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Sarmiento JVM, Casis RM, Opinaldo PVA. Understanding the Brain-Heart Connection Through a Case of Angry Glioma Syndrome. Brain Tumor Res Treat 2024; 12:121-124. [PMID: 38742261 PMCID: PMC11096629 DOI: 10.14791/btrt.2024.0004] [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: 01/22/2024] [Revised: 03/28/2024] [Accepted: 04/05/2024] [Indexed: 05/16/2024] Open
Abstract
We discuss a patient with a tumor on the anterior corpus callosum who underwent open biopsy eventually succumbing to cerebrogenic fatal arrhythmia following wounded glioma syndrome. A healthy 37-year-old female patient was admitted to our department due to a history of headache for 13 months. MRI revealed a suspicious glioma infiltrating the anterior corpus callosum. Neurologic examination only showed low cognitive assessment score (Montreal Cognitive Assessment score 20/30). ECG was normal sinus rhythm. Steroids and levetiracetam were administered prior to operation. Patient underwent right frontal craniotomy and biopsy of tumor with unremarkable events. During the first hospital day, patient had episodes of bradycardia followed by decrease in sensorium. Brain CT scan showed progression of edema without hemorrhage within the tumor bed. This was followed minutes later by two episodes of generalized tonic-clonic seizures and pulseless ventricular tachycardia. Cardiac resuscitation was done for 24 minutes but patient eventually expired. Location of the lesion and the epileptogenicity of the peritumoral cortex greatly contributed to the patient's demise. Involvement of the fronto-mesial structures, particularly the insula and the cingulate cortex, and their connection to the central autonomic network, increased susceptibility to arrhythmias. Decreased seizure threshold worsened post-operative edema, further aggravating the dysregulation of the brain-heart-connection.
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Affiliation(s)
| | - Rhoderick M Casis
- St. Luke's Medical Center, Institute for Neurosciences, Quezon City, Philippines
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2
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Salas-Gallardo GA, Lorea-Hernández JJ, Robles-Gómez ÁA, Del Campo CCM, Peña-Ortega F. Morphological differentiation of peritumoral brain zone microglia. PLoS One 2024; 19:e0297576. [PMID: 38451958 PMCID: PMC10919594 DOI: 10.1371/journal.pone.0297576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 01/08/2024] [Indexed: 03/09/2024] Open
Abstract
The Peritumoral Brain Zone (PBZ) contributes to Glioblastoma (GBM) relapse months after the resection of the original tumor, which is influenced by a variety of pathological factors. Among those, microglia are recognized as one of the main regulators of GBM progression and probably relapse. Although microglial morphology has been analyzed inside GBM and its immediate surroundings, it has not been objectively characterized throughout the PBZ. Thus, we aimed to perform a thorough characterization of microglial morphology in the PBZ and its likely differentiation not just from the tumor-associated microglia but from control tissue microglia. For this purpose, Sprague Dawley rats were intrastriatally implanted with C6 cells to induce a GBM formation. Gadolinium-based magnetic resonance imaging (MRI) was performed to locate the tumor and to define the PBZ (2 mm beyond the tumor border), thus delimitating the different regions of interest (ROIs: core tumoral zone and immediate interface; contralateral striatum as control). Brain slices were obtained and immunolabeled with the microglia marker Iba-1. Sixteen morphological parameters were measured for each cell, significative differences were found in all parameters when comparing the four ROIs. To determine if PBZ microglia could be morphologically differentiated from microglia in other ROIs, hierarchical clustering analysis was performed, revealing that microglia can be separated into four morphologically differentiated clusters, each of them mostly integrated by cells sampled in each ROI. Furthermore, a classifier based on linear discriminant analysis, including only three morphological parameters, categorized microglial cells across the studied ROIs and showed a gradual transition between them. The robustness of this classification was assessed through principal component analysis with the remaining 13 morphological parameters, corroborating the obtained results. Thus, in this study we provided objective and quantitative evidence that PBZ microglia represent a differentiable microglial morphotype that could contribute to the recurrence of GBM in this area.
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Affiliation(s)
- G. Anahí Salas-Gallardo
- Laboratorio de Células Neurales Troncales, CIACYT-Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, San Luis Potosí, México
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, México
| | - Jonathan-Julio Lorea-Hernández
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, México
| | - Ángel Abdiel Robles-Gómez
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, México
| | - Claudia Castillo-Martin Del Campo
- Laboratorio de Células Neurales Troncales, CIACYT-Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, San Luis Potosí, México
| | - Fernando Peña-Ortega
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, México
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3
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Tripathi S, Nathan CL, Tate MC, Horbinski CM, Templer JW, Rosenow JM, Sita TL, James CD, Deneen B, Miller SD, Heimberger AB. The immune system and metabolic products in epilepsy and glioma-associated epilepsy: emerging therapeutic directions. JCI Insight 2024; 9:e174753. [PMID: 38193532 PMCID: PMC10906461 DOI: 10.1172/jci.insight.174753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024] Open
Abstract
Epilepsy has a profound impact on quality of life. Despite the development of new antiseizure medications (ASMs), approximately one-third of affected patients have drug-refractory epilepsy and are nonresponsive to medical treatment. Nearly all currently approved ASMs target neuronal activity through ion channel modulation. Recent human and animal model studies have implicated new immunotherapeutic and metabolomic approaches that may benefit patients with epilepsy. In this Review, we detail the proinflammatory immune landscape of epilepsy and contrast this with the immunosuppressive microenvironment in patients with glioma-related epilepsy. In the tumor setting, excessive neuronal activity facilitates immunosuppression, thereby contributing to subsequent glioma progression. Metabolic modulation of the IDH1-mutant pathway provides a dual pathway for reversing immune suppression and dampening seizure activity. Elucidating the relationship between neurons and immunoreactivity is an area for the prioritization and development of the next era of ASMs.
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Affiliation(s)
- Shashwat Tripathi
- Department of Neurological Surgery
- Malnati Brain Tumor Institute of the Robert H. Lurie Comprehensive Cancer Center
| | | | | | - Craig M. Horbinski
- Malnati Brain Tumor Institute of the Robert H. Lurie Comprehensive Cancer Center
- Department of Pathology, and
| | | | | | - Timothy L. Sita
- Department of Neurological Surgery
- Department of Radiation Oncology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Charles D. James
- Department of Neurological Surgery
- Malnati Brain Tumor Institute of the Robert H. Lurie Comprehensive Cancer Center
| | - Benjamin Deneen
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Stephen D. Miller
- Department of Microbiology-Immunology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Amy B. Heimberger
- Department of Neurological Surgery
- Malnati Brain Tumor Institute of the Robert H. Lurie Comprehensive Cancer Center
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Woo AM, Sontheimer H. Interactions between astrocytes and extracellular matrix structures contribute to neuroinflammation-associated epilepsy pathology. FRONTIERS IN MOLECULAR MEDICINE 2023; 3:1198021. [PMID: 39086689 PMCID: PMC11285605 DOI: 10.3389/fmmed.2023.1198021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/31/2023] [Indexed: 08/02/2024]
Abstract
Often considered the "housekeeping" cells of the brain, astrocytes have of late been rising to the forefront of neurodegenerative disorder research. Identified as crucial components of a healthy brain, it is undeniable that when astrocytes are dysfunctional, the entire brain is thrown into disarray. We offer epilepsy as a well-studied neurological disorder in which there is clear evidence of astrocyte contribution to diseases as evidenced across several different disease models, including mouse models of hippocampal sclerosis, trauma associated epilepsy, glioma-associated epilepsy, and beta-1 integrin knockout astrogliosis. In this review we suggest that astrocyte-driven neuroinflammation, which plays a large role in the pathology of epilepsy, is at least partially modulated by interactions with perineuronal nets (PNNs), highly structured formations of the extracellular matrix (ECM). These matrix structures affect synaptic placement, but also intrinsic neuronal properties such as membrane capacitance, as well as ion buffering in their immediate milieu all of which alters neuronal excitability. We propose that the interactions between PNNs and astrocytes contribute to the disease progression of epilepsy vis a vis neuroinflammation. Further investigation and alteration of these interactions to reduce the resultant neuroinflammation may serve as a potential therapeutic target that provides an alternative to the standard anti-seizure medications from which patients are so frequently unable to benefit.
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Affiliation(s)
- AnnaLin M. Woo
- Neuroscience Graduate Program, Neuroscience Department, University of Virginia, Charlottesville, VA, United States
| | - Harald Sontheimer
- Neuroscience Department, University of Virginia, Charlottesville, VA, United States
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5
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Kumar K, Dubey V, Zaidi SS, Tripathi M, Siraj F, Sharma MC, Chandra PS, Doddamani R, Dixit AB, Banerjee J. RNA Sequencing of Intraoperative Peritumoral Tissues Reveals Potential Pathways Involved in Glioma-Related Seizures. J Mol Neurosci 2023; 73:437-447. [PMID: 37268865 DOI: 10.1007/s12031-023-02125-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/18/2023] [Indexed: 06/04/2023]
Abstract
Tumor-induced changes in the peritumoral neocortex play a crucial role in generation of seizures. This study aimed to investigate the molecular mechanisms potentially involved in peritumoral epilepsy in low-grade gliomas (LGGs). Intraoperative peritumoral brain tissues resected from LGG patients with seizures (pGRS) or without seizures (pGNS) were used for RNA sequencing (RNA-seq). Comparative transcriptomics was performed to identify differentially expressed genes (DEGs) in pGRS compared to pGNS using deseq2 and edgeR packages (R). Gene set enrichment analysis (GSEA) using Gene Ontology terms and Kyoto Encyclopedia of Genes & Genomes (KEGG) pathways was performed using the clusterProfiler package (R). The expression of key genes was validated at the transcript and protein levels in the peritumoral region using real-time PCR and immunohistochemistry, respectively. A total of 1073 DEGs were identified in pGRS compared to pGNS, of which 559 genes were upregulated and 514 genes were downregulated (log2 fold-change ≥ 2, padj < 0.001). The DEGs in pGRS were highly enriched in the "Glutamatergic Synapse" and "Spliceosome" pathways, with increased expression of GRIN2A (NR2A), GRIN2B (NR2B), GRIA1 (GLUR1), GRIA3 (GLUR3), GRM5, CACNA1C, CACNA1A, and ITPR2. Moreover, increased immunoreactivity was observed for NR2A, NR2B, and GLUR1 proteins in the peritumoral tissues of GRS. These findings suggest that altered glutamatergic signaling and perturbed Ca2+ homeostasis may be potential causes of peritumoral epilepsy in gliomas. This explorative study identifies important genes/pathways that merit further characterization for their potential involvement in glioma-related seizures.
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Affiliation(s)
| | - Vivek Dubey
- Department of Biophysics, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India
| | - Syeda S Zaidi
- Department of Biophysics, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India
| | | | - Fouzia Siraj
- ICMR-National Institute of Pathology, New Delhi, India
| | | | | | | | - Aparna Banerjee Dixit
- Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi, Delhi, India.
| | - Jyotirmoy Banerjee
- Department of Biophysics, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India.
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6
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Hills KE, Kostarelos K, Wykes RC. Converging Mechanisms of Epileptogenesis and Their Insight in Glioblastoma. Front Mol Neurosci 2022; 15:903115. [PMID: 35832394 PMCID: PMC9271928 DOI: 10.3389/fnmol.2022.903115] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/25/2022] [Indexed: 12/15/2022] Open
Abstract
Glioblastoma (GBM) is the most common and advanced form of primary malignant tumor occurring in the adult central nervous system, and it is frequently associated with epilepsy, a debilitating comorbidity. Seizures are observed both pre- and post-surgical resection, indicating that several pathophysiological mechanisms are shared but also prompting questions about how the process of epileptogenesis evolves throughout GBM progression. Molecular mutations commonly seen in primary GBM, i.e., in PTEN and p53, and their associated downstream effects are known to influence seizure likelihood. Similarly, various intratumoral mechanisms, such as GBM-induced blood-brain barrier breakdown and glioma-immune cell interactions within the tumor microenvironment are also cited as contributing to network hyperexcitability. Substantial alterations to peri-tumoral glutamate and chloride transporter expressions, as well as widespread dysregulation of GABAergic signaling are known to confer increased epileptogenicity and excitotoxicity. The abnormal characteristics of GBM alter neuronal network function to result in metabolically vulnerable and hyperexcitable peri-tumoral tissue, properties the tumor then exploits to favor its own growth even post-resection. It is evident that there is a complex, dynamic interplay between GBM and epilepsy that promotes the progression of both pathologies. This interaction is only more complicated by the concomitant presence of spreading depolarization (SD). The spontaneous, high-frequency nature of GBM-associated epileptiform activity and SD-associated direct current (DC) shifts require technologies capable of recording brain signals over a wide bandwidth, presenting major challenges for comprehensive electrophysiological investigations. This review will initially provide a detailed examination of the underlying mechanisms that promote network hyperexcitability in GBM. We will then discuss how an investigation of these pathologies from a network level, and utilization of novel electrophysiological tools, will yield a more-effective, clinically-relevant understanding of GBM-related epileptogenesis. Further to this, we will evaluate the clinical relevance of current preclinical research and consider how future therapeutic advancements may impact the bidirectional relationship between GBM, SDs, and seizures.
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Affiliation(s)
- Kate E. Hills
- Nanomedicine Lab, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Kostas Kostarelos
- Nanomedicine Lab, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Catalan Institute for Nanoscience and Nanotechnology (ICN2), Edifici ICN2, Campus UAB, Barcelona, Spain
| | - Robert C. Wykes
- Nanomedicine Lab, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom
- *Correspondence: Robert C. Wykes
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7
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Watanabe N, Ishikawa E, Sugii N, Sakakura K, Matsuda M, Kohzuki H, Tsurubuchi T, Masuda Y, Zaboronok A, Kino H, Hayakawa M, Takano S, Matsumaru Y, Akutsu H. Levetiracetam Versus Levetiracetam Plus Sodium Channel Blockers for Postoperative Epileptic Seizure Prevention in Brain Tumor Patients. Cureus 2022; 14:e24894. [PMID: 35698711 PMCID: PMC9184260 DOI: 10.7759/cureus.24894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2022] [Indexed: 11/23/2022] Open
Abstract
Background Brain tumor patients tend to develop postoperative epileptic seizures, which can lead to an unfavorable outcome. Although the incidence of postoperative epileptic seizures and adverse events are improved with the advent of levetiracetam (LEV), postoperative epilepsy occurs at a frequency of 4.6% or higher. In brain tumor patients, the addition of sodium channel blockers (SCBs) to LEV significantly reduces seizures, though confirmed in a non-postoperative study. Thus, the combination of SCBs with LEV might be promising. Objective In this prospective randomized controlled trial we investigated the safety, evaluated by adverse events during one and two weeks after surgery, and the efficacy, evaluated by the incidence of early epilepsy, including non-convulsive status epilepticus (NCSE), of using LEV alone or SCBs added to LEV in patients who underwent craniotomy or biopsy for brain tumors or brain mass lesions. Methods Patients with brain tumors or brain mass lesions undergoing surgical interventions, excluding endoscopic endonasal surgery (EES), with a diagnosis of epilepsy were eligible for this study. Patients are randomized into either Group A or B (B1 or B2) after the informed consents are taken; LEV alone in Group A patients, while LEV and SCBs in Group B patients (GroupB1, intravenous fosphenytoin plus oral lacosamide (LCM) and GroupB2, intravenous LCM plus oral LCM) were administered postoperatively. Fifty-three patients were enrolled during the first two and a half years of the study and four of them were excluded, resulting in the accumulation of 49 patients’ data. Results Postoperative epileptic seizures occurred only in three out of 49 patients during the first week (6.1%) and in seven patients within two weeks after surgery (14.3%, including the three patients during the first week). In Group A, epileptic seizures occurred in two out of 26 patients during the first week (7.7%) and in five patients within two weeks (19.2%) after surgery. In Group B, epileptic seizures occurred in one out of 23 patients during the first week (4.3%) and in two patients during the first two weeks (8.7%). Low complication grade of epileptic seizures was observed in Group B rather than in Group A, however, without significant difference (p=0.256). There was no difference in the frequency of adverse effects in each group. Conclusion Although not statistically significant, the incidence of epileptic seizures within one week after surgery was lesser in LEV+SCBs groups than in LEV alone. No hepatic damage or renal function worsening occurred with the addition of LCM, suggesting the safety of LEV+SCBs therapy.
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8
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Schlehofer B, Blettner M, Moissonnier M, Deltour I, Giles GG, Armstrong B, Siemiatycki J, Parent ME, Krewski D, Johansen C, Auvinen A, Lahkola A, Hours M, Berg-Beckhoff G, Sadetzki S, Lagorio S, Takebayashi T, Yamaguchi N, Woodward A, Cook A, Tynes T, Klaboe L, Feychting M, Feltbower R, Swerdlow A, Schoemaker M, Cardis E, Schüz J. Association of allergic diseases and epilepsy with risk of glioma, meningioma and acoustic neuroma: results from the INTERPHONE international case-control study. Eur J Epidemiol 2022; 37:503-512. [PMID: 35118581 DOI: 10.1007/s10654-022-00843-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/16/2022] [Indexed: 11/03/2022]
Abstract
We investigated the association of allergic diseases and epilepsy with risk of brain tumours, in Interphone, a 13-country case-control study. Data were obtained from 2693 glioma cases, 2396 meningioma cases, and 1102 acoustic neuroma cases and their 6321 controls. Conditional logistic regression models were used to estimate pooled odds ratios (ORs) and their respective 95% confidence intervals (CIs), adjusted for education and time at interview. Reduced ORs were observed for glioma in relation to physician-diagnosed asthma (OR = 0.73; CI 0.58-0.92), hay fever (OR 0.72; CI 0.61-0.86), and eczema (OR 0.78, CI 0.64-0.94), but not for meningioma or acoustic neuroma. Previous diagnosis of epilepsy was associated with an increased OR for glioma (2.94; CI 1.87-4.63) and for meningioma (2.12; CI 1.27-3.56), but not for acoustic neuroma. This large-scale case-control study adds to the growing evidence that people with allergies have a lower risk of developing glioma, but not meningioma or acoustic neuroma. It also supports clinical observations of epilepsy prior to the diagnosis of glioma and meningioma.
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Affiliation(s)
- Brigitte Schlehofer
- Leimen, Germany (retired); formerly: Unit of Environmental Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Maria Blettner
- Institute of Medical Biostatistics, Epidemiology and Informatics, University of Mainz, Mainz, Germany
| | - Monika Moissonnier
- International Agency for Research On Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, Lyon, France
| | - Isabelle Deltour
- International Agency for Research On Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, Lyon, France
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Bruce Armstrong
- School of Public Health, University of Sydney, Sydney, Australia
| | | | | | - Daniel Krewski
- McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada
| | | | - Anssi Auvinen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- STUK Radiation and Nuclear Safety Authority, Environmental Radiation Surveillance, Helsinki, Finland
| | - Anna Lahkola
- STUK Radiation and Nuclear Safety Authority, Environmental Radiation Surveillance, Helsinki, Finland
| | | | - Gabriele Berg-Beckhoff
- Unit for Health Promotion Research, Department of Public Health, and Hospital South West Jutland Esbjerg, University of Southern Denmark, Odense, Denmark
| | - Siegal Sadetzki
- Cancer & Radiation Epidemiology Unit, Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Ministry of Health, Jerusalem, Israel
| | - Susanna Lagorio
- Department of Oncology and Molecular Medicine, Istituto Superiore Di Sanità, Rome, Italy
| | - Toru Takebayashi
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Naohito Yamaguchi
- Department of Public Health, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Alistair Woodward
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Angus Cook
- Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Tore Tynes
- National Institute of Occupational Health, Oslo, Norway
| | - Lars Klaboe
- Norwegian Radiation Protection Authority, Østerås; The Cancer Registry of Norway, Oslo, Norway
| | - Maria Feychting
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | | | | | - Elisabeth Cardis
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain
- University Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiologia Y Salud Pública, Madrid, Spain
| | - Joachim Schüz
- International Agency for Research On Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, Lyon, France.
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Silva M, Vivancos C, Duffau H. The Concept of «Peritumoral Zone» in Diffuse Low-Grade Gliomas: Oncological and Functional Implications for a Connectome-Guided Therapeutic Attitude. Brain Sci 2022; 12:brainsci12040504. [PMID: 35448035 PMCID: PMC9032126 DOI: 10.3390/brainsci12040504] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 12/22/2022] Open
Abstract
Diffuse low-grade gliomas (DLGGs) are heterogeneous and poorly circumscribed neoplasms with isolated tumor cells that extend beyond the margins of the lesion depicted on MRI. Efforts to demarcate the glioma core from the surrounding healthy brain led us to define an intermediate region, the so-called peritumoral zone (PTZ). Although most studies about PTZ have been conducted on high-grade gliomas, the purpose here is to review the cellular, metabolic, and radiological characteristics of PTZ in the specific context of DLGG. A better delineation of PTZ, in which glioma cells and neural tissue strongly interact, may open new therapeutic avenues to optimize both functional and oncological results. First, a connectome-based “supratotal” surgical resection (i.e., with the removal of PTZ in addition to the tumor core) resulted in prolonged survival by limiting the risk of malignant transformation, while improving the quality of life, thanks to a better control of seizures. Second, the timing and order of (neo)adjuvant medical treatments can be modulated according to the pattern of peritumoral infiltration. Third, the development of new drugs specifically targeting the PTZ could be considered from an oncological (such as immunotherapy) and epileptological perspective. Further multimodal investigations of PTZ are needed to maximize long-term outcomes in DLGG patients.
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Affiliation(s)
- Melissa Silva
- Department of Neurosurgery, Hospital Garcia de Orta, 2805-267 Almada, Portugal;
| | - Catalina Vivancos
- Department of Neurosurgery, Hospital Universitario La Paz, 28046 Madrid, Spain;
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34295 Montpellier, France
- Team “Plasticity of Central Nervous System, Stem Cells and Glial Tumors”, Institute of Functional Genomics, National Institute for Health and Medical Research (INSERM) U1191, University of Montpellier, 34295 Montpellier, France
- Correspondence:
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10
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Yu N, Aboud O. Metabolomics in High Grade Gliomas. RAS ONCOLOGY & THERAPY 2022; 3:17. [PMID: 36643416 PMCID: PMC9839194 DOI: 10.51520/2766-2586-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Gliomas are central nervous system (CNS) cancers that are challenging to treat due to their high proliferation and mutation rates. High grade gliomas include grade 3 and grade 4 tumors, which characteristically have a poor prognosis despite advancements in diagnostic methods and therapeutic options. Advances in metabolomics are resulting in more insight as to how cancer modifies the metabolism of the cell and surrounding tissue. Hence, this avenue of research may also emerge as a way to precisely target metabolites unique to gliomas. These biomarkers may provide opportunities for glioma diagnosis, prognosis and future therapeutic intervention. In this review, we harvest the literature that highlights notable biomolecules in high grade gliomas and promising therapeutic targets and interventions.
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Affiliation(s)
- Nina Yu
- University of California, Davis School of Medicine, Sacramento, CA, United States
| | - Orwa Aboud
- Department of Neurology and Neurological Surgery, University of California, Davis, Sacramento, CA, United States
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11
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Zhu Q, Liang Y, Fan Z, Liu Y, Zhou C, Zhang H, Li T, Zhou Y, Yang J, Wang L. The utility of intraoperative ECoG in tumor-related epilepsy: Systematic review. Clin Neurol Neurosurg 2021; 212:107054. [PMID: 34896866 DOI: 10.1016/j.clineuro.2021.107054] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/14/2021] [Accepted: 11/15/2021] [Indexed: 11/03/2022]
Abstract
OBJECT Epilepsy is one of the most common clinical manifestations of primary brain tumors. Intraoperative electrocorticography (ECoG) has been widely used in tumor resection. We aim to describe the indication and utility of ECoG during brain tumor surgery. METHODS We performed a systematic review of the literature on the prognosis of tumor-related epilepsy surgery guided by intraoperative ECoG. The published studies were searched in PubMed, Embase, and Web of Science using the keyword 'seizure' or 'epilepsy' and 'electrocorticography' or 'ECoG'. Two reviewer authors screened studies and extracted data independently. RESULTS Thirteen studies included 569 patients were finally selected, of which eight investigated medically intractable epilepsy. Three publications described temporal tumor-related epilepsy. All included studies were retrospective, and the age of all patients ranged from 1 to 71 years. The duration of epilepsy ranged from 1 month to 30 years. Patients with tumor-related epilepsy underwent surgical treatment with Engel I outcomes ranging from 56.5%-100%. CONCLUSION Intraoperative ECoG is generally considered a useful technique in delineating epileptogenic areas and improving the prognosis of surgical treatment of tumor-related epilepsy. However, large-scale randomized control trials are still needed to verify these findings and formulate appropriate surgical strategies.
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Affiliation(s)
- Qiang Zhu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Yuchao Liang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Ziwen Fan
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Yukun Liu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Chunyao Zhou
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Hong Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Tianshi Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Yanpeng Zhou
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Jianing Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Lei Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.
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12
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Parmigiani E, Scalera M, Mori E, Tantillo E, Vannini E. Old Stars and New Players in the Brain Tumor Microenvironment. Front Cell Neurosci 2021; 15:709917. [PMID: 34690699 PMCID: PMC8527006 DOI: 10.3389/fncel.2021.709917] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/04/2021] [Indexed: 12/12/2022] Open
Abstract
In recent years, the direct interaction between cancer cells and tumor microenvironment (TME) has emerged as a crucial regulator of tumor growth and a promising therapeutic target. The TME, including the surrounding peritumoral regions, is dynamically modified during tumor progression and in response to therapies. However, the mechanisms regulating the crosstalk between malignant and non-malignant cells are still poorly understood, especially in the case of glioma, an aggressive form of brain tumor. The presence of unique brain-resident cell types, namely neurons and glial cells, and an exceptionally immunosuppressive microenvironment pose additional important challenges to the development of effective treatments targeting the TME. In this review, we provide an overview on the direct and indirect interplay between glioma and neuronal and glial cells, introducing new players and mechanisms that still deserve further investigation. We will focus on the effects of neural activity and glial response in controlling glioma cell behavior and discuss the potential of exploiting these cellular interactions to develop new therapeutic approaches with the aim to preserve proper brain functionality.
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Affiliation(s)
- Elena Parmigiani
- Embryology and Stem Cell Biology, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Marta Scalera
- Neuroscience Institute, Consiglio Nazionale delle Ricerche (CNR), Pisa, Italy
| | | | - Elena Tantillo
- Neuroscience Institute, Consiglio Nazionale delle Ricerche (CNR), Pisa, Italy
| | - Eleonora Vannini
- Neuroscience Institute, Consiglio Nazionale delle Ricerche (CNR), Pisa, Italy
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13
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Serpe C, Monaco L, Relucenti M, Iovino L, Familiari P, Scavizzi F, Raspa M, Familiari G, Civiero L, D’Agnano I, Limatola C, Catalano M. Microglia-Derived Small Extracellular Vesicles Reduce Glioma Growth by Modifying Tumor Cell Metabolism and Enhancing Glutamate Clearance through miR-124. Cells 2021; 10:2066. [PMID: 34440835 PMCID: PMC8393731 DOI: 10.3390/cells10082066] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/26/2021] [Accepted: 08/06/2021] [Indexed: 12/12/2022] Open
Abstract
Brain homeostasis needs continuous exchange of intercellular information among neurons, glial cells, and immune cells, namely microglial cells. Extracellular vesicles (EVs) are active players of this process. All the cells of the body, including the brain, release at least two subtypes of EVs, the medium/large EVs (m/lEVs) and small EVs (sEVs). sEVs released by microglia play an important role in brain patrolling in physio-pathological processes. One of the most common and malignant forms of brain cancer is glioblastoma. Altered intercellular communications constitute a base for the onset and the development of the disease. In this work, we used microglia-derived sEVs to assay their effects in vitro on murine glioma cells and in vivo in a glioma model on C57BL6/N mice. Our findings indicated that sEVs carry messages to cancer cells that modify glioma cell metabolism, reducing lactate, nitric oxide (NO), and glutamate (Glu) release. sEVs affect Glu homeostasis, increasing the expression of Glu transporter Glt-1 on astrocytes. We demonstrated that these effects are mediated by miR-124 contained in microglia-released sEVs. The in vivo benefit of microglia-derived sEVs results in a significantly reduced tumor mass and an increased survival of glioma-bearing mice, depending on miR-124.
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Affiliation(s)
- Carmela Serpe
- Department of Physiology and Pharmacology, Sapienza University, 00185 Rome, Italy; (C.S.); (L.M.)
| | - Lucia Monaco
- Department of Physiology and Pharmacology, Sapienza University, 00185 Rome, Italy; (C.S.); (L.M.)
| | - Michela Relucenti
- Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University, 00185 Rome, Italy; (M.R.); (G.F.)
| | - Ludovica Iovino
- Department of Biology, University of Padova, 35131 Padova, Italy; (L.I.); (L.C.)
| | - Pietro Familiari
- Department of Human Neurosciences, Division of Neurosurgery, Sapienza University, 00185 Rome, Italy;
| | - Ferdinando Scavizzi
- Institute of Biochemistry and Cell Biology (IBBC), CNR, 00015 Monterotond, Italy; (F.S.); (M.R.)
| | - Marcello Raspa
- Institute of Biochemistry and Cell Biology (IBBC), CNR, 00015 Monterotond, Italy; (F.S.); (M.R.)
| | - Giuseppe Familiari
- Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University, 00185 Rome, Italy; (M.R.); (G.F.)
| | - Laura Civiero
- Department of Biology, University of Padova, 35131 Padova, Italy; (L.I.); (L.C.)
- IRCCS San Camillo Hospital, 30126 Venice, Italy
| | - Igea D’Agnano
- Institute of Biomedical Technologies, CNR, 20054 Segrate, Italy;
| | - Cristina Limatola
- Department of Physiology and Pharmacology, Laboratory Affiliated to Istituto Pasteur Italia Fondazione Cenci Bolognetti, Sapienza University, 00185 Rome, Italy
- IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Myriam Catalano
- Department of Physiology and Pharmacology, Sapienza University, 00185 Rome, Italy; (C.S.); (L.M.)
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14
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Pototskiy E, Dellinger JR, Bumgarner S, Patel J, Sherrerd-Smith W, Musto AE. Brain injuries can set up an epileptogenic neuronal network. Neurosci Biobehav Rev 2021; 129:351-366. [PMID: 34384843 DOI: 10.1016/j.neubiorev.2021.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 08/01/2021] [Indexed: 10/20/2022]
Abstract
Development of epilepsy or epileptogenesis promotes recurrent seizures. As of today, there are no effective prophylactic therapies to prevent the onset of epilepsy. Contributing to this deficiency of preventive therapy is the lack of clarity in fundamental neurobiological mechanisms underlying epileptogenesis and lack of reliable biomarkers to identify patients at risk for developing epilepsy. This limits the development of prophylactic therapies in epilepsy. Here, neural network dysfunctions reflected by oscillopathies and microepileptiform activities, including neuronal hyperexcitability and hypersynchrony, drawn from both clinical and experimental epilepsy models, have been reviewed. This review suggests that epileptogenesis reflects a progressive and dynamic dysfunction of specific neuronal networks which recruit further interconnected groups of neurons, with this resultant pathological network mediating seizure occurrence, recurrence, and progression. In the future, combining spatial and temporal resolution of neuronal non-invasive recordings from patients at risk of developing epilepsy, together with analytics and computational tools, may contribute to determining whether the brain is undergoing epileptogenesis in asymptomatic patients following brain injury.
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Affiliation(s)
- Esther Pototskiy
- Department of Anatomy & Pathology, Eastern Virginia Medical School, Department of Pathology, Norfolk, Virginia, USA; College of Sciences, Old Dominion University, Norfolk, Virginia
| | - Joshua Ryan Dellinger
- Department of Anatomy & Pathology, Eastern Virginia Medical School, Department of Pathology, Norfolk, Virginia, USA
| | - Stuart Bumgarner
- Department of Anatomy & Pathology, Eastern Virginia Medical School, Department of Pathology, Norfolk, Virginia, USA
| | - Jay Patel
- Department of Anatomy & Pathology, Eastern Virginia Medical School, Department of Pathology, Norfolk, Virginia, USA
| | - William Sherrerd-Smith
- Department of Anatomy & Pathology, Eastern Virginia Medical School, Department of Pathology, Norfolk, Virginia, USA
| | - Alberto E Musto
- Department of Anatomy & Pathology, Eastern Virginia Medical School, Department of Pathology, Norfolk, Virginia, USA; Department of Neurology, Eastern Virginia Medical School, Department of Pathology, Norfolk, Virginia, USA.
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15
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Synergistic Effect of Perampanel and Temozolomide in Human Glioma Cell Lines. J Pers Med 2021; 11:jpm11050390. [PMID: 34068749 PMCID: PMC8150827 DOI: 10.3390/jpm11050390] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/03/2021] [Accepted: 05/06/2021] [Indexed: 12/23/2022] Open
Abstract
Glioblastoma is characterized by a high proliferative rate and drug resistance. The standard of care includes maximal safe surgery, followed by radiotherapy and temozolomide chemotherapy. The expression of glutamate receptors has been previously reported in human glioma cell lines. The aim of this study was to examine the cellular effects of perampanel, a broad-spectrum antiepileptic drug acting as an α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPA) glutamate receptor antagonist, alone or in combination with temozolomide. Four human glioma cell lines were exposed to different concentrations of perampanel and temozolomide, alone or in combination. The type of drug interaction was assessed using the Chou-Talalay method. Apoptosis, cell cycle perturbation, and glutamate receptors (GluRs) subunit expression were assessed by flow cytometry. Perampanel significantly inhibited the growth, inducing high levels of apoptosis. A strong synergistic effect of the combination of perampanel with temozolomide was detected in U87 and A172, but not in U138. Treatment with perampanel resulted in an increased GluR2/3 subunit expression in U87 and U138. Perampanel displays a pro-apoptotic effect on human glioblastoma cell lines when used alone, possibly due to increased GluR2/3 expression. The observed synergistic effect of the combination of temozolomide with perampanel suggests further investigation on the impact of this combination on oncologic outcomes in glioblastoma.
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16
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Cohen-Salmon M, Slaoui L, Mazaré N, Gilbert A, Oudart M, Alvear-Perez R, Elorza-Vidal X, Chever O, Boulay AC. Astrocytes in the regulation of cerebrovascular functions. Glia 2020; 69:817-841. [PMID: 33058289 DOI: 10.1002/glia.23924] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/18/2020] [Accepted: 09/21/2020] [Indexed: 12/18/2022]
Abstract
Astrocytes are the most numerous type of neuroglia in the brain and have a predominant influence on the cerebrovascular system; they control perivascular homeostasis, the integrity of the blood-brain barrier, the dialogue with the peripheral immune system, the transfer of metabolites from the blood, and blood vessel contractility in response to neuronal activity. These regulatory processes occur in a specialized interface composed of perivascular astrocyte extensions that almost completely cover the cerebral blood vessels. Scientists have only recently started to study how this interface is formed and how it influences cerebrovascular functions. Here, we review the literature on the astrocytes' role in the regulation of the cerebrovascular system. We cover the anatomy and development of the gliovascular interface, the known gliovascular functions, and molecular factors, the latter's implication in certain pathophysiological situations, and recent cutting-edge experimental tools developed to examine the astrocytes' role at the vascular interface. Finally, we highlight some open questions in this field of research.
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Affiliation(s)
- Martine Cohen-Salmon
- Physiology and Physiopathology of the Gliovascular Unit Research Group, Center for Interdisciplinary Research in Biology (CIRB), College de France, CNRS Unité Mixte de Recherche 724, INSERM Unité 1050, Labex Memolife, PSL Research University, Paris, France
| | - Leila Slaoui
- Physiology and Physiopathology of the Gliovascular Unit Research Group, Center for Interdisciplinary Research in Biology (CIRB), College de France, CNRS Unité Mixte de Recherche 724, INSERM Unité 1050, Labex Memolife, PSL Research University, Paris, France
| | - Noémie Mazaré
- Physiology and Physiopathology of the Gliovascular Unit Research Group, Center for Interdisciplinary Research in Biology (CIRB), College de France, CNRS Unité Mixte de Recherche 724, INSERM Unité 1050, Labex Memolife, PSL Research University, Paris, France
| | - Alice Gilbert
- Physiology and Physiopathology of the Gliovascular Unit Research Group, Center for Interdisciplinary Research in Biology (CIRB), College de France, CNRS Unité Mixte de Recherche 724, INSERM Unité 1050, Labex Memolife, PSL Research University, Paris, France
| | - Marc Oudart
- Physiology and Physiopathology of the Gliovascular Unit Research Group, Center for Interdisciplinary Research in Biology (CIRB), College de France, CNRS Unité Mixte de Recherche 724, INSERM Unité 1050, Labex Memolife, PSL Research University, Paris, France
| | - Rodrigo Alvear-Perez
- Physiology and Physiopathology of the Gliovascular Unit Research Group, Center for Interdisciplinary Research in Biology (CIRB), College de France, CNRS Unité Mixte de Recherche 724, INSERM Unité 1050, Labex Memolife, PSL Research University, Paris, France
| | - Xabier Elorza-Vidal
- Physiology and Physiopathology of the Gliovascular Unit Research Group, Center for Interdisciplinary Research in Biology (CIRB), College de France, CNRS Unité Mixte de Recherche 724, INSERM Unité 1050, Labex Memolife, PSL Research University, Paris, France
| | - Oana Chever
- Normandie University, UNIROUEN, INSERM, DC2N, IRIB, Rouen, France
| | - Anne-Cécile Boulay
- Physiology and Physiopathology of the Gliovascular Unit Research Group, Center for Interdisciplinary Research in Biology (CIRB), College de France, CNRS Unité Mixte de Recherche 724, INSERM Unité 1050, Labex Memolife, PSL Research University, Paris, France
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17
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Bouckaert C, Germonpré C, Verhoeven J, Chong SA, Jacquin L, Mairet-Coello G, André VM, Leclercq K, Vanhove C, De Vos F, Van den Broecke C, Goethals I, Descamps B, Donche S, Carrette E, Wadman W, Boon P, Vonck K, Raedt R. Development of a Rat Model for Glioma-Related Epilepsy. Int J Mol Sci 2020; 21:E6999. [PMID: 32977526 PMCID: PMC7582710 DOI: 10.3390/ijms21196999] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/18/2020] [Accepted: 09/21/2020] [Indexed: 12/13/2022] Open
Abstract
Seizures are common in patients with high-grade gliomas (30-60%) and approximately 15-30% of glioblastoma (GB) patients develop drug-resistant epilepsy. Reliable animal models are needed to develop adequate treatments for glioma-related epilepsy. Therefore, fifteen rats were inoculated with F98 GB cells (GB group) and four rats with vehicle only (control group) in the right entorhinal cortex. MRI was performed to visualize tumor presence. A subset of seven GB and two control rats were implanted with recording electrodes to determine the occurrence of epileptic seizures with video-EEG recording over multiple days. In a subset of rats, tumor size and expression of tumor markers were investigated with histology or mRNA in situ hybridization. Tumors were visible on MRI six days post-inoculation. Time-dependent changes in tumor morphology and size were visible on MRI. Epileptic seizures were detected in all GB rats monitored with video-EEG. Twenty-one days after inoculation, rats were euthanized based on signs of discomfort and pain. This study describes, for the first time, reproducible tumor growth and spontaneous seizures upon inoculation of F98 cells in the rat entorhinal cortex. The development of this new model of GB-related epilepsy may be valuable to design new therapies against tumor growth and associated epileptic seizures.
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Affiliation(s)
- Charlotte Bouckaert
- 4Brain, Department of Head and Skin, Ghent University, 9000 Ghent, East Flanders, Belgium; (C.B.); (C.G.); (E.C.); (W.W.); (P.B.); (K.V.)
| | - Charlotte Germonpré
- 4Brain, Department of Head and Skin, Ghent University, 9000 Ghent, East Flanders, Belgium; (C.B.); (C.G.); (E.C.); (W.W.); (P.B.); (K.V.)
| | - Jeroen Verhoeven
- Department of Pharmaceutical Analysis, Ghent University, 9000 Ghent, East Flanders, Belgium; (J.V.); (F.D.V.); (C.V.d.B.)
| | - Seon-Ah Chong
- Early Solutions, Neuroscience Therapeutic Area, UCB Pharma, 1420 Braine-l’Alleud, Brabant Wallon, Belgium; (S.-A.C.); (L.J.); (G.M.-C.); (V.M.A.); (K.L.)
| | - Lucas Jacquin
- Early Solutions, Neuroscience Therapeutic Area, UCB Pharma, 1420 Braine-l’Alleud, Brabant Wallon, Belgium; (S.-A.C.); (L.J.); (G.M.-C.); (V.M.A.); (K.L.)
| | - Georges Mairet-Coello
- Early Solutions, Neuroscience Therapeutic Area, UCB Pharma, 1420 Braine-l’Alleud, Brabant Wallon, Belgium; (S.-A.C.); (L.J.); (G.M.-C.); (V.M.A.); (K.L.)
| | - Véronique Marie André
- Early Solutions, Neuroscience Therapeutic Area, UCB Pharma, 1420 Braine-l’Alleud, Brabant Wallon, Belgium; (S.-A.C.); (L.J.); (G.M.-C.); (V.M.A.); (K.L.)
| | - Karine Leclercq
- Early Solutions, Neuroscience Therapeutic Area, UCB Pharma, 1420 Braine-l’Alleud, Brabant Wallon, Belgium; (S.-A.C.); (L.J.); (G.M.-C.); (V.M.A.); (K.L.)
| | - Christian Vanhove
- Department of Electronics and information systems, Ghent University Hospital, 9000 Ghent, East Flanders, Belgium; (C.V.); (B.D.)
| | - Filip De Vos
- Department of Pharmaceutical Analysis, Ghent University, 9000 Ghent, East Flanders, Belgium; (J.V.); (F.D.V.); (C.V.d.B.)
| | - Caroline Van den Broecke
- Department of Pharmaceutical Analysis, Ghent University, 9000 Ghent, East Flanders, Belgium; (J.V.); (F.D.V.); (C.V.d.B.)
| | - Ingeborg Goethals
- Department of Diagnostic Sciences, Ghent University Hospital, 9000 Ghent, East Flanders, Belgium; (I.G.); (S.D.)
| | - Benedicte Descamps
- Department of Electronics and information systems, Ghent University Hospital, 9000 Ghent, East Flanders, Belgium; (C.V.); (B.D.)
| | - Sam Donche
- Department of Diagnostic Sciences, Ghent University Hospital, 9000 Ghent, East Flanders, Belgium; (I.G.); (S.D.)
| | - Evelien Carrette
- 4Brain, Department of Head and Skin, Ghent University, 9000 Ghent, East Flanders, Belgium; (C.B.); (C.G.); (E.C.); (W.W.); (P.B.); (K.V.)
| | - Wytse Wadman
- 4Brain, Department of Head and Skin, Ghent University, 9000 Ghent, East Flanders, Belgium; (C.B.); (C.G.); (E.C.); (W.W.); (P.B.); (K.V.)
| | - Paul Boon
- 4Brain, Department of Head and Skin, Ghent University, 9000 Ghent, East Flanders, Belgium; (C.B.); (C.G.); (E.C.); (W.W.); (P.B.); (K.V.)
| | - Kristl Vonck
- 4Brain, Department of Head and Skin, Ghent University, 9000 Ghent, East Flanders, Belgium; (C.B.); (C.G.); (E.C.); (W.W.); (P.B.); (K.V.)
| | - Robrecht Raedt
- 4Brain, Department of Head and Skin, Ghent University, 9000 Ghent, East Flanders, Belgium; (C.B.); (C.G.); (E.C.); (W.W.); (P.B.); (K.V.)
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18
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Tantillo E, Vannini E, Cerri C, Spalletti C, Colistra A, Mazzanti CM, Costa M, Caleo M. Differential roles of pyramidal and fast-spiking, GABAergic neurons in the control of glioma cell proliferation. Neurobiol Dis 2020; 141:104942. [DOI: 10.1016/j.nbd.2020.104942] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/15/2020] [Accepted: 05/05/2020] [Indexed: 12/14/2022] Open
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19
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Luo L, Guan X, Begum G, Ding D, Gayden J, Hasan MN, Fiesler VM, Dodelson J, Kohanbash G, Hu B, Amankulor NM, Jia W, Castro MG, Sun B, Sun D. Blockade of Cell Volume Regulatory Protein NKCC1 Increases TMZ-Induced Glioma Apoptosis and Reduces Astrogliosis. Mol Cancer Ther 2020; 19:1550-1561. [PMID: 32393472 DOI: 10.1158/1535-7163.mct-19-0910] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 01/29/2020] [Accepted: 05/04/2020] [Indexed: 11/16/2022]
Abstract
Glioma is one of the most common primary malignant tumors of the central nervous system accounting for approximately 40% of all intracranial tumors. Temozolomide is a conventional chemotherapy drug for adjuvant treatment of patients with high-risk gliomas, including grade II to grade IV. Our bioinformatic analysis of The Cancer Genome Atlas and Chinese Glioma Genome Atlas datasets and immunoblotting assay show that SLC12A2 gene and its encoded Na+-K+-2Cl- cotransporter isoform 1 (NKCC1) protein are abundantly expressed in grade II-IV gliomas. NKCC1 regulates cell volume and intracellular Cl- concentration, which promotes glioma cell migration, resistance to temozolomide, and tumor-related epilepsy in experimental glioma models. Using mouse syngeneic glioma models with intracranial transplantation of two different glioma cell lines (GL26 and SB28), we show that NKCC1 protein in glioma tumor cells as well as in tumor-associated reactive astrocytes was significantly upregulated in response to temozolomide monotherapy. Combination therapy of temozolomide with the potent NKCC1 inhibitor bumetanide reduced tumor proliferation, potentiated the cytotoxic effects of temozolomide, decreased tumor-associated reactive astrogliosis, and restored astrocytic GLT-1 and GLAST glutamate transporter expression. The combinatorial therapy also led to suppressed tumor growth and prolonged survival of mice bearing GL26 glioma cells. Taken together, these results demonstrate that NKCC1 protein plays multifaceted roles in the pathogenesis of glioma tumors and presents as a therapeutic target for reducing temozolomide-mediated resistance and tumor-associated astrogliosis.
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Affiliation(s)
- Lanxin Luo
- School of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, Shenyang, Liaoning, China.,School of Functional Food and Wine, Shenyang Pharmaceutical University, Shenyang, Liaoning, China.,Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Xiudong Guan
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Chinese National Clinical Research Center for Neurological Diseases, Beijing, China.,Beijing Neurosurgical Institute, Beijing, China.,Chinese Glioma Genome Atlas Network, Beijing, China
| | - Gulnaz Begum
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Dawei Ding
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jenesis Gayden
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Md Nabiul Hasan
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Victoria M Fiesler
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jacob Dodelson
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Gary Kohanbash
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Immunology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Baoli Hu
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Nduka M Amankulor
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Wang Jia
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Chinese National Clinical Research Center for Neurological Diseases, Beijing, China.,Beijing Neurosurgical Institute, Beijing, China.,Chinese Glioma Genome Atlas Network, Beijing, China
| | - Maria G Castro
- Department of Neurosurgery and Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, Michigan
| | - Baoshan Sun
- School of Functional Food and Wine, Shenyang Pharmaceutical University, Shenyang, Liaoning, China. .,Pólo Dois Portos, Instituto National de Investigação Agrária e Veterinária, I.P., Quinta da Almoinha, Dois Portos, Portugal
| | - Dandan Sun
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania. .,Veterans Affairs Pittsburgh Health Care System, Geriatric Research, Educational and Clinical Center, Pittsburgh, Pennsylvania
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20
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Bette S, Barz M, Ly Nham H, Huber T, Berndt M, Sales A, Schmidt-Graf F, Meyer HS, Ryang YM, Meyer B, Zimmer C, Kirschke JS, Wiestler B, Gempt J. Image Analysis Reveals Microstructural and Volumetric Differences in Glioblastoma Patients with and without Preoperative Seizures. Cancers (Basel) 2020; 12:E994. [PMID: 32316566 PMCID: PMC7226080 DOI: 10.3390/cancers12040994] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/06/2020] [Accepted: 04/09/2020] [Indexed: 01/05/2023] Open
Abstract
Purpose: Seizures related to tumor growth are common in glioma patients, especially in low-grade glioma patients this is often the first tumor manifestation. We hypothesize that there are associations between preoperative seizures and morphologic features (e.g., tumor size, location) and histogram features in patients with glioblastoma (GB). Methods: Retrospectively, 160 consecutive patients with initial diagnosis and surgery of GB (WHO IV) and preoperative MRI were analyzed. Preoperative MRI sequences were co-registered (T2-FLAIR, T1-contrast, DTI) and tumors were segmented by a neuroradiologist using the software ITK-snap blinded to the clinical data. Tumor volume (FLAIR, T1-contrast) and histogram analyses of ADC- and FA-maps were recorded in the contrast enhancing tumor part (CET) and the non-enhancing peritumoral edema (FLAIR). Location was determined after co-registration of the data with an atlas. Permutation-based multiple-testing adjusted t statistics were calculated to compare imaging variables between patients with and without seizures. Results: Patients with seizures showed significantly smaller tumors (CET, adj. p = 0.029) than patients without preoperative seizures. Less seizures were observed in patients with tumor location in the right cingulate gyrus (adj. p = 0.048) and in the right caudate nucleus (adj. p = 0.009). Significant differences of histogram analyses of FA in the contrast enhancing tumor part were observed between patients with and without seizures considering also tumor location and size. Conclusion: Preoperative seizures in GB patients are associated with lower preoperative tumor volume. The different histogram analyses suggest that there might be microstructural differences in the contrast enhancing tumor part of patients with seizures measured by fractional anisotropy. Higher variance of GB presenting without seizures might indicate a more aggressive growth of these tumors.
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Affiliation(s)
- Stefanie Bette
- Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (S.B.); (H.L.N.); (M.B.); (C.Z.); (J.S.K.); (B.W.)
- Department of Diagnostic and Interventional Radiology, Universitätsklinikum Augsburg, Stenglinstr. 2, 85156 Augsburg, Germany
| | - Melanie Barz
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (M.B.); (A.S.); (H.S.M.); (Y.-M.R.); (B.M.)
| | - Huong Ly Nham
- Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (S.B.); (H.L.N.); (M.B.); (C.Z.); (J.S.K.); (B.W.)
| | - Thomas Huber
- Department of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany;
| | - Maria Berndt
- Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (S.B.); (H.L.N.); (M.B.); (C.Z.); (J.S.K.); (B.W.)
| | - Arthur Sales
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (M.B.); (A.S.); (H.S.M.); (Y.-M.R.); (B.M.)
| | - Friederike Schmidt-Graf
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany;
| | - Hanno S. Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (M.B.); (A.S.); (H.S.M.); (Y.-M.R.); (B.M.)
| | - Yu-Mi Ryang
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (M.B.); (A.S.); (H.S.M.); (Y.-M.R.); (B.M.)
- Department of Neurosurgery, HELIOS Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125 Berlin, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (M.B.); (A.S.); (H.S.M.); (Y.-M.R.); (B.M.)
| | - Claus Zimmer
- Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (S.B.); (H.L.N.); (M.B.); (C.Z.); (J.S.K.); (B.W.)
| | - Jan S. Kirschke
- Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (S.B.); (H.L.N.); (M.B.); (C.Z.); (J.S.K.); (B.W.)
| | - Benedikt Wiestler
- Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (S.B.); (H.L.N.); (M.B.); (C.Z.); (J.S.K.); (B.W.)
| | - Jens Gempt
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany; (M.B.); (A.S.); (H.S.M.); (Y.-M.R.); (B.M.)
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21
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Henker C, Kriesen T, Scherer M, Glass Ä, von Deimling A, Bendszus M, Weber MA, Herold-Mende C, Unterberg A, Piek J. Association Between Tumor Compartment Volumes, the Incidence of Pretreatment Seizures, and Statin-Mediated Protective Effects in Glioblastoma. Neurosurgery 2020; 85:E722-E729. [PMID: 30888031 DOI: 10.1093/neuros/nyz079] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 02/14/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Seizures are a common initial symptom of malignant brain tumors such as glioblastoma (GBM). However, why some of these tumors are epileptogenic and others never trigger seizures remains controversial. OBJECTIVE To identify potential clinical and radiological features of epileptogenic tumors and the effect of initial seizures on survival. METHODS The analyzed patient cohort was retrospectively compiled (bicentric), only isocitrate dehydrogenase wild-type GBMs were included. Volumetric assessment was performed on pretreatment magnetic resonance imaging with the aid of a semi-automated 3D measurement (tumor, necrosis, and edema volume). Two ratios were calculated, reflecting the proportion of peritumoral edema and necrosis (NTR) toward the tumor volume. For overall survival analyses, only patients after a surgical resection (residual tumor volume <2 cm3) followed by standard radiation and chemotherapy were included. RESULTS Pretreatment seizures occurred in 33% of cases (n = 224), younger patients (≤60 yr) were predominantly affected (P = .022). All measured volumes were inversely correlated with the onset of seizures (P = .001). In multivariate analyses, the total tumor volume and the NTR were considerably smaller within epileptogenic GBMs (P = .050, P = .019, respectively). A positive statin intake was associated with significantly lesser seizure (P = .007, odds ratio 4.94). Neither the occurrence of seizures nor the intake of statins had an impact on OS (P = .357, P = .507, respectively). CONCLUSION The size and amount of necrosis was significantly smaller in epileptogenic GBMs, maybe owed to the fact that these tumors were clinically detected at an earlier stage of their growth. Furthermore, the intake of statins was associated with a decreased occurrence of pretreatment seizures.
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Affiliation(s)
- Christian Henker
- Department of Neurosurgery, University Medicine of Rostock, Rostock, Germany
| | - Thomas Kriesen
- Department of Neurosurgery, University Medicine of Rostock, Rostock, Germany
| | - Moritz Scherer
- Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Änne Glass
- Institute for Biostatistics and Informatics in Medicine, University Medicine of Rostock, Rostock, Germany
| | - Andreas von Deimling
- Department of Neuropathology, Institute of Pathology, University Hospital, and, CCU Neuropathology German Cancer Research Center (DKFZ), and DKTK, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, University Medicine of Rostock, Rostock, Germany
| | | | - Andreas Unterberg
- Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Jürgen Piek
- Department of Neurosurgery, University Medicine of Rostock, Rostock, Germany
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22
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Leonetti A, Baroli G, Fratini E, Pietropaoli S, Marcoli M, Mariottini P, Cervelli M. Epileptic seizures and oxidative stress in a mouse model over-expressing spermine oxidase. Amino Acids 2020; 52:129-139. [PMID: 31197571 DOI: 10.1007/s00726-019-02749-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 06/05/2019] [Indexed: 12/19/2022]
Abstract
Several studies have demonstrated high polyamine levels in brain diseases such as epilepsy. Epilepsy is the fourth most common neurological disorder and affects people of all ages. Excitotoxic stress has been associated with epilepsy and it is considered one of the main causes of neuronal degeneration and death. The transgenic mouse line Dach-SMOX, with CD1 background, specifically overexpressing spermine oxidase in brain cortex, has been proven to be highly susceptible to epileptic seizures and excitotoxic stress induced by kainic acid. In this study, we analysed the effect of spermine oxidase over-expression in a different epileptic model, pentylenetetrazole. Behavioural evaluations of transgenic mice compared to controls showed a higher susceptibility towards pentylentetrazole. High-performance liquid chromatography analysis of transgenic brain from treated mice revealed altered polyamine content. Immunoistochemical analysis indicated a rise of 8-oxo-7,8-dihydro-2'-deoxyguanosine, demonstrating an increase in oxidative damage, and an augmentation of system xc- as a defence mechanism. This cascade of events can be initially linked to an increase in protein kinase C alpha, as shown by Western blot. This research points out the role of spermine oxidase, as a hydrogen peroxide producer, in the oxidative stress during epilepsy. Moreover, Dach-SMOX susceptibility demonstrated by two different epileptic models strongly indicates this transgenic mouse line as a potential animal model to study epilepsy.
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Affiliation(s)
- Alessia Leonetti
- Department of Science, University of Rome "Roma Tre", Viale Marconi 446, 00146, Rome, Italy
| | - Giulia Baroli
- Department of Science, University of Rome "Roma Tre", Viale Marconi 446, 00146, Rome, Italy
| | - Emiliano Fratini
- Department of Science, University of Rome "Roma Tre", Viale Marconi 446, 00146, Rome, Italy
| | - Stefano Pietropaoli
- Department of Science, University of Rome "Roma Tre", Viale Marconi 446, 00146, Rome, Italy
| | - Manuela Marcoli
- Section of Pharmacology and Toxicology, Department of Pharmacy, University of Genova, Viale Cembrano 4, 16148, Genoa, Italy
- Center of Excellence for Biomedical Research, University of Genova, Viale Benedetto XV 5, 16132, Genoa, Italy
| | - Paolo Mariottini
- Department of Science, University of Rome "Roma Tre", Viale Marconi 446, 00146, Rome, Italy
- Interuniversity Consortium of Structural and Systems Biology, Viale Medaglie d'Oro 305, 00136, Rome, Italy
| | - Manuela Cervelli
- Department of Science, University of Rome "Roma Tre", Viale Marconi 446, 00146, Rome, Italy.
- Interuniversity Consortium of Structural and Systems Biology, Viale Medaglie d'Oro 305, 00136, Rome, Italy.
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23
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Distinct P2Y Receptors Mediate Extension and Retraction of Microglial Processes in Epileptic and Peritumoral Human Tissue. J Neurosci 2020; 40:1373-1388. [PMID: 31896671 DOI: 10.1523/jneurosci.0218-19.2019] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 09/27/2019] [Accepted: 09/30/2019] [Indexed: 12/12/2022] Open
Abstract
Microglia exhibit multiple, phenotype-dependent motility patterns often triggered by purinergic stimuli. However, little data exist on motility of human microglia in pathological situations. Here we examine motility of microglia stained with a fluorescent lectin in tissue slices from female and male epileptic patients diagnosed with mesial temporal lobe epilepsy or cortical glioma (peritumoral cortex). Microglial shape varied from ramified to amoeboid cells predominantly in regions of high neuronal loss or closer to a tumor. Live imaging revealed unstimulated or purine-induced microglial motilities, including surveillance movements, membrane ruffling, and process extension or retraction. At different concentrations, ADP triggered opposing motilities. Low doses triggered process extension. It was suppressed by P2Y12 receptor antagonists, which also reduced process length and surveillance movements. Higher purine doses caused process retraction and membrane ruffling, which were blocked by joint application of P2Y1 and P2Y13 receptor antagonists. Purinergic effects on motility were similar for all microglia tested. Both amoeboid and ramified cells from mesial temporal lobe epilepsy or peritumoral cortex tissue expressed P2Y12 receptors. A minority of microglia expressed the adenosine A2A receptor, which has been linked with process withdrawal of rodent cells. Laser-mediated tissue damage let us test the functional significance of these effects. Moderate damage induced microglial process extension, which was blocked by P2Y12 receptor antagonists. Overall, the purine-induced motility of human microglia in epileptic tissue is similar to that of rodent microglia in that the P2Y12 receptor initiates process extension. It differs in that retraction is triggered by joint activation of P2Y1/P2Y13 receptors.SIGNIFICANCE STATEMENT Microglial cells are brain-resident immune cells with multiple functions in healthy or diseased brains. These diverse functions are associated with distinct phenotypes, including different microglial shapes. In the rodent, purinergic signaling is associated with changes in cell shape, such as process extension toward tissue damage. However, there are little data on living human microglia, especially in diseased states. We developed a reliable technique to stain microglia from epileptic and glioma patients to examine responses to purines. Low-intensity purinergic stimuli induced process extension, as in rodents. In contrast, high-intensity stimuli triggered a process withdrawal mediated by both P2Y1 and P2Y13 receptors. P2Y1/P2Y13 receptor activation has not previously been linked to microglial morphological changes.
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24
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Potassium and glutamate transport is impaired in scar-forming tumor-associated astrocytes. Neurochem Int 2019; 133:104628. [PMID: 31825815 PMCID: PMC6957761 DOI: 10.1016/j.neuint.2019.104628] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 01/09/2023]
Abstract
Unprovoked recurrent seizures are a serious comorbidity affecting most patients who suffer from glioma, a primary brain tumor composed of malignant glial cells. Cellular mechanisms contributing to the development of recurrent spontaneous seizures include the release of the excitatory neurotransmitter glutamate from glioma into extracellular space. Under physiological conditions, astrocytes express two high affinity glutamate transporters, Glt-1 and Glast, which are responsible for the removal of excess extracellular glutamate. In the context of neurological disease or brain injury, astrocytes become reactive which can negatively affect neuronal function, causing hyperexcitability and/or death. Using electrophysiology, immunohistochemistry, fluorescent in situ hybridization, and Western blot analysis in different orthotopic xenograft and allograft models of human and mouse gliomas, we find that peritumoral astrocytes exhibit astrocyte scar formation characterized by proliferation, cellular hypertrophy, process elongation, and increased GFAP and pSTAT3. Overall, peritumoral reactive astrocytes show a significant reduction in glutamate and potassium uptake, as well as decreased glutamine synthetase activity. A subset of peritumoral astrocytes displayed a depolarized resting membrane potential, further contributing to reduced potassium and glutamate homeostasis. These changes may contribute to the propagation of peritumoral neuronal hyperexcitability and excitotoxic death.
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25
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Chen X, Tamang SM, Du F, Ongur D. Glutamate diffusion in the rat brain in vivo under light and deep anesthesia conditions. Magn Reson Med 2019; 82:84-94. [PMID: 30860289 DOI: 10.1002/mrm.27722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 01/08/2019] [Accepted: 02/11/2019] [Indexed: 11/08/2022]
Abstract
PURPOSE Glutamate (Glu) is the most abundant neurotransmitter in the human central nervous system and glutamatergic neurotransmission has been implicated in many common and severe neuropsychiatric disorders. In vivo MRS techniques have been developed to measure brain Glu concentration to investigate the pathophysiology of various brain disorders. However, it is difficult to interpret Glu signal changes because Glu plays multiple roles in the brain and is found in multiple microenvironments including cytosolic, vesicular, and extracellular. METHODS In vivo diffusion-weighted MRS (DW-MRS) with low to very high b-values was performed on the rat prefrontal cortex at 9.4T under both light and deep anesthetic conditions to examine Glu diffusion properties. RESULTS Significant alterations in Glu diffusion as well as reduced Glu concentration were observed under deep anesthesia compared with superficial anesthesia in the absence of similar changes in NAA or creatine. CONCLUSION The modifications in Glu diffusion under deep anesthesia might reflect changes in Glu microenvironment. The present work shows that Glu DW-MRS could be an important tool to explore Glu physiology with changing levels of neuronal activity and synaptic function.
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Affiliation(s)
- Xi Chen
- McLean Imaging Center, McLean Hospital, Harvard Medical School, Belmont, Massachusetts.,Psychotic Disorders Division, McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Siddartha M Tamang
- Psychotic Disorders Division, McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Fei Du
- McLean Imaging Center, McLean Hospital, Harvard Medical School, Belmont, Massachusetts.,Psychotic Disorders Division, McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Dost Ongur
- Psychotic Disorders Division, McLean Hospital, Harvard Medical School, Belmont, Massachusetts
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26
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Canzian J, Fontana BD, Quadros VA, Müller TE, Duarte T, Rosemberg DB. Single pentylenetetrazole exposure increases aggression in adult zebrafish at different time intervals. Neurosci Lett 2019; 692:27-32. [DOI: 10.1016/j.neulet.2018.10.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/18/2018] [Accepted: 10/19/2018] [Indexed: 12/28/2022]
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27
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Dührsen L, Sauvigny T, Ricklefs FL, Mende K, Schaper M, Matschke J, Goebell E, Westphal M, Martens T. Seizures as presenting symptom in patients with glioblastoma. Epilepsia 2018; 60:149-154. [DOI: 10.1111/epi.14615] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 11/06/2018] [Accepted: 11/07/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Lasse Dührsen
- Department of Neurosurgery University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Thomas Sauvigny
- Department of Neurosurgery University Medical Center Hamburg‐Eppendorf Hamburg Germany
- Center for Molecular Neurobiology Institute for Molecular and Cellular Cognition Hamburg Germany
| | - Franz L. Ricklefs
- Department of Neurosurgery University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Klaus‐Christian Mende
- Department of Neurosurgery University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Miriam Schaper
- Department of Neurosurgery University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Jakob Matschke
- Institute of Neuropathology University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Einar Goebell
- Department of Neuroradiology University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Manfred Westphal
- Department of Neurosurgery University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Tobias Martens
- Department of Neurosurgery University Medical Center Hamburg‐Eppendorf Hamburg Germany
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28
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Abstract
The World Health Organization classifies diffuse low-grade gliomas (DLGGs) are highly epileptogenic primary brain tumors; epileptic seizures occur in more than 90% of cases. Epileptic seizures and drug resistance progress during the course of DLGGs. The glioma-related epileptogenic mechanisms are multifactorial; epileptogenic foci lie within the infiltrated peritumoral neocortex. A short seizure duration before surgery and a large extent of resection are the main predictors of postoperative seizure control in DLGGs. A supratotal resection of a DLGG can improve postoperative seizure control. Epileptic seizure at diagnosis positively affects DLGGs malignant transformation and overall survival.
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Affiliation(s)
- Johan Pallud
- Department of Neurosurgery, Sainte-Anne Hospital, 1 rue Cabanis, Paris Cedex 14 75674, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France; French Glioma Study Group, Réseau d'Etude des Gliomes, REG, Groland, France; Inserm, U894, Centre Psychiatrie et Neurosciences, Paris, France.
| | - Guy M McKhann
- Department of Neurological Surgery, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY, USA
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29
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Osipova ED, Semyachkina-Glushkovskaya OV, Morgun AV, Pisareva NV, Malinovskaya NA, Boitsova EB, Pozhilenkova EA, Belova OA, Salmin VV, Taranushenko TE, Noda M, Salmina AB. Gliotransmitters and cytokines in the control of blood-brain barrier permeability. Rev Neurosci 2018; 29:567-591. [DOI: 10.1515/revneuro-2017-0092] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 11/26/2017] [Indexed: 11/15/2022]
Abstract
AbstractThe contribution of astrocytes and microglia to the regulation of neuroplasticity or neurovascular unit (NVU) is based on the coordinated secretion of gliotransmitters and cytokines and the release and uptake of metabolites. Blood-brain barrier (BBB) integrity and angiogenesis are influenced by perivascular cells contacting with the abluminal side of brain microvessel endothelial cells (pericytes, astrocytes) or by immune cells existing (microglia) or invading the NVU (macrophages) under pathologic conditions. The release of gliotransmitters or cytokines by activated astroglial and microglial cells is provided by distinct mechanisms, affects intercellular communication, and results in the establishment of microenvironment controlling BBB permeability and neuroinflammation. Glial glutamate transporters and connexin and pannexin hemichannels working in the tight functional coupling with the purinergic system serve as promising molecular targets for manipulating the intercellular communications that control BBB permeability in brain pathologies associated with excessive angiogenesis, cerebrovascular remodeling, and BBB-mediated neuroinflammation. Substantial progress in deciphering the molecular mechanisms underlying the (patho)physiology of perivascular glia provides promising approaches to novel clinically relevant therapies for brain disorders. The present review summarizes the current understandings on the secretory machinery expressed in glial cells (glutamate transporters, connexin and pannexin hemichannels, exocytosis mechanisms, membrane-derived microvesicles, and inflammasomes) and the role of secreted gliotransmitters and cytokines in the regulation of NVU and BBB permeability in (patho)physiologic conditions.
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30
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Zhao X, Chen R, Liu M, Feng J, Chen J, Hu K. Remodeling the blood-brain barrier microenvironment by natural products for brain tumor therapy. Acta Pharm Sin B 2017; 7:541-553. [PMID: 28924548 PMCID: PMC5595291 DOI: 10.1016/j.apsb.2017.07.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 06/08/2017] [Accepted: 07/12/2017] [Indexed: 12/23/2022] Open
Abstract
Brain tumor incidence shows an upward trend in recent years; brain tumors account for 5% of adult tumors, while in children, this figure has increased to 70%. Moreover, 20%-30% of malignant tumors will eventually metastasize into the brain. Both benign and malignant tumors can cause an increase in intracranial pressure and brain tissue compression, leading to central nervous system (CNS) damage which endangers the patients' lives. Despite the many approaches to treating brain tumors and the progress that has been made, only modest gains in survival time of brain tumor patients have been achieved. At present, chemotherapy is the treatment of choice for many cancers, but the special structure of the blood-brain barrier (BBB) limits most chemotherapeutic agents from passing through the BBB and penetrating into tumors in the brain. The BBB microenvironment contains numerous cell types, including endothelial cells, astrocytes, peripheral cells and microglia, and extracellular matrix (ECM). Many chemical components of natural products are reported to regulate the BBB microenvironment near brain tumors and assist in their treatment. This review focuses on the composition and function of the BBB microenvironment under both physiological and pathological conditions, and the current research progress in regulating the BBB microenvironment by natural products to promote the treatment of brain tumors.
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Affiliation(s)
- Xiao Zhao
- Murad Research Center for Modernized Chinese Medicine, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Rujing Chen
- Murad Research Center for Modernized Chinese Medicine, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Mei Liu
- Murad Research Center for Modernized Chinese Medicine, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jianfang Feng
- Murad Research Center for Modernized Chinese Medicine, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jun Chen
- Key Laboratory of Smart Drug Delivery, Fudan University, Ministry of Education, Shanghai 201203, China
| | - Kaili Hu
- Murad Research Center for Modernized Chinese Medicine, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
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31
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Huang C, Chi XS, Hu X, Chen N, Zhou Q, Zhou D, Li JM. Predictors and mechanisms of epilepsy occurrence in cerebral gliomas: What to look for in clinicopathology. Exp Mol Pathol 2017; 102:115-122. [PMID: 28087392 DOI: 10.1016/j.yexmp.2017.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 01/02/2017] [Accepted: 01/06/2017] [Indexed: 02/05/2023]
Abstract
Gliomas, especially low-grade gliomas, are highly epileptogenic brain tumors. Histopathological information is valuable in evaluating the diagnosis and/or biologic behavior of various gliomas. Here we explored the clinical data and histopathological predictors of the occurrence of epilepsy in patients with gliomas. A retrospective study examined 310 consecutive patients who had undergone surgical treatment for gliomas in our institution from January 2013 to January 2015. Clinical data and pathological examination results were analyzed. Literatures regarding the predictors and etiology of glioma associated epileptic seizures in the period of 1995-2015 were also reviewed. A total of 234 (75.5%) astrocytic tumors and 76 (24.5%) oligodendrial tumors were included. At diagnosis, 33.6% of patients had epileptic seizures. Multivariate analysis revealed cortex involvement (OR=7.991, 95%CI=1.599-39.926), lower World Health Organization grade (OR=3.584, 95%CI=1.032-12.346) and topoisomerase II (TopoII) positivity (OR=0.943, 95%CI=0.903-0.982) were strong predictors for preoperative epileptic seizures. Gender, disease course, tumor classification, location or volume did not significantly affect epileptic seizure occurrence. Forty-three publications involved glioma-associated epilepsy were found in PubMed online database and key data were extracted and summarized. The present studies on glioma-related epilepsy are relatively limited and inconsistent. Low-grade gliomas, cortex involvement and TopoII positivity were independent predictors of a history of epileptic seizures at diagnosis. Further studies to examine the underlying mechanism of topoisomerase II as well as other molecules in epilepsy occurrence in brain gliomas are needed in the future.
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Affiliation(s)
- Cheng Huang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China; Rehabilitation Medicine Center, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Xiao-Sa Chi
- Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Xin Hu
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Ni Chen
- Department of Pathology, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Qiao Zhou
- Department of Pathology, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Dong Zhou
- Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Jin-Mei Li
- Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China.
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32
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Zhou XW, Wang X, Yang Y, Luo JW, Dong H, Liu YH, Mao Q. Biomarkers related with seizure risk in glioma patients: A systematic review. Clin Neurol Neurosurg 2016; 151:113-119. [PMID: 27821299 DOI: 10.1016/j.clineuro.2016.10.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 10/03/2016] [Indexed: 02/05/2023]
Abstract
Increasing evidence indicates that genetic biomarkers play important roles in the development of glioma-associated seizures. Thus, we performed a systematic review to summarise biomarkers that are associated with seizures in glioma patients. An electronic literature search of public databases (PubMed, Embase and Medline) was performed using the keywords glioma, seizure and epilepsy. A totall of 26 eligible studies with 2224 cases were included in this systematic review of publications to 20 June, 2016. Genetic biomarkers such as isocitrate dehydrogenase 1 (IDH1) mutations, low expression of excitatory amino acid transporter 2 (EAAT2), high xCT expression, overexpression of adenosine kinase (ADK) and low expression of very large G-protein-coupled receptor-1 (VLGR1) are primarily involved in synaptic transmission, whereas BRAF mutations, epidermal growth factor receptor (EGFR) amplification, miR-196b expression and low ki-67 expression are associated with regulation of cell proliferation. However, there is limited evidence regarding the roles of RAD50 interactor 1 (RINT1) and olig2 in epileptogenesis among glioma patients. Glioma-related seizure was related to the dysfunction of tumor microenvironment. Our findings may provide new mechanistic insights into targeted therapy for glioma-related seizures and may result in the development of multi-target therapies.
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Affiliation(s)
- Xing-Wang Zhou
- Department of Neurosurgery, West China Hospital, Si Chuan University, Chengdu 610041, China
| | - Xiang Wang
- Department of Neurosurgery, West China Hospital, Si Chuan University, Chengdu 610041, China
| | - Yuan Yang
- Department of Neurosurgery, West China Hospital, Si Chuan University, Chengdu 610041, China
| | - Jie-Wen Luo
- Department of Neurosurgery, West China Hospital, Si Chuan University, Chengdu 610041, China
| | - Hui Dong
- Department of Neurosurgery, West China Hospital, Si Chuan University, Chengdu 610041, China
| | - Yan-Hui Liu
- Department of Neurosurgery, West China Hospital, Si Chuan University, Chengdu 610041, China
| | - Qing Mao
- Department of Neurosurgery, West China Hospital, Si Chuan University, Chengdu 610041, China.
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33
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Keen JR, Swanger SA, Traynelis SF, Olson JJ. The role of glutamate transport and SLC7A11 expression in tumor-associate seizures and survival in patients with malignant gliomas. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:S18. [PMID: 27867986 DOI: 10.21037/atm.2016.10.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Joseph R Keen
- Department of Neurosurgery, Emory University, Atlanta, GA 30322, USA
| | - Sharon A Swanger
- Department of Pharmacology, Emory University, Atlanta, GA 30322, USA
| | | | - Jeffrey J Olson
- Department of Neurosurgery, Emory University, Atlanta, GA 30322, USA
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34
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Abstract
Epilepsy is among the most prevalent chronic neurological diseases and affects an estimated 2.2 million people in the United States alone. About one third of patients are resistant to currently available antiepileptic drugs, which are exclusively targeting neuronal function. Yet, reactive astrocytes have emerged as potential contributors to neuronal hyperexcitability and seizures. Astrocytes react to any kind of CNS insult with a range of cellular adjustments to form a scar and protect uninjured brain regions. This process changes astrocyte physiology and can affect neuronal network function in various ways. Traumatic brain injury and stroke, both conditions that trigger astroglial scar formation, are leading causes of acquired epilepsies and surgical removal of this glial scar in patients with drug-resistant epilepsy can alleviate the seizures. This review will summarize the currently available evidence suggesting that epilepsy is not a disease of neurons alone, but that astrocytes, glial cells in the brain, can be major contributors to the disease, especially when they adopt a reactive state in response to central nervous system insult.
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Affiliation(s)
- Stefanie Robel
- Virginia Tech Carilion Research Institute, Roanoke, VA, USA
- Virginia Tech School of Neuroscience, Blacksburg, VA, USA
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35
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Huberfeld G, Vecht CJ. Seizures and gliomas — towards a single therapeutic approach. Nat Rev Neurol 2016; 12:204-16. [DOI: 10.1038/nrneurol.2016.26] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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36
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Robel S, Sontheimer H. Glia as drivers of abnormal neuronal activity. Nat Neurosci 2016; 19:28-33. [PMID: 26713746 PMCID: PMC4966160 DOI: 10.1038/nn.4184] [Citation(s) in RCA: 139] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 09/04/2015] [Indexed: 12/13/2022]
Abstract
Reactive astrocytes have been proposed to become incompetent bystanders in epilepsy as a result of cellular changes rendering them unable to perform important housekeeping functions. Indeed, successful surgical treatment of mesiotemporal lobe epilepsy hinges on the removal of the glial scar. New research now extends the role of astrocytes, suggesting that they may drive the disease process by impairing the inhibitory action of neuronal GABA receptors. Here we discuss studies that include hyperexcitability resulting from impaired supply of astrocytic glutamine for neuronal GABA synthesis, and epilepsy resulting from genetically induced astrogliosis or malignant transformation, both of which render the inhibitory neurotransmitter GABA excitatory. In these examples, glial cells alter the expression or function of neuronal proteins involved in excitability. Although epilepsy has traditionally been thought of as a disease caused by changes in neuronal properties exclusively, these new findings challenge us to consider the contribution of glial cells as drivers of epileptogenesis in acquired epilepsies.
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Affiliation(s)
- Stefanie Robel
- Virginia Tech Carilion Research Institute, Glial Biology in Health, Disease, and Cancer Center, Roanoke, Virginia, USA
| | - Harald Sontheimer
- Virginia Tech Carilion Research Institute, Glial Biology in Health, Disease, and Cancer Center, Roanoke, Virginia, USA
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37
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Armstrong TS, Grant R, Gilbert MR, Lee JW, Norden AD. Epilepsy in glioma patients: mechanisms, management, and impact of anticonvulsant therapy. Neuro Oncol 2015; 18:779-89. [PMID: 26527735 DOI: 10.1093/neuonc/nov269] [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: 08/01/2015] [Accepted: 10/01/2015] [Indexed: 12/16/2022] Open
Abstract
Seizures are a well-recognized symptom of primary brain tumors, and anticonvulsant use is common. This paper provides an overview of epilepsy and the use of anticonvulsants in glioma patients. Overall incidence and mechanisms of epileptogenesis are reviewed. Factors to consider with the use of antiepileptic drugs (AEDs) including incidence during the disease trajectory and prophylaxis along with considerations in the selection of anticonvulsant use (ie, potential side effects, drug interactions, adverse effects, and impact on survival) are also reviewed. Finally, areas for future research and exploring the pathophysiology and use of AEDs in this population are also discussed.
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Affiliation(s)
- Terri S Armstrong
- Department of Family Health, University of Texas Health Science Center at Houston, Houston, Texas (T.S.A.); Edinburgh Centre for Neuro-Oncology, Edinburgh, UK (R.G.); Neuro-Oncology Branch, National Cancer Institute and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland (M.R.G.); Division of EEG and Epilepsy, Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts (J.W.L.); Center for Neuro-Oncology, Dana-Farber Cancer Institute; Division of Cancer Neurology, Department of Neurology, Brigham and Women's Hospital; and Harvard Medical School, Boston, Massachusetts (A.D.N.)
| | - Robin Grant
- Department of Family Health, University of Texas Health Science Center at Houston, Houston, Texas (T.S.A.); Edinburgh Centre for Neuro-Oncology, Edinburgh, UK (R.G.); Neuro-Oncology Branch, National Cancer Institute and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland (M.R.G.); Division of EEG and Epilepsy, Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts (J.W.L.); Center for Neuro-Oncology, Dana-Farber Cancer Institute; Division of Cancer Neurology, Department of Neurology, Brigham and Women's Hospital; and Harvard Medical School, Boston, Massachusetts (A.D.N.)
| | - Mark R Gilbert
- Department of Family Health, University of Texas Health Science Center at Houston, Houston, Texas (T.S.A.); Edinburgh Centre for Neuro-Oncology, Edinburgh, UK (R.G.); Neuro-Oncology Branch, National Cancer Institute and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland (M.R.G.); Division of EEG and Epilepsy, Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts (J.W.L.); Center for Neuro-Oncology, Dana-Farber Cancer Institute; Division of Cancer Neurology, Department of Neurology, Brigham and Women's Hospital; and Harvard Medical School, Boston, Massachusetts (A.D.N.)
| | - Jong Woo Lee
- Department of Family Health, University of Texas Health Science Center at Houston, Houston, Texas (T.S.A.); Edinburgh Centre for Neuro-Oncology, Edinburgh, UK (R.G.); Neuro-Oncology Branch, National Cancer Institute and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland (M.R.G.); Division of EEG and Epilepsy, Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts (J.W.L.); Center for Neuro-Oncology, Dana-Farber Cancer Institute; Division of Cancer Neurology, Department of Neurology, Brigham and Women's Hospital; and Harvard Medical School, Boston, Massachusetts (A.D.N.)
| | - Andrew D Norden
- Department of Family Health, University of Texas Health Science Center at Houston, Houston, Texas (T.S.A.); Edinburgh Centre for Neuro-Oncology, Edinburgh, UK (R.G.); Neuro-Oncology Branch, National Cancer Institute and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland (M.R.G.); Division of EEG and Epilepsy, Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts (J.W.L.); Center for Neuro-Oncology, Dana-Farber Cancer Institute; Division of Cancer Neurology, Department of Neurology, Brigham and Women's Hospital; and Harvard Medical School, Boston, Massachusetts (A.D.N.)
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38
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Van Liefferinge J, Bentea E, Demuyser T, Albertini G, Follin-Arbelet V, Holmseth S, Merckx E, Sato H, Aerts JL, Smolders I, Arckens L, Danbolt NC, Massie A. Comparative analysis of antibodies to xCT (Slc7a11): Forewarned is forearmed. J Comp Neurol 2015; 524:1015-32. [DOI: 10.1002/cne.23889] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 08/24/2015] [Accepted: 08/25/2015] [Indexed: 12/21/2022]
Affiliation(s)
- Joeri Van Liefferinge
- Department of Pharmaceutical Chemistry and Drug Analysis, Center for Neurosciences; Vrije Universiteit Brussel; Brussels 1090 Belgium
| | - Eduard Bentea
- Department of Pharmaceutical Biotechnology and Molecular Biology, Center for Neurosciences; Vrije Universiteit Brussel; Brussels 1090 Belgium
| | - Thomas Demuyser
- Department of Pharmaceutical Chemistry and Drug Analysis, Center for Neurosciences; Vrije Universiteit Brussel; Brussels 1090 Belgium
| | - Giulia Albertini
- Department of Pharmaceutical Chemistry and Drug Analysis, Center for Neurosciences; Vrije Universiteit Brussel; Brussels 1090 Belgium
| | - Virginie Follin-Arbelet
- Department of Molecular Medicine, Institute of Basic Medical Sciences; University of Oslo; Oslo 0317 Norway
| | - Silvia Holmseth
- Department of Molecular Medicine, Institute of Basic Medical Sciences; University of Oslo; Oslo 0317 Norway
| | - Ellen Merckx
- Department of Pharmaceutical Biotechnology and Molecular Biology, Center for Neurosciences; Vrije Universiteit Brussel; Brussels 1090 Belgium
| | - Hideyo Sato
- Laboratory of Biochemistry and Molecular Biology, Department of Medical Technology; Niigata University; Niigata Niigata Prefecture 950-2181 Japan
| | - Joeri L. Aerts
- Laboratory of Molecular and Cellular Therapy, Department of Immunology-Physiology; Vrije Universiteit Brussel; Brussels 1090 Belgium
| | - Ilse Smolders
- Department of Pharmaceutical Chemistry and Drug Analysis, Center for Neurosciences; Vrije Universiteit Brussel; Brussels 1090 Belgium
| | - Lutgarde Arckens
- Laboratory of Neuroplasticity and Neuroproteomics; KU Leuven; Leuven 3000 Belgium
| | - Niels C. Danbolt
- Department of Molecular Medicine, Institute of Basic Medical Sciences; University of Oslo; Oslo 0317 Norway
| | - Ann Massie
- Department of Pharmaceutical Biotechnology and Molecular Biology, Center for Neurosciences; Vrije Universiteit Brussel; Brussels 1090 Belgium
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39
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Choi J, Stradmann-Bellinghausen B, Yakubov E, Savaskan NE, Régnier-Vigouroux A. Glioblastoma cells induce differential glutamatergic gene expressions in human tumor-associated microglia/macrophages and monocyte-derived macrophages. Cancer Biol Ther 2015; 16:1205-13. [PMID: 26047211 PMCID: PMC4623498 DOI: 10.1080/15384047.2015.1056406] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Glioblastoma cells produce and release high amounts of glutamate into the extracellular milieu and subsequently can trigger seizure in patients. Tumor-associated microglia/macrophages (TAMs), consisting of both parenchymal microglia and monocytes-derived macrophages (MDMs) recruited from the blood, are known to populate up to 1/3 of the glioblastoma tumor environment and exhibit an alternative, tumor-promoting and supporting phenotype. However, it is unknown how TAMs respond to the excess extracellular glutamate in the glioblastoma microenvironment. We investigated the expressions of genes related to glutamate transport and metabolism in human TAMs freshly isolated from glioblastoma resections. Quantitative real-time PCR analysis showed (i) significant increases in the expressions of GRIA2 (GluA2 or AMPA receptor 2), SLC1A2 (EAAT2), SLC1A3 (EAAT1), (ii) a near-significant decrease in the expression of SLC7A11 (cystine-glutamate antiporter xCT) and (iii) a remarkable increase in GLUL expression (glutamine synthetase) in these cells compared to adult primary human microglia. TAMs co-cultured with glioblastoma cells also exhibited a similar glutamatergic profile as freshly isolated TAMs except for a slight increase in SLC7A11 expression. We next analyzed these genes expressions in cultured human MDMs derived from peripheral blood monocytes for comparison. In contrast, MDMs co-cultured with glioblastoma cells compared to MDMs co-cultured with normal astrocytes exhibited decreased expressions in the tested genes except for GLUL. This is the first study to demonstrate transcriptional changes in glutamatergic signaling of TAMs in a glioblastoma microenvironment, and the findings here suggest that TAMs and MDMs might potentially elicit different cellular responses in the presence of excess extracellular glutamate.
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Key Words
- GS, glutamine synthetase
- HBSS, Hanks' Balance Salts Solution
- IL-10, interleukin-10
- MACS, magnetic-activated cell sorting
- MDMs, monocytes-derived macrophages
- MRC1, mannose receptor
- NHA, normal human astrocytes
- TAMs, Tumor-associated microglia/macrophages
- VEGF, vascular endothelial growth factor
- glioblastoma
- glutamate
- monocyte-derived macrophages
- qRT-PCR, quantitative real-time PCR
- tumor-associated microglia/macrophages
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Affiliation(s)
- Judy Choi
- a Johannes Gutenberg University of Mainz; Mainz, Germany
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40
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Pallud J, Le Van Quyen M, Bielle F, Pellegrino C, Varlet P, Cresto N, Baulac M, Duyckaerts C, Kourdougli N, Chazal G, Devaux B, Rivera C, Miles R, Capelle L, Huberfeld G. Cortical GABAergic excitation contributes to epileptic activities around human glioma. Sci Transl Med 2015; 6:244ra89. [PMID: 25009229 DOI: 10.1126/scitranslmed.3008065] [Citation(s) in RCA: 191] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Brain gliomas are highly epileptogenic. Excitatory glutamatergic mechanisms are involved in the generation of epileptic activities in the neocortex surrounding gliomas. However, chloride homeostasis is known to be perturbed in glioma cells. Thus, the contribution of γ-aminobutyric acidergic (GABAergic) mechanisms that depend on intracellular chloride merits closer study. We studied the occurrence, networks, cells, and signaling basis of epileptic activities in neocortical slices from the peritumoral surgical margin resected around human brain gliomas. Postoperative glioma tissue from 69% of patients spontaneously generated interictal-like discharges, synchronized, with a high-frequency oscillation signature, in superficial layers of neocortex around areas of glioma infiltration. Interictal-like events depended both on glutamatergic AMPA receptor-mediated transmission and on depolarizing GABAergic signaling. GABA released by interneurons depolarized 65% of pyramidal cells, in which chloride homeostasis was perturbed because of changes in expression of neuronal chloride cotransporters: KCC2 (K-Cl cotransporter 2) was reduced by 42% and expression of NKCC1 (Na-K-2Cl cotransporter 1) increased by 144%. Ictal-like activities were initiated by convulsant stimuli exclusively in these epileptogenic areas. This study shows that epileptic activities are sustained by excitatory effects of GABA in human peritumoral neocortex, as reported in temporal lobe epilepsies, suggesting that both glutamate and GABA signaling and cellular chloride regulation processes, all also involved in oncogenesis as already shown, induce an imbalance between synaptic excitation and inhibition underlying epileptic discharges in glioma patients. Thus, the control of chloride in neurons and glioma cells may provide a therapeutic target for patients with epileptogenic gliomas.
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Affiliation(s)
- Johan Pallud
- Institut du Cerveau et de la Moelle Epinière, INSERM UMRS975, CNRS UMR7225, Université Pierre et Marie Curie (UPMC), Paris, France.,Service de Neurochirurgie, Centre Hospitalier Sainte-Anne, Paris, France.,Université Paris Descartes, France
| | - Michel Le Van Quyen
- Institut du Cerveau et de la Moelle Epinière, INSERM UMRS975, CNRS UMR7225, Université Pierre et Marie Curie (UPMC), Paris, France
| | - Franck Bielle
- Service de Neuropathologie, Centre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Christophe Pellegrino
- INMED, Parc Scientifique de Luminy, Marseille, France.,Université de la Méditerranée, UMR S901 Aix-Marseille Université, Marseille, France
| | - Pascale Varlet
- Service de Neuropathologie, Centre Hospitalier Sainte-Anne, Paris, France
| | - Noemie Cresto
- Institut du Cerveau et de la Moelle Epinière, INSERM UMRS975, CNRS UMR7225, Université Pierre et Marie Curie (UPMC), Paris, France
| | - Michel Baulac
- Institut du Cerveau et de la Moelle Epinière, INSERM UMRS975, CNRS UMR7225, Université Pierre et Marie Curie (UPMC), Paris, France.,Unité d'Epileptologie, Centre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Charles Duyckaerts
- Service de Neuropathologie, Centre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Nazim Kourdougli
- INMED, Parc Scientifique de Luminy, Marseille, France.,Université de la Méditerranée, UMR S901 Aix-Marseille Université, Marseille, France
| | - Geneviève Chazal
- INMED, Parc Scientifique de Luminy, Marseille, France.,Université de la Méditerranée, UMR S901 Aix-Marseille Université, Marseille, France
| | - Bertrand Devaux
- Service de Neurochirurgie, Centre Hospitalier Sainte-Anne, Paris, France.,Université Paris Descartes, France
| | - Claudio Rivera
- INMED, Parc Scientifique de Luminy, Marseille, France.,Université de la Méditerranée, UMR S901 Aix-Marseille Université, Marseille, France.,Neuroscience Center, University of Helsinki, Finland
| | - Richard Miles
- Institut du Cerveau et de la Moelle Epinière, INSERM UMRS975, CNRS UMR7225, Université Pierre et Marie Curie (UPMC), Paris, France
| | - Laurent Capelle
- Institut du Cerveau et de la Moelle Epinière, INSERM UMRS975, CNRS UMR7225, Université Pierre et Marie Curie (UPMC), Paris, France.,Service de Neurochirurgie, Centre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Gilles Huberfeld
- Institut du Cerveau et de la Moelle Epinière, INSERM UMRS975, CNRS UMR7225, Université Pierre et Marie Curie (UPMC), Paris, France.,Service de Neuropathologie, Centre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France.,Unité d'Epileptologie, Centre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France.,Département de Neurophysiologie, UPMC, Centre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
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41
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Masoudian N, Riazi GH, Afrasiabi A, Modaresi SMS, Dadras A, Rafiei S, Yazdankhah M, Lyaghi A, Jarah M, Ahmadian S, Seidkhani H. Variations of glutamate concentration within synaptic cleft in the presence of electromagnetic fields: an artificial neural networks study. Neurochem Res 2015; 40:629-42. [PMID: 25577979 DOI: 10.1007/s11064-014-1509-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 12/20/2014] [Accepted: 12/26/2014] [Indexed: 12/31/2022]
Abstract
Glutamate is an excitatory neurotransmitter that is released by the majority of central nervous system synapses and is involved in developmental processes, cognitive functions, learning and memory. Excessive elevated concentrations of Glu in synaptic cleft results in neural cell apoptosis which is called excitotoxicity causing neurodegenerative diseases. Hence, we investigated the possibility of extremely low frequency electromagnetic fields (ELF-EMF) as a risk factor which is able to change Glu concentration in synaptic clef. Synaptosomes as a model of nervous terminal were exposed to ELF-EMF for 15-55 min in flux intensity range from 0.1 to 2 mT and frequency range from 50 to 230 Hz. Finally, all raw data by INForm v4.02 software as an artificial neural network program was analyzed to predict the effect of whole mentioned range spectra. The results showed the tolerance of all effects between the ranges from -35 to +40 % compared to normal state when glutamatergic systems exposed to ELF-EMF. It indicates that glutamatergic system attempts to compensate environmental changes though release or reuptake in order to keep the system safe. Regarding to the wide range of ELF-EMF acquired in this study, the obtained outcomes have potential for developing treatments based on ELF-EMF for some neurological diseases; however, in vivo experiments on the cross linking responses between glutamatergic and cholinergic systems in the presence of ELF-EMF would be needed.
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Affiliation(s)
- Neda Masoudian
- Institute of Biochemistry and Biophysics (I.B.B.), University of Tehran, Tehran, Iran
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42
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Cifuentes Castro VH, López Valenzuela CL, Salazar Sánchez JC, Peña KP, López Pérez SJ, Ibarra JO, Villagrán AM. An update of the classical and novel methods used for measuring fast neurotransmitters during normal and brain altered function. Curr Neuropharmacol 2014; 12:490-508. [PMID: 25977677 PMCID: PMC4428024 DOI: 10.2174/1570159x13666141223223657] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 11/22/2014] [Accepted: 12/19/2014] [Indexed: 11/22/2022] Open
Abstract
To understand better the cerebral functions, several methods have been developed to study the brain activity, they could be related with morphological, electrophysiological, molecular and neurochemical techniques. Monitoring neurotransmitter concentration is a key role to know better how the brain works during normal or pathological conditions, as well as for studying the changes in neurotransmitter concentration with the use of several drugs that could affect or reestablish the normal brain activity. Immediate response of the brain to environmental conditions is related with the release of the fast acting neurotransmission by glutamate (Glu), γ-aminobutyric acid (GABA) and acetylcholine (ACh) through the opening of ligand-operated ion channels. Neurotransmitter release is mainly determined by the classical microdialysis technique, this is generally coupled to high performance liquid chromatography (HPLC). Detection of neurotransmitters can be done by fluorescence, optical density, electrochemistry or other detection systems more sophisticated. Although the microdialysis method is the golden technique to monitor the brain neurotransmitters, it has a poor temporal resolution. Recently, with the use of biosensor the drawback of temporal resolution has been improved considerably, however other inconveniences have merged, such as stability, reproducibility and the lack of reliable biosensors mainly for GABA. The aim of this review is to show the important advances in the different ways to measure neurotransmitter concentrations; both with the use of classic techniques as well as with the novel methods and alternant approaches to improve the temporal resolution.
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Affiliation(s)
| | | | | | | | | | | | - Alberto Morales Villagrán
- Department of Molecular and Cellular Biology, Camino Ramón Padilla Sánchez 2100, Nextipac, Zapopan,
Jalisco, México, Zip code: 45110, Mexico
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43
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Di Angelantonio S, Murana E, Cocco S, Scala F, Bertollini C, Molinari MG, Lauro C, Bregestovski P, Limatola C, Ragozzino D. A role for intracellular zinc in glioma alteration of neuronal chloride equilibrium. Cell Death Dis 2014; 5:e1501. [PMID: 25356870 PMCID: PMC4237258 DOI: 10.1038/cddis.2014.437] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 09/04/2014] [Accepted: 09/09/2014] [Indexed: 11/16/2022]
Abstract
Glioma patients commonly suffer from epileptic seizures. However, the mechanisms of glioma-associated epilepsy are far to be completely understood. Using glioma-neurons co-cultures, we found that tumor cells are able to deeply influence neuronal chloride homeostasis, by depolarizing the reversal potential of γ-aminobutyric acid (GABA)-evoked currents (EGABA). EGABA depolarizing shift is due to zinc-dependent reduction of neuronal KCC2 activity and requires glutamate release from glioma cells. Consistently, intracellular zinc loading rapidly depolarizes EGABA in mouse hippocampal neurons, through the Src/Trk pathway and this effect is promptly reverted upon zinc chelation. This study provides a possible molecular mechanism linking glioma invasion to excitation/inhibition imbalance and epileptic seizures, through the zinc-mediated disruption of neuronal chloride homeostasis.
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Affiliation(s)
- S Di Angelantonio
- Istituto Pasteur-Fondazione Cenci Bolognetti, Department of Physiology and Pharmacology, Sapienza University of Rome, Piazzale Aldo Piazzale Aldo Moro 5, Roma 00185, Italy
- Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia, Viale Regina Elena 291, Roma 00161, Italy
| | - E Murana
- Istituto Pasteur-Fondazione Cenci Bolognetti, Department of Physiology and Pharmacology, Sapienza University of Rome, Piazzale Aldo Piazzale Aldo Moro 5, Roma 00185, Italy
| | - S Cocco
- Istituto Pasteur-Fondazione Cenci Bolognetti, Department of Physiology and Pharmacology, Sapienza University of Rome, Piazzale Aldo Piazzale Aldo Moro 5, Roma 00185, Italy
| | - F Scala
- Istituto Pasteur-Fondazione Cenci Bolognetti, Department of Physiology and Pharmacology, Sapienza University of Rome, Piazzale Aldo Piazzale Aldo Moro 5, Roma 00185, Italy
| | - C Bertollini
- Istituto Pasteur-Fondazione Cenci Bolognetti, Department of Physiology and Pharmacology, Sapienza University of Rome, Piazzale Aldo Piazzale Aldo Moro 5, Roma 00185, Italy
| | - M G Molinari
- Istituto Pasteur-Fondazione Cenci Bolognetti, Department of Physiology and Pharmacology, Sapienza University of Rome, Piazzale Aldo Piazzale Aldo Moro 5, Roma 00185, Italy
| | - C Lauro
- Istituto Pasteur-Fondazione Cenci Bolognetti, Department of Physiology and Pharmacology, Sapienza University of Rome, Piazzale Aldo Piazzale Aldo Moro 5, Roma 00185, Italy
| | - P Bregestovski
- INSERM URM 1106, Aix-Marseille University, Brain Dynamics Institute, Marseille, France
| | - C Limatola
- Istituto Pasteur-Fondazione Cenci Bolognetti, Department of Physiology and Pharmacology, Sapienza University of Rome, Piazzale Aldo Piazzale Aldo Moro 5, Roma 00185, Italy
- IRCCS Neuromed, Via Atinese, Pozzilli, Italy
| | - D Ragozzino
- Istituto Pasteur-Fondazione Cenci Bolognetti, Department of Physiology and Pharmacology, Sapienza University of Rome, Piazzale Aldo Piazzale Aldo Moro 5, Roma 00185, Italy
- IRCCS Neuromed, Via Atinese, Pozzilli, Italy
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44
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Cowie CJ, Cunningham MO. Peritumoral epilepsy: relating form and function for surgical success. Epilepsy Behav 2014; 38:53-61. [PMID: 24894847 PMCID: PMC4265733 DOI: 10.1016/j.yebeh.2014.05.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 05/09/2014] [Indexed: 10/28/2022]
Abstract
Seizures are a prominent symptom in patients with both primary and secondary brain tumors. Medical management of seizure control in this patient group is problematic as the mechanisms linking tumorigenesis and epileptogenesis are poorly understood. It is possible that several mechanisms contribute to tumor-associated epileptic zone formation. In this review, we discuss key candidates that may be implicated in peritumoral epileptogenesis and, in so doing, hope to highlight areas for future research. Furthermore, we summarize the current role of antiepileptic medications in this type of epilepsy and examine the changes in surgical practice which may lead to improved seizure rates after tumor surgery. Lastly, we speculate on possible future preoperative and intraoperative considerations for improving seizure control after tumor resection.
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Affiliation(s)
- Christopher J.A. Cowie
- Department of Neurosurgery, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, UK,Institute of Neuroscience, The Medical School, Framlington Place, Newcastle University, Newcastle upon Tyne, UK
| | - Mark O. Cunningham
- Institute of Neuroscience, The Medical School, Framlington Place, Newcastle University, Newcastle upon Tyne, UK,Corresponding author at: Institute of Neuroscience, The Medical School, Framlington Place, Newcastle University, Newcastle upon Tyne NE2 4HH, UK. Tel.: + 44 191 2088935.
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Pallud J, Capelle L, Huberfeld G. Tumoral epileptogenicity: How does it happen? Epilepsia 2013; 54 Suppl 9:30-4. [DOI: 10.1111/epi.12440] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Johan Pallud
- Neurosurgery Unit; Sainte-Anne Hospital; Paris France
- Paris Descartes University; Paris France
| | - Laurent Capelle
- Neurosurgery Unit; Pitie-Salpetriere University Hospital; Assistance Publique - Hopitaux de Paris (AP-HP); Paris France
| | - Gilles Huberfeld
- Neurophysiology Department; Pitie-Salpetriere University Hospital; Assistance Publique - Hopitaux de Paris (AP-HP); Paris France
- Brain & Spine Institute; INSERM UMRS975; CNRS UMR7225; Pierre and Marie Curie University (UPMC); Paris France
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