Cellular transplantation to the brain and spinal cord remains a promising approach both for probing basic biological questions and as a potential therapy for neurological diseases. This chapter summarizes some of the main constraints that continue to limit general biological applications and, specifically, clinical applications. These constraints include the critical features of the successful donor cell as well as those of the receptive host tissue and organism. In addition, we explore future directions, with special emphasis on genetic engineering, combinations of novel cell types combined with trophic factors, and training of the host organism to improve the accurate integration of grafted cells. Some speculations are made regarding universal donor cells, but these advances will depend on additional basic work to bring this approach to the clinic. The convergence of advanced molecular and cellular methods together with improved methods of in vivo imaging adds to our optimism for significant advances in cellular transplantation in the near future.
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