclein preformed fibrils, accelerates the formation of α-synuclein protein aggregates and precipitates neurological dysfunction in animals [129,130]. The identification of pathology in regions remote from the injection sites further supports an intercellular trans-synaptic

spread of protein transmission as do studies showing expression of human α-synuclein in rodent allografts implanted in animals expressing human α-synuclein [131]. In the latter study, human α-synuclein had been shown to colocalize with markers of endosomes and exosomes [131], which could represent the route by which it is transferred [131,132]. LY2157299 clinical trial None of the reports on transplantation in HD patients herein described has mentioned the presence of mHtt in the genetically unrelated grafts. Expression of the mutant protein seems to be confined to the host parenchyma [42,43,46]. However, we cannot exclude that after longer periods, mHtt protein may spread to grafted tissue. There is

in vitro evidence suggesting that mHtt can be taken up at least by neurones [133–135]. Remarkably, selective overexpression of the mHtt protein in astrocytes can induce an HD-like behavioural phenotype in mice [136,137]. To some extent, graft outcomes can also be predicted by technical factors related to the harvesting and preparation of donor tissue. Patient selection is also paramount and each characteristic, for example age at the time of Trametinib datasheet transplantation, symptom duration, number of CAG repeats, time of transplantation from diagnosis and Unified

Huntington’s disease rating scale (UHDRS) motor score – if not selected carefully, may jeopardize the significant clinical benefits that could be derived from this therapy. Tissue preparation Tacrolimus (FK506) is essential to successful transplantation. However, despite the fact that some aspects of the protocols utilized in each of the pilot trial were similar, in some respect, they are not identical (Table 1). First, the area of the foetal brain that is dissected to select cells of striatal origin was not the same in these studies. In some cases, the whole ganglionic eminence (WGE) was retrieved [18,19,22,52] while others used the lateral ganglionic eminence (LGE) [16] or the far lateral portion of the LGE [17] (Table 1). Furthermore, tissue was subsequently implanted either as a cell suspension [19,52] or as solid pieces [16–18,22]. All of these differences make comparisons across studies particularly challenging. Foetal cells are collected at the final phases of mitotic division and when they are committed to a distinct phenotype. Knowing the exact developmental stage of the foetal tissue is essential, as validated both in vitro and in animal models [138].