CDNF Protein Therapy in Parkinson’s Disease

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http://hdl.handle.net/10138/304437

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Huttunen , H J & Saarma , M 2019 , ' CDNF Protein Therapy in Parkinson’s Disease ' , Cell Transplantation , vol. 28 , no. 4 , pp. 349-366 . https://doi.org/10.1177/0963689719840290

Title: CDNF Protein Therapy in Parkinson’s Disease
Author: Huttunen, Henri J.; Saarma, Mart
Contributor: University of Helsinki, Doctoral Programme in Drug Research
University of Helsinki, Mart Saarma / Principal Investigator
Date: 2019-04-04
Language: eng
Number of pages: 18
Belongs to series: Cell Transplantation
ISSN: 0963-6897
URI: http://hdl.handle.net/10138/304437
Abstract: Neurotrophic factors (NTF) are a subgroup of growth factors that promote survival and differentiation of neurons. Due to their neuroprotective and neurorestorative properties, their therapeutic potential has been tested in various neurodegenerative diseases. Bioavailability of NTFs in the target tissue remains a major challenge for NTF-based therapies. Various intracerebral delivery approaches, both protein and gene transfer-based, have been tested with varying outcomes. Three growth factors, glial cell-line derived neurotrophic factor (GDNF), neurturin (NRTN) and platelet-derived growth factor (PDGF-BB) have been tested in clinical trials in Parkinson?s Disease (PD) during the past 20 years. A new protein can now be added to this list, as cerebral dopamine neurotrophic factor (CDNF) has recently entered clinical trials. Despite their misleading names, CDNF, together with its closest relative mesencephalic astrocyte-derived neurotrophic factor (MANF), form a novel family of unconventional NTF that are both structurally and mechanistically distinct from other growth factors. CDNF and MANF are localized mainly to the lumen of endoplasmic reticulum (ER) and their primary function appears to be modulation of the unfolded protein response (UPR) pathway. Prolonged ER stress, via the UPR signaling pathways, contributes to the pathogenesis in a number of chronic degenerative diseases, and is an important target for therapeutic modulation. Intraputamenally administered recombinant human CDNF has shown robust neurorestorative effects in a number of small and large animal models of PD, and had a good safety profile in preclinical toxicology studies. Intermittent monthly bilateral intraputamenal infusions of CDNF are currently being tested in a randomized placebo-controlled phase I?II clinical study in moderately advanced PD patients. Here, we review the history of growth factor-based clinical trials in PD, and discuss how CDNF differs from the previously tested growth factors.
Subject: 1182 Biochemistry, cell and molecular biology
neurotrophic factors
neurorestoration
clinical trial
mechanism of action
endoplasmic reticulum stress
CDNF
MANF
GDNF
ENDOPLASMIC-RETICULUM STRESS
DOPAMINE NEUROTROPHIC FACTOR
CONVECTION-ENHANCED DELIVERY
ALPHA-SYNUCLEIN
SUBSTANTIA-NIGRA
ER STRESS
RAT MODEL
DOUBLE-BLIND
FUNCTIONAL RECOVERY
CDNF/MANF FAMILY
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