1
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Rios-Hoyo A, Arriola E. Immunotherapy and brain metastasis in lung cancer: connecting bench side science to the clinic. Front Immunol 2023; 14:1221097. [PMID: 37876939 PMCID: PMC10590916 DOI: 10.3389/fimmu.2023.1221097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 09/15/2023] [Indexed: 10/26/2023] Open
Abstract
Brain metastases (BMs) are the most common form of intracranial malignant neoplasms in adults, with a profound impact on quality of life and traditionally associated with a dismal prognosis. Lung cancer accounts for approximately 40%-50% of BM across different tumors. The process leading to BMs is complex and includes local invasion, intravasation, tumor cells circulation into the bloodstream, disruption of the blood-brain barrier, extravasation of tumor cells into the brain parenchyma, and interaction with cells of the brain microenvironment, among others. Once the tumor cells have seeded in the brain parenchyma, they encounter different glial cells of the brain, as well as immune cells. The interaction between these cells and tumor cells is complex and is associated with both antitumoral and protumoral effects. To overcome the lethal prognosis associated with BMs, different treatment strategies have been developed, such as immunotherapy with immune checkpoint inhibitors, particularly inhibitors of the PD-1/PD-L1 axis, which have demonstrated to be an effective treatment in both non-small cell lung cancer and small cell lung cancer. These antibodies have shown to be effective in the treatment of BM, alone or in combination with chemotherapy or radiotherapy. However, many unsolved questions remain to be answered, such as the sequencing of immunotherapy and radiotherapy, the optimal management in symptomatic BMs, the role of the addition of anti-CTLA-4 antibodies, and so forth. The complexity in the management of BMs in the era of immunotherapy requires a multidisciplinary approach to adequately treat this devastating event. The aim of this review is to summarize evidence regarding epidemiology of BM, its pathophysiology, current approach to treatment strategies, as well as future perspectives.
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Affiliation(s)
- Alejandro Rios-Hoyo
- Yale Cancer Center, Yale School of Medicine, Yale University, New Haven, CT, United States
| | - Edurne Arriola
- Department of Medical Oncology, Hospital del Mar-CIBERONC (Centro de Investigación Biomédica en Red de Oncología), Barcelona, Spain
- Cancer Research Program, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Barcelona, Spain
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2
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Anastasopoulou S, Harila-Saari A, Als-Nielsen B, Eriksson MA, Heyman M, Johannsdottir IM, Marquart HV, Niinimäki R, Pronk CJ, Schmiegelow K, Vaitkeviciene G, Thastrup M, Ranta S. Does minimal central nervous system involvement in childhood acute lymphoblastic leukemia increase the risk for central nervous system toxicity? Pediatr Blood Cancer 2022; 69:e29745. [PMID: 35488712 DOI: 10.1002/pbc.29745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/03/2022] [Accepted: 04/04/2022] [Indexed: 12/17/2022]
Abstract
Central nervous system (CNS) involvement in childhood acute lymphoblastic leukemia (ALL) implicates enhanced intrathecal chemotherapy, which is related to CNS toxicity. Whether CNS involvement alone contributes to CNS toxicity remains unclear. We studied the occurrence of all CNS toxicities, seizures, and posterior reversible encephalopathy syndrome (PRES) in children with ALL without enhanced intrathecal chemotherapy with CNS involvement (n = 64) or without CNS involvement (n = 256) by flow cytometry. CNS involvement increased the risk for all CNS toxicities, seizures, and PRES in univariate analysis and, after adjusting for induction therapy, for seizures (hazard ratio [HR] = 3.33; 95% confidence interval [CI]: 1.26-8.82; p = 0.016) and PRES (HR = 4.85; 95% CI: 1.71-13.75; p = 0.003).
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Affiliation(s)
- Stavroula Anastasopoulou
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden
| | - Arja Harila-Saari
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Bodil Als-Nielsen
- Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Mats Anders Eriksson
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Neuropediatric Unit, Karolinska Institutet, Stockholm, Sweden
| | - Mats Heyman
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden
| | | | - Hanne Vibeke Marquart
- Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Riitta Niinimäki
- Department of Children and Adolescents, Oulu University Hospital and University of Oulu, PEDEGO Research Unit, Oulu, Finland
| | | | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Goda Vaitkeviciene
- Children's Hospital, Affiliate of Vilnius University Hospital Santaros Klinikos and Vilnius University, Vilnius, Lithuania
| | - Maria Thastrup
- Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Susanna Ranta
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden
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3
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Rathi S, Griffith JI, Zhang W, Zhang W, Oh JH, Talele S, Sarkaria JN, Elmquist WF. The influence of the blood-brain barrier in the treatment of brain tumours. J Intern Med 2022; 292:3-30. [PMID: 35040235 DOI: 10.1111/joim.13440] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Brain tumours have a poor prognosis and lack effective treatments. The blood-brain barrier (BBB) represents a major hurdle to drug delivery to brain tumours. In some locations in the tumour, the BBB may be disrupted to form the blood-brain tumour barrier (BBTB). This leaky BBTB enables diagnosis of brain tumours by contrast enhanced magnetic resonance imaging; however, this disruption is heterogeneous throughout the tumour. Thus, relying on the disrupted BBTB for achieving effective drug concentrations in brain tumours has met with little clinical success. Because of this, it would be beneficial to design drugs and drug delivery strategies to overcome the 'normal' BBB to effectively treat the brain tumours. In this review, we discuss the role of BBB/BBTB in brain tumour diagnosis and treatment highlighting the heterogeneity of the BBTB. We also discuss various strategies to improve drug delivery across the BBB/BBTB to treat both primary and metastatic brain tumours. Recognizing that the BBB represents a critical determinant of drug efficacy in central nervous system tumours will allow a more rapid translation from basic science to clinical application. A more complete understanding of the factors, such as BBB-limited drug delivery, that have hindered progress in treating both primary and metastatic brain tumours, is necessary to develop more effective therapies.
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Affiliation(s)
- Sneha Rathi
- Department of Pharmaceutics, University of Minnesota, Minneapolis, MN, USA
| | - Jessica I Griffith
- Department of Pharmaceutics, University of Minnesota, Minneapolis, MN, USA
| | - Wenjuan Zhang
- Department of Pharmaceutics, University of Minnesota, Minneapolis, MN, USA
| | - Wenqiu Zhang
- Department of Pharmaceutics, University of Minnesota, Minneapolis, MN, USA
| | - Ju-Hee Oh
- Department of Pharmaceutics, University of Minnesota, Minneapolis, MN, USA
| | - Surabhi Talele
- Department of Pharmaceutics, University of Minnesota, Minneapolis, MN, USA
| | - Jann N Sarkaria
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - William F Elmquist
- Department of Pharmaceutics, University of Minnesota, Minneapolis, MN, USA
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4
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Srinivasan ES, Deshpande K, Neman J, Winkler F, Khasraw M. The microenvironment of brain metastases from solid tumors. Neurooncol Adv 2021; 3:v121-v132. [PMID: 34859239 PMCID: PMC8633769 DOI: 10.1093/noajnl/vdab121] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Brain metastasis (BrM) is an area of unmet medical need that poses unique therapeutic challenges and heralds a dismal prognosis. The intracranial tumor microenvironment (TME) presents several challenges, including the therapy-resistant blood-brain barrier, a unique immune milieu, distinct intercellular interactions, and specific metabolic conditions, that are responsible for treatment failures and poor clinical outcomes. There is a complex interplay between malignant cells that metastasize to the central nervous system (CNS) and the native TME. Cancer cells take advantage of vascular, neuronal, immune, and anatomical vulnerabilities to proliferate with mechanisms specific to the CNS. In this review, we discuss unique aspects of the TME in the context of brain metastases and pathways through which the TME may hold the key to the discovery of new and effective therapies for patients with BrM.
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Affiliation(s)
- Ethan S Srinivasan
- Duke Brain and Spine Metastases Center, Duke University, Durham, North Carolina, USA
| | - Krutika Deshpande
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Josh Neman
- Department of Neurological Surgery, Physiology and Neuroscience, USC Brain Tumor Center, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Frank Winkler
- Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neurooncology, German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany
| | - Mustafa Khasraw
- Duke Brain and Spine Metastases Center, Duke University, Durham, North Carolina, USA
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5
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Mucke HAM. Drug Repurposing Patent Applications July-September 2020. Assay Drug Dev Technol 2021; 19:204-208. [PMID: 33606552 DOI: 10.1089/adt.2020.1072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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6
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Salehi P, Tafvizi F, Kamyab Hesari K. Low Expression of Occludin in the Melanoma Patient. IRANIAN JOURNAL OF PATHOLOGY 2019; 14:272-278. [PMID: 31754355 PMCID: PMC6824771 DOI: 10.30699/ijp.2019.85213.1801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 01/12/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND & OBJECTIVE Malignant melanoma is the fatal cutaneous neoplasm which is curable by the early diagnosis. The expression of occludin protein which is an integral membrane protein is altered in an epithelial-to-mesenchymal transition. Although, recent studies provide sufficient evidence supporting the functional importance of occludin in cancer, the prognostic significance of occludin expression levels in melanoma remains obscure. The aim of this study was to determine occludin expression level and its correlation with clinicopathological features of the patients with melanoma. METHODS The occludin mRNA level was compared between paraffin-embedded tissues of 40 patients with melanoma and 10 subjects with normal skin. The quality and quantity of the RNA was determined and occludin expression level was measured using Real-time PCR and ∆∆CT computational technique. RESULTS The occludin mRNA level reduced five-fold in the melanoma patients compared to the control group (P=0.000). No significant difference was observed between male and female cases (P=0.533). No significant correlation was observed between occludin mRNA level, mitotic count (P=0.252), and Breslow levels (P=0.171). CONCLUSION We can conclude that down-regulation of occludin expression in the patients with melanoma is a hallmark of cancer progression and it might be used as a prognostic factor. No significant correlation was found between occludin gene expression and clinicopathological characteristics including Clark level, Breslow staging, mitotic count, age and gender (P<0.05).
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Affiliation(s)
- Pouri Salehi
- Department of Biology, Parand Branch, Islamic Azad University, Parand, Iran
| | - Farzaneh Tafvizi
- Department of Biology, Parand Branch, Islamic Azad University, Parand, Iran
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7
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Morita-Takemura S, Wanaka A. Blood-to-brain communication in the hypothalamus for energy intake regulation. Neurochem Int 2019; 128:135-142. [DOI: 10.1016/j.neuint.2019.04.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 04/08/2019] [Accepted: 04/11/2019] [Indexed: 01/03/2023]
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8
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Wen L, Tan Y, Dai S, Zhu Y, Meng T, Yang X, Liu Y, Liu X, Yuan H, Hu F. VEGF-mediated tight junctions pathological fenestration enhances doxorubicin-loaded glycolipid-like nanoparticles traversing BBB for glioblastoma-targeting therapy. Drug Deliv 2017; 24:1843-1855. [PMID: 29182025 PMCID: PMC8241127 DOI: 10.1080/10717544.2017.1386731] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 09/25/2017] [Accepted: 09/27/2017] [Indexed: 01/03/2023] Open
Abstract
The existence of blood-brain barrier (BBB) greatly hindered the penetration and accumulation of chemotherapeutics into glioblastoma (GBM), accompany with poor therapeutic effects. The growth of GBM supervene the impairment of tight junctions (TJs); however, the pathogenesis of BBB breakdown in GBM is essentially poorly understood. This study found that vascular endothelial growth factor (VEGF) secreted by GBM cells plays an important role in increasing the permeability of BBB by disrupting endothelial tight junction proteins claudin-5 and thus gave doxorubicin (DOX)-loaded glycolipid-like nanoparticles (Ap-CSSA/DOX), an effective entrance to brain tumor region for GBM-targeting therapy. In addition, VEGF downregulates the expression of claudin-5 with a dose-dependent mode, and interfering with the VEGF/VEGFR pathway using its inhibitor axitinib could reduce the permeability of BBB and enhance the integrity of the barrier. Ap-CSSA/DOX nanoparticles showed high affinity to expressed low-density lipoprotein receptor-related proteins 1 (LRP1) in both BBB and GBM. And BBB pathological fenestration in GBM further exposed more LRP1 binding sites for Ap-CSSA/DOX nanoparticles targeting to brain tumor, resulting in a higher transmembrane transport ratio in vitro and a stronger brain tumor biodistribution in vivo, and finally realizing a considerable antitumor effect. Overall, taking advantage of BBB pathological features to design an appropriate nanodrug delivery system (NDDS) might provide new insights into other central nervous system (CNS) diseases treatment.
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Affiliation(s)
- Lijuan Wen
- College of Pharmaceutical Science, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China
| | - Yanan Tan
- Ocean College, Zhejiang University, Zhoushan, Zhejiang, People’s Republic of China
| | - Suhuan Dai
- College of Pharmaceutical Science, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China
| | - Yun Zhu
- Ocean College, Zhejiang University, Zhoushan, Zhejiang, People’s Republic of China
| | - Tingting Meng
- College of Pharmaceutical Science, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China
| | - Xiqin Yang
- College of Pharmaceutical Science, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China
| | - Yupeng Liu
- College of Pharmaceutical Science, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China
| | - Xuan Liu
- College of Pharmaceutical Science, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China
| | - Hong Yuan
- College of Pharmaceutical Science, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China
| | - Fuqiang Hu
- College of Pharmaceutical Science, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China
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9
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Sengul EA, Artunay O, Kumral ET, Yenerel M, Rasier R, Kockar A, Yuzbasioglu E. Retinal Nerve Fiber Layer Thickness Changes in Age-Related Macular Degeneration Treated with Multiple Intravitreal Ranibizumab. J Ocul Pharmacol Ther 2016; 32:665-670. [PMID: 27860530 DOI: 10.1089/jop.2016.0014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE The objective of this study was to investigate the effect of multiple intravitreal ranibizumab (IVR) injections on the retinal nerve fiber layer (RNFL) in neovascular age-related macular degeneration (nAMD). METHODS One hundred sixty-eight eyes of 168 patients with nAMD who received an IVR at least 3 times were included in this prospective interventional case series. The RNFL thickness data on 80 healthy eyes, used as the control group, were obtained. The patients were grouped as follows: 3-10 injections (group 1, 62 eyes, 37%), 10-20 injections (group 2, 62 eyes, 37%), and ≥20 injections (group 3, 44 eyes, 26%). The RNFL thickness was measured by spectral domain optical coherence tomography. RESULTS The mean baseline measurement of the RNFL thickness was 97.4 ± 6.4 μm in the control group, 96.4 ± 5.6 μm in group 1, 93.8 ± 4.6 μm in group 2, and 93.2 ± 5.3 μm in group 3. At the last follow-up, it was 95.1 ± 2.4 μm in the control group, 93.4 ± 7.3 μm in group 1, 90.5 ± 3.6 μm in group 2, and 89.2 ± 4.9 μm in group 3 (all P values >0.050). A statistically significant difference was not found between the mean total RNFL thickness of the eyes that received injections and that of the eyes in the healthy control group (P value >0.050). A statistically significant difference was not found in all the treatment groups between the intraocular pressure level taken 1 day after the administration of the injections and that recorded preintervention (all P values >0.050). CONCLUSION Repeated IVR did not lead to a significant change in RNFL thickness in patients with nAMD.
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Affiliation(s)
- Elvan Alper Sengul
- 1 Ophthalmology Department, Medical Faculty, T.C. Istanbul Bilim University , Istanbul, Turkey
| | - Ozgur Artunay
- 2 Ophthalmology Department, Istanbul Medicine Hospital , Istanbul, Turkey
| | - Esra Turkseven Kumral
- 3 Ophthalmology Department, Haydarpasa Numune Training and Research Hospital , Istanbul, Turkey
| | - Melda Yenerel
- 3 Ophthalmology Department, Haydarpasa Numune Training and Research Hospital , Istanbul, Turkey
| | - Rifat Rasier
- 1 Ophthalmology Department, Medical Faculty, T.C. Istanbul Bilim University , Istanbul, Turkey
| | - Alev Kockar
- 1 Ophthalmology Department, Medical Faculty, T.C. Istanbul Bilim University , Istanbul, Turkey
| | - Erdal Yuzbasioglu
- 1 Ophthalmology Department, Medical Faculty, T.C. Istanbul Bilim University , Istanbul, Turkey
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10
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Demaree CJ, Soliz JM, Gebhardt R. Cancer Seeding Risk from an Epidural Blood Patch in Patients with Leukemia or Lymphoma. PAIN MEDICINE 2016; 18:786-790. [DOI: 10.1093/pm/pnw218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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11
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Reusch U, Duell J, Ellwanger K, Herbrecht C, Knackmuss SH, Fucek I, Eser M, McAleese F, Molkenthin V, Gall FL, Topp M, Little M, Zhukovsky EA. A tetravalent bispecific TandAb (CD19/CD3), AFM11, efficiently recruits T cells for the potent lysis of CD19(+) tumor cells. MAbs 2016; 7:584-604. [PMID: 25875246 DOI: 10.1080/19420862.2015.1029216] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
To harness the potent tumor-killing capacity of T cells for the treatment of CD19(+) malignancies, we constructed AFM11, a humanized tetravalent bispecific CD19/CD3 tandem diabody (TandAb) consisting solely of Fv domains. The molecule exhibits good manufacturability and stability properties. AFM11 has 2 binding sites for CD3 and 2 for CD19, an antigen that is expressed from early B cell development through differentiation into plasma cells, and is an attractive alternative to CD20 as a target for the development of therapeutic antibodies to treat B cell malignancies. Comparison of the binding and cytotoxicity of AFM11 with those of a tandem scFv bispecific T cell engager (BiTE) molecule targeting the same antigens revealed that AFM11 elicited more potent in vitro B cell lysis. Though possessing high affinity to CD3, the TandAb mediates serial-killing of CD19(+) cells with little dependence of potency or efficacy upon effector:target ratio, unlike the BiTE. The advantage of the TandAb over the BiTE was most pronounced at lower effector:target ratios. AFM11 mediated strictly target-dependent T cell activation evidenced by CD25 and CD69 induction, proliferation, and cytokine release, notwithstanding bivalent CD3 engagement. In a NOD/scid xenograft model, AFM11 induced dose-dependent growth inhibition of Raji tumors in vivo, and radiolabeled TandAb exhibited excellent localization to tumor but not to normal tissue. After intravenous administration in mice, half-life ranged from 18.4 to 22.9 h. In a human ex vivo B-cell chronic lymphocytic leukemia study, AFM11 exhibited substantial cytotoxic activity in an autologous setting. Thus, AFM11 may represent a promising therapeutic for treatment of CD19(+) malignancies with an advantageous safety risk profile and anticipated dosing regimen.
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Key Words
- ALL
- AUCtot, total area under the curve
- B-ALL, B-precursor acute lymphoblastic leukemia
- BBB, blood-brain barrier
- BiTE, bispecific T cell engager
- CAR, chimeric antigen receptor
- CCS, cell culture supernatant
- CD, cluster of differentiation
- CD3
- CDR, complementarity determining region
- CHO, Chinese hamster ovary
- CL, clearance
- CLL, chronic lymphocytic leukemia
- CNS, central nervous system
- Cmax, maximal concentration
- DMSO, dimethyl sulfoxide
- E:T, effector:target
- EC50, half maximal effective concentration
- ECL, electrochemiluminescence
- F, fluorescence
- FACS, fluorescence-activated cell sorting
- FCS, fetal calf serum
- FR, framework region
- Fab, fragment antigen-binding
- Fc, fragment crystallizable
- FcRn, neonatal Fc receptor
- FcgR, Fc gamma receptor
- Fv, variable fragment
- HMF, high molecular weight forms
- HSA, human serum albumin
- His, histidine
- IFN, interferon
- IL, interleukin
- IgG, immunoglobulin G
- KD, dissociation constant
- LMF, low molecular weight forms
- MSD, MesoScale Discovery
- MWCO, molecular weight cut-off
- NHL, non-Hodgkin lymphoma
- NK, natural killer
- NOD/scid, nonobese diabetic/severe combined immunodeficiency
- Non-Hodgkin lymphoma
- ORR, overall response rate
- PBMC, peripheral blood mononuclear cell
- PBS, phosphate buffered saline
- PES, polyethersulfone
- PHA, phytohemagglutinin
- PI, propidium iodide
- SABC, standardized antibody binding capacity
- SD, standard deviation
- SDS-PAGE, sodium dodecyl sulfate polyacrylamide gel electrophoresis
- SE-HPLC, size exclusion high-pressure liquid chromatography
- SEC, size exclusion chromatography
- SPR, surface plasmon resonance
- T cells
- TNF, tumor necrosis factor
- TandAb, tandem diabody
- VH, variable heavy
- VL, variable light
- Vss, volume of distribution at steady state
- WBA, whole body autoradiography
- bispecific antibodies
- ctrl., control
- i.v., intravenous
- ka, association rate constant
- kd, dissociation rate constant
- s.c., subcutaneous
- scFv, single-chain variable fragment
- t1/2, terminal elimination half-life
- w/o, without
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Affiliation(s)
- Uwe Reusch
- a Affimed Therapeutics AG ; Heidelberg , Germany
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12
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Zhao F, Deng J, Yu X, Li D, Shi H, Zhao Y. Protective effects of vascular endothelial growth factor in cultured brain endothelial cells against hypoglycemia. Metab Brain Dis 2015; 30:999-1007. [PMID: 25761767 PMCID: PMC4491374 DOI: 10.1007/s11011-015-9659-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 02/16/2015] [Indexed: 12/21/2022]
Abstract
Hypoglycemia is a common and serious problem among patients with type 1 diabetes receiving treatment with insulin. Clinical studies have demonstrated that hypoglycemic edema is involved in the initiation of hypoglycemic brain damage. However, the mechanisms of this edema are poorly understood. Vascular endothelial growth factor (VEGF), a potent regulator of blood vessel function, has been observed an important candidate hormone induced by hypoglycemia to protect neurons by restoring plasma glucose. Whether VEGF has a protective effect against hypoglycemia-induced damage in brain endothelial cells is still unknown. To investigate the effects of hypoglycemia on cerebral microvascular endothelial cells and assess the protective effect of exogenous VEGF on endothelial cells during hypoglycemia, confluent monolayers of the brain endothelial cell line bEnd.3 were treated with normal (5.5 mM glucose), hypoglycemic (0, 0.5, 1 mM glucose) medium or hypoglycemic medium in the presence of VEGF. The results clearly showed that hypoglycemia significantly downregulated the expression of claudin-5 in bEnd.3 cells, without affecting ZO-1 and occludin expression and distribution. Besides, transendothelial permeability significantly increased under hypoglycemic conditions compared to that under control conditions. Moreover, the hypoglycemic medium in presence of VEGF decreased endothelial permeability via the inhibition of claudin-5 degradation and improved hypoglycemia-induced cell toxicity. Furthermore, Glucose transporter-1 (Glut-1) and apoptosis regulator Bcl-2 expression were significantly upregulated. Taken together, hypoglycemia can significantly increase paraendocellular permeability by downregulating claudin-5 expression. We further showed that VEGF protected brain endothelial cells against hypoglycemia by enhancing glucose passage, reducing endothelial cell death, and ameliorating paraendocellular permeability.
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Affiliation(s)
- Fei Zhao
- Neurologic Department, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, No.600, Yishan Road, Xuhui District, Shanghai, 200233 China
| | - Jiangshan Deng
- Neurologic Department, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, No.600, Yishan Road, Xuhui District, Shanghai, 200233 China
| | - Xiaoyan Yu
- Neurologic Department, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, No.600, Yishan Road, Xuhui District, Shanghai, 200233 China
| | - Dawei Li
- School of Pharmacy, Shanghai Jiao Tong University, No.800, Dongchuan Road, Minhang District, Shanghai, 200240 China
| | - Hong Shi
- Neurologic Department, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, No.600, Yishan Road, Xuhui District, Shanghai, 200233 China
| | - Yuwu Zhao
- Neurologic Department, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, No.600, Yishan Road, Xuhui District, Shanghai, 200233 China
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13
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Jiang M, Qin C, Han M. Primary breast cancer induces pulmonary vascular hyperpermeability and promotes metastasis via the VEGF-PKC pathway. Mol Carcinog 2015; 55:1087-95. [PMID: 26152457 DOI: 10.1002/mc.22352] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 05/20/2015] [Accepted: 05/28/2015] [Indexed: 01/22/2023]
Abstract
The lung is one of the most frequent target organs for breast cancer metastasis. When breast cancer cells from a primary tumor do not colonize the lung, which we named the premetastatic phase, the microenvironment of the lung has already been influenced by the primary tumor. However, little is known about the exact premetastatic alteration and regulatory mechanisms of the lung. Here, we used 4T1 cells (a mouse breast cancer cell line which can specifically metastasize to the lung) to build a mouse breast cancer model. We found that primary breast tumor induced increased pulmonary vascular permeability in the premetastatic phase, which facilitated the leakage of rhodamine-dextran and the extravasation of intravenous therapy injected cancer cells. Furthermore, tight junctions (TJs) were disrupted, and the expression of zonula occludens-1(ZO-1), one of the most important components of tight junctions, was decreased in the premetastatic lung. In addition, elevated serum vascular endothelial growth factor (VEGF) was involved in the destabilization of tight junctions and the VEGF antagonist bevacizumab reversed the primary tumor-induced vascular hyperpermeability. Moreover, activation of the protein kinase C (PKC) pathway disrupted the integrity of TJs and accordingly, the disruption could be alleviated by blocking VEGF. Taken together, these data demonstrate that primary breast cancer may induce tight junction disruptions in the premetastatic lung via the VEGF-PKC pathway and promote pulmonary vascular hyperpermeability before metastasis. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Man Jiang
- Cancer Therapy and Research Center, Shandong Provincial Hospital, Shandong University, Jinan, PR China
| | - Chengyong Qin
- Cancer Therapy and Research Center, Shandong Provincial Hospital, Shandong University, Jinan, PR China
| | - Mingyong Han
- Cancer Therapy and Research Center, Shandong Provincial Hospital, Shandong University, Jinan, PR China
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Wu K, Fukuda K, Xing F, Zhang Y, Sharma S, Liu Y, Chan MD, Zhou X, Qasem SA, Pochampally R, Mo YY, Watabe K. Roles of the cyclooxygenase 2 matrix metalloproteinase 1 pathway in brain metastasis of breast cancer. J Biol Chem 2015; 290:9842-54. [PMID: 25691572 DOI: 10.1074/jbc.m114.602185] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Indexed: 01/19/2023] Open
Abstract
Brain is one of the major sites of metastasis in breast cancer; however, the pathological mechanism of brain metastasis is poorly understood. One of the critical rate-limiting steps of brain metastasis is the breaching of blood-brain barrier, which acts as a selective interface between the circulation and the central nervous system, and this process is considered to involve tumor-secreted proteinases. We analyzed clinical significance of 21 matrix metalloproteinases on brain metastasis-free survival of breast cancer followed by verification in brain metastatic cell lines and found that only matrix metalloproteinase 1 (MMP1) is significantly correlated with brain metastasis. We have shown that MMP1 is highly expressed in brain metastatic cells and is capable of degrading Claudin and Occludin but not Zo-1, which are key components of blood-brain barrier. Knockdown of MMP1 in brain metastatic cells significantly suppressed their ability of brain metastasis in vivo, whereas ectopic expression of MMP1 significantly increased the brain metastatic ability of the cells that are not brain metastatic. We also found that COX2 was highly up-regulated in brain metastatic cells and that COX2-induced prostaglandins were directly able to promote the expression of MMP1 followed by augmenting brain metastasis. Furthermore, we found that COX2 and prostaglandin were able to activate astrocytes to release chemokine (C-C motif) ligand 7 (CCL7), which in turn promoted self-renewal of tumor-initiating cells in the brain and that knockdown of COX2 significantly reduced the brain metastatic ability of tumor cells. Our results suggest the COX2-MMP1/CCL7 axis as a novel therapeutic target for brain metastasis.
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Affiliation(s)
- Kerui Wu
- From the Department of Cancer Biology, Wake Forest University School of Medicine, Winston Salem, North Carolina 27157
| | - Koji Fukuda
- Cancer Research Institute, Kanazawa University, Kanazawa 920-0934, Japan
| | - Fei Xing
- From the Department of Cancer Biology, Wake Forest University School of Medicine, Winston Salem, North Carolina 27157
| | - Yingyu Zhang
- Cancer Institute, University of Mississippi Medical Center, Jackson, Mississippi 39216, and
| | - Sambad Sharma
- From the Department of Cancer Biology, Wake Forest University School of Medicine, Winston Salem, North Carolina 27157
| | - Yin Liu
- From the Department of Cancer Biology, Wake Forest University School of Medicine, Winston Salem, North Carolina 27157
| | - Michael D Chan
- From the Department of Cancer Biology, Wake Forest University School of Medicine, Winston Salem, North Carolina 27157
| | - Xiaobo Zhou
- From the Department of Cancer Biology, Wake Forest University School of Medicine, Winston Salem, North Carolina 27157
| | - Shadi A Qasem
- From the Department of Cancer Biology, Wake Forest University School of Medicine, Winston Salem, North Carolina 27157
| | - Radhika Pochampally
- Cancer Institute, University of Mississippi Medical Center, Jackson, Mississippi 39216, and
| | - Yin-Yuan Mo
- Cancer Institute, University of Mississippi Medical Center, Jackson, Mississippi 39216, and
| | - Kounosuke Watabe
- From the Department of Cancer Biology, Wake Forest University School of Medicine, Winston Salem, North Carolina 27157,
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15
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Shenoy AK, Lu J. Cancer cells remodel themselves and vasculature to overcome the endothelial barrier. Cancer Lett 2014; 380:534-544. [PMID: 25449784 DOI: 10.1016/j.canlet.2014.10.031] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 10/27/2014] [Accepted: 10/28/2014] [Indexed: 12/19/2022]
Abstract
Metastasis refers to the spread of cancer cells from a primary tumor to distant organs mostly via the bloodstream. During the metastatic process, cancer cells invade blood vessels to enter circulation, and later exit the vasculature at a distant site. Endothelial cells that line blood vessels normally serve as a barrier to the movement of cells into or out of the blood. It is thus critical to understand how metastatic cancer cells overcome the endothelial barrier. Epithelial cancer cells acquire increased motility and invasiveness through epithelial-to-mesenchymal transition (EMT), which enables them to move toward vasculature. Cancer cells also express a variety of adhesion molecules that allow them to attach to vascular endothelium. Finally, cancer cells secrete or induce growth factors and cytokines to actively prompt vascular hyperpermeability that compromises endothelial barrier function and facilitates transmigration of cancer cells through the vascular wall. Elucidation of the mechanisms underlying metastatic dissemination may help develop new anti-metastasis therapeutics.
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Affiliation(s)
- Anitha K Shenoy
- Department of Biochemistry and Molecular Biology, University of Florida College of Medicine, Gainesville, FL 32610, United States.
| | - Jianrong Lu
- Department of Biochemistry and Molecular Biology, University of Florida College of Medicine, Gainesville, FL 32610, United States.
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16
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Basu SK, Remick SC, Monga M, Gibson LF. Breaking and entering into the CNS: clues from solid tumor and nonmalignant models with relevance to hematopoietic malignancies. Clin Exp Metastasis 2013; 31:257-67. [PMID: 24306183 DOI: 10.1007/s10585-013-9623-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 11/01/2013] [Indexed: 12/16/2022]
Abstract
Various malignancies invade the CNS sanctuary site, accounting for the vast majority of CNS neoplastic foci and contributing to significant morbidity as well as mortality. The blood-brain barrier (BBB) exhibits considerable impermeability to chemotherapeutic agents, severely limiting therapeutic options available for patients developing metastatic CNS involvement, accounting for poor outcomes. The mechanisms by which malignant cells breach the highly exclusive BBB and subsequently survive in this unique anatomical site remain poorly understood, with most of the current knowledge stemming from nonmalignant and solid malignancy models. While solid and hematologic malignancies may face different challenges once within the CNS (e.g., solid tumor parenchymal metastasis compared to masses/nodules/leptomeningeal disease in hematologic malignancies), commonality exists in the process of migrating across the BBB from the circulation. Specifically considering this last point, this review aims to survey the current mechanistic knowledge regarding malignant migration across the BBB, necessarily emphasizing the better studied solid tumor and nonmalignant models with the intention of highlighting both the current knowledge gap and additional work required to effectively consider how hematopoietic malignancies breach the CNS.
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Affiliation(s)
- Soumit K Basu
- Alexander B. Osborn Hematopoietic Malignancy and Transplantation Program, Mary Babb Randolph Cancer Center, West Virginia University School of Medicine, Morgantown, WV, USA,
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17
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García-Román J, Zentella-Dehesa A. Vascular permeability changes involved in tumor metastasis. Cancer Lett 2013; 335:259-69. [DOI: 10.1016/j.canlet.2013.03.005] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Revised: 03/05/2013] [Accepted: 03/06/2013] [Indexed: 12/12/2022]
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18
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Yashin AI, Wu D, Arbeev KG, Kulminski AM, Stallard E, Ukraintseva SV. Why does melanoma metastasize into the brain? Genes with pleiotropic effects might be the key. Front Genet 2013; 4:75. [PMID: 23641255 PMCID: PMC3640189 DOI: 10.3389/fgene.2013.00075] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 04/15/2013] [Indexed: 12/26/2022] Open
Affiliation(s)
- Anatoliy I Yashin
- Center for Population Health and Aging, Social Science Research Institute, Duke University Durham, NC, USA
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19
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Das T, Bhattacharya S, Biswas A, Gupta SD, Gomes A, Gomes A. Inhibition of leukemic U937 cell growth by induction of apoptosis, cell cycle arrest and suppression of VEGF, MMP-2 and MMP-9 activities by cytotoxin protein NN-32 purified from Indian spectacled cobra (Naja naja) venom. Toxicon 2013; 65:1-4. [DOI: 10.1016/j.toxicon.2013.01.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 01/03/2013] [Accepted: 01/08/2013] [Indexed: 11/27/2022]
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20
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Tang YT, Jiang F, Guo L, Si MY, Jiao XY. Expression and significance of vascular endothelial growth factor A and C in leukemia central nervous system metastasis. Leuk Res 2013; 37:359-66. [PMID: 23137522 DOI: 10.1016/j.leukres.2012.10.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 10/03/2012] [Accepted: 10/12/2012] [Indexed: 02/05/2023]
Abstract
Metastasis to the central nervous system (CNS) is an obstacle for leukemia treatment, the mechanisms of which remain to be elucidated. VEGF-A and VEGF-C are suspected to participate in this process. Paired of cerebrospinal fluid (CSF) and serum samples were collected from leukemia and control cases. Levels of VEGF-A and VEGF-C in both CSF (VEGF-ACSF, VEGF-CCSF) and serum (VEGF-ASerum, VEGF-CSerum) were detected by ELISA. Our data show that higher levels of VEGF-ACSF are closely related to CNS leukemia (CNSL), and VEGF-ACSF may be a better predictor than the other risk factors elucidating the pathogenesis and development of CNSL.
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Affiliation(s)
- Yue-Ting Tang
- Department of Hematology Laboratory, First Affiliated Hospital of Shantou University Medical College, Guangdong, China
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21
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Hamilton A, Sibson NR. Role of the systemic immune system in brain metastasis. Mol Cell Neurosci 2013; 53:42-51. [PMID: 23073146 DOI: 10.1016/j.mcn.2012.10.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Revised: 09/24/2012] [Accepted: 10/04/2012] [Indexed: 10/27/2022] Open
Abstract
Metastatic disease in the central nervous system (CNS) is a cause of increasing mortality amongst cancer patients. As with other types of cancer, cells of the systemic immune system play a range of important roles in the development of metastatic lesions in the CNS, both repressing and promoting tumour growth. Recent advances in immunotherapy have changed the emphasis in cancer treatment away from conventional chemotherapy and radiotherapy for certain tumour types. Despite this, our understanding of systemic immune system involvement in CNS metastases remains poor. The blood-brain barrier prevents the majority of diagnostic and therapeutic agents from crossing into the brain parenchyma until the late stages of metastatic disease. Thus, the development of immunotherapy for CNS pathologies is particularly desirable. This review draws together our current understanding in the relationships between CNS metastases and circulating systemic immune cells. We discuss the roles that circulating systemic immune cells may play in the homing of metastatic cells to the perivascular space, and the pro-metastatic and antagonistic roles that infiltrating systemic immune cells may play at sites of metastasis. This article is part of a Special Issue entitled 'Neuroinflammation in neurodegeneration and neurodysfunction'.
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Affiliation(s)
- Alastair Hamilton
- CR-UK/MRC Gray Institute for Radiation Oncology and Biology, Department of Oncology, University of Oxford, Oxford, UK
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22
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Abstract
Acute myeloid leukemia and acute lymphoblastic leukemia remain devastating diseases. Only approximately 40% of younger and 10% of older adults are long-term survivors. Although curing the leukemia is always the most formidable challenge, complications from the disease itself and its treatment are associated with significant morbidity and mortality. Such complications, discussed herein, include tumor lysis, hyperleukocytosis, cytarabine-induced cellebellar toxicity, acute promyelocytic leukemia differentiation syndrome, thrombohemorrhagic syndrome in acute promyelocytic leukemia, L-asparaginase-associated thrombosis, leukemic meningitis, neutropenic fever, neutropenic enterocolitis, and transfussion-associated GVHD. Whereas clinical trials form the backbone for the management of acute leukemia, emergent clinical situations, predictable or not, are common and do not readily lend themselves to clinical trial evaluation. Furthermore, practice guidelines are often lacking. Not only are prospective trials impractical because of the emergent nature of the issue at hand, but clinicians are often reluctant to randomize such patients. Extensive practical experience is crucial and, even if there is no consensus, management of such emergencies should be guided by an understanding of the underlying pathophysiologic mechanisms.
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23
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Johansson B. Opacification of anterior part of hydrophilic acrylic IOL or a prelenticular inflammatory membrane? J Cataract Refract Surg 2012; 38:1115-6; author reply 1116. [PMID: 22624928 DOI: 10.1016/j.jcrs.2012.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2012] [Indexed: 10/28/2022]
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