Metabolic syndrome factors and risk of postoperative depression in high-grade glioma patients in a 1.5-year prospective study

Research progress on ferroptosis in gliomas (Review)

Glioma is the most prevalent type of brain tumor characterized by a poor 5-year survival rate and a high mortality rate. Malignant gliomas are commonly treated by surgery, chemotherapy and radiotherapy. However, due to toxicity and resistance to chemoradiotherapy, these treatments can be ineffective. Anxiety and depression are highly prevalent in patients with glioma, adversely affecting disease prognosis and posing societal concerns. Ferroptosis is a type of non-apoptotic, iron-dependent cell death characterized by the accumulation of lethal reactive oxygen species produced by iron metabolism, and it serves a key role in numerous diseases. Regulation of iron phagocytosis may serve as a therapeutic strategy for the development of novel glioma treatments. The present review discusses the mechanisms underlying the occurrence and regulation of ferroptosis, its role in the genesis and evolution of gliomas, and its association with glioma-related anxiety and depression. By exploring potential targets for glioma treatment, the present review provides a theoretical basis for the development of novel therapeutic strategies against glioma.

Serum lipids concentration on prognosis of high-grade glioma

OBJECTIVE

To investigate the effect of serum lipids concentration on the prognosis of high-grade glioma patients undergoing postoperative radiotherapy.

METHODS

Retrospective analysis of the patients with high-grade glioma who received postoperative Intensity Modulated Radiotherapy between 13 May 2013 and 12 September 2018 was performed. The patients were grouped according to the average values of serum total cholesterol, LDL, and HDL concentration in peripheral blood (before surgery, 6 months after therapy). Cox proportional hazards model was performed to determine whether the total cholesterol concentration, LDL concentration, and HDL concentration in peripheral blood before therapy and their changes after therapy were factors influencing the prognosis.

RESULTS

The results of COX regression analysis showed that the independent prognostic factors of high-grade glioma patients were pathological grade, the extent of resection, serum cholesterol concentration pre-surgery, and the change of LDL concentration from pre-surgery to post-therapy. The prognosis of patients with high serum total cholesterol concentration before therapy was worse than those of patients with low total cholesterol concentration. The 5-year survival rate and the median survival time of patients with high serum total cholesterol concentration before therapy were 4.9% and 23.6 months, but the low cholesterol concentration group were 19.6% and 24.5 months, respectively. Besides, the average serum LDL concentration in high-grade glioma patients gradually increased after therapy. The 5-year survival rate of patients and the median survival time with elevated LDL concentration after therapy is 11.8% and 20.4 months, but the reduced LDL concentration group was 16.7% and 28.4 months, respectively. The total cholesterol and LDL concentration increased significantly after therapy in Grade IV patients while Grade III patients did not.

CONCLUSIONS

The cholesterol concentration before therapy and LDL concentration change from pre-surgery to post-therapy are the factors that affect the prognosis of high-grade glioma patients who have undergone postoperative radiotherapy. In the final analysis, the high serum cholesterol pre-surgery and the increased in serum LDL concentration from pre-surgery to post-therapy were associated with worse survival of patients.

Anxiety and depression in glioma patients: prevalence, risk factors, and their correlation with survival

AIMS

This study aimed to investigate the risk factors and prognostic value of anxiety and depression in glioma patients.

METHODS

A total of 190 glioma patients who underwent resection were consecutively enrolled. Anxiety was assessed using hospital anxiety and depression scale (HADS) and Zung self-rating anxiety scale (SAS); depression was assessed with the use of HADS and Zung self-rating depression scale (SDS). All patients were followed up to death or 36 months. Overall survival (OS) was calculated according to the survival data.

RESULTS

The prevalence of anxiety ranged from 36.3 to 37.4%, and the prevalence of depression ranged from 28.4 to 32.6% based on different assessment scales. Female, diabetes, and increased WHO grade were correlated with HADS anxiety and SAS anxiety, while female, single/divorced/widowed status, hyperlipidemia, diabetes, and CKD were associated with HADS depression and SDS depression. Further multivariate logistic analyses disclosed the following: single/divorced/widowed status and WHO grade were independent risk factors for HADS anxiety; female and hyperlipidemia were independent risk factors for SAS anxiety; whereas education duration (< 12 years), single/divorced/widowed status, and CKD were independent risk factors for HADS depression; female, single/divorced/widowed status, and hyperlipidemia were independent risk factors for SDS depression. Besides, HADS anxiety, SAS anxiety and SDS depression were correlated with shorter OS, while HADS depression was not.

CONCLUSIONS

Our findings about the risk factors and prognostic value of anxiety and depression might aid for their early prevention and prognosis improvement in glioma patients.

Effects of microRNA-26b on proliferation and invasion of glioma cells and related mechanisms

Neuroglioma is the most common primary malignant tumor in neurosurgery. Due to its short survival period and high patient mortality rate, neuroglioma is a major challenge in clinics. Elucidating the pathogenic mechanisms and associated molecular targets of neuroglioma can therefore benefit diagnosis and treatment of glioma. Previous studies have established the role of microRNA (miR)‑26b in various tumors, including breast cancer, lymphoma and glioma. Its function and mechanism in neuroglioma, however, remains to be elucidated. In the present study, in vitro cultured U87 glioma cells were randomly divided into miR‑26b mimic, miR‑26b inhibitor and respective control (NC) groups. MTT assay was performed to detect the effect of miR‑26b on cell proliferation, while a cell invasion assay detected its effects on cell invasion. Caspase‑3 activity was also quantified to test cell apoptosis, followed by reverse transcription-quantitative polymerase chain reaction and western blotting to detect the variation of Bcl‑2 expression under the effect of miR‑26b. miR‑26b mimics transfection upregulated its expression in U87 cells, which had significantly reduced Bcl‑2 mRNA and protein expression levels and higher casapse3 activity, and inhibited cell proliferation and invasion compared with the control group. The transfection of miR‑26b inhibitor, in contrast, facilitated U87 cell proliferation and invasion, inhibited caspase‑3 activity and elevated Bcl‑2 mRNA/protein expression. In conclusion, miR‑26 could facilitate apoptosis and inhibit proliferation/invasion of neuroglioma cells via downregulating Bcl‑2 expression and potentiating caspase-3 activity.