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Spille DC, Bunk EC, Thomas C, Özdemir Z, Wagner A, Akkurt BH, Mannil M, Paulus W, Grauer OM, Stummer W, Senner V, Brokinkel B. Protoporphyrin IX (PpIX) Fluorescence during Meningioma Surgery: Correlations with Histological Findings and Expression of Heme Pathway Molecules. Cancers (Basel) 2023; 15:cancers15010304. [PMID: 36612300 PMCID: PMC9818642 DOI: 10.3390/cancers15010304] [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: 12/03/2022] [Revised: 12/25/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023] Open
Abstract
Background: The usefulness of 5-ALA-mediated fluorescence-guided resection (FGR) in meningiomas is controversial, and information on the molecular background of fluorescence is sparse. Methods: Specimens obtained during 44 FGRs of intracranial meningiomas were analyzed for the presence of tumor tissue and fluorescence. Protein/mRNA expression of key transmembrane transporters/enzymes involved in PpIX metabolism (ABCB6, ABCG2, FECH, CPOX) were investigated using immunohistochemistry/qPCR. Results: Intraoperative fluorescence was observed in 70 of 111 specimens (63%). No correlation was found between fluorescence and the WHO grade (p = 0.403). FGR enabled the identification of neoplastic tissue (sensitivity 84%, specificity 67%, positive and negative predictive value of 86% and 63%, respectively, AUC: 0.75, p < 0.001), and was improved in subgroup analyses excluding dura specimens (86%, 88%, 96%, 63% and 0.87, respectively; p < 0.001). No correlation was found between cortical fluorescence and tumor invasion (p = 0.351). Protein expression of ABCB6, ABCG2, FECH and CPOX was found in meningioma tissue and was correlated with fluorescence (p < 0.05, each), whereas this was not confirmed for mRNA expression. Aberrant expression was observed in the CNS. Conclusion: FGR enables the intraoperative identification of meningioma tissue with limitations concerning dura invasion and due to ectopic expression in the CNS. ABCB6, ABCG2, FECH and CPOX are expressed in meningioma tissue and are related to fluorescence.
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Affiliation(s)
- Dorothee C. Spille
- Department of Neurosurgery, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149 Münster, Germany
- Correspondence: ; Tel.: +49251-83-43959/-47472; Fax: +49251-83-45646
| | - Eva C. Bunk
- Department of Neurosurgery, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149 Münster, Germany
| | - Christian Thomas
- Institute of Neuropathology, University Hospital Münster, 48149 Münster, Germany
| | - Zeynep Özdemir
- Department of Neurosurgery, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149 Münster, Germany
| | - Andrea Wagner
- Institute of Neuropathology, University Hospital Münster, 48149 Münster, Germany
| | - Burak H. Akkurt
- Department of Radiology, University Hospital Münster, 48149 Münster, Germany
| | - Manoj Mannil
- Department of Radiology, University Hospital Münster, 48149 Münster, Germany
| | - Werner Paulus
- Institute of Neuropathology, University Hospital Münster, 48149 Münster, Germany
| | - Oliver M. Grauer
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, 48149 Münster, Germany
| | - Walter Stummer
- Department of Neurosurgery, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149 Münster, Germany
| | - Volker Senner
- Institute of Neuropathology, University Hospital Münster, 48149 Münster, Germany
| | - Benjamin Brokinkel
- Department of Neurosurgery, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149 Münster, Germany
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Hosmann A, Jaber M, Roetzer-Pejrimovsky T, Timelthaler G, Borkovec M, Kiesel B, Wadiura LI, Millesi M, Mercea PA, Phillips J, Hervey-Jumper S, Berghoff AS, Hainfellner JA, Berger MS, Stummer W, Widhalm G. CD34 microvascularity in low-grade glioma: correlation with 5-aminolevulinic acid fluorescence and patient prognosis in a multicenter study at three specialized centers. J Neurosurg 2022; 138:1281-1290. [PMID: 36115057 DOI: 10.3171/2022.7.jns22921] [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: 04/26/2022] [Accepted: 07/25/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Early markers are urgently needed in low-grade glioma (LGG) evaluation to rapidly estimate the individual patient's prognosis and to determine the optimal postoperative management. Generally, visible 5-aminolevulinic acid (5-ALA) fluorescence is present in only a few LGGs. Recently, the authors identified visible 5-ALA fluorescence as a powerful intraoperative marker for unfavorable outcome in LGG treatment. However, its precise histopathological correlate is unclear. Neoangiogenesis represents a crucial event in tumor evolution, and CD34 is an established marker for vascular endothelial progenitors potentially indicating tumor progression. The aim of this study was thus to correlate 5-ALA fluorescence and CD34 microvascularity as well as to investigate the prognostic value of CD34 in a large series of LGGs. METHODS In this retrospective study including 3 specialized centers, patients with histopathologically confirmed isocitrate dehydrogenase-mutated LGGs (WHO grade II) receiving 5-ALA prior to resection were included. During surgery, the presence of visible fluorescence was analyzed and one representative tumor sample from the area with the maximum fluorescence effect (tumor with focal fluorescence or nonfluorescing tumor) was selected for each LGG. All fluorescing or nonfluorescing tumor samples were stained for CD34 and semiquantitatively analyzed for microvascular proliferation patterns (physiological vessels, branching capillaries, or microvessel clusters) as well as automatically quantified for CD34 microvessel density (MVD) by standardized histomorphometry software. These semiquantitative/quantitative CD34 data were correlated to the fluorescence status and patient outcome including progression-free survival (PFS), malignant transformation-free survival (MTFS), and overall survival (OS). RESULTS In a total of 86 LGGs, visible fluorescence was found during surgery in 13 (15%) cases. First, the semiquantitative CD34 score significantly correlated with intraoperative fluorescence (p = 0.049). Accordingly, the quantitative CD34 MVD was significantly higher in tumors showing fluorescence (p = 0.03). Altogether, the semiquantitative CD34 score showed a strong correlation with quantitative CD34 MVD (p < 0.001). At a mean follow-up of 5.4 ± 2.6 years, microvessel clusters in semiquantitative analysis were a prognostic marker for poor PFS (p = 0.01) and MTFS (p = 0.006), but not OS (p = 0.28). Finally, quantitative CD34 MVD > 10 vessels/mm2 was a prognostic marker for poor PFS (p = 0.01), MTFS (p = 0.008), and OS (p = 0.049). CONCLUSIONS The data indicate that CD34 microvascularity is associated with intraoperative 5-ALA fluorescence and outcomes in patients with LGG. Thus, visible fluorescence in LGGs might indicate increased CD34 microvascularity, serving as an early prognostic marker for unfavorable patient outcome that is already available during surgery.
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Affiliation(s)
- Arthur Hosmann
- 1Department of Neurosurgery, Medical University of Vienna, Austria
| | - Mohammed Jaber
- 2Department of Neurosurgery, University Hospital Münster, Germany
| | - Thomas Roetzer-Pejrimovsky
- 3Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Austria
| | | | - Martin Borkovec
- 1Department of Neurosurgery, Medical University of Vienna, Austria
| | - Barbara Kiesel
- 1Department of Neurosurgery, Medical University of Vienna, Austria
| | - Lisa I Wadiura
- 1Department of Neurosurgery, Medical University of Vienna, Austria
| | - Matthias Millesi
- 1Department of Neurosurgery, Medical University of Vienna, Austria
| | - Petra A Mercea
- 1Department of Neurosurgery, Medical University of Vienna, Austria
| | - Joanna Phillips
- 5Department of Pathology, University of California, San Francisco, California
| | - Shawn Hervey-Jumper
- 6Department of Neurological Surgery, University of California, San Francisco, California; and
| | - Anna S Berghoff
- 7Division of Oncology, Department of Medicine I, Medical University of Vienna, Austria
| | - Johannes A Hainfellner
- 3Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Austria
| | - Mitchel S Berger
- 6Department of Neurological Surgery, University of California, San Francisco, California; and
| | - Walter Stummer
- 2Department of Neurosurgery, University Hospital Münster, Germany
| | - Georg Widhalm
- 1Department of Neurosurgery, Medical University of Vienna, Austria
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3
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Mischkulnig M, Kiesel B, Rötzer-Pejrimovsky T, Borkovec M, Lang A, Millesi M, Wadiura LI, Hervey-Jumper S, Penninger JM, Berger MS, Widhalm G, Erhart F. The impact of heme biosynthesis regulation on glioma aggressiveness: Correlations with diagnostic molecular markers. Front Mol Neurosci 2022; 15:928355. [PMID: 36187350 PMCID: PMC9515895 DOI: 10.3389/fnmol.2022.928355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 08/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background The prognosis of diffusely infiltrating glioma patients is dismal but varies greatly between individuals. While characterization of gliomas primarily relied on histopathological features, molecular markers increasingly gained importance and play a key role in the recently published 5th edition of the World Health Organization (WHO) classification. Heme biosynthesis represents a crucial pathway due to its paramount importance in oxygen transport, energy production and drug metabolism. Recently, we described a “heme biosynthesis mRNA expression signature” that correlates with histopathological glioma grade and survival. The aim of the current study was to correlate this heme biosynthesis mRNA expression signature with diagnostic molecular markers and investigate its continued prognostic relevance. Materials and methods In this study, patient data were derived from the “The Cancer Genome Atlas” (TCGA) lower-grade glioma and glioblastoma cohorts. We identified diffusely infiltrating gliomas correlating molecular tumor diagnosis according to the most recent WHO classification with heme biosynthesis mRNA expression. The following molecular markers were analyzed: EGFR amplification, TERT promoter mutation, CDKN2A/B homozygous loss, chromosome 7 + /10- aneuploidy, MGMT methylation, IDH mutation, ATRX loss, p53 mutation and 1p19q codeletion. Subsequently, we calculated the heme biosynthesis mRNA expression signature for correlation with distinct molecular glioma markers/molecular subgroups and performed survival analyses. Results A total of 649 patients with available data on up-to-date molecular markers and heme biosynthesis mRNA expression were included. According to analysis of individual molecular markers, we found a significantly higher heme biosynthesis mRNA expression signature in gliomas with IDH wildtype (p < 0.0005), without 1p19q codeletion (p < 0.0005), with homozygous CDKN2A/B loss (p < 0.0005) and with EGFR amplification (p = 0.001). Furthermore, we observed that the heme biosynthesis mRNA expression signature increased with molecular subgroup aggressiveness (p < 0.0005), being lowest in WHO grade 2 oligodendrogliomas and highest in WHO grade 4 glioblastomas. Finally, the heme biosynthesis mRNA expression signature was a statistically significant survival predictor after multivariate correction for all molecular markers (p < 0.0005). Conclusion Our data demonstrate a significant correlation between heme biosynthesis regulation and diagnostic molecular markers and a prognostic relevance independent of these established markers. Consequently, heme biosynthesis expression is a promising biomarker for glioma aggressiveness and might constitute a potential target for novel therapeutic approaches.
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Affiliation(s)
- Mario Mischkulnig
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
- Central Nervous System Tumors Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Barbara Kiesel
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
- Central Nervous System Tumors Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Thomas Rötzer-Pejrimovsky
- Central Nervous System Tumors Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Martin Borkovec
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
- Department of Statistics, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Alexandra Lang
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
- Central Nervous System Tumors Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Matthias Millesi
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
- Central Nervous System Tumors Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Lisa I. Wadiura
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
- Central Nervous System Tumors Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Shawn Hervey-Jumper
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Josef M. Penninger
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences, Vienna, Austria
- Department of Medical Genetics, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
| | - Mitchel S. Berger
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Georg Widhalm
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
- Central Nervous System Tumors Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- *Correspondence: Georg Widhalm,
| | - Friedrich Erhart
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
- Central Nervous System Tumors Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Friedrich Erhart,
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4
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Mischkulnig M, Roetzer-Pejrimovsky T, Lötsch-Gojo D, Kastner N, Bruckner K, Prihoda R, Lang A, Martinez-Moreno M, Furtner J, Berghoff A, Woehrer A, Berger W, Widhalm G, Kiesel B. Heme Biosynthesis Factors and 5-ALA Induced Fluorescence: Analysis of mRNA and Protein Expression in Fluorescing and Non-fluorescing Gliomas. Front Med (Lausanne) 2022; 9:907442. [PMID: 35665365 PMCID: PMC9157484 DOI: 10.3389/fmed.2022.907442] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
Objective The intraoperative visualization of adult-type diffuse gliomas with 5-aminolevulinic acid (5-ALA) induced fluorescence is widely used in the neurosurgical field. While visible 5-ALA induced fluorescence is found in the majority of high-grade gliomas, most low-grade gliomas lack visible fluorescence during surgery. Recently, the heme biosynthesis pathway was identified as crucial influencing factor for presence of visible fluorescence since it metabolizes 5-ALA to fluorescing Protoporphyrin IX (PpIX). However, the exact alterations within the heme biosynthesis pathway resulting in visible 5-ALA induced fluorescence in gliomas are still unclear. The aim of the present study was thus to compare the mRNA and protein expression of promising intramitochondrial heme biosynthesis enzymes/transporters in glioma tissue samples of different fluorescence behavior. Methods A total of 19 strongly fluorescing and 21 non-fluorescing tissue samples from neurosurgical adult-type diffuse gliomas (WHO grades II-IV) were included in the current analysis. In these samples, we investigated the mRNA expression by quantitative real time PCR and protein expression using immunohistochemistry of the intramitochondrial heme biosynthesis enzymes Coproporphyrinogen Oxidase (CPOX), Protoporphyrinogen Oxidase (PPOX), Ferrochelatase (FECH), and the transporter ATP-binding Cassette Subfamily B Member 2 (ABCG2). Results Regarding mRNA expression analysis, we found a significantly decreased ABCG2 expression in fluorescing specimens compared to non-fluorescing samples (p = 0.001), whereas no difference in CPOX, PPOX and FECH was present. With respect to protein expression, significantly higher levels of CPOX (p = 0.005), PPOX (p < 0.01) and FECH (p = 0.003) were detected in fluorescing samples. Similar to mRNA expression analysis, the protein expression of ABCG2 (p = 0.001) was significantly lower in fluorescing samples. Conclusion Distinct alterations of the analyzed heme biosynthesis factors were found primarily on protein level. Our data indicate that heme biosynthesis pathway activity in general is enhanced in fluorescing gliomas with upregulation of PpIX generating enzymes and decreased ABCG2 mediated PpIX efflux outweighing the also increased further metabolization of PpIX to heme. Intramitochondrial heme biosynthesis factors thus constitute promising pharmacological targets to optimize intraoperative 5-ALA fluorescence visualization of usually non-fluorescing tumors such as low-grade gliomas.
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Affiliation(s)
- Mario Mischkulnig
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
- Comprehensive Cancer Center–Central Nervous System Tumours Unit, Medical University of Vienna, Vienna, Austria
| | - Thomas Roetzer-Pejrimovsky
- Comprehensive Cancer Center–Central Nervous System Tumours Unit, Medical University of Vienna, Vienna, Austria
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Daniela Lötsch-Gojo
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
- Comprehensive Cancer Center–Central Nervous System Tumours Unit, Medical University of Vienna, Vienna, Austria
| | - Nina Kastner
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Katharina Bruckner
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Romana Prihoda
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
- Department of Neurosurgery, University Hospital of St. Poelten, Karl Landsteiner University of Health Sciences, St. Poelten, Austria
| | - Alexandra Lang
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
- Comprehensive Cancer Center–Central Nervous System Tumours Unit, Medical University of Vienna, Vienna, Austria
| | | | - Julia Furtner
- Comprehensive Cancer Center–Central Nervous System Tumours Unit, Medical University of Vienna, Vienna, Austria
- Department of Radiology and Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - Anna Berghoff
- Comprehensive Cancer Center–Central Nervous System Tumours Unit, Medical University of Vienna, Vienna, Austria
- Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Adelheid Woehrer
- Comprehensive Cancer Center–Central Nervous System Tumours Unit, Medical University of Vienna, Vienna, Austria
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Walter Berger
- Institute of Cancer Research, Medical University of Vienna, Vienna, Austria
| | - Georg Widhalm
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
- Comprehensive Cancer Center–Central Nervous System Tumours Unit, Medical University of Vienna, Vienna, Austria
| | - Barbara Kiesel
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
- Comprehensive Cancer Center–Central Nervous System Tumours Unit, Medical University of Vienna, Vienna, Austria
- *Correspondence: Barbara Kiesel,
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Akishina AA, Cherezov RO, Vorontsova YE, Simonova OB. Effect of the Histone Deacetylase (HDAC) Inhibitor Belinostat on the Expression of the Aryl Hydrocarbon Receptor and its Target Genes in Human Cell Cultures. Russ J Dev Biol 2022. [DOI: 10.1134/s1062360422020023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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6
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Analysis of corticosteroid and antiepileptic drug treatment effects on heme biosynthesis mRNA expression in lower-grade gliomas: potential implications for 5-ALA metabolization. Photodiagnosis Photodyn Ther 2022; 38:102755. [PMID: 35149260 DOI: 10.1016/j.pdpdt.2022.102755] [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: 12/26/2021] [Revised: 01/22/2022] [Accepted: 02/07/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Intraoperative visualization of gliomas with 5-aminolevulinic acid (5-ALA) induced fluorescence constitutes a powerful technique. While visible fluorescence is typically observed in high-grade gliomas, fluorescence is considerably less common in lower-grade gliomas (LGGs) WHO grade II&III. Whereas the exact mechanisms determining fluorescence in LGGs are not fully understood, metabolization of non-fluorescent 5-ALA to fluorescent Protoporphyrin IX by specific heme biosynthesis enzymes/transporters has been identified as relevant mechanism influencing fluorescence behavior. Furthermore, recent in-vitro studies have suggested preoperative treatment with corticosteroids and anti-epileptic drugs (AED) as potential factors influencing 5-ALA induced fluorescence. METHODS The goal of this study was thus to investigate the effect of preoperative corticosteroid/AED treatment on heme biosynthesis mRNA expression in a clinically relevant patient population. For this purpose, we analyzed the mRNA expression levels of specific heme biosynthesis factors including ALAD, HMBS, UROS, UROD, CPOX, PPOX, FECH, ABCB6, ACG2, SLC15A1 and SLC15A2, ABCB1, ABCB10 in a cohort of LGGs from "The Cancer Genome Atlas". RESULTS Altogether, 403 patients with available data on preoperative corticosteroid/AED treatment and heme biosynthesis mRNA expression were identified. Regarding corticosteroid treatment, no significant differences in expression of any of the 11 investigated heme biosynthesis factors were found. In contrast, a marginal yet statistically significant increase in SLC15A1 levels and decrease in ABCB6 levels were observed in patients with preoperative AED treatment. CONCLUSION While no significant differences in heme biosynthesis mRNA expression were observed according to preoperative corticosteroid treatment, changes in SLC15A1 as well as ABCB6 expression were detected in patients treated with AED. However, since these alterations were minor and have opposing effects on 5-ALA metabolization, our findings do not support a distinct effect of AED and corticosteroid treatment on heme biosynthesis regulation in LGGs.
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7
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Kucheryavenko AS, Chernomyrdin NV, Gavdush AA, Alekseeva AI, Nikitin PV, Dolganova IN, Karalkin PA, Khalansky AS, Spektor IE, Skorobogatiy M, Tuchin VV, Zaytsev KI. Terahertz dielectric spectroscopy and solid immersion microscopy of ex vivo glioma model 101.8: brain tissue heterogeneity. BIOMEDICAL OPTICS EXPRESS 2021; 12:5272-5289. [PMID: 34513256 PMCID: PMC8407834 DOI: 10.1364/boe.432758] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/15/2021] [Accepted: 07/22/2021] [Indexed: 05/23/2023]
Abstract
Terahertz (THz) technology holds strong potential for the intraoperative label-free diagnosis of brain gliomas, aimed at ensuring their gross-total resection. Nevertheless, it is still far from clinical applications due to the limited knowledge about the THz-wave-brain tissue interactions. In this work, rat glioma model 101.8 was studied ex vivo using both the THz pulsed spectroscopy and the 0.15λ-resolution THz solid immersion microscopy (λ is a free-space wavelength). The considered homograft model mimics glioblastoma, possesses heterogeneous character, unclear margins, and microvascularity. Using the THz spectroscopy, effective THz optical properties of brain tissues were studied, as averaged within the diffraction-limited beam spot. Thus measured THz optical properties revealed a persistent difference between intact tissues and a tumor, along with fluctuations of the tissue response over the rat brain. The observed THz microscopic images showed heterogeneous character of brain tissues at the scale posed by the THz wavelengths, which is due to the distinct response of white and gray matters, the presence of different neurovascular structures, as well as due to the necrotic debris and hemorrhage in a tumor. Such heterogeneities might significantly complicate delineation of tumor margins during the intraoperative THz neurodiagnosis. The presented results for the first time pose the problem of studying the inhomogeneity of brain tissues that causes scattering of THz waves, as well as the urgent need to use the radiation transfer theory for describing the THz-wave - tissue interactions.
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Affiliation(s)
- A S Kucheryavenko
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Russia
- Institute of Solid State Physics of the Russian Academy of Sciences, Russia
| | - N V Chernomyrdin
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Russia
- Bauman Moscow State Technical University, Russia
| | - A A Gavdush
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Russia
- Bauman Moscow State Technical University, Russia
| | | | - P V Nikitin
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Russia
- Institute for Regenerative Medicine, Sechenov University, Russia
- Burdenko Neurosurgery Institute, Russia
| | - I N Dolganova
- Institute of Solid State Physics of the Russian Academy of Sciences, Russia
- Bauman Moscow State Technical University, Russia
- Institute for Regenerative Medicine, Sechenov University, Russia
| | - P A Karalkin
- Institute for Cluster Oncology, Sechenov University, Russia
| | | | - I E Spektor
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Russia
| | - M Skorobogatiy
- Department of Engineering Physics, Polytechnique Montreal, Canada
| | - V V Tuchin
- Science Medical Center, Saratov State University, Russia
- Institute of Precision Mechanics and Control of the Russian Academy of Sciences, Russia
- National Research Tomsk State University, Russia
| | - K I Zaytsev
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Russia
- Bauman Moscow State Technical University, Russia
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8
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Hosmann A, Millesi M, Wadiura LI, Kiesel B, Mercea PA, Mischkulnig M, Borkovec M, Furtner J, Roetzer T, Wolfsberger S, Phillips JJ, Berghoff AS, Hervey-Jumper S, Berger MS, Widhalm G. 5-ALA Fluorescence Is a Powerful Prognostic Marker during Surgery of Low-Grade Gliomas (WHO Grade II)-Experience at Two Specialized Centers. Cancers (Basel) 2021; 13:cancers13112540. [PMID: 34064222 PMCID: PMC8196836 DOI: 10.3390/cancers13112540] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 12/21/2022] Open
Abstract
The prediction of the individual prognosis of low-grade glioma (LGG) patients is limited in routine clinical practice. Nowadays, 5-aminolevulinic acid (5-ALA) fluorescence is primarily applied for improved intraoperative visualization of high-grade gliomas. However, visible fluorescence is also observed in rare cases despite LGG histopathology and might be an indicator for aggressive tumor behavior. The aim of this study was thus to investigate the value of intraoperative 5-ALA fluorescence for prognosis in LGG patients. We performed a retrospective analysis of patients with newly diagnosed histopathologically confirmed LGG and preoperative 5-ALA administration at two independent specialized centers. In this cohort, we correlated the visible intraoperative fluorescence status with progression-free survival (PFS), malignant transformation-free survival (MTFS) and overall survival (OS). Altogether, visible fluorescence was detected in 7 (12%) of 59 included patients in focal intratumoral areas. At a mean follow-up time of 5.3 ± 2.9 years, patients with fluorescing LGG had significantly shorter PFS (2.3 ± 0.7 vs. 5.0 ± 0.4 years; p = 0.01), MTFS (3.9 ± 0.7 vs. 8.0 ± 0.6 years; p = 0.03), and OS (5.4 ± 1.0 vs. 10.3 ± 0.5 years; p = 0.01) than non-fluorescing tumors. Our data indicate that visible 5-ALA fluorescence during surgery of pure LGG might be an already intraoperatively available marker of unfavorable patient outcome and thus close imaging follow-up might be considered.
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Affiliation(s)
- Arthur Hosmann
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria; (A.H.); (M.M.); (L.I.W.); (B.K.); (P.A.M.); (M.M.); (M.B.); (S.W.)
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
| | - Matthias Millesi
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria; (A.H.); (M.M.); (L.I.W.); (B.K.); (P.A.M.); (M.M.); (M.B.); (S.W.)
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
| | - Lisa I. Wadiura
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria; (A.H.); (M.M.); (L.I.W.); (B.K.); (P.A.M.); (M.M.); (M.B.); (S.W.)
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
| | - Barbara Kiesel
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria; (A.H.); (M.M.); (L.I.W.); (B.K.); (P.A.M.); (M.M.); (M.B.); (S.W.)
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
| | - Petra A. Mercea
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria; (A.H.); (M.M.); (L.I.W.); (B.K.); (P.A.M.); (M.M.); (M.B.); (S.W.)
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
| | - Mario Mischkulnig
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria; (A.H.); (M.M.); (L.I.W.); (B.K.); (P.A.M.); (M.M.); (M.B.); (S.W.)
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
| | - Martin Borkovec
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria; (A.H.); (M.M.); (L.I.W.); (B.K.); (P.A.M.); (M.M.); (M.B.); (S.W.)
| | - Julia Furtner
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, 1090 Vienna, Austria;
| | - Thomas Roetzer
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria
| | - Stefan Wolfsberger
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria; (A.H.); (M.M.); (L.I.W.); (B.K.); (P.A.M.); (M.M.); (M.B.); (S.W.)
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
| | - Joanna J. Phillips
- Department of Pathology, University of California, San Francisco (UCSF), CA 94143, USA;
| | - Anna S. Berghoff
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
- Division of Oncology, Department of Medicine I, Medical University of Vienna, 1090 Vienna, Austria
| | - Shawn Hervey-Jumper
- Department of Neurological Surgery, University of California, San Francisco (UCSF), CA 94143, USA; (S.H.-J.); (M.S.B.)
| | - Mitchel S. Berger
- Department of Neurological Surgery, University of California, San Francisco (UCSF), CA 94143, USA; (S.H.-J.); (M.S.B.)
| | - Georg Widhalm
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria; (A.H.); (M.M.); (L.I.W.); (B.K.); (P.A.M.); (M.M.); (M.B.); (S.W.)
- Comprehensive Cancer Center—Central Nervous System Tumours Unit (CCC-CNS), Medical University of Vienna, 1090 Vienna, Austria; (T.R.); (A.S.B.)
- Correspondence: ; Tel.: +43-1-40400-45650
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9
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Traylor JI, Pernik MN, Sternisha AC, McBrayer SK, Abdullah KG. Molecular and Metabolic Mechanisms Underlying Selective 5-Aminolevulinic Acid-Induced Fluorescence in Gliomas. Cancers (Basel) 2021; 13:cancers13030580. [PMID: 33540759 PMCID: PMC7867275 DOI: 10.3390/cancers13030580] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/22/2021] [Accepted: 01/26/2021] [Indexed: 02/06/2023] Open
Abstract
Simple Summary 5-aminolevulinic acid (5-ALA) is a medication that produces fluorescence in certain cancers, which enables surgeons to visualize tumor margins during surgery. Gliomas are brain tumors that can be difficult to fully resect due to their infiltrative nature. In this review we explored what is known about the mechanism of 5-ALA, recent discoveries that increase our understanding of that mechanism, and potential targets to increase fluorescence in lower grade gliomas. Abstract 5-aminolevulinic acid (5-ALA) is a porphyrin precursor in the heme synthesis pathway. When supplied exogenously, certain cancers consume 5-ALA and convert it to the fluorogenic metabolite protoporphyrin IX (PpIX), causing tumor-specific tissue fluorescence. Preoperative administration of 5-ALA is used to aid neurosurgical resection of high-grade gliomas such as glioblastoma, allowing for increased extent of resection and progression free survival for these patients. A subset of gliomas, especially low-grade tumors, do not accumulate PpIX intracellularly or readily fluoresce upon 5-ALA administration, making gross total resection difficult to achieve in diffuse lesions. We review existing literature on 5-ALA metabolism and PpIX accumulation to explore potential mechanisms of 5-ALA-induced glioma tissue fluorescence. Targeting the heme synthesis pathway and understanding its dysregulation in malignant tissues could aid the development of adjunct therapies to increase intraoperative fluorescence after 5-ALA treatment.
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Affiliation(s)
- Jeffrey I. Traylor
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA; (J.I.T.); (M.N.P.)
| | - Mark N. Pernik
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA; (J.I.T.); (M.N.P.)
| | - Alex C. Sternisha
- Children’s Medical Center Research Institute, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Samuel K. McBrayer
- Children’s Medical Center Research Institute, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
- Correspondence: (S.K.M.); (K.G.A.); Tel.: +1-(214)-648-3730 (S.K.M.); +1-(214)-645-2300 (K.G.A.)
| | - Kalil G. Abdullah
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA; (J.I.T.); (M.N.P.)
- Correspondence: (S.K.M.); (K.G.A.); Tel.: +1-(214)-648-3730 (S.K.M.); +1-(214)-645-2300 (K.G.A.)
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10
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Gavdush AA, Chernomyrdin NV, Komandin GA, Dolganova IN, Nikitin PV, Musina GR, Katyba GM, Kucheryavenko AS, Reshetov IV, Potapov AA, Tuchin VV, Zaytsev KI. Terahertz dielectric spectroscopy of human brain gliomas and intact tissues ex vivo: double-Debye and double-overdamped-oscillator models of dielectric response. BIOMEDICAL OPTICS EXPRESS 2021; 12:69-83. [PMID: 33659071 PMCID: PMC7899500 DOI: 10.1364/boe.411025] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/25/2020] [Accepted: 11/30/2020] [Indexed: 05/07/2023]
Abstract
Terahertz (THz) technology offers novel opportunities in the intraoperative neurodiagnosis. Recently, the significant progress was achieved in the study of brain gliomas and intact tissues, highlighting a potential for THz technology in the intraoperative delineation of tumor margins. However, a lack of physical models describing the THz dielectric permittivity of healthy and pathological brain tissues restrains the further progress in this field. In the present work, the ex vivo THz dielectric response of human brain tissues was analyzed using relaxation models of complex dielectric permittivity. Dielectric response of tissues was parametrized by a pair of the Debye relaxators and a pair of the overdamped-oscillators - namely, the double-Debye (DD) and double-overdamped-oscillator (DO) models. Both models accurately reproduce the experimental curves for the intact tissues and the WHO Grades I-IV gliomas. While the DD model is more common for THz biophotonics, the DO model is more physically rigorous, since it satisfies the sum rule. In this way, the DO model and the sum rule were, then, applied to estimate the content of water in intact tissues and gliomas ex vivo. The observed results agreed well with the earlier-reported data, justifying water as a main endogenous label of brain tumors in the THz range. The developed models can be used to describe completely the THz-wave - human brain tissues interactions in the frameworks of classical electrodynamics, being quite important for further research and developments in THz neurodiagnosis of tumors.
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Affiliation(s)
- A A Gavdush
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia
| | - N V Chernomyrdin
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - G A Komandin
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia
| | - I N Dolganova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Institute of Solid State Physics of the Russian Academy of Sciences, Chernogolovka, Russia
| | - P V Nikitin
- P.K. Anokhin Institute of Normal Physiology, Moscow, Russia
| | - G R Musina
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia
| | - G M Katyba
- Institute of Solid State Physics of the Russian Academy of Sciences, Chernogolovka, Russia
| | - A S Kucheryavenko
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia
- Institute of Solid State Physics of the Russian Academy of Sciences, Chernogolovka, Russia
| | - I V Reshetov
- Institute for Cluster Oncology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - A A Potapov
- Burdenko Neurosurgery Institute, Moscow, Russia
| | - V V Tuchin
- Saratov State University, Saratov, Russia
- Institute of Precision Mechanics and Control of the Russian Academy of Sciences, Saratov, Russia
- National Research Tomsk State University, Tomsk, Russia
| | - K I Zaytsev
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia
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11
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Role of Bcl-2 Family Proteins in Photodynamic Therapy Mediated Cell Survival and Regulation. Molecules 2020; 25:molecules25225308. [PMID: 33203053 PMCID: PMC7696921 DOI: 10.3390/molecules25225308] [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: 10/05/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 12/20/2022] Open
Abstract
Photodynamic therapy (PDT) is a treatment modality that involves three components: combination of a photosensitizer, light and molecular oxygen that leads to localized formation of reactive oxygen species (ROS). The ROS generated from this promising therapeutic modality can be lethal to the cell and leads to consequential destruction of tumor cells. However, sometimes the ROS trigger a stress response survival mechanism that helps the cells to cope with PDT-induced damage, resulting in resistance to the treatment. One preferred mechanism of cell death induced by PDT is apoptosis, and B-cell lymphoma 2 (Bcl-2) family proteins have been described as a major determinant of life or death decision of the death pathways. Apoptosis is a cellular self-destruction mechanism to remove old cells through the biological event of tissue homeostasis. The Bcl-2 family proteins act as a critical mediator of a life–death decision of cells in maintaining tissue homeostasis. There are several reports that show cancer cells developing resistance due to the increased interaction of the pro-survival Bcl-2 family proteins. However, the key mechanisms leading to apoptosis evasion and drug resistance have not been adequately understood. Therefore, it is critical to understand the mechanisms of PDT resistance, as well as the Bcl-2 family proteins, to give more insight into the treatment outcomes. In this review, we describe the role of Bcl-2 gene family proteins’ interaction in response to disease progression and PDT-induced resistance mechanisms.
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12
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Dolganova IN, Aleksandrova PV, Nikitin PV, Alekseeva AI, Chernomyrdin NV, Musina GR, Beshplav ST, Reshetov IV, Potapov AA, Kurlov VN, Tuchin VV, Zaytsev KI. Capability of physically reasonable OCT-based differentiation between intact brain tissues, human brain gliomas of different WHO grades, and glioma model 101.8 from rats. BIOMEDICAL OPTICS EXPRESS 2020; 11:6780-6798. [PMID: 33282523 PMCID: PMC7687948 DOI: 10.1364/boe.409692] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/19/2020] [Accepted: 10/22/2020] [Indexed: 05/17/2023]
Abstract
Optical coherence tomography (OCT) of the ex vivo rat and human brain tissue samples is performed. The set of samples comprises intact white and gray matter, as well as human brain gliomas of the World Health Organization (WHO) Grades I-IV and glioma model 101.8 from rats. Analysis of OCT signals is aimed at comparing the physically reasonable properties of tissues, and determining the attenuation coefficient, parameter related to effective refractive index, and their standard deviations. Data analysis is based on the linear discriminant analysis and estimation of their dispersion in a four-dimensional principal component space. The results demonstrate the distinct contrast between intact tissues and low-grade gliomas and moderate contrast between intact tissues and high-grade gliomas. Particularly, the mean values of attenuation coefficient are 7.56±0.91, 3.96±0.98, and 5.71±1.49 mm-1 for human white matter, glioma Grade I, and glioblastoma, respectively. The significant variability of optical properties of high Grades and essential differences between rat and human brain tissues are observed. The dispersion of properties enlarges with increase of the glioma WHO Grade, which can be attributed to the growing heterogeneity of pathological brain tissues. The results of this study reveal the advantages and drawbacks of OCT for the intraoperative diagnosis of brain gliomas and compare its abilities separately for different grades of malignancy. The perspective of OCT to differentiate low-grade gliomas is highlighted by the low performance of the existing intraoperational methods and instruments.
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Affiliation(s)
- I. N. Dolganova
- Institute of Solid State Physics of the Russian Academy of Sciences, Chernogolovka 142432, Russia
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow 119991, Russia
| | - P. V. Aleksandrova
- Institute of Solid State Physics of the Russian Academy of Sciences, Chernogolovka 142432, Russia
| | - P. V. Nikitin
- Burdenko Neurosurgery Institute, Moscow 125047, Russia
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow 119991, Russia
| | - A. I. Alekseeva
- Institute of Solid State Physics of the Russian Academy of Sciences, Chernogolovka 142432, Russia
- Research Institute of Human Morphology, Moscow 117418, Russia
| | - N. V. Chernomyrdin
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow 119991, Russia
| | - G. R. Musina
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow 119991, Russia
| | - S. T. Beshplav
- Burdenko Neurosurgery Institute, Moscow 125047, Russia
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow 119991, Russia
| | - I. V. Reshetov
- Institute for Cluster Oncology, Sechenov First Moscow State Medical University (Sechenov University), Moscow 119991, Russia
- Academy of Postgraduate Education FSCC FMBA, Moscow 125310, Russia
| | - A. A. Potapov
- Burdenko Neurosurgery Institute, Moscow 125047, Russia
| | - V. N. Kurlov
- Institute of Solid State Physics of the Russian Academy of Sciences, Chernogolovka 142432, Russia
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow 119991, Russia
| | - V. V. Tuchin
- Saratov State University, Saratov 410012, Russia
- Institute of Precision Mechanics and Control of the Russian Academy of Sciences, Saratov 410028, Russia
- Tomsk State University, Tomsk 634050, Russia
| | - K. I. Zaytsev
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow 119991, Russia
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow 119991, Russia
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13
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Mapping and Quantification of Non-Coding RNA Originating from the rDNA in Human Glioma Cells. Cancers (Basel) 2020; 12:cancers12082090. [PMID: 32731436 PMCID: PMC7464196 DOI: 10.3390/cancers12082090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/24/2020] [Accepted: 07/25/2020] [Indexed: 12/14/2022] Open
Abstract
Ribosomal DNA is one of the most conserved parts of the genome, especially in its rRNA coding regions, but some puzzling pieces of its noncoding repetitive sequences harbor secrets of cell growth and development machinery. Disruptions in the neat mechanisms of rDNA orchestrating the cell functioning result in malignant conversion. In cancer cells, the organization of rRNA coding genes and their transcription somehow differ from that of normal cells, but little is known about the particular mechanism for this switch. In this study, we demonstrate that the region ~2 kb upstream of the rDNA promoter is transcriptionally active in one type of the most malignant human brain tumors, and we compare its expression rate to that of healthy human tissues and cell cultures. Sense and antisense non-coding RNA transcripts were detected and mapped, but their secondary structure and functions remain to be elucidated. We propose that the transcripts may relate to a new class of so-called promoter-associated RNAs (pRNAs), or have some other regulatory functions. We also hope that the expression of these non-coding RNAs can be used as a marker in glioma diagnostics and prognosis.
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14
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Mischkulnig M, Kiesel B, Lötsch D, Roetzer T, Borkovec M, Wadiura LI, Mercea PA, Jaklin FJ, Hervey-Jumper S, Roessler K, Berger MS, Widhalm G, Erhart F. TCGA mRNA Expression Analysis of the Heme Biosynthesis Pathway in Diffusely Infiltrating Gliomas: A Comparison of Typically 5-ALA Fluorescent and Non-Fluorescent Gliomas. Cancers (Basel) 2020; 12:cancers12082043. [PMID: 32722247 PMCID: PMC7466145 DOI: 10.3390/cancers12082043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 12/13/2022] Open
Abstract
5-Aminolevulinic acid (5-ALA) is a fluorescent dye that after metabolization to Protoporphyrin IX (PpIX) by the heme biosynthesis pathway typically leads to visible fluorescence in WHO grade IV but not grade II gliomas. The exact mechanism for high PpIX levels in WHO grade IV gliomas and low PpIX levels in WHO grade II gliomas is not fully clarified. To detect relevant changes in mRNA expression, we performed an in-silico analysis of WHO grade II and IV glioma sequencing datasets provided by The Cancer Genome Atlas (TCGA) to investigate mRNA expression levels of relevant heme biosynthesis genes: Solute Carrier Family 15 Member 1 and 2 (SLC15A1 and SLC15A2), Aminolevulinate-Dehydratase (ALAD), Hydroxymethylbilane-Synthase (HMBS), Uroporphyrinogen-III-Synthase (UROS), Uroporphyrinogen-Decarboxylase (UROD), Coproporphyrinogen-Oxidase (CPOX), Protoporphyrinogen-Oxidase (PPOX), ATP-binding Cassette Subfamily B Member 6 (ABCB6)/G Member 2 (ABCG2) and Ferrochelatase (FECH). Altogether, 258 WHO grade II and 166 WHO grade IV samples were investigated. The mRNA expression levels showed significant differences in 8 of 11 examined genes between WHO grade II and IV gliomas. Significant differences in mRNA expression included increases of HMBS, UROD, FECH and PPOX as well as decreases of SLC15A2, ALAD, UROS and ABCB6 in WHO IV gliomas. Since the majority of changes was found in directions that might actually impair PpIX accumulation in WHO grade IV gliomas, additional studies are needed to analyze the corresponding factors of the heme biosynthesis also on protein level.
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Affiliation(s)
- Mario Mischkulnig
- Department of Neurosurgery, Medical University Vienna, 1090 Vienna, Austria; (M.M.); (B.K.); (D.L.); (M.B.); (L.I.W.); (P.A.M.); (F.J.J.); (K.R.); (F.E.)
- Comprehensive Cancer Center-Central Nervous System Tumours Unit, Medical University Vienna, 1090 Vienna, Austria;
| | - Barbara Kiesel
- Department of Neurosurgery, Medical University Vienna, 1090 Vienna, Austria; (M.M.); (B.K.); (D.L.); (M.B.); (L.I.W.); (P.A.M.); (F.J.J.); (K.R.); (F.E.)
- Comprehensive Cancer Center-Central Nervous System Tumours Unit, Medical University Vienna, 1090 Vienna, Austria;
| | - Daniela Lötsch
- Department of Neurosurgery, Medical University Vienna, 1090 Vienna, Austria; (M.M.); (B.K.); (D.L.); (M.B.); (L.I.W.); (P.A.M.); (F.J.J.); (K.R.); (F.E.)
- Comprehensive Cancer Center-Central Nervous System Tumours Unit, Medical University Vienna, 1090 Vienna, Austria;
| | - Thomas Roetzer
- Comprehensive Cancer Center-Central Nervous System Tumours Unit, Medical University Vienna, 1090 Vienna, Austria;
- Department of Neurology, Division of Neuropathology and Neurochemistry, Medical University Vienna, 1090 Vienna, Austria
| | - Martin Borkovec
- Department of Neurosurgery, Medical University Vienna, 1090 Vienna, Austria; (M.M.); (B.K.); (D.L.); (M.B.); (L.I.W.); (P.A.M.); (F.J.J.); (K.R.); (F.E.)
- Department of Statistics, Ludwig-Maximilians-University, 80539 Munich, Germany
| | - Lisa I. Wadiura
- Department of Neurosurgery, Medical University Vienna, 1090 Vienna, Austria; (M.M.); (B.K.); (D.L.); (M.B.); (L.I.W.); (P.A.M.); (F.J.J.); (K.R.); (F.E.)
- Comprehensive Cancer Center-Central Nervous System Tumours Unit, Medical University Vienna, 1090 Vienna, Austria;
| | - Petra A. Mercea
- Department of Neurosurgery, Medical University Vienna, 1090 Vienna, Austria; (M.M.); (B.K.); (D.L.); (M.B.); (L.I.W.); (P.A.M.); (F.J.J.); (K.R.); (F.E.)
- Comprehensive Cancer Center-Central Nervous System Tumours Unit, Medical University Vienna, 1090 Vienna, Austria;
| | - Florian J. Jaklin
- Department of Neurosurgery, Medical University Vienna, 1090 Vienna, Austria; (M.M.); (B.K.); (D.L.); (M.B.); (L.I.W.); (P.A.M.); (F.J.J.); (K.R.); (F.E.)
| | - Shawn Hervey-Jumper
- Department of Neurological Surgery, University of California, San Francisco, CA 94143, USA; (S.H.-J.); (M.S.B.)
| | - Karl Roessler
- Department of Neurosurgery, Medical University Vienna, 1090 Vienna, Austria; (M.M.); (B.K.); (D.L.); (M.B.); (L.I.W.); (P.A.M.); (F.J.J.); (K.R.); (F.E.)
- Comprehensive Cancer Center-Central Nervous System Tumours Unit, Medical University Vienna, 1090 Vienna, Austria;
| | - Mitchel S. Berger
- Department of Neurological Surgery, University of California, San Francisco, CA 94143, USA; (S.H.-J.); (M.S.B.)
| | - Georg Widhalm
- Department of Neurosurgery, Medical University Vienna, 1090 Vienna, Austria; (M.M.); (B.K.); (D.L.); (M.B.); (L.I.W.); (P.A.M.); (F.J.J.); (K.R.); (F.E.)
- Comprehensive Cancer Center-Central Nervous System Tumours Unit, Medical University Vienna, 1090 Vienna, Austria;
- Correspondence: ; Tel.: +43-1-40400-45650
| | - Friedrich Erhart
- Department of Neurosurgery, Medical University Vienna, 1090 Vienna, Austria; (M.M.); (B.K.); (D.L.); (M.B.); (L.I.W.); (P.A.M.); (F.J.J.); (K.R.); (F.E.)
- Comprehensive Cancer Center-Central Nervous System Tumours Unit, Medical University Vienna, 1090 Vienna, Austria;
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15
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Valli D, Belykh E, Zhao X, Gandhi S, Cavallo C, Martirosyan NL, Nakaji P, Lawton MT, Preul MC. Development of a Simulation Model for Fluorescence-Guided Brain Tumor Surgery. Front Oncol 2019; 9:748. [PMID: 31475107 PMCID: PMC6706957 DOI: 10.3389/fonc.2019.00748] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 07/25/2019] [Indexed: 12/11/2022] Open
Abstract
Objective: Fluorescence dyes are increasingly used in brain tumor surgeries, and thus the development of simulation models is important for teaching neurosurgery trainees how to perform fluorescence-guided operations. We aimed to create a tumor model for fluorescence-guided surgery in high-grade glioma (HGG). Methods: The tumor model was generated by the following steps: creating a tumor gel with a similar consistency to HGG, selecting fluorophores at optimal concentrations with realistic color, mixing the fluorophores with tumor gel, injecting the gel into fresh pig/sheep brain, and testing resection of the tumor model under a fluorescence microscope. The optimal tumor gel was selected among different combinations of agar and gelatin. The fluorophores included fluorescein, indocyanine green (ICG), europium, chlorin e6 (Ce6), and protoporphyrin IX (PpIX). The tumor model was tested by neurosurgeons and neurosurgery trainees, and a survey was used to assess the validity of the model. In addition, the photobleaching phenomenon was studied to evaluate its influence on fluorescence detection. Results: The best tumor gel formula in terms of consistency and tactile response was created using 100 mL water at 100°C, 0.5 g of agar, and 3 g of gelatin mixed thoroughly for 3 min. An additional 1 g of agar was added when the tumor gel cooled to 50°C. The optimal fluorophore concentration ranges were fluorescein 1.9 × 10−4 to 3.8 × 10−4 mg/mL, ICG 4.9 × 10−3 to 9.8 × 10−3 mg/mL, europium 7.0 × 10−2 to 1.4 × 10−1 mg/mL, Ce6 2.2 × 10−3 to 4.4 × 10−3 mg/mL, and PpIX 1.8 × 10−2 to 3.5 × 10−2 mg/mL. No statistical differences among fluorophores were found for face validity, content validity, and fluorophore preference. Europium, ICG, and fluorescein were shown to be relatively stable during photobleaching experiments, while chlorin e6 and PpIX had lower stability. Conclusions: The model can efficiently highlight the “tumor” with 3 different colors—green, yellow, or infrared green with color overlay. These models showed high face and content validity, although there was no significant difference among the models regarding the degree of simulation and training effectiveness. They are useful educational tools for teaching the key concepts of intra-axial tumor resection techniques, such as subpial dissection and nuances of fluorescence-guided surgery.
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Affiliation(s)
- Daniel Valli
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
| | - Evgenii Belykh
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
| | - Xiaochun Zhao
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
| | - Sirin Gandhi
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
| | - Claudio Cavallo
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
| | | | - Peter Nakaji
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
| | - Michael T Lawton
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
| | - Mark C Preul
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
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16
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Gavdush AA, Chernomyrdin NV, Malakhov KM, Beshplav SIT, Dolganova IN, Kosyrkova AV, Nikitin PV, Musina GR, Katyba GM, Reshetov IV, Cherkasova OP, Komandin GA, Karasik VE, Potapov AA, Tuchin VV, Zaytsev KI. Terahertz spectroscopy of gelatin-embedded human brain gliomas of different grades: a road toward intraoperative THz diagnosis. JOURNAL OF BIOMEDICAL OPTICS 2019; 24:1-5. [PMID: 30729762 PMCID: PMC6988181 DOI: 10.1117/1.jbo.24.2.027001] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 01/11/2019] [Indexed: 05/18/2023]
Abstract
We applied terahertz (THz)-pulsed spectroscopy to study ex vivo the refractive index and absorption coefficient of human brain gliomas featuring different grades, as well as perifocal regions containing both intact and edematous tissues. Glioma samples from 26 patients were considered and analyzed according to further histological examination. In order to fix tissues for the THz measurements, we applied gelatin embedding, which allows for sustaining their THz response unaltered, as compared to that of the freshly excised tissues. We observed a statistical difference between the THz optical constants of intact tissues and gliomas of grades I to IV, while the response of edema was similar to that of tumor. The results of this paper justify a potential of THz technology in the intraoperative label-free diagnosis of human brain gliomas for ensuring the gross-total resection.
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Affiliation(s)
- Arseniy A. Gavdush
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia
- Bauman Moscow State Technical University, Moscow, Russia
| | - Nikita V. Chernomyrdin
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia
- Bauman Moscow State Technical University, Moscow, Russia
| | - Kirill M. Malakhov
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia
- Bauman Moscow State Technical University, Moscow, Russia
| | | | - Irina N. Dolganova
- Bauman Moscow State Technical University, Moscow, Russia
- Institute of Solid State Physics of the Russian Academy of Sciences, Chernogolovka, Russia
| | | | | | - Guzel R. Musina
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia
- Bauman Moscow State Technical University, Moscow, Russia
| | - Gleb M. Katyba
- Bauman Moscow State Technical University, Moscow, Russia
- Institute of Solid State Physics of the Russian Academy of Sciences, Chernogolovka, Russia
| | - Igor V. Reshetov
- Sechenov First Moscow State Medical University, Institute of Regenerative Medicine, Moscow, Russia
| | - Olga P. Cherkasova
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia
- Institute of Laser Physics of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - Gennady A. Komandin
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia
| | | | | | | | - Kirill I. Zaytsev
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia
- Bauman Moscow State Technical University, Moscow, Russia
- Address all correspondence to Kirill I. Zaytsev, E-mail:
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Zaytsev K, Dolganova I, Chernomyrdin N, Komandin G, Schcedrina M, Beshplav SI, Goryaynov S, Karasik V, Reshetov I, Potapov A, Tuchin V. Intraoperative diagnosis of malignant brain gliomas using terahertz pulsed spectroscopy and optical coherence tomography. EPJ WEB OF CONFERENCES 2018. [DOI: 10.1051/epjconf/201819510018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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