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Zhang L, Kuo HC, Duhon BH, Adunka OF, Dodson EE, Hardesty DA, Prevedello DM, Otero JJ, Ren Y. Identifying Tumor Microenvironment Biomarkers in Adherent and Cystic Vestibular Schwannomas. Otol Neurotol 2024; 45:e113-e122. [PMID: 38082472 PMCID: PMC10843289 DOI: 10.1097/mao.0000000000004073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
OBJECTIVE A subset of vestibular schwannomas (VSs), including cystic tumors, have higher postoperative morbidity because of the presence of adhesions between the tumor, facial nerve (FN), and brainstem. We identify tumor microenvironment (TME) biomarkers to better classify these tumors and predict the degree of tumor adherence. STUDY DESIGN Retrospective case series. SETTING Tertiary skull base referral center. METHODS Adult patients with cystic and solid VS matched in tumor size who underwent surgical resection were included. Expressions of seven biomarkers of extracellular matrix remodeling and tumor immune response were quantified via immunohistochemistry. The distribution of CD45+ immune cells was evaluated in intratumoral and perivascular compartments. The degree of tumor adherence was categorized as none, adherent to FN, or adherent to both FN and brainstem. RESULTS Twenty-eight patients were included. Cystic VSs were significantly more adherent than solid VSs ( p = 0.02). Patients with adherent VS had shorter duration of symptoms and were more likely to undergo subtotal resection. In solid tumors, matrix metalloproteinase (MMP)-2 expression ( p = 0.02) and CD163+ macrophage infiltration ( p = 0.007) were correlated with tumor size. Linear discriminant analyses (LDAs) demonstrated MMP-2, MMP-14, CD80, CD163, and perivascular CD45 to be individually predictive of the degree of tumor adherence (all p < 0.05), with perivascular CD45 being the best independent predictor ( p = 0.005). An LDA model including these biomarkers demonstrated 100% accurate discrimination of all three levels of tumor adherence ( p = 0.04). CONCLUSIONS Adherent VS have a distinct proinflammatory TME characterized by elevated MMP expression, enrichment of tumor-associated macrophages, and perivascular immune cell infiltration.
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Affiliation(s)
- Lisa Zhang
- Division of Otology, Neurotology and Cranial Base Surgery, Department of Otolaryngology – Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Hsuan-Chih Kuo
- Division of Otology, Neurotology and Cranial Base Surgery, Department of Otolaryngology – Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Bailey H. Duhon
- Division of Otology, Neurotology and Cranial Base Surgery, Department of Otolaryngology – Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Oliver F. Adunka
- Division of Otology, Neurotology and Cranial Base Surgery, Department of Otolaryngology – Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Edward E. Dodson
- Division of Otology, Neurotology and Cranial Base Surgery, Department of Otolaryngology – Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Douglas A. Hardesty
- Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Daniel M. Prevedello
- Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Jose J. Otero
- Division of Neuropathology, Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Yin Ren
- Division of Otology, Neurotology and Cranial Base Surgery, Department of Otolaryngology – Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Nguyen HTN, Duhon BH, Kuo HC, Fisher M, Brickey OM, Zhang L, Otero JJ, Prevedello DM, Adunka OF, Ren Y. Matrix metalloproteinase 9: An emerging biomarker for classification of adherent vestibular schwannoma. Neurooncol Adv 2024; 6:vdae058. [PMID: 38887507 PMCID: PMC11181934 DOI: 10.1093/noajnl/vdae058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024] Open
Abstract
Background The progression of vestibular schwannoma (VS) is intricately linked with interactions between schwannoma cells and the extracellular matrix. Surgical resection of VS is associated with substantial risks as tumors are adherent to the brainstem and cranial nerves. We evaluate the role of matrix metalloproteinase 9 (MMP9) in VS and explore its potential as a biomarker to classify adherent VS. Methods Transcriptomic analysis of a murine schwannoma allograft model and immunohistochemical analysis of 17 human VS were performed. MMP9 abundance was assessed in mouse and human schwannoma cell lines. Transwell studies were performed to evaluate the effect of MMP9 on schwannoma invasion in vitro. Plasma biomarkers were identified from a multiplexed proteomic analysis in 45 prospective VS patients and validated in primary culture. The therapeutic efficacy of MMP9 inhibition was evaluated in a mouse schwannoma model. Results MMP9 was the most highly upregulated protease in mouse schwannomas and was significantly enriched in adherent VS, particularly around tumor vasculature. High levels of MMP9 were found in plasma of patients with adherent VS. MMP9 outperformed clinical and radiographic variables to classify adherent VS with outstanding discriminatory ability. Human schwannoma cells secreted MMP9 in response to TNF-α which promoted cellular invasion and adhesion protein expression in vitro. Lastly, MMP9 inhibition decreased mouse schwannoma growth in vivo. Conclusions We identify MMP9 as a preoperative biomarker to classify adherent VS. MMP9 may represent a new therapeutic target in adherent VS associated with poor surgical outcomes that lack other viable treatment options.
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Affiliation(s)
- Han T N Nguyen
- Division of Otology, Neurotology, and Cranial Base Surgery, Department of Otolaryngology—Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Bailey H Duhon
- Division of Otology, Neurotology, and Cranial Base Surgery, Department of Otolaryngology—Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Hsuan-Chih Kuo
- Division of Otology, Neurotology, and Cranial Base Surgery, Department of Otolaryngology—Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Melanie Fisher
- Division of Otology, Neurotology, and Cranial Base Surgery, Department of Otolaryngology—Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Olivia M Brickey
- Division of Otology, Neurotology, and Cranial Base Surgery, Department of Otolaryngology—Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Lisa Zhang
- Division of Otology, Neurotology, and Cranial Base Surgery, Department of Otolaryngology—Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Jose J Otero
- Division of Neuropathology, Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Daniel M Prevedello
- Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Oliver F Adunka
- Division of Otology, Neurotology, and Cranial Base Surgery, Department of Otolaryngology—Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Yin Ren
- Division of Otology, Neurotology, and Cranial Base Surgery, Department of Otolaryngology—Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Nourbakhsh A, Dinh CT. Updates on Tumor Biology in Vestibular Schwannoma. Otolaryngol Clin North Am 2023; 56:421-434. [PMID: 37121611 DOI: 10.1016/j.otc.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Vestibular schwannomas (VSs) are benign tumors that develop after biallelic inactivation of the neurofibromatosis type 2 (NF2) gene that encodes the tumor suppressor merlin. Merlin inactivation leads to cell proliferation by dysregulation of receptor tyrosine kinase signaling and other intracellular pathways. In VS without NF2 mutations, dysregulation of non-NF2 genes can promote pathways favoring cell proliferation and tumorigenesis. The tumor microenvironment of VS consists of multiple cell types that influence VS tumor biology through complex intercellular networking and communications.
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Affiliation(s)
- Aida Nourbakhsh
- Department of Otolaryngology, University of Miami Miller School of Medicine, 1120 Northwest 14th Street, Suite 579, Miami, FL 33136, USA; Sylvester Comprehensive Cancer Center, 1475 Northwest 12th Avenue, Miami, FL 33136, USA
| | - Christine T Dinh
- Department of Otolaryngology, University of Miami Miller School of Medicine, 1120 Northwest 14th Street, Suite 579, Miami, FL 33136, USA; Sylvester Comprehensive Cancer Center, 1475 Northwest 12th Avenue, Miami, FL 33136, USA.
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Cazzador D, Astolfi L, Daloiso A, Tealdo G, Simoni E, Mazzoni A, Zanoletti E, Marioni G. Tumor Microenvironment in Sporadic Vestibular Schwannoma: A Systematic, Narrative Review. Int J Mol Sci 2023; 24:ijms24076522. [PMID: 37047498 PMCID: PMC10094882 DOI: 10.3390/ijms24076522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/26/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Although diagnosis and treatment of vestibular schwannomas (VSs) improved in recent years, no factors have yet been identified as being capable of predicting tumor growth. Molecular rearrangements occur in neoplasms before any macroscopic morphological changes become visible, and the former are the underlying cause of disease behavior. Tumor microenvironment (TME) encompasses cellular and non-cellular elements interacting together, resulting in a complex and dynamic key of tumorigenesis, drug response, and treatment outcome. The aim of this systematic, narrative review was to assess the level of knowledge on TME implicated in the biology, behavior, and prognosis of sporadic VSs. A search (updated to November 2022) was run in Scopus, PubMed, and Web of Science electronic databases according to the PRISMA guidelines, retrieving 624 titles. After full-text evaluation and application of inclusion/exclusion criteria, 37 articles were included. VS microenvironment is determined by the interplay of a dynamic ecosystem of stromal and immune cells which produce and remodel extracellular matrix, vascular networks, and promote tumor growth. However, evidence is still conflicting. Further studies will enhance our understanding of VS biology by investigating TME-related biomarkers able to predict tumor growth and recognize immunological and molecular factors that could be potential therapeutic targets for medical treatment.
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Affiliation(s)
- Diego Cazzador
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, 35100 Padova, Italy
- Correspondence: (D.C.); (G.M.)
| | - Laura Astolfi
- Bioacoustics Research Laboratory, Department of Neuroscience DNS, University of Padova, 35100 Padova, Italy
| | - Antonio Daloiso
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, 35100 Padova, Italy
| | - Giulia Tealdo
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, 35100 Padova, Italy
| | - Edi Simoni
- Bioacoustics Research Laboratory, Department of Neuroscience DNS, University of Padova, 35100 Padova, Italy
| | - Antonio Mazzoni
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, 35100 Padova, Italy
| | - Elisabetta Zanoletti
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, 35100 Padova, Italy
| | - Gino Marioni
- Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, 31100 Treviso, Italy
- Correspondence: (D.C.); (G.M.)
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Constanzo F, Teixeira BCDA, Sens P, Smaili H, Escuissato DL, Ramina R. Perfusion-weighted imaging in vestibular schwannoma: the influence that cystic status and tumor size have on perfusion profiles. Radiol Bras 2023; 56:67-74. [PMID: 37168041 PMCID: PMC10165972 DOI: 10.1590/0100-3984.2022.0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/12/2022] [Indexed: 05/13/2023] Open
Abstract
Objective The perfusion profile of vestibular schwannomas (VSs) and the factors that influence it have yet to be determined. Materials and Methods Twenty patients with sporadic VS were analyzed by calculating parameters related to the extravascular extracellular space (EES)-the volume transfer constant between a vessel and the EES (Ktrans); the EES volume per unit of tissue volume (Ve); and the rate transfer constant between EES and blood plasma (Kep)-as well as the relative cerebral blood volume (rCBV), and by correlating those parameters with the size of the tumor and its structure (solid, cystic, or heterogeneous). Results Although Ktrans, Ve, and Kep were measurable in all tumors, rCBV was measurable only in large tumors. We detected a positive correlation between Ktrans and rCBV (r = 0.62, p = 0.031), a negative correlation between Ve and Kep (r = -0.51, p = 0.021), and a positive correlation between Ktrans and Ve only in solid VSs (r = 0.64, p = 0.048). Comparing the means for small and large VSs, we found that the former showed lower Ktrans (0.13 vs. 0.029, p < 0.001), higher Kep (0.68 vs. 0.46, p = 0.037), and lower Ve (0.45 vs. 0.83, p < 0.001). The mean Ktrans was lower in the cystic portions of cystic VSs than in their solid portions (0.14 vs. 0.32, p < 0.001), as was the mean Ve (0.37 vs. 0.78, p < 0.001). There were positive correlations between the solid and cystic portions for Ktrans (r = 0.71, p = 0.048) and Kep (r = 0.74, p = 0.037). Conclusion In VS, tumor size appears to be consistently associated with perfusion values. In cystic VS, the cystic portions seem to have lower Ktrans and Ve than do the solid portions.
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Affiliation(s)
- Felipe Constanzo
- Clínica Biobío, Concepción, Chile
- Hospital Clínico Regional de Concepción, Concepción,
Chile
| | | | - Patricia Sens
- Instituto de Neurologia de Curitiba (INC), Curitiba, PR, Brazil
| | - Hamzah Smaili
- Instituto de Neurologia de Curitiba (INC), Curitiba, PR, Brazil
| | | | - Ricardo Ramina
- Instituto de Neurologia de Curitiba (INC), Curitiba, PR, Brazil
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Gerganov V, Petrov M, Sakelarova T. Schwannomas of Brain and Spinal Cord. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1405:331-362. [PMID: 37452944 DOI: 10.1007/978-3-031-23705-8_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Schwannomas are benign tumors originating from the Schwann cells of cranial or spinal nerves. The most common cranial schwannomas originate from the eight cranial nervevestibular schwannomas (VS). VS account for 6-8% of all intracranial tumors, 25-33% of the tumors localized in the posterior cranial fossa, and 80-94% of the tumors in the cerebellopontine angle (CPA). Schwannomas of other cranial nerves/trigeminal, facial, and schwannomas of the lower cranial nerves/are much less frequent. According to the World Health Organization (WHO), intracranial and intraspinal schwannomas are classified as Grade I. Some VS are found incidentally, but most present with hearing loss (95%), tinnitus (63%), disequilibrium (61%), or headache (32%). The neurological symptoms of VSs are mainly due to compression on the surrounding structures, such as the cranial nerves and vessels, or the brainstem. The gold standard for the imaging diagnosis of VS is MRI scan. The optimal management of VSs remains controversial. There are three main management options-conservative treatment or "watch-and-wait" policy, surgical treatment, and radiotherapy in all its variations. Currently, surgery of VS is not merely a life-saving procedure. The functional outcome of surgery and the quality of life become issues of major importance. The most appropriate surgical approach for each patient should be considered according to some criteria including indications, risk-benefit ratio, and prognosis of each patient. The approaches to the CPA and VS removal are generally divided in posterior and lateral. The retrosigmoid suboccipital approach is a safe and simple approach, and it is favored for VS surgery in most neurosurgical centers. Radiosurgery is becoming more and more available nowadays and is established as one of the main treatment modalities in VS management. Radiosurgery (SRS) is performed with either Gamma knife, Cyber knife, or linear accelerator. Larger tumors are being increasingly frequently managed with combined surgery and radiosurgery. The main goal of VS management is preservation of neurological function - facial nerve function, hearing, etc. The reported recurrence rate after microsurgical tumor removal is 0.5-5%. Postoperative follow-up imaging is essential to diagnose any recurrence.
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Affiliation(s)
- Venelin Gerganov
- International Neuroscience Institute, Hannover, Germany
- University Multiprofile Hospital for Active Treatment With Emergency Medicine N. I. Pirogov, Sofia, Bulgaria
| | - Mihail Petrov
- University Multiprofile Hospital for Active Treatment With Emergency Medicine N. I. Pirogov, Sofia, Bulgaria.
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Tumor Biology and Microenvironment of Vestibular Schwannoma-Relation to Tumor Growth and Hearing Loss. Biomedicines 2022; 11:biomedicines11010032. [PMID: 36672540 PMCID: PMC9856152 DOI: 10.3390/biomedicines11010032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022] Open
Abstract
Vestibular schwannoma is the most common benign neoplasm of the cerebellopontine angle. It arises from Schwann cells of the vestibular nerve. The first symptoms of vestibular schwannoma include hearing loss, tinnitus, and vestibular symptoms. In the event of further growth, cerebellar and brainstem symptoms, along with palsy of the adjacent cranial nerves, may be present. Although hearing impairment is present in 95% of patients diagnosed with vestibular schwannoma, most tumors do not progress in size or have low growth rates. However, the clinical picture has unpredictable dynamics, and there are currently no reliable predictors of the tumor's behavior. The etiology of the hearing loss in patients with vestibular schwannoma is unclear. Given the presence of hearing loss in patients with non-growing tumors, a purely mechanistic approach is insufficient. A possible explanation for this may be that the function of the auditory system may be affected by the paracrine activity of the tumor. Moreover, initiation of the development and growth progression of vestibular schwannomas is not yet clearly understood. Biallelic loss of the NF2 gene does not explain the occurrence in all patients; therefore, detection of gene expression abnormalities in cases of progressive growth is required. As in other areas of cancer research, the tumor microenvironment is coming to the forefront, also in vestibular schwannomas. In the paradigm of the tumor microenvironment, the stroma of the tumor actively influences the tumor's behavior. However, research in the area of vestibular schwannomas is at an early stage. Thus, knowledge of the molecular mechanisms of tumorigenesis and interactions between cells present within the tumor is crucial for the diagnosis, prediction of tumor behavior, and targeted therapeutic interventions. In this review, we provide an overview of the current knowledge in the field of molecular biology and tumor microenvironment of vestibular schwannomas, as well as their relationship to tumor growth and hearing loss.
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Hypervascularized Large Vestibular Schwannomas: Single-Center Experience in a Series of Forty Cases. World Neurosurg X 2022; 17:100142. [PMID: 36341135 PMCID: PMC9627095 DOI: 10.1016/j.wnsx.2022.100142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/22/2022] [Indexed: 11/07/2022] Open
Abstract
Background Vestibular schwannomas (VS) are usually hypovascularized benign tumors. Large VS (Koos grade IV) with unusual vascular architecture are defined as hypervascular (HVVS); the excessive bleeding during microsurgery has a negative impact on results. Methods Forty consecutive patients were operated on for HVVS (group A). A tendency to bleed and adherence of capsule to nervous structures were evaluated by reviewing intraoperative video records. The cisternal facial nerve (FN) position was reported. Microsurgical removal was classified as total, near-total, subtotal, or partial and the MIB-1 index was evaluated in all. FN results were classified according to the House-Brackmann scale. Results Results of Group A were compared with those of 45 patients operated on for large low-bleeding VS (group B). Mean tumor diameter was 3.81 cm in group A and 3.58 cm in group B; the mean age was 42.4 and 56.3 years, respectively. The mean American Society of Anesthesiologists Physical Status Scale class of group A was 1.67 versus 2.31 of group B (P < 0.01). Total or near-total resection was accomplished in 76.5% of group A versus 73.3% of group B. Tight capsule adhesion was observed in 67.5% of group A versus 57.8% of group B. Mean MIB-1 was 1.25% and 1.08%, respectively. FN anatomic preservation was possible in 84.6% of group A versus 95.5% of group B; 67.5% of group A had HB grade I or II FN outcome versus 93.3% of group B (P < 0.001). In group A, 8 patients (20.0%) experienced transient postoperative complications versus 4.4% of group B. Recurrence/regrowth was observed in 4 patients in group A versus 1 in group B. Conclusions Intraoperative video for classification of HVVS was used. Microsurgery of large HVVS was associated with higher (usually transient) complications and recurrence/regrowth rates and poorer FN outcome, especially in patients with tight capsule adhesion.
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Zhang Y, Long J, Ren J, Huang X, Zhong P, Wang B. Potential Molecular Biomarkers of Vestibular Schwannoma Growth: Progress and Prospects. Front Oncol 2021; 11:731441. [PMID: 34646772 PMCID: PMC8503266 DOI: 10.3389/fonc.2021.731441] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 09/06/2021] [Indexed: 12/25/2022] Open
Abstract
Vestibular schwannomas (VSs, also known as acoustic neuromas) are relatively rare benign brain tumors stem from the Schwann cells of the eighth cranial nerve. Tumor growth is the paramount factor for neurosurgeons to decide whether to choose aggressive treatment approach or careful follow-up with regular magnetic resonance imaging (MRI), as surgery and radiation can introduce significant trauma and affect neurological function, while tumor enlargement during long-term follow-up will compress the adjacent nerves and tissues, causing progressive hearing loss, tinnitus and vertigo. Recently, with the deepening research of VS biology, some proteins that regulate merlin conformation changes, inflammatory cytokines, miRNAs, tissue proteins and cerebrospinal fluid (CSF) components have been proposed to be closely related to tumor volume increase. In this review, we discuss advances in the study of biomarkers that associated with VS growth, providing a reference for exploring the growth course of VS and determining the optimal treatment strategy for each patient.
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Affiliation(s)
- Yu Zhang
- Department of Pharmacy, Huashan Hospital, Fudan University, Shanghai, China
| | - Jianfei Long
- Department of Pharmacy, Huashan Hospital, Fudan University, Shanghai, China
| | - Junwei Ren
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiang Huang
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Ping Zhong
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Bin Wang
- Department of Pharmacy, Huashan Hospital, Fudan University, Shanghai, China
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Mastronardi L, Campione A, Cacciotti G, Carpineta E, Scavo CG, Roperto R, Stati G, Sufianov AA, Schaller K. Microsurgical treatment of symptomatic vestibular schwannomas in patients under 40: different results before and after age of 30. Neurosurg Rev 2021; 45:873-882. [PMID: 34405315 DOI: 10.1007/s10143-021-01603-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/02/2021] [Accepted: 07/04/2021] [Indexed: 11/25/2022]
Abstract
In 10-15% of cases of vestibular schwannoma (VS), age at diagnosis is 40 years or less. Little is known about the differences in natural history, surgical findings, and postoperative outcomes of such younger patients as compared to those of greater age. To analyze clinical and surgical and imaging data of a consecutive series of n = 50 patients with unilateral sporadic VS, aged 40 years or younger - separated in a very young group (15-30 years) and a moderately young group (31-40 years). Retrospective case series. Fifty consecutive patients under 40 years of age underwent microsurgical resection of unilateral sporadic VS via the retrosigmoid approach. The study cohort was subdivided into two groups according to the age range: group A, age range 15-30 years (n = 23 patients), and group B, age range 31-40 years (n = 27 patients). The adherence of VS capsule to surrounding nervous structures and the tendency of the tumors to bleed were evaluated by reviewing video records; the course of the FN in relation to the tumor's surface was assessed in each case. Microsurgical removal of tumor was classified as total (T), near total (residual tumor volume < 5%), subtotal (residual tumor volume 5-10%), or partial (residual tumor volume > 10%). Mean tumor size of entire cohort was 2.53 (range: 0.6-5.8) cm: 2.84 cm in group A and 2.36 cm in group B (p = NS). Facial nerve course and position within the cerebellopontine angle did not differ significantly between the two groups. At 6-month follow-up, FN functional outcome was HBI-II in 69.5% in group A, versus 96.3% in group B (p < .001). Hearing preservation was achieved in 60.0% of patients of group A and in 58.3% of group B (p = NS). Total and near-total resection was feasible in 95.6% of cases of group A and in 88.9% of group B (p = NS). Tumor capsule was tightly adherent to nervous structures in 69.6% patients of group A and in 22.2% of group B (p < .05). Significant bleeding was encountered in 56.5% of group A tumors, and in 29.6% of group B tumors (p < .01). Microsurgery of VS in patients aged 40 or less is associated with good functional results, and with high rates of total and near total tumor removal. Patients < 30 years of age have more adherent tumor capsules. Furthermore, their tumors exhibit a tendency to larger sizes, to hypervascularization, to profuse intraoperative bleeding and they present worse long-term functional FN results when compared to patients in their fourth decade of life. Our limited experience seems to suggest that a near total resection in very young VS patients with large tumors should be preferred in adherent and hypervascularized cases, in order to maximize resection and preserve function.
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Affiliation(s)
- Luciano Mastronardi
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy. .,Department of Neurosurgery, The State Education Institution of Higher Professional Training, The First Sechenov Moscow State Medical University Under Ministry of Health, Moscow, Russian Federation.
| | - Alberto Campione
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy
| | | | - Ettore Carpineta
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy
| | | | - Raffaele Roperto
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy
| | - Giovanni Stati
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy
| | - Albert A Sufianov
- Department of Neurosurgery, The State Education Institution of Higher Professional Training, The First Sechenov Moscow State Medical University Under Ministry of Health, Moscow, Russian Federation.,Federal Centre of Neurosurgery, Tyumen, Russian Federation
| | - Karl Schaller
- Department of Neurosurgery, University of Geneva Medical Center & Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Mastronardi L, Campione A, Boccacci F, Scavo CG, Carpineta E, Cacciotti G, Roperto R, Sufianov A, Zomorodi A. Koos grade IV vestibular schwannomas: considerations on a consecutive series of 60 cases-searching for the balance between preservation of function and maximal tumor removal. Neurosurg Rev 2021; 44:3349-3358. [PMID: 33598820 DOI: 10.1007/s10143-021-01501-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/24/2021] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
Koos grade IV vestibular schwannomas (VS) (maximum diameter > 3 cm) compress the brainstem and displace the fourth ventricle. Microsurgical resection with attention to the right balance between preservation of function and maximal tumor removal is the treatment of choice. Our series consists of 60 consecutive patients with unilateral VS, operated on from December 2010 to July 2019. All patients underwent microsurgical removal via the retrosigmoid approach. The adherence of VS' capsule to the surrounding nervous structures and the excessive tendency of tumor to bleed during debulking, because of a redundant vascular architecture, was evaluated by reviewing video records. Microsurgical removal of tumor was classified as total (T), near-total (NT: residue < 5%), subtotal (ST: residue 5-10%), or partial (P: residue > 10%). Maximal mean tumor diameter was 3,97 cm (SD ± 1,13; range 3,1-5,8 cm). Preoperative severely impaired hearing or deafness (AAO-HNS classes C-D) was present in 52 cases (86,7%). Total or NT resection was accomplished in 46 cases (76,7%), 65,8% in cases with, and 95,4% without tight adhesion of capsule to nervous structures (p < 0,001). Endoscopic-assisted microsurgical removal of VS in the IAC was performed in 23 patients: in these cases, a T resection was obtained in 78,3% versus 45,9% of microsurgery only (p < 0,001). The capsule of VS was tightly adherent to nervous structures in 63,3% of patients, whereas hypervascular high-bleeding tumors represented 56,7%. Hearing preservation was possible in 2 out of 8 patients with preoperative class B hearing. At last follow-up, 34 (56,7%) patients had a normal postoperative FN outcome (HBI), 9 (15,0%) were HBII, 8 (13,3%) HBIII, and 9 (15,0%) HBIV. The total NT resection of solid and low-bleeding VS, without tight capsule adhesion, was associated with better FN outcome. Mortality was zero; permanent complications were observed in 2 cases (diplopia, hydrocephalus), transient in 9. Microsurgery of Koos grade IV VS seems to be associated with more than acceptable functional results, with high rate of T and NT removal of tumor. Long-term FN results seem to be worse in patients with cystic Koos grade IV VS, in cases with tight capsule adherences to nervous structures and in high-bleeding tumors.
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Affiliation(s)
- Luciano Mastronardi
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy. .,Department of Neurosurgery, The State Education Institution of Higher Professional Training, The First Sechenov Moscow State Medical University under Ministry of Health, Moscow, Russian Federation.
| | - Alberto Campione
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy
| | - Fabio Boccacci
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy
| | | | - Ettore Carpineta
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy
| | | | - Raffaelino Roperto
- Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy
| | - Albert Sufianov
- Department of Neurosurgery, The State Education Institution of Higher Professional Training, The First Sechenov Moscow State Medical University under Ministry of Health, Moscow, Russian Federation.,Federal Centre of Neurosurgery, Tyumen, Russian Federation
| | - Ali Zomorodi
- Vascular Neurosurgery Medical Director, Co-Director of Skull Base Surgery Center, Duke University Medical Center, Durham, NC, USA
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12
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Whitley H, Benedict NT, Tringali S, Gurusinghe NT, Roberts G, Fieux M, Alalade AF. Identifying Factors Associated with the Growth of Vestibular Schwannomas: A Systematic Review. World Neurosurg 2021; 149:e766-e779. [PMID: 33540091 DOI: 10.1016/j.wneu.2021.01.101] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Surveillance imaging is a valid management option for selected vestibular schwannomas (VS). An ideal protocol for radiologic monitoring would highlight growth-related risk factors and tailor management accordingly. This study aims to identify variables associated with the growth of sporadic VS to enhance surveillance imaging, enable early intervention, and optimize outcomes. METHODS The review was conducted according to the PRISMA guidelines. A systematic review of 5 databases (PubMed, Ovid, Cochrane Library, Web of Science, and Google Scholar) was performed to identify negative and positive growth predictors of sporadic vestibular schwannomas. The search was limited to studies reported between January 2015 and January 2020. We conducted an individual patient data meta-analysis using a 1-stage multivariate mixed-effect logistic regression model. RESULTS A total of 437 studies were identified, of which 25 met our criteria for full-text analysis. Articles that measured VS with comparable methods were determined eligible for meta-analysis inclusion. The selected articles were highly heterogeneous in their use of grading scales and assessment of tumor size. Our review showed that size at diagnosis (odds ratio, 1.15; 95% confidence interval, 1.11-1.18; P < 0.0001) and intracanalicular localization (odds ratio, 0.49; 95% confidence interval, 0.26-0.90; P = 0.023) were associated with VS growth. CONCLUSIONS The factors most frequently reported as being associated with growth within the literature were size of VS at diagnosis and localization of an intracanalicular component. Greater attention should be placed on these criteria within the surveillance imaging algorithm for VS.
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Affiliation(s)
- Helen Whitley
- First Faculty of Medicine, Charles University in Prague, Nove Mesto, Czech Republic
| | - Narmatha T Benedict
- First Faculty of Medicine, Charles University in Prague, Nove Mesto, Czech Republic
| | - Stephane Tringali
- Service d'ORL, d'otoneurochirurgie et de chirurgie cervico-faciale, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France; Université de Lyon, Université Lyon 1, Lyon, France
| | - Nihal T Gurusinghe
- Department of Neurosurgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
| | - Gareth Roberts
- Department of Neurosurgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
| | - Maxime Fieux
- Service d'ORL, d'otoneurochirurgie et de chirurgie cervico-faciale, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France; Université de Lyon, Université Lyon 1, Lyon, France
| | - Andrew F Alalade
- Department of Neurosurgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom.
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13
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Li P, Li S, Wang Y, Zhao F, Wang Z, Wang X, Wang B, Yang Z, Liu P. Clinical risk factor analysis of bilateral vestibular schwannoma's growth pattern inconsistency in individual NF2 patients. Clin Neurol Neurosurg 2020; 200:106365. [PMID: 33243701 DOI: 10.1016/j.clineuro.2020.106365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/05/2020] [Accepted: 11/07/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Although bilateral vestibular schwannomas (VSs) in individual NF2 patients have the same NF2 gene mutation, they often show different growth patterns. We attempted to identify factors associated with this growth pattern inconsistency. PATIENTS AND METHODS Cranial MR images of 120 untreated VSs in 60 NF2 patients were carefully reviewed for their growth rates. Growth pattern analysis was performed on 68 VSs in 34 NF2 patients followed up for more than three years with at least three cranial MR scans. RESULTS Patient age and tumor volume were significantly associated with NF2 VS absolute growth rates (p < 0.05). Bilateral VS growth patterns in individual NF2 patients were the same in 18 (52.9 %) and different in 16 (47.1 %) patients. Patients with consistent bilateral growth patterns were significantly younger than the inconsistent patients (21.8 ± 5.8 years vs. 30.8 ± 13.1 years, p = 0.014). The bilateral VS volume consistency rates were significantly higher in patients with consistent growth patterns than in patients with inconsistent growth patterns (10/18 vs. 3/16, p = 0.028). CONCLUSIONS Patient age and volume consistency are the clinical risk factors for bilateral NF2 VS growth pattern inconsistencies. Bilateral VSs in young NF2 patients tend to have the same growth patterns. These findings may help us to predict the future clinical behavior of small NF2 VSs based on the past clinical history of the large ones.
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Affiliation(s)
- Peng Li
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Shiwei Li
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Ying Wang
- Neural Reconstruction Department, Beijing Neurosurgical Institute, Capital Medical University, China
| | - Fu Zhao
- Neural Reconstruction Department, Beijing Neurosurgical Institute, Capital Medical University, China
| | - Zhenmin Wang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Xingchao Wang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Bo Wang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Zhijun Yang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Pinan Liu
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.
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14
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Ren Y, Hyakusoku H, Sagers JE, Landegger LD, Welling DB, Stankovic KM. MMP-14 (MT1-MMP) Is a Biomarker of Surgical Outcome and a Potential Mediator of Hearing Loss in Patients With Vestibular Schwannomas. Front Cell Neurosci 2020; 14:191. [PMID: 32848608 PMCID: PMC7424165 DOI: 10.3389/fncel.2020.00191] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 06/02/2020] [Indexed: 11/13/2022] Open
Abstract
Improved biomarkers are needed for vestibular schwannoma (VS), the most common tumor of the cerebellopontine angle, as existing clinical biomarkers have poor predictive value. Factors such as tumor size or growth rate do not shed light on the pathophysiology of associated sensorineural hearing loss (SNHL) and suffer from low specificity and sensitivity, whereas histological markers only sample a fraction of the tumor and are difficult to ascertain before tumor treatment or surgical intervention. Proteases play diverse and critical roles in tumorigenesis and could be leveraged as a new class of VS biomarkers. Using a combination of in silico, in vitro, and ex vivo approaches, we identified matrixmetalloprotease 14 (MMP-14; also known as MT1-MMP), from a panel of candidate proteases that were differentially expressed through the largest meta-analysis of human VS transcriptomes. The abundance and proteolytic activity of MMP-14 in the plasma and tumor secretions from VS patients correlated with clinical parameters and the degree of SNHL. Further, MMP-14 plasma levels correlated with surgical outcomes such as the extent of resection. Finally, the application of MMP-14 at physiologic concentrations to cochlear explant cultures led to damage to spiral ganglion neuronal fibers and synapses, thereby providing mechanistic insight into VS-associated SNHL. Taken together, MMP-14 represents a novel molecular biomarker that merits further validation in both diagnostic and prognostic applications for VS.
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Affiliation(s)
- Yin Ren
- Eaton Peabody Laboratories, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States.,Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, United States.,Division of Otolaryngology-Head and Neck Surgery, University of California, San Diego, San Diego, CA, United States
| | - Hiroshi Hyakusoku
- Eaton Peabody Laboratories, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States.,Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, United States.,Department of Otorhinolaryngology, Yokosuka Kyosai Hospital, Kanagawa, Japan
| | - Jessica E Sagers
- Eaton Peabody Laboratories, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States.,Program in Speech and Hearing Bioscience and Technology, Harvard Medical School, Boston, MA, United States.,Harvard Program in Therapeutic Science, Harvard University, Boston, MA, United States
| | - Lukas D Landegger
- Eaton Peabody Laboratories, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States.,Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, United States
| | - D Bradley Welling
- Eaton Peabody Laboratories, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States.,Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, United States.,Program in Speech and Hearing Bioscience and Technology, Harvard Medical School, Boston, MA, United States
| | - Konstantina M Stankovic
- Eaton Peabody Laboratories, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States.,Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, United States.,Program in Speech and Hearing Bioscience and Technology, Harvard Medical School, Boston, MA, United States.,Harvard Program in Therapeutic Science, Harvard University, Boston, MA, United States
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15
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Xia L, Yang S, Wang C, Yu E, Zhang H, Zhang Y, Ruan L, Shi L, Ni J, Luo J, Cao Z, Wen M. Immunohistochemical Profiles of Matrix Metalloproteinases and Vascular Endothelial Growth Factor Overexpression in the Antoni B Area of Vestibular Schwannomas. World Neurosurg 2020; 144:e72-e79. [PMID: 32758656 DOI: 10.1016/j.wneu.2020.07.208] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/25/2020] [Accepted: 07/28/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the clinical manifestations of cystic vestibular schwannomas (VSs), investigate the immunohistochemical profiles of matrix metalloproteinases (MMPs) and vascular endothelial growth factor (VEGF) expression in Antoni A and B areas, and speculate the pathogenesis of cystic formation and intratumoral hemorrhage. METHODS Clinical features and outcomes of 24 cases of cystic VSs and 38 cases of solid VSs were retrospectively compared. Immunohistochemical studies were conducted to evaluate the characteristics of MMPs and VEGF in cystic and solid VSs. RESULTS The tumor size was 38.92 ± 1.86 mm and 31.95 ± 1.74 mm in the cystic and solid VSs group, respectively (P = 0.011). Cystic VSs were rich in the Antoni B area. MMP-9 expression was low in the Antoni A and B areas. MMP-2 was moderately expressed. No significant difference in MMP-2 expression existed between the Antoni A and B areas (P > 0.05). VEGF and MMP-14 expression were moderate in the Antoni A area and intense in the Antoni B area, and the expression of both was significantly greater in the Antoni B area than in the Antoni A area (P < 0.001). CONCLUSIONS MMP-14 and VEGF expression were significantly greater in the Antoni B area than in the Antoni A area. Upregulated MMP-14 may degrade loose collagen in the Antoni B area and contribute to cystic formation. MMP-14 can enhance VEGF activity, which may induce extravasation of a plasma ultrafiltrate, cystic expansion, and intratumoral hemorrhage. Therefore, MMP-14 inhibition may be a therapeutic strategy for treating cystic VSs.
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Affiliation(s)
- Lei Xia
- Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, Department of Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Su Yang
- Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, Department of Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chengde Wang
- Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, Department of Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Enxing Yu
- Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, Department of Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hengli Zhang
- Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, Department of Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ying Zhang
- Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, Department of Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Linhui Ruan
- Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, Department of Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Liuzhi Shi
- Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang Province, Wenzhou, China
| | - Jinyao Ni
- Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang Province, Wenzhou, China
| | - JinBiao Luo
- Department of Neurosurgery, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - ZhiKai Cao
- Department of Neurosurgery, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Min Wen
- Department of Neurosurgery, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China.
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16
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Sass H, Cayé-Thomasen P. Contemporary Molecular Biology of Sporadic Vestibular Schwannomas: A Systematic Review and Clinical Implications. J Int Adv Otol 2019; 14:322-329. [PMID: 30100540 DOI: 10.5152/iao.2018.4929] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
In light of missing systematic reviews in the literature, the objective of this paper is to present the contemporary knowledge on the molecular biology of vestibular schwannomas (VS), based on a systematic literature search. In addition, current and prospected medical therapy based on molecular biology is addressed. A systematic literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The systematic search was performed in the Pubmed and Embase databases. The following were the words searched: acoustic neuroma/vestibular schwannoma, molecular biology, gene, and microRNA. Specific inclusion and exclusion criteria were determined prior to search. The systematic search rendered 486 articles, ultimately yielding 69 included articles, whereas 35 were from relevant references. The occurrence of at least one mutation in the merlin gene was reported to range between 54% and 76%, whereas the loss of heterozygosity (LOH) corresponding to chromosome 22 occurs in 25% to 83% of sporadic VS. Global gene expression studies indicate that a number of genes other than merlin are at play. No high-level methylation of the merlin gene has been found. Several miRNAs are deregulated in tumor tissue, among others let-7d, miR-221, and miR-21. The acquired knowledge on molecular biology has led to several clinical implementations. Lack of the tumor suppressor merlin plays a principal role in the development of VS. Existing knowledge on the molecular biology has led to the first attempts of targeted medical treatment to prevent tumor growth. Future research is likely to introduce potential imaging markers with prognostic value and new targets for medical therapy.
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Affiliation(s)
- Hjalte Sass
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Copenhagen, Denmark; University of Copenhagen, School of Health and Medical Sciences, Copenhagen, Denmark
| | - Per Cayé-Thomasen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Copenhagen, Denmark; University of Copenhagen, School of Health and Medical Sciences, Copenhagen, Denmark
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17
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MacKeith S, Wasson J, Baker C, Guilfoyle M, John D, Donnelly N, Mannion R, Jefferies S, Axon P, Tysome JR. Aspirin does not prevent growth of vestibular schwannomas: A case-control study. Laryngoscope 2018; 128:2139-2144. [DOI: 10.1002/lary.27114] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 01/04/2018] [Accepted: 01/08/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Samuel MacKeith
- Department of Otolaryngology; Addenbrooke's Hospital; Cambridge United Kingdom
| | - Joseph Wasson
- Department of Otolaryngology; Addenbrooke's Hospital; Cambridge United Kingdom
| | - Charlotte Baker
- Department of Otolaryngology; Addenbrooke's Hospital; Cambridge United Kingdom
| | - Matthew Guilfoyle
- Department of Neurosurgery; Addenbrooke's Hospital; Cambridge United Kingdom
| | - Deepa John
- Department of Otolaryngology; Addenbrooke's Hospital; Cambridge United Kingdom
| | - Neil Donnelly
- Department of Otolaryngology; Addenbrooke's Hospital; Cambridge United Kingdom
| | - Richard Mannion
- Department of Neurosurgery; Addenbrooke's Hospital; Cambridge United Kingdom
| | - Sarah Jefferies
- Department of Clinical Oncology; Addenbrooke's Hospital; Cambridge United Kingdom
| | - Patrick Axon
- Department of Otolaryngology; Addenbrooke's Hospital; Cambridge United Kingdom
| | - James R. Tysome
- Department of Otolaryngology; Addenbrooke's Hospital; Cambridge United Kingdom
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18
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Wang X, Khalil RA. Matrix Metalloproteinases, Vascular Remodeling, and Vascular Disease. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2017; 81:241-330. [PMID: 29310800 DOI: 10.1016/bs.apha.2017.08.002] [Citation(s) in RCA: 330] [Impact Index Per Article: 47.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Matrix metalloproteinases (MMPs) are a family of zinc-dependent endopeptidases that degrade various proteins in the extracellular matrix (ECM). Typically, MMPs have a propeptide sequence, a catalytic metalloproteinase domain with catalytic zinc, a hinge region or linker peptide, and a hemopexin domain. MMPs are commonly classified on the basis of their substrates and the organization of their structural domains into collagenases, gelatinases, stromelysins, matrilysins, membrane-type (MT)-MMPs, and other MMPs. MMPs are secreted by many cells including fibroblasts, vascular smooth muscle (VSM), and leukocytes. MMPs are regulated at the level of mRNA expression and by activation through removal of the propeptide domain from their latent zymogen form. MMPs are often secreted in an inactive proMMP form, which is cleaved to the active form by various proteinases including other MMPs. MMPs degrade various protein substrates in ECM including collagen and elastin. MMPs could also influence endothelial cell function as well as VSM cell migration, proliferation, Ca2+ signaling, and contraction. MMPs play a role in vascular tissue remodeling during various biological processes such as angiogenesis, embryogenesis, morphogenesis, and wound repair. Alterations in specific MMPs could influence arterial remodeling and lead to various pathological disorders such as hypertension, preeclampsia, atherosclerosis, aneurysm formation, as well as excessive venous dilation and lower extremity venous disease. MMPs are often regulated by endogenous tissue inhibitors of metalloproteinases (TIMPs), and the MMP/TIMP ratio often determines the extent of ECM protein degradation and tissue remodeling. MMPs may serve as biomarkers and potential therapeutic targets for certain vascular disorders.
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Affiliation(s)
- Xi Wang
- Vascular Surgery Research Laboratories, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Raouf A Khalil
- Vascular Surgery Research Laboratories, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
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19
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Matrix Metalloproteinase Inhibitors as Investigational and Therapeutic Tools in Unrestrained Tissue Remodeling and Pathological Disorders. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2017; 148:355-420. [PMID: 28662828 DOI: 10.1016/bs.pmbts.2017.04.003] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Matrix metalloproteinases (MMPs) are zinc-dependent proteolytic enzymes that degrade various proteins in the extracellular matrix (ECM). MMPs may also regulate the activity of membrane receptors and postreceptor signaling mechanisms and thereby affect cell function. The MMP family includes collagenases, gelatinases, stromelysins, matrilysins, membrane-type MMPs, and other MMPs. Inactive proMMPs are cleaved by other MMPs or proteases into active MMPs, which interact with various protein substrates in ECM and cell surface. MMPs regulate important biological processes such as vascular remodeling and angiogenesis and may be involved in the pathogenesis of cardiovascular disorders such as hypertension, atherosclerosis, and aneurysm. The role of MMPs is often assessed by measuring their mRNA expression, protein levels, and proteolytic activity using gel zymography. MMP inhibitors are also used to assess the role of MMPs in different biological processes and pathological conditions. MMP activity is regulated by endogenous tissue inhibitors of metalloproteinases (TIMPs), and the MMP/TIMP balance could determine the net MMP activity, ECM turnover, and tissue remodeling. Also, several synthetic MMP inhibitors have been developed. Synthetic MMP inhibitors include a large number of zinc-binding globulins (ZBGs), in addition to non-ZBGs and mechanism-based inhibitors. MMP inhibitors have been proposed as potential tools in the management of osteoarthritis, cancer, and cardiovascular disorders. However, most MMP inhibitors have broad-spectrum actions on multiple MMPs and could cause undesirable musculoskeletal side effects. Currently, doxycycline is the only MMP inhibitor approved by the Food and Drug Administration. New generation biological and synthetic MMP inhibitors may show greater MMP specificity and fewer side effects and could be useful in targeting specific MMPs, reducing unrestrained tissue remodeling, and the management of MMP-related pathological disorders.
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20
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Kleijwegt MC, van der Mey AGL, Wiggers-deBruine FT, Malessy MJA, van Osch MJP. Perfusion magnetic resonance imaging provides additional information as compared to anatomical imaging for decision-making in vestibular schwannoma. Eur J Radiol Open 2016; 3:127-33. [PMID: 27366777 PMCID: PMC4919314 DOI: 10.1016/j.ejro.2016.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 05/31/2016] [Indexed: 11/26/2022] Open
Abstract
DSC/ASL-MRI can be acquired in growing VS with sufficient image quality. In most patients DSC and ASL techniques provide similar qualitative scores. These techniques can be of importance in future decision-making.
Objective The added value of perfusion MRI for decision-making in vestibular schwannoma (VS) patients is unknown. MRI offers two perfusion methods: the first employing contrast agent (dynamic susceptibility contrast (DSC)-MRI) that provides information on cerebral blood volume (CBV) and cerebral blood flow (CBF), the second by magnetic labeling of blood (arterial spin labeling (ASL)-MRI), providing CBF-images. The goal of the current study is to investigate whether DSC and ASL perfusion MRI provides complimentary information to current anatomical imaging in treatment selection process of VS. Methods Nine patients with growing VS with extrameatal diameter >9 mm were included (>2 mm/year and 20% volume expansion/year) and one patient with 23 mm extrameatal VS without growth. DSC and ASL perfusion MRI were obtained on 3 T MRI. Perfusion in VS was scored as hyperintense, hypointense or isointense compared to the contralateral region. Results Seven patients showed hyperintense signal on DSC and ASL sequences. Three patients showed iso- or hypointense signal on at least one perfusion map (1 patient hypointense on both DSC-MRI and ASL; 1 patient isointense on DSC-CBF; 1 patient isointense on ASL). All patients showed enhancement on post-contrast T1 anatomical scan. Conclusion Perfusion MR provides additional information compared to anatomical imaging for decision-making in VS.
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Key Words
- AAO-HNS, American Academy of Otolaryngology-Head and Neck Surgery
- ASL, arterial spin labeling
- CA, contrast agent
- CBF, cerebral blood flow
- CBV, cerebral blood volume
- DSC, dynamic susceptibility contrast
- Decision making
- Dynamic susceptibility contrast (DSC) and arterial spin labeling (ASL)
- EPI, echo planar imaging
- FA, flip angle
- FOV, field of view
- Gd, gadolinium
- MR, magnetic resonance
- MRI, magnetic resonance imaging
- PCASL, pseudo-continuous arterial spin labeling
- Perfusion weighted MR
- RF, radiofrequency
- SNR, signal to noise ratio
- TE, echo time
- TR, repetition time
- VS, vestibular schwannoma
- Vestibular schwannoma
- rCBV, relative CBV
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Affiliation(s)
- M C Kleijwegt
- ENT Department, Leiden University Medical Center, Leiden, The Netherlands
| | - A G L van der Mey
- ENT Department, Leiden University Medical Center, Leiden, The Netherlands
| | | | - M J A Malessy
- Neurosurgery Department, Leiden University Medical Center, Leiden, The Netherlands
| | - M J P van Osch
- C.J. Gorter Center for High Field MRI, Radiology Department, Leiden University Medical Center, Leiden, The Netherlands
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21
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Tumor Biology of Vestibular Schwannoma: A Review of Experimental Data on the Determinants of Tumor Genesis and Growth Characteristics. Otol Neurotol 2016; 36:1128-36. [PMID: 26049313 DOI: 10.1097/mao.0000000000000788] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Provide an overview of the literature on vestibular schwannoma biology with special attention to tumor behavior and targeted therapy. BACKGROUND Vestibular schwannomas are benign tumors originating from the eighth cranial nerve and arise due to inactivation of the NF2 gene and its product merlin. Unraveling the biology of these tumors helps to clarify their growth pattern and is essential in identifying therapeutic targets. METHODS PubMed search for English-language articles on vestibular schwannoma biology from 1994 to 2014. RESULTS Activation of merlin and its role in cell signaling seem as key aspects of vestibular schwannoma biology. Merlin is regulated by proteins such as CD44, Rac, and myosin phosphatase-targeting subunit 1. The tumor-suppressive functions of merlin are related to receptor tyrosine kinases, such as the platelet-derived growth factor receptor and vascular endothelial growth factor receptor. Merlin mediates the Hippo pathway and acts within the nucleus by binding E3 ubiquiting ligase CRL4. Angiogenesis is an important mechanism responsible for the progression of these tumors and is affected by processes such as hypoxia and inflammation. Inhibiting angiogenesis by targeting vascular endothelial growth factor receptor seems to be the most successful pharmacologic strategy, but additional therapeutic options are emerging. CONCLUSION Over the years, the knowledge on vestibular schwannoma biology has significantly increased. Future research should focus on identifying new therapeutic targets by investigating vestibular schwannoma (epi)genetics, merlin function, and tumor behavior. Besides identifying novel targets, testing new combinations of existing treatment strategies can further improve vestibular schwannoma therapy.
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Saito T, Kasamatsu A, Ogawara K, Miyamoto I, Saito K, Iyoda M, Suzuki T, Endo-Sakamoto Y, Shiiba M, Tanzawa H, Uzawa K. Semaphorin7A Promotion of Tumoral Growth and Metastasis in Human Oral Cancer by Regulation of G1 Cell Cycle and Matrix Metalloproteases: Possible Contribution to Tumoral Angiogenesis. PLoS One 2015; 10:e0137923. [PMID: 26378920 PMCID: PMC4574527 DOI: 10.1371/journal.pone.0137923] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 08/23/2015] [Indexed: 12/21/2022] Open
Abstract
Background Semaphorins (SEMAs) consist of a large family of secreted and membrane-anchored proteins that are important in neuronal pathfinding and axon guidance in selected areas of the developing nervous system. Of them, SEMA7A has been reported to have a chemotactic activity in neurogenesis and to be an immunomodulator; however, little is known about the relevance of SEMA7A in the behaviors of oral squamous cell carcinoma (OSCC). Methods We evaluated SEMA7A expression in OSCC-derived cell lines and primary OSCC samples using quantitative reverse transcriptase-polymerase chain reaction, immunoblotting, and semiquantitative immunohistochemistry (sq-IHC). In addition, SEMA7A knockdown cells (shSEMA7A cells) were used for functional experiments, including cellular proliferation, invasiveness, and migration assays. We also analyzed the clinical correlation between SEMA7A status and clinical behaviors in patients with OSCC. Results SEMA7A mRNA and protein were up-regulated significantly (P<0.05) in OSCC-derived cell lines compared with human normal oral keratinocytes. The shSEMA7A cells showed decreased cellular growth by cell-cycle arrest at the G1 phase, resulting from up-regulation of cyclin-dependent kinase inhibitors (p21Cip1 and p27Kip1) and down-regulation of cyclins (cyclin D1, cyclin E) and cyclin-dependent kinases (CDK2, CDK4, and CDK6); and decreased invasiveness and migration activities by reduced secretion of matrix metalloproteases (MMPs) (MMP-2, proMMP-2, pro-MMP-9), and expression of membrane type 1- MMP (MT1-MMP). We also found inactivation of the extracellular regulated kinase 1/2 and AKT pathways, an upstream molecule of cell-cycle arrest at the G1 phase, and reduced secretion of MMPs in shSEMA7A cells. sq-IHC showed that SEMA7A expression in the primary OSCCs was significantly (P = 0.001) greater than that in normal counterparts and was correlated with primary tumoral size (P = 0.0254) and regional lymph node metastasis (P = 0.0002). Conclusion Our data provide evidence for an essential role of SEMA7A in tumoral growth and metastasis in OSCC and indicated that SEMA7A may play a potential diagnostic/therapeutic target for use in patients with OSCC.
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Affiliation(s)
- Tomoaki Saito
- Department of Oral Science, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260–8670, Japan
| | - Atsushi Kasamatsu
- Department of Dentistry and Oral-Maxillofacial Surgery, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba, 260–8670, Japan
| | - Katsunori Ogawara
- Division of Oral Surgery and Oral Implant Center, Funabashi Central Hospital, 6-13-10 Kaijin, Funabashi, Chiba, 273–8556, Japan
| | - Isao Miyamoto
- Department of Oral Science, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260–8670, Japan
| | - Kengo Saito
- Department of Molecular Virology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260–8670, Japan
| | - Manabu Iyoda
- Division of Oral Surgery, Chiba Rosai Hospital, 2–16 Tatsumidaihigashi, Ichihara, Chiba, 290–0003, Japan
| | - Takane Suzuki
- Department of Environmental Health Science, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260–8670, Japan
| | - Yosuke Endo-Sakamoto
- Department of Dentistry and Oral-Maxillofacial Surgery, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba, 260–8670, Japan
| | - Masashi Shiiba
- Department of Clinical Oncology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260–8670, Japan
| | - Hideki Tanzawa
- Department of Oral Science, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260–8670, Japan
- Department of Dentistry and Oral-Maxillofacial Surgery, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba, 260–8670, Japan
| | - Katsuhiro Uzawa
- Department of Oral Science, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260–8670, Japan
- Department of Dentistry and Oral-Maxillofacial Surgery, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba, 260–8670, Japan
- * E-mail:
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Li YX, Li Y, Je JY, Kim SK. Dieckol as a novel anti-proliferative and anti-angiogenic agent and computational anti-angiogenic activity evaluation. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2015; 39:259-70. [PMID: 25531264 DOI: 10.1016/j.etap.2014.11.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 11/13/2014] [Accepted: 11/15/2014] [Indexed: 06/04/2023]
Abstract
In the current study it was found that dieckol isolated from edible brown algae, Ecklonia cava (EC), as potent anti-proliferative and anti-angiogenic agent. Vascular endothelial growth factor (VEGF) induced EA.hy926 cell proliferation was suppressed by dieckol treatment. Further, it showed a significant inhibition of cell migration via inhibiting the protein and gene expression levels of matrix metalloproteinases, MMP-2 and -9. The signaling cascade underlying these responses was found as the dieckol induced inhibition of mitogen-activated protein kinase (MAPK) signaling pathway molecules, ERK and p38. Docking calculations were carried out on AP-N, VEGFR-1, MMP-2, MMP-9, Akt and Erk2 proteins model. Collectively, these results demonstrate the effective anti-proliferative and anti-migratory activity of dieckol on VEGF induced EA.hy926 through MAPK molecular signaling pathways which could be effectively correlated to its potential as an anti-angiogenic candidate. Therefore, this study reveals the potential of dieckol to be used in the design of anti-angiogenic agents.
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Affiliation(s)
- Yong-Xin Li
- Marine Bioprocess Research Center, Pukyong National University, Busan 608-737, Republic of Korea
| | - Yong Li
- School of Pharmaceutical Sciences, Changchun University of Chinese Medicine, 1035, Boshuo Road, Jing Yue Economic Development Zone, Chanchun City, Jilin Province, People's Republic of China
| | - Jae-Young Je
- Specialized Graduate School Science and Technology Convergence, Department of Marine Bio Convergence Science, Pukyong National University, Busan 608-737, Republic of Korea
| | - Se-Kwon Kim
- Marine Bioprocess Research Center, Pukyong National University, Busan 608-737, Republic of Korea; Specialized Graduate School Science and Technology Convergence, Department of Marine Bio Convergence Science, Pukyong National University, Busan 608-737, Republic of Korea.
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Hu Z, Wang Z, Wu H, Yang Z, Jiang W, Li L, Hu X. Ang II enhances noradrenaline release from sympathetic nerve endings thus contributing to the up-regulation of metalloprotease-2 in aortic dissection patients' aorta wall. PLoS One 2013; 8:e76922. [PMID: 24194850 PMCID: PMC3806742 DOI: 10.1371/journal.pone.0076922] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 09/04/2013] [Indexed: 12/25/2022] Open
Abstract
Object To test the hypothesis that angiotensin II (Ang II) could enhance noradrenaline (NA) release from sympathetic nerve endings of the aorta thus contributing to the up-regulation of matrix metalloproteinase 2 (MMP-2) during the formation of aortic dissection (AD). Methods Ang II, NA, MMP-2, MMP-9 of the aorta sample obtained during operation from aortic dissection patients were detected by High Performance Liquid Chromatography and ELISA and compared with controls. Isotope labelling method was used to test the impact of exogenous Ang II and noradrenaline on the NA release and MMP-2, MMP-9 expression on Sprague Dawley (SD) rat aorta rings in vitro. Two kidneys, one clip, models were replicated for further check of that impact in SD rats in vivo. Results The concentration of Ang II, MMP-2, 9 was increased and NA concentration was decreased in aorta samples from AD patients. Exogenous Ang II enhanced while exogenous NA restrained NA release from aortic sympathetic endings. The Ang II stimulated NA release and the following MMP-2 up-regulation could be weakened by Losartan and chemical sympathectomy. Beta blocker did not influence NA release but down-regulated MMP-2. Long term in vivo experiments confirmed that Ang II could enhance NA release and up-regulate MMP-2. Conclusions AD is initiated by MMP-2 overexpression as a result of increased NA release from sympathetic nervous endings in response to Ang II. This indicates an interaction of RAS and SAS during the formation of AD.
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Affiliation(s)
- Zhipeng Hu
- Department of Cardiothoracic Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
- Department of Cardiothoracic Surgery, Xiangyang Central Hospital, Xiangyang, Hubei Province, China
| | - Zhiwei Wang
- Department of Cardiothoracic Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
- * E-mail:
| | - Hongbing Wu
- Department of Cardiothoracic Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Zhimin Yang
- Department of Cardiothoracic Surgery, Xiangyang Central Hospital, Xiangyang, Hubei Province, China
| | - Wanli Jiang
- Department of Cardiothoracic Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Luocheng Li
- Department of Cardiothoracic Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Xiaoping Hu
- Department of Cardiothoracic Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
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Koutsimpelas D, Bjelopavlovic M, Yetis R, Frauenknecht K, Adryan B, Schmidtmann I, Gouveris H, Fruth K, Heinrich UR, Stauber RH, Mann WJ, Brieger J. The VEGF/VEGF-R axis in sporadic vestibular schwannomas correlates with irradiation and disease recurrence. ORL J Otorhinolaryngol Relat Spec 2013; 74:330-8. [PMID: 23344215 DOI: 10.1159/000346238] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2012] [Accepted: 11/19/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS The molecular mechanisms downstream of mutated neurofibromatosis type 2 (NF2) gene resulting in the growth and development of vestibular schwannoma (VS) are controversial. Several lines of evidence suggest the involvement of the vascular endothelial growth factor (VEGF) pathway in VS development. Given that recent studies of VEGF blockade in patients with NF2-associated VS showed positive effects on VS growth control, we initiated this comprehensive study of the VEGF pathway in sporadic VS. METHODS A tissue microarray analysis of 182 sporadic VS was conducted. The expression of VEGF and its receptors as well as the proliferative activity of the tumors were quantified. The expression data were correlated to tumor volumes and diameters as well as to tumor recurrence and previous irradiation. RESULTS All studied tumors expressed VEGF and its receptors. Proliferative activity was related to the growth characteristics of the tumors. Moreover, we found significantly higher VEGF levels in recurrent tumors (p = 0.0387) and in preoperatively irradiated tumors (p = 0.0213). CONCLUSION Our data suggest a relevant role of the VEGF pathway in VS growth and therapy outcome. Therefore, targeting this pathway using antiangiogenic compounds might be beneficial for patients with sporadic VS, especially those with recurrent or irradiated tumors.
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Affiliation(s)
- D Koutsimpelas
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Germany
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Yener U, Avsar T, Akgün E, Şeker A, Bayri Y, Kılıç T. Assessment of antiangiogenic effect of imatinib mesylate on vestibular schwannoma tumors using in vivo corneal angiogenesis assay. J Neurosurg 2012; 117:697-704. [DOI: 10.3171/2012.6.jns112263] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
Angiogenesis and the platelet-derived growth factor (PDGF) pathway are active in the pathogenesis of vestibular schwannomas (VSs). The purpose of this study was to test whether imatinib mesylate (Gleevec), a PDGF receptor (PDGFR) blocker, reduces angiogenic capacity in sporadic VS and in VS associated with neurofibromatosis Type 2 (NF2) using a corneal angiogenesis assay.
Methods
From 121 VS tissue samples stored in the tumor bank at the Marmara University Institute of Neurological Sciences, 10 samples (6 from sporadic cases, 4 from NF2-associated cases) were selected at random for use in this study. Expression of PDGF-A and PDGF-B and their receptors was evaluated in sporadic and NF2-associated VS as well as in glioblastoma (GBM) and normal brain tissue by means of immunohistochemistry and Western blot analysis. Corneal angiogenesis assay was then used to evaluate the angiogenic capacity of tissue specimens from sporadic and NF2-associated VS with and without imatinib treatment as well as positive and negative controls (GBM and normal brain tissue).
Results
The angiogenic potential of the sporadic and NF2-associated VS tumor tissue differed significantly from that of the positive and negative control tissues (p <0.05). Furthermore, NF2-associated VS showed significantly lower angiogenic potential than sporadic VS (p <0.05). Imatinib treatment significantly reduced the angiogenic potential in both the sporadic VS and the NF2-associated VS groups. The level of PDGF-A and PDGFR-α as well as PDGF-B and PDGFR-β expression in sporadic VS and NF2-associated VS also differed significantly (p <0.05) from the levels in controls. Additionally the level of PDGFR-β was significantly higher in sporadic VS than in NF2-associated VS (p <0.05).
Conclusions
The findings of this study indicate that NF2-associated VS has significantly more angiogenic potential than sporadic VS and normal brain tissue. Additionally, imatinib reduces the angiogenic activity of both sporadic and NF2-associated VS. The authors conclude that imatinib may be a potential treatment for VS, especially for NF2-associated lesions that cannot be cured with resection or radiosurgery.
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Affiliation(s)
- Ulaş Yener
- 1Institute of Neurological Sciences and
- 2Department of Neurosurgery, Faculty of Medicine, Marmara University; and
| | - Timucin Avsar
- 1Institute of Neurological Sciences and
- 3Dr Orhan Öcalgiray Molecular Biology-Biotechnology and Genetics Research Centre, Istanbul Technical University, Istanbul, Turkey
| | | | - Aşkın Şeker
- 1Institute of Neurological Sciences and
- 2Department of Neurosurgery, Faculty of Medicine, Marmara University; and
| | - Yaşar Bayri
- 1Institute of Neurological Sciences and
- 2Department of Neurosurgery, Faculty of Medicine, Marmara University; and
| | - Türker Kılıç
- 1Institute of Neurological Sciences and
- 2Department of Neurosurgery, Faculty of Medicine, Marmara University; and
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TAURONE SAMANTA, BIANCHI ENRICA, ATTANASIO GIUSEPPE, DI GIOIA CIRA, IERINÓ ROCCO, CARUBBI CECILIA, GALLI DANIELA, PASTORE FRANCESCOSAVERIO, GIANGASPERO FELICE, FILIPO ROBERTO, ZANZA CHRISTIAN, ARTICO MARCO. Immunohistochemical profile of cytokines and growth factors expressed in vestibular schwannoma and in normal vestibular nerve tissue. Mol Med Rep 2012; 12:737-45. [DOI: 10.3892/mmr.2015.3415] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 01/21/2015] [Indexed: 11/06/2022] Open
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Matrix metalloproteinase inhibitors as investigative tools in the pathogenesis and management of vascular disease. EXPERIENTIA SUPPLEMENTUM (2012) 2012; 103:209-79. [PMID: 22642194 DOI: 10.1007/978-3-0348-0364-9_7] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Matrix metalloproteinases (MMPs) are proteolytic enzymes that degrade various components of the extracellular matrix (ECM). MMPs could also regulate the activity of several non-ECM bioactive substrates and consequently affect different cellular functions. Members of the MMPs family include collagenases, gelatinases, stromelysins, matrilysins, membrane-type MMPs, and others. Pro-MMPs are cleaved into active MMPs, which in turn act on various substrates in the ECM and on the cell surface. MMPs play an important role in the regulation of numerous physiological processes including vascular remodeling and angiogenesis. MMPs may also be involved in vascular diseases such as hypertension, atherosclerosis, aortic aneurysm, and varicose veins. MMPs also play a role in the hemodynamic and vascular changes associated with pregnancy and preeclampsia. The role of MMPs is commonly assessed by measuring their gene expression, protein amount, and proteolytic activity using gel zymography. Because there are no specific activators of MMPs, MMP inhibitors are often used to investigate the role of MMPs in different physiologic processes and in the pathogenesis of specific diseases. MMP inhibitors include endogenous tissue inhibitors (TIMPs) and pharmacological inhibitors such as zinc chelators, doxycycline, and marimastat. MMP inhibitors have been evaluated as diagnostic and therapeutic tools in cancer, autoimmune disease, and cardiovascular disease. Although several MMP inhibitors have been synthesized and tested both experimentally and clinically, only one MMP inhibitor, i.e., doxycycline, is currently approved by the Food and Drug Administration. This is mainly due to the undesirable side effects of MMP inhibitors especially on the musculoskeletal system. While most experimental and clinical trials of MMP inhibitors have not demonstrated significant benefits, some trials still showed promising results. With the advent of new genetic and pharmacological tools, disease-specific MMP inhibitors with fewer undesirable effects are being developed and could be useful in the management of vascular disease.
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McCarter LL. Dual flagellar systems enable motility under different circumstances. J Mol Microbiol Biotechnol 2004; 7:18-29. [PMID: 15170400 DOI: 10.1159/000077866] [Citation(s) in RCA: 212] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Flagella are extremely effective organelles of locomotion used by a variety of bacteria and archaea. Some bacteria, including Aeromonas, Azospirillum, Rhodospirillum, and Vibrio species, possess dual flagellar systems that are suited for movement under different circumstances. Swimming in liquid is promoted by a single polar flagellum. Swarming over surfaces or in viscous environments is enabled by the production of numerous peritrichous, or lateral, flagella. The polar flagellum is produced continuously, while the lateral flagella are produced under conditions that disable polar flagellar function. Thus at times, two types of flagellar organelles are assembled simultaneously. This review focuses on the polar and lateral flagellar systems of Vibrio parahaemolyticus. Approximately 50 polar and 40 lateral flagellar genes have been identified encoding distinct structural, motor, export/assembly, and regulatory elements. The sodium motive force drives polar flagellar rotation, and the proton motive force powers lateral translocation. Polar genes are found exclusively on the large chromosome, and lateral genes reside entirely on the small chromosome of the organism. The timing of gene expression corresponds to the temporal demand for components during assembly of the organelle: RpoN and lateral- and polar-specific sigma(54)-dependent transcription factors control early/intermediate gene transcription; lateral- and polar-specific sigma(28) factors direct late flagellar gene expression. Although a different gene set encodes each flagellar system, the constituents of a central navigation system (i.e., chemotaxis signal transduction) are shared.
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Affiliation(s)
- Linda L McCarter
- Department of Microbiology, The University of Iowa, Iowa City, Iowa 52246, USA.
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