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Takase H, Chou SHY, Hamanaka G, Ohtomo R, Islam MR, Lee JW, Hsu L, Mathew J, Reyes-Bricio E, Hayakawa K, Xing C, Ning MM, Wang X, Arai K, Lo EH, Lok J. Soluble vascular endothelial-cadherin in CSF after subarachnoid hemorrhage. Neurology 2020; 94:e1281-e1293. [PMID: 32107323 DOI: 10.1212/wnl.0000000000008868] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 10/04/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To determine if CSF and plasma levels of soluble vascular endothelial (sVE)-cadherin are associated with functional outcome after subarachnoid hemorrhage (SAH) and to investigate sVE-cadherin effects on microglia. METHODS Serial CSF and plasma were collected from prospectively enrolled patients with nontraumatic SAH from a ruptured aneurysm in the anterior circulation and who required an external ventricular drain for clinical indications. Patients with normal-pressure hydrocephalus without SAH served as controls. For prospective assessment of long-term outcomes at 3 and 6 months after SAH, modified Rankin Scale scores (mRS) were obtained and dichotomized into good (mRS ≤ 2) vs poor (mRS > 2) outcome groups. For SAH severity, Hunt and Hess grade was assessed. Association of CSF sVE-cadherin levels with long-term outcomes, HH grade, and CSF tumor necrosis factor (TNF)-α levels were evaluated. sVE-cadherin effects on microglia were also studied. RESULTS sVE-cadherin levels in CSF, but not in plasma, were higher in patients with SAH and were associated with higher clinical severity and higher CSF TNF-α levels. Patients with SAH with higher CSF sVE-cadherin levels over time were more likely to develop worse functional outcome at 3 months after SAH. Incubation of cultured microglia with sVE-cadherin resulted in increased inducible nitric oxide synthase, interleukin-1β, reactive oxygen species, cell soma size, and metabolic activity, consistent with microglia activation. Microinjection of sVE-cadherin fragments into mouse brain results in an increased number of microglia surrounding the injection site, compared to injection of denatured vascular endothelial-cadherin fragments. CONCLUSIONS These results support the existence of a novel pathway by which sVE-cadherin, released from injured endothelium after SAH, can shift microglia into a more proinflammatory phenotype and contribute to neuroinflammation and poor outcome in SAH.
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Affiliation(s)
- Hajime Takase
- From Neuroprotection Research Laboratories (H.T., S.H.-Y.C., G.H., R.O., M.R.I., J.M., E.R.-B., K.H., C.X., M.M.N., X.W., K.A., E.H.L., J.L.), Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown; Departments of Neurology (S.H.-Y.C., J.W.L.) and Radiology (L.H.), Brigham and Women's Hospital, Boston; Department of Pediatrics, Pediatric Critical Care Medicine (J.L.), Department of Radiology (E.H.L.), and Department of Neurology (M.M.N., E.H.L.), Massachusetts General Hospital, Boston; Department of Neurosurgery (H.T.), Yokohama City University, Yokohama, Japan; and Departments of Critical Care Medicine, Neurology, and Neurosurgery (S.H.-Y.C.), University of Pittsburgh, PA
| | - Sherry Hsiang-Yi Chou
- From Neuroprotection Research Laboratories (H.T., S.H.-Y.C., G.H., R.O., M.R.I., J.M., E.R.-B., K.H., C.X., M.M.N., X.W., K.A., E.H.L., J.L.), Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown; Departments of Neurology (S.H.-Y.C., J.W.L.) and Radiology (L.H.), Brigham and Women's Hospital, Boston; Department of Pediatrics, Pediatric Critical Care Medicine (J.L.), Department of Radiology (E.H.L.), and Department of Neurology (M.M.N., E.H.L.), Massachusetts General Hospital, Boston; Department of Neurosurgery (H.T.), Yokohama City University, Yokohama, Japan; and Departments of Critical Care Medicine, Neurology, and Neurosurgery (S.H.-Y.C.), University of Pittsburgh, PA
| | - Gen Hamanaka
- From Neuroprotection Research Laboratories (H.T., S.H.-Y.C., G.H., R.O., M.R.I., J.M., E.R.-B., K.H., C.X., M.M.N., X.W., K.A., E.H.L., J.L.), Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown; Departments of Neurology (S.H.-Y.C., J.W.L.) and Radiology (L.H.), Brigham and Women's Hospital, Boston; Department of Pediatrics, Pediatric Critical Care Medicine (J.L.), Department of Radiology (E.H.L.), and Department of Neurology (M.M.N., E.H.L.), Massachusetts General Hospital, Boston; Department of Neurosurgery (H.T.), Yokohama City University, Yokohama, Japan; and Departments of Critical Care Medicine, Neurology, and Neurosurgery (S.H.-Y.C.), University of Pittsburgh, PA
| | - Ryo Ohtomo
- From Neuroprotection Research Laboratories (H.T., S.H.-Y.C., G.H., R.O., M.R.I., J.M., E.R.-B., K.H., C.X., M.M.N., X.W., K.A., E.H.L., J.L.), Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown; Departments of Neurology (S.H.-Y.C., J.W.L.) and Radiology (L.H.), Brigham and Women's Hospital, Boston; Department of Pediatrics, Pediatric Critical Care Medicine (J.L.), Department of Radiology (E.H.L.), and Department of Neurology (M.M.N., E.H.L.), Massachusetts General Hospital, Boston; Department of Neurosurgery (H.T.), Yokohama City University, Yokohama, Japan; and Departments of Critical Care Medicine, Neurology, and Neurosurgery (S.H.-Y.C.), University of Pittsburgh, PA
| | - Mohammad R Islam
- From Neuroprotection Research Laboratories (H.T., S.H.-Y.C., G.H., R.O., M.R.I., J.M., E.R.-B., K.H., C.X., M.M.N., X.W., K.A., E.H.L., J.L.), Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown; Departments of Neurology (S.H.-Y.C., J.W.L.) and Radiology (L.H.), Brigham and Women's Hospital, Boston; Department of Pediatrics, Pediatric Critical Care Medicine (J.L.), Department of Radiology (E.H.L.), and Department of Neurology (M.M.N., E.H.L.), Massachusetts General Hospital, Boston; Department of Neurosurgery (H.T.), Yokohama City University, Yokohama, Japan; and Departments of Critical Care Medicine, Neurology, and Neurosurgery (S.H.-Y.C.), University of Pittsburgh, PA
| | - Jong Woo Lee
- From Neuroprotection Research Laboratories (H.T., S.H.-Y.C., G.H., R.O., M.R.I., J.M., E.R.-B., K.H., C.X., M.M.N., X.W., K.A., E.H.L., J.L.), Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown; Departments of Neurology (S.H.-Y.C., J.W.L.) and Radiology (L.H.), Brigham and Women's Hospital, Boston; Department of Pediatrics, Pediatric Critical Care Medicine (J.L.), Department of Radiology (E.H.L.), and Department of Neurology (M.M.N., E.H.L.), Massachusetts General Hospital, Boston; Department of Neurosurgery (H.T.), Yokohama City University, Yokohama, Japan; and Departments of Critical Care Medicine, Neurology, and Neurosurgery (S.H.-Y.C.), University of Pittsburgh, PA
| | - Liangge Hsu
- From Neuroprotection Research Laboratories (H.T., S.H.-Y.C., G.H., R.O., M.R.I., J.M., E.R.-B., K.H., C.X., M.M.N., X.W., K.A., E.H.L., J.L.), Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown; Departments of Neurology (S.H.-Y.C., J.W.L.) and Radiology (L.H.), Brigham and Women's Hospital, Boston; Department of Pediatrics, Pediatric Critical Care Medicine (J.L.), Department of Radiology (E.H.L.), and Department of Neurology (M.M.N., E.H.L.), Massachusetts General Hospital, Boston; Department of Neurosurgery (H.T.), Yokohama City University, Yokohama, Japan; and Departments of Critical Care Medicine, Neurology, and Neurosurgery (S.H.-Y.C.), University of Pittsburgh, PA
| | - Justin Mathew
- From Neuroprotection Research Laboratories (H.T., S.H.-Y.C., G.H., R.O., M.R.I., J.M., E.R.-B., K.H., C.X., M.M.N., X.W., K.A., E.H.L., J.L.), Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown; Departments of Neurology (S.H.-Y.C., J.W.L.) and Radiology (L.H.), Brigham and Women's Hospital, Boston; Department of Pediatrics, Pediatric Critical Care Medicine (J.L.), Department of Radiology (E.H.L.), and Department of Neurology (M.M.N., E.H.L.), Massachusetts General Hospital, Boston; Department of Neurosurgery (H.T.), Yokohama City University, Yokohama, Japan; and Departments of Critical Care Medicine, Neurology, and Neurosurgery (S.H.-Y.C.), University of Pittsburgh, PA
| | - Estefania Reyes-Bricio
- From Neuroprotection Research Laboratories (H.T., S.H.-Y.C., G.H., R.O., M.R.I., J.M., E.R.-B., K.H., C.X., M.M.N., X.W., K.A., E.H.L., J.L.), Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown; Departments of Neurology (S.H.-Y.C., J.W.L.) and Radiology (L.H.), Brigham and Women's Hospital, Boston; Department of Pediatrics, Pediatric Critical Care Medicine (J.L.), Department of Radiology (E.H.L.), and Department of Neurology (M.M.N., E.H.L.), Massachusetts General Hospital, Boston; Department of Neurosurgery (H.T.), Yokohama City University, Yokohama, Japan; and Departments of Critical Care Medicine, Neurology, and Neurosurgery (S.H.-Y.C.), University of Pittsburgh, PA
| | - Kazuhide Hayakawa
- From Neuroprotection Research Laboratories (H.T., S.H.-Y.C., G.H., R.O., M.R.I., J.M., E.R.-B., K.H., C.X., M.M.N., X.W., K.A., E.H.L., J.L.), Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown; Departments of Neurology (S.H.-Y.C., J.W.L.) and Radiology (L.H.), Brigham and Women's Hospital, Boston; Department of Pediatrics, Pediatric Critical Care Medicine (J.L.), Department of Radiology (E.H.L.), and Department of Neurology (M.M.N., E.H.L.), Massachusetts General Hospital, Boston; Department of Neurosurgery (H.T.), Yokohama City University, Yokohama, Japan; and Departments of Critical Care Medicine, Neurology, and Neurosurgery (S.H.-Y.C.), University of Pittsburgh, PA
| | - Changhong Xing
- From Neuroprotection Research Laboratories (H.T., S.H.-Y.C., G.H., R.O., M.R.I., J.M., E.R.-B., K.H., C.X., M.M.N., X.W., K.A., E.H.L., J.L.), Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown; Departments of Neurology (S.H.-Y.C., J.W.L.) and Radiology (L.H.), Brigham and Women's Hospital, Boston; Department of Pediatrics, Pediatric Critical Care Medicine (J.L.), Department of Radiology (E.H.L.), and Department of Neurology (M.M.N., E.H.L.), Massachusetts General Hospital, Boston; Department of Neurosurgery (H.T.), Yokohama City University, Yokohama, Japan; and Departments of Critical Care Medicine, Neurology, and Neurosurgery (S.H.-Y.C.), University of Pittsburgh, PA
| | - Ming Ming Ning
- From Neuroprotection Research Laboratories (H.T., S.H.-Y.C., G.H., R.O., M.R.I., J.M., E.R.-B., K.H., C.X., M.M.N., X.W., K.A., E.H.L., J.L.), Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown; Departments of Neurology (S.H.-Y.C., J.W.L.) and Radiology (L.H.), Brigham and Women's Hospital, Boston; Department of Pediatrics, Pediatric Critical Care Medicine (J.L.), Department of Radiology (E.H.L.), and Department of Neurology (M.M.N., E.H.L.), Massachusetts General Hospital, Boston; Department of Neurosurgery (H.T.), Yokohama City University, Yokohama, Japan; and Departments of Critical Care Medicine, Neurology, and Neurosurgery (S.H.-Y.C.), University of Pittsburgh, PA
| | - Xiaoying Wang
- From Neuroprotection Research Laboratories (H.T., S.H.-Y.C., G.H., R.O., M.R.I., J.M., E.R.-B., K.H., C.X., M.M.N., X.W., K.A., E.H.L., J.L.), Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown; Departments of Neurology (S.H.-Y.C., J.W.L.) and Radiology (L.H.), Brigham and Women's Hospital, Boston; Department of Pediatrics, Pediatric Critical Care Medicine (J.L.), Department of Radiology (E.H.L.), and Department of Neurology (M.M.N., E.H.L.), Massachusetts General Hospital, Boston; Department of Neurosurgery (H.T.), Yokohama City University, Yokohama, Japan; and Departments of Critical Care Medicine, Neurology, and Neurosurgery (S.H.-Y.C.), University of Pittsburgh, PA
| | - Ken Arai
- From Neuroprotection Research Laboratories (H.T., S.H.-Y.C., G.H., R.O., M.R.I., J.M., E.R.-B., K.H., C.X., M.M.N., X.W., K.A., E.H.L., J.L.), Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown; Departments of Neurology (S.H.-Y.C., J.W.L.) and Radiology (L.H.), Brigham and Women's Hospital, Boston; Department of Pediatrics, Pediatric Critical Care Medicine (J.L.), Department of Radiology (E.H.L.), and Department of Neurology (M.M.N., E.H.L.), Massachusetts General Hospital, Boston; Department of Neurosurgery (H.T.), Yokohama City University, Yokohama, Japan; and Departments of Critical Care Medicine, Neurology, and Neurosurgery (S.H.-Y.C.), University of Pittsburgh, PA
| | - Eng H Lo
- From Neuroprotection Research Laboratories (H.T., S.H.-Y.C., G.H., R.O., M.R.I., J.M., E.R.-B., K.H., C.X., M.M.N., X.W., K.A., E.H.L., J.L.), Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown; Departments of Neurology (S.H.-Y.C., J.W.L.) and Radiology (L.H.), Brigham and Women's Hospital, Boston; Department of Pediatrics, Pediatric Critical Care Medicine (J.L.), Department of Radiology (E.H.L.), and Department of Neurology (M.M.N., E.H.L.), Massachusetts General Hospital, Boston; Department of Neurosurgery (H.T.), Yokohama City University, Yokohama, Japan; and Departments of Critical Care Medicine, Neurology, and Neurosurgery (S.H.-Y.C.), University of Pittsburgh, PA
| | - Josephine Lok
- From Neuroprotection Research Laboratories (H.T., S.H.-Y.C., G.H., R.O., M.R.I., J.M., E.R.-B., K.H., C.X., M.M.N., X.W., K.A., E.H.L., J.L.), Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown; Departments of Neurology (S.H.-Y.C., J.W.L.) and Radiology (L.H.), Brigham and Women's Hospital, Boston; Department of Pediatrics, Pediatric Critical Care Medicine (J.L.), Department of Radiology (E.H.L.), and Department of Neurology (M.M.N., E.H.L.), Massachusetts General Hospital, Boston; Department of Neurosurgery (H.T.), Yokohama City University, Yokohama, Japan; and Departments of Critical Care Medicine, Neurology, and Neurosurgery (S.H.-Y.C.), University of Pittsburgh, PA.
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Kros JM, Mustafa DM, Dekker LJM, Sillevis Smitt PAE, Luider TM, Zheng PP. Circulating glioma biomarkers. Neuro Oncol 2014; 17:343-60. [PMID: 25253418 DOI: 10.1093/neuonc/nou207] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 07/13/2014] [Indexed: 02/06/2023] Open
Abstract
Validated biomarkers for patients suffering from gliomas are urgently needed for standardizing measurements of the effects of treatment in daily clinical practice and trials. Circulating body fluids offer easily accessible sources for such markers. This review highlights various categories of tumor-associated circulating biomarkers identified in blood and cerebrospinal fluid of glioma patients, including circulating tumor cells, exosomes, nucleic acids, proteins, and oncometabolites. The validation and potential clinical utility of these biomarkers is briefly discussed. Although many candidate circulating protein biomarkers were reported, none of these have reached the required validation to be introduced for clinical practice. Recent developments in tracing circulating tumor cells and their derivatives as exosomes and circulating nuclear acids may become more successful in providing useful biomarkers. It is to be expected that current technical developments will contribute to the finding and validation of circulating biomarkers.
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Affiliation(s)
- Johan M Kros
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., P.-P.Z.); Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands (L.J.M.D., P.A.E.S.S., T.M.L.); Brain Tumor Center Rotterdam, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., L.J.M.D., P.A.E.S.S., T.M.L., P.-P.Z.)
| | - Dana M Mustafa
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., P.-P.Z.); Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands (L.J.M.D., P.A.E.S.S., T.M.L.); Brain Tumor Center Rotterdam, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., L.J.M.D., P.A.E.S.S., T.M.L., P.-P.Z.)
| | - Lennard J M Dekker
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., P.-P.Z.); Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands (L.J.M.D., P.A.E.S.S., T.M.L.); Brain Tumor Center Rotterdam, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., L.J.M.D., P.A.E.S.S., T.M.L., P.-P.Z.)
| | - Peter A E Sillevis Smitt
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., P.-P.Z.); Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands (L.J.M.D., P.A.E.S.S., T.M.L.); Brain Tumor Center Rotterdam, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., L.J.M.D., P.A.E.S.S., T.M.L., P.-P.Z.)
| | - Theo M Luider
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., P.-P.Z.); Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands (L.J.M.D., P.A.E.S.S., T.M.L.); Brain Tumor Center Rotterdam, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., L.J.M.D., P.A.E.S.S., T.M.L., P.-P.Z.)
| | - Ping-Pin Zheng
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., P.-P.Z.); Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands (L.J.M.D., P.A.E.S.S., T.M.L.); Brain Tumor Center Rotterdam, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., L.J.M.D., P.A.E.S.S., T.M.L., P.-P.Z.)
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