Huntington disease is a neurological movement disorder involving massive neuronal death in the caudate-putamen region of the brain. Neither preventive nor curative therapy exists for this disease. The implantation of cross-species striatal neural precursor cells into the lesioned striatum of nonhuman primates (baboons) reduced the abnormal movements seen in the disease model. These abnormal movements reappeared after immunological rejection of the implanted striatal cells and were not modified by transplantation with nonstriatal cells. These findings encourage further experimentation toward the use of cell sources other than human fetal cells in a potential clinical application to Huntington disease.Huntington disease (HD) evolves over several years with a continuous deterioration of the patient's condition. The motor and cognitive symptoms are associated with neuronal loss in the caudate-putamen, cerebral cortex, globus pallidus, and substantia nigra (1-5). The neuropathological changes in HD are dominated by the severe atrophy, neuronal cell loss, and astrocytic reaction in the caudate-putamen complex (striatum). By intrastriatal application of the neurotoxin ibotenic acid (IA), we have created a striatal pathology similar to HD in the baboon to evaluate therapeutic strategies, such as neuronal implantation (6). Intrastriatal injections of the glutamate receptor agonist IA and other glutamate agonists cause severe neuronal loss of striatal output neurons but spare axons of passage and striatal afferents, a characteristic pathological feature of HD (6-10). The many neuropathological and neurochemical similarities between such striatal lesions in the rat brain and alterations found in the brain of choreic patients have suggested a role for glutamate receptor agonists in the neurodegenerative mechanisms underlying HD (8,(10)(11)(12). Previous studies have utilized intrastriatal injections of IA, quinolinic, or kainic acid to produce a primate model of HD (6,13,14). Whatever the toxin used, the primates receiving such striatal lesions all display a variety of abnormal movements similar to the symptoms observed in HD patients, including dyskinesia, orofacial dyskinesia, chorea, and dystonia. These findings contrast sharply with previous rat models where involuntary choreiform movements have not been described (15)(16)(17)(18)(19)(20). We therefore used a primate model of HD to evaluate whether striatal cell replacement in the degenerated striatum could ameliorate the characteristic motor symptoms observed. We also investigated whether such symptoms would reappear after removal of immunosuppressive treatment and if implanted nonstriatal neural precursor cells could have a beneficial effect.
MATERIALS AND METHODSWe performed intrastriatal stereotaxic injections of IA into the right caudate-putamen complex of 15 baboons. Six weeks later, 5 of these animals received fetal rat striatal cells by injection into the lesioned caudate-putamen. In addition to these 5 transplanted animals a 6th baboon received a contro...