1
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Liu Y, Zhang B, Duan R, Liu Y. Mitochondrial DNA Leakage and cGas/STING Pathway in Microglia: Crosstalk Between Neuroinflammation and Neurodegeneration. Neuroscience 2024; 548:1-8. [PMID: 38685462 DOI: 10.1016/j.neuroscience.2024.04.009] [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: 02/03/2024] [Revised: 04/04/2024] [Accepted: 04/24/2024] [Indexed: 05/02/2024]
Abstract
Neurodegenerative diseases, characterized by abnormal deposition of misfolded proteins, often present with progressive loss of neurons. Chronic neuroinflammation is a striking hallmark of neurodegeneration. Microglia, as the primary immune cells in the brain, is the main type of cells that participate in the formation of inflammatory microenvironment. Cytoplasmic free mitochondrial DNA (mtDNA), a common component of damage-associated molecular patterns (DAMPs), can activate the cGas/stimulator of interferon genes (STING) signalling, which subsequently produces type I interferon and proinflammatory cytokines. There are various sources of free mtDNA in microglial cytoplasm, but mitochondrial oxidative stress accumulation plays the vital role. The upregulation of cGas/STING pathway in microglia contributes to the abnormal and persistent microglial activation, accompanied by excessive secretion of neurotoxic inflammatory mediators such as interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α), which exacerbates the damage of neurons and promotes the development of neurodegeneration. Currently, novel therapeutic approaches need to be found to delay the progression of neurodegenerative disorders, and regulation of the cGas/STING signaling in microglia may be a potential target.
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Affiliation(s)
- Yuqian Liu
- Qilu Hospital of Shandong University, Jinan, China
| | - Bohan Zhang
- Qilu Hospital of Shandong University, Jinan, China
| | - Ruonan Duan
- Qilu Hospital of Shandong University, Jinan, China.
| | - Yiming Liu
- Qilu Hospital of Shandong University, Jinan, China.
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2
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Tsui B, Calabrese E, Zaharchuk G, Rauschecker AM. Reducing Gadolinium Contrast With Artificial Intelligence. J Magn Reson Imaging 2023. [PMID: 37905681 DOI: 10.1002/jmri.29095] [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: 08/03/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 11/02/2023] Open
Abstract
Gadolinium contrast is an important agent in magnetic resonance imaging (MRI), particularly in neuroimaging where it can help identify blood-brain barrier breakdown from an inflammatory, infectious, or neoplastic process. However, gadolinium contrast has several drawbacks, including nephrogenic systemic fibrosis, gadolinium deposition in the brain and bones, and allergic-like reactions. As computer hardware and technology continues to evolve, machine learning has become a possible solution for eliminating or reducing the dose of gadolinium contrast. This review summarizes the clinical uses of gadolinium contrast, the risks of gadolinium contrast, and state-of-the-art machine learning methods that have been applied to reduce or eliminate gadolinium contrast administration, as well as their current limitations, with a focus on neuroimaging applications. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Brian Tsui
- Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Evan Calabrese
- Department of Radiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Greg Zaharchuk
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Andreas M Rauschecker
- Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
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3
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Yi H, Liu K, Yang W, Li Y, Wang X, Zhang T, Liu C, Li Y, Mi Y. MRI manifestations of central nervous system leukaemia and cytological analysis of the cerebrospinal fluid. Clin Radiol 2023:S0009-9260(23)00213-1. [PMID: 37330321 DOI: 10.1016/j.crad.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 03/24/2023] [Accepted: 04/28/2023] [Indexed: 06/19/2023]
Abstract
AIM To investigate the magnetic resonance imaging (MRI) features and explore the value of MRI in the diagnosis of central nervous system leukaemia (CNSL). MATERIALS AND METHODS A retrospective study was performed in 68 patients with leukaemia who underwent cranial MRI between January 2020 and June 2022 at Institute of Hematology and Blood Diseases Hospital. RESULTS A total of 33 patients fulfilled the requirements for inclusion. The findings showed that 87.9% patients exhibited neurological symptoms, and 23 patients showed abnormal MRI findings. No differences were observed between the MRI+ and MRI- groups in terms of age, sex, neurological symptoms, glucose in the cerebrospinal fluid (CSF), chloride in the CSF, abnormal cells detected using conventional cytology (CC), bone marrow status at the diagnosis of CNSL, signal intensity ratio, and mortality, except for protein concentration and the number of leukaemic cells detected using flow cytometry (FCM) in the CSF. Kaplan-Meier survival analysis in patients with leukaemia revealed no statistical differences in the median survival times between the MRI+ group and MRI- group. Cox regression analysis and multivariate analysis showed no significant difference in survival rate between the MRI+ and MRI- groups. Kappa consistency test shows weak diagnostic consistency between MRI and CC, and weak diagnostic inconsistency between MRI and FCM. CONCLUSION MRI could serve as an important complementary tool to CC and FCM in the diagnosis of CNSL, especially in patients without leptomeningeal involvement.
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Affiliation(s)
- H Yi
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300020, China
| | - K Liu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300020, China
| | - W Yang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300020, China
| | - Y Li
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300020, China
| | - X Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300020, China
| | - T Zhang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300020, China
| | - C Liu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300020, China
| | - Y Li
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300020, China
| | - Y Mi
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300020, China.
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4
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Bressler I, Ben Bashat D, Buchsweiler Y, Aizenstein O, Limon D, Bokestein F, Blumenthal TD, Nevo U, Artzi M. Model-free dynamic contrast-enhanced MRI analysis: differentiation between active tumor and necrotic tissue in patients with glioblastoma. MAGMA (NEW YORK, N.Y.) 2023; 36:33-42. [PMID: 36287282 DOI: 10.1007/s10334-022-01045-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/09/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Treatment response assessment in patients with high-grade gliomas (HGG) is heavily dependent on changes in lesion size on MRI. However, in conventional MRI, treatment-related changes can appear as enhancing tissue, with similar presentation to that of active tumor tissue. We propose a model-free data-driven method for differentiation between these tissues, based on dynamic contrast-enhanced (DCE) MRI. MATERIALS AND METHODS The study included a total of 66 scans of patients with glioblastoma. Of these, 48 were acquired from 1 MRI vendor and 18 scans were acquired from a different MRI vendor and used as test data. Of the 48, 24 scans had biopsy results. Analysis included semi-automatic arterial input function (AIF) extraction, direct DCE pharmacokinetic-like feature extraction, and unsupervised clustering of the two tissue types. Validation was performed via (a) comparison to biopsy result (b) correlation to literature-based DCE curves for each tissue type, and (c) comparison to clinical outcome. RESULTS Consistency between the model prediction and biopsy results was found in 20/24 cases. An average correlation of 82% for active tumor and 90% for treatment-related changes was found between the predicted component and population-based templates. An agreement between the predicted results and radiologist's assessment, based on RANO criteria, was found in 11/12 cases. CONCLUSION The proposed method could serve as a non-invasive method for differentiation between lesion tissue and treatment-related changes.
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Affiliation(s)
- Idan Bressler
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,The Iby and Aladar Fleischman Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Dafna Ben Bashat
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann St, 64239, Tel-Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Yuval Buchsweiler
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,The Iby and Aladar Fleischman Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Orna Aizenstein
- Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann St, 64239, Tel-Aviv, Israel.,Division of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Dror Limon
- Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann St, 64239, Tel-Aviv, Israel.,Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Felix Bokestein
- Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann St, 64239, Tel-Aviv, Israel.,Neuro-Oncology Service, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - T Deborah Blumenthal
- Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann St, 64239, Tel-Aviv, Israel.,Neuro-Oncology Service, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Uri Nevo
- The Iby and Aladar Fleischman Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Moran Artzi
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann St, 64239, Tel-Aviv, Israel. .,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
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5
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Krigers A, Demetz M, Grams AE, Thomé C, Freyschlag CF. The diagnostic value of contrast enhancement on MRI in diffuse and anaplastic gliomas. Acta Neurochir (Wien) 2022; 164:2035-2040. [PMID: 35018531 DOI: 10.1007/s00701-021-05103-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/25/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE We evaluated differentiations in gadolinium contrast enhancement (CE) between low-grade WHO °II and high-grade WHO °III gliomas in conventional MRI, which have been repeatedly questioned. METHODS Ninety-nine patients, who underwent first resection of WHO°II and °III gliomas, were retrospectively retrieved from a prospective database. The quantitative metric volume of Gd-CE in T1-weighted pre-operative MRI was measured using volumetric segmentation. RESULTS The OR to detect CE in anaplastic gliomas was seven times higher than that in diffuse gliomas (CI95% 2.8-17.2, p<0.0001). No CE was seen in 50% (8/16) of focal anaplastic and in 28% (10/36) of entirely anaplastic gliomas. CE was present in 21% (10/47) of diffuse gliomas. Anaplasia correlated with a larger CE volume (r=0.49, p<0.0001) and provided additional 4 cm3 of CE volume compared to entirely diffuse tumors. The OR to have CE was 3.6 times for IDH1 wild-type tumors (CI95% 1.3-10.2, p=0.05) and 4.8 for tumors with ATRX expression (CI95% 1.3-17.2, p=0.05). In all sub-groups, at least a quarter of cases showed no CE at all and there were cases with present CE. CONCLUSION CE is associated with higher odds of unfavorable prognostic features like anaplasia, wild-type IDH1 and retained ATRX. There was no CE in one-fourth of anaplastic gliomas and half of gliomas with focal anaplasia.
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Affiliation(s)
- Aleksandrs Krigers
- Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
| | - Matthias Demetz
- Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Astrid E Grams
- Department of Neuroradiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Claudius Thomé
- Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Christian F Freyschlag
- Department of Neurosurgery, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
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6
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Tang L, Feng Y, Gao S, Mu Q, Liu C. Nanotherapeutics Overcoming the Blood-Brain Barrier for Glioblastoma Treatment. Front Pharmacol 2021; 12:786700. [PMID: 34899350 PMCID: PMC8655904 DOI: 10.3389/fphar.2021.786700] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/10/2021] [Indexed: 01/10/2023] Open
Abstract
Glioblastoma (GBM) is the most common malignant primary brain tumor with a poor prognosis. The current standard treatment regimen represented by temozolomide/radiotherapy has an average survival time of 14.6 months, while the 5-year survival rate is still less than 5%. New therapeutics are still highly needed to improve the therapeutic outcome of GBM treatment. The blood-brain barrier (BBB) is the main barrier that prevents therapeutic drugs from reaching the brain. Nanotechnologies that enable drug delivery across the BBB hold great promise for the treatment of GBM. This review summarizes various drug delivery systems used to treat glioma and focuses on their approaches for overcoming the BBB to enhance the accumulation of small molecules, protein and gene drugs, etc. in the brain.
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Affiliation(s)
- Lin Tang
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, Beijing University of Chemical Technology, Beijing, China
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Yicheng Feng
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, Beijing University of Chemical Technology, Beijing, China
| | - Sai Gao
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, Beijing University of Chemical Technology, Beijing, China
| | - Qingchun Mu
- The People’s Hospital of Gaozhou, Gaozhou, China
| | - Chaoyong Liu
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, Beijing University of Chemical Technology, Beijing, China
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
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7
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A rare case of intraparenchymal subependymoma in a child. Childs Nerv Syst 2021; 37:1759-1764. [PMID: 32803310 DOI: 10.1007/s00381-020-04862-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/11/2020] [Indexed: 01/18/2023]
Abstract
Subependymoma is a slow-growing, exophytic, intraventricular glial neoplasm that commonly arises in the ventricular system. However, a report found that the frequency of intracerebral subependymoma was 0.4% in 1000 routine autopsies. To the best of our knowledge, only seven cases of intracerebral subependymoma have been reported. We report a rare case of intracerebral subependymoma in a child. An 11-year-old girl with generalized tonic-clonic seizures visited the emergency room and had an intraparenchymal tumor on the left frontal lobe on magnetic resonance imaging (MRI). Craniotomy with gross total removal was performed without any perioperative morbidities. The tumor was finally histopathologically diagnosed as a subependymoma.
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8
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Shahein M, Prevedello DM, Beaumont TL, Ismail K, Nouby R, Palettas M, Prevedello LM, Otto BA, Carrau RL. The role of indocyanine green fluorescence in endoscopic endonasal skull base surgery and its imaging correlations. J Neurosurg 2020; 135:923-933. [PMID: 33186906 DOI: 10.3171/2020.6.jns192775] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 06/18/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The use of endoscope-integrated indocyanine green (E-ICG) has recently been introduced in skull base surgery. The quantitative correlation between E-ICG and T1-weighted gadolinium-enhanced (T1WGd) images for skull base tumors has not been previously assessed, to the authors' knowledge. In this study, the authors investigated the indications for use and the limitations of E-ICG and sought to correlate the endoscopic fluorescence pattern with MRI contrast enhancement. METHODS Following IRB approval, 20 patients undergoing endoscopic endonasal skull base surgery between June 2017 and August 2018 were enrolled in the study. Tumor fluorescence was measured using a blue color value and blood fluorescence as a control. Signal intensities (SIs) of tumor T1WGd images were measured and the internal carotid artery (ICA) SI was used as a control. For pituitary adenoma, the pituitary gland fluorescence was also measured. The relationships between ICG fluorescence and MRI enhancement measurements were analyzed. RESULTS Data showed that in pituitary adenoma there was a strong correlation between the ratios of gland/blood fluorescence to gland/ICA SI (n = 8; r = 0.92; p = 0.001) and tumor/blood fluorescence to tumor/ICA SI (n = 9; r = 0.82; p = 0.006). In other pathologies there was a strong correlation between the ratios of tumor/blood fluorescence and tumor/ICA SI (n = 9; r = 0.74; p = 0.022). The ICG fluorescence allowed perfusion assessment of the pituitary gland as well as of the nasoseptal flaps. Visualization of the surrounding vasculature was also feasible. CONCLUSIONS Defining the indications and understanding the limitations are critical for the effective use of E-ICG. Tumor fluorescence seems to correlate with preoperative MRI contrast enhancement.
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Affiliation(s)
- Mostafa Shahein
- Departments of1Neurological Surgery
- 3Department of Neurosurgery, Aswan University Hospitals, Aswan University, Aswan, Egypt
| | | | | | - Khalid Ismail
- 3Department of Neurosurgery, Aswan University Hospitals, Aswan University, Aswan, Egypt
| | - Radwan Nouby
- 3Department of Neurosurgery, Aswan University Hospitals, Aswan University, Aswan, Egypt
| | | | - Luciano M Prevedello
- 5Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio; and
| | - Bradley A Otto
- Departments of1Neurological Surgery
- 2Otolaryngology-Head and Neck Surgery
| | - Ricardo L Carrau
- Departments of1Neurological Surgery
- 2Otolaryngology-Head and Neck Surgery
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9
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Ansari MA, Chung IM, Rajakumar G, Alzohairy MA, Alomary MN, Thiruvengadam M, Pottoo FH, Ahmad N. Current Nanoparticle Approaches in Nose to Brain Drug Delivery and Anticancer Therapy - A Review. Curr Pharm Des 2020; 26:1128-1137. [PMID: 31951165 DOI: 10.2174/1381612826666200116153912] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 01/09/2020] [Indexed: 12/27/2022]
Abstract
Nanoparticles (NPs) are unique may be organic or inorganic, play a vital role in the development of drug delivery targeting the central nervous system (CNS). Intranasal drug delivery has shown to be an efficient strategy with attractive application for drug delivery to the CNS related diseases, such as Parkinson's disease, Alzheimer 's disease and brain solid tumors. Blood brain barrier (BBB) and blood-cerebrospinal fluid barriers are natural protective hindrances for entry of drug molecules into the CNS. Nanoparticles exhibit excellent intruding capacity for therapeutic agents and overcome protective barriers. By using nanotechnology based NPs targeted, drug delivery can be improved across BBB with discharge drugs in a controlled manner. NPs confer safe from degradation phenomenon. Several kinds of NPs are used for nose to the brain (N2B) enroute, such as lipidemic nanoparticles, polymeric nanoparticles, inorganic NPs, solid lipid NPs, dendrimers. Among them, popular lipidemic and polymeric NPs are discussed, and their participation in anti-cancer activity has also been highlighted in this review.
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Affiliation(s)
- Mohammad A Ansari
- Department of Epidemic Disease Research, Institutes for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, 31441 Dammam, Saudi Arabia
| | - Ill-Min Chung
- Department of Crop Science, College of Sanghuh Life Science, Konkuk University, Seoul 05029, Korea
| | - Govindasamy Rajakumar
- Department of Crop Science, College of Sanghuh Life Science, Konkuk University, Seoul 05029, Korea
| | - Mohammad A Alzohairy
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Qassim 51431, Saudi Arabia
| | - Mohammad N Alomary
- National Center of Biotechnology, Life Science and Environmental Research Institute, King Abdulaziz City for Science and Technology, Riyadh 11442, Saudi Arabia
| | - Muthu Thiruvengadam
- Department of Crop Science, College of Sanghuh Life Science, Konkuk University, Seoul 05029, Korea
| | - Faheem H Pottoo
- Department of Pharmacology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, P. O. Box 1982, Dammam 31441, Saudi Arabia
| | - Niyaz Ahmad
- Department of Pharmaceutics, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
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10
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Blood-Brain Barrier Modulation to Improve Glioma Drug Delivery. Pharmaceutics 2020; 12:pharmaceutics12111085. [PMID: 33198244 PMCID: PMC7697580 DOI: 10.3390/pharmaceutics12111085] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 02/07/2023] Open
Abstract
The blood-brain barrier (BBB) is formed by brain microvascular endothelial cells that are sealed by tight junctions, making it a significant obstacle for most brain therapeutics. The poor BBB penetration of newly developed therapeutics has therefore played a major role in limiting their clinical success. A particularly challenging therapeutic target is glioma, which is the most frequently occurring malignant brain tumor. Thus, to enhance therapeutic uptake in tumors, researchers have been developing strategies to modulate BBB permeability. However, most conventional BBB opening strategies are difficult to apply in the clinical setting due to their broad, non-specific modulation of the BBB, which can result in damage to normal brain tissue. In this review, we have summarized strategies that could potentially be used to selectively and efficiently modulate the tumor BBB for more effective glioma treatment.
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11
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Magnetic resonance imaging evaluation of brain glioma before postoperative radiotherapy. Clin Transl Oncol 2020; 23:820-826. [PMID: 32857338 DOI: 10.1007/s12094-020-02474-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 08/03/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To investigate the magnetic resonance imaging (MRI) images of brain glioma before postoperative radiotherapy, and to provide reference for the delineation of postoperative radiotherapy target area. METHODS Retrospective analysis was performed on 106 cases of brain glioma confirmed by surgery and pathology in our hospital, including 70 cases of high-grade glioma (HGG) and 36 cases of low-grade glioma (LGG). The MRI images of the lesions within 1 month before and after surgery were analyzed, the apparent diffusion coefficient (ADC) values in the near and far tumor areas were measured, respectively, and the corresponding rADC values were calculated. RESULTS The incidence of residual tumors of postoperative HGG and LGG was 0, 15.7% (0/36, 11/70), respectively. The incidence of postoperative reactive enhancement was 11.0% and 52.9% (4/36 and 37/70), respectively. About 30.6% and 81.4% (11/36 and 57/70) of patients with adjacent meningeal enhancement were found in the operative area. CONCLUSIONS The MRI images of HGG and LGG before postoperative radiotherapy had certain characteristics, providing a favorable guidance for the delineation of the target area of radiotherapy and the formulation of treatment plan.
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12
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Abstract
Background:
Drug delivery to cancerous brain is a challenging task as it is
surrounded by an efficient protective barrier. The main hurdles for delivery of bioactive
molecules to cancerous brain are blood brain barrier (BBB), the invasive nature of gliomas,
drug resistance, and difficult brain interstitium transportation. Therefore, treatment
of brain cancer with the available drug regimen is difficult and has shown little improvement
in recent years.
Methods:
We searched about recent advancements in the use of nanomedicine for effective
treatment of the brain cancer. We focused on the use of liposomes, nanoparticles,
polymeric micelles, and dendrimers to improve brain cancer therapy.
Results:
Nanomedicines are well suited for the treatment of brain cancer owing to their
highly acceptable biological, chemical, and physical properties. Smaller size of nanomedicines
also enhances their anticancer potential and penetration into blood brain barrier
(BBB).
Conclusion:
Recently, nanomedicine based approaches have been developed and investigated
for effective treatment of brain cancer. Some of these have been translated into
clinical practice, in order to attain therapeutic needs of gliomas. Future advancements in
nanomedicines will likely produce significant changes in methods and practice of brain
cancer therapy.
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Affiliation(s)
- Shivani Verma
- I. K. Gujral Punjab Technical University, Jalandhar-Punjab 144601, India
| | - Puneet Utreja
- I. K. Gujral Punjab Technical University, Jalandhar-Punjab 144601, India
| | - Lalit Kumar
- I. K. Gujral Punjab Technical University, Jalandhar-Punjab 144601, India
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13
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Arduino I, Depalo N, Re F, Dal Magro R, Panniello A, Margiotta N, Fanizza E, Lopalco A, Laquintana V, Cutrignelli A, Lopedota AA, Franco M, Denora N. PEGylated solid lipid nanoparticles for brain delivery of lipophilic kiteplatin Pt(IV) prodrugs: An in vitro study. Int J Pharm 2020; 583:119351. [PMID: 32339634 DOI: 10.1016/j.ijpharm.2020.119351] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 10/24/2022]
Abstract
Here, polyethylene glycol (PEG)-stabilized solid lipid nanoparticles (SLNs) containing Pt(IV) prodrugs derived from kiteplatin were designed and proposed as novel nanoformulations potentially useful for the treatment of glioblastoma multiforme. Four different Pt(IV) prodrugs were synthesized, starting from kiteplatin by the addition of two carboxylate ligands with different length of the alkyl chains and lipophilicity degree, and embedded in the core of PEG-stabilized SLNs composed of cetyl palmitate. The SLNs were extensively characterized by complementary optical and morphological techniques. The results proved the formation of SLNs characterized by average size under 100 nm and dependence of drug encapsulation efficiency on the lipophilicity degree of the tested Pt(IV) prodrugs. A monolayer of immortalized human cerebral microvascular endothelial cells (hCMEC/D3) was used as in vitro model of blood-brain barrier (BBB) to evaluate the ability of the SLNs to penetrate the BBB. For this purpose, optical traceable SLNs were achieved by co-incorporation of Pt(IV) prodrugs and luminescent carbon dots (C-Dots) in the SLNs. Finally, an in vitro study was performed by using a human glioblastoma cell line (U87), to investigate on the antitumor efficiency of the SLNs and on their improved ability to be cell internalized respect to the free Pt(IV) prodrugs.
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Affiliation(s)
- Ilaria Arduino
- Department of Pharmacy - Pharmaceutical Sciences, University of Bari "Aldo Moro", Orabona St. 4, 70125, Bari, Italy
| | - Nicoletta Depalo
- CNR-Institute for Physical and Chemical Processes SS, Bari, Italy
| | - Francesca Re
- School of Medicine and Surgery, Nanomedicine Center NANOMIB, University of Milano-Bicocca, Vedano al Lambro, MB, Italy
| | - Roberta Dal Magro
- School of Medicine and Surgery, Nanomedicine Center NANOMIB, University of Milano-Bicocca, Vedano al Lambro, MB, Italy
| | | | - Nicola Margiotta
- Department of Chemistry, University of Bari Aldo Moro, Orabona St. 4, 70125 Bari, Italy
| | - Elisabetta Fanizza
- CNR-Institute for Physical and Chemical Processes SS, Bari, Italy; Department of Chemistry, University of Bari Aldo Moro, Orabona St. 4, 70125 Bari, Italy
| | - Antonio Lopalco
- Department of Pharmacy - Pharmaceutical Sciences, University of Bari "Aldo Moro", Orabona St. 4, 70125, Bari, Italy
| | - Valentino Laquintana
- Department of Pharmacy - Pharmaceutical Sciences, University of Bari "Aldo Moro", Orabona St. 4, 70125, Bari, Italy
| | - Annalisa Cutrignelli
- Department of Pharmacy - Pharmaceutical Sciences, University of Bari "Aldo Moro", Orabona St. 4, 70125, Bari, Italy
| | - Angela Assunta Lopedota
- Department of Pharmacy - Pharmaceutical Sciences, University of Bari "Aldo Moro", Orabona St. 4, 70125, Bari, Italy
| | - Massimo Franco
- Department of Pharmacy - Pharmaceutical Sciences, University of Bari "Aldo Moro", Orabona St. 4, 70125, Bari, Italy
| | - Nunzio Denora
- Department of Pharmacy - Pharmaceutical Sciences, University of Bari "Aldo Moro", Orabona St. 4, 70125, Bari, Italy; CNR-Institute for Physical and Chemical Processes SS, Bari, Italy.
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14
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Azuma M, Khant ZA, Kitajima M, Uetani H, Watanabe T, Yokogami K, Takeshima H, Hirai T. Usefulness of Contrast-Enhanced 3D-FLAIR MR Imaging for Differentiating Rathke Cleft Cyst from Cystic Craniopharyngioma. AJNR Am J Neuroradiol 2019; 41:106-110. [PMID: 31857323 DOI: 10.3174/ajnr.a6359] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 10/29/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Because it can be difficult to discriminate between a Rathke cleft cyst and cystic craniopharyngioma by conventional MR imaging alone, we investigated whether contrast-enhanced 3D T2-FLAIR MR imaging at 3T helps to distinguish a Rathke cleft cyst from a cystic craniopharyngioma. MATERIALS AND METHODS We evaluated pre- and postcontrast T1-weighted and 3D T2-FLAIR images of 17 patients with pathologically confirmed Rathke cleft cyst (n = 10) or cystic craniopharyngioma (n = 7). All underwent 3T MR imaging studies before surgery. Two neuroradiologists independently recorded the enhancement grade of the lesion wall as grade 2 (most of the wall enhanced), grade 1 (some of the wall enhanced), and grade 0 (none of the wall enhanced). One neuroradiologist performed a blinded reading study of conventional MR images with/without 3D T2-FLAIR images. Interobserver agreement was determined by calculating the κ coefficient. Statistical analyses, including receiver operating characteristic curve analysis were performed. RESULTS Interobserver agreement for postcontrast T1WI and 3D T2-FLAIR images was excellent (κ = 0.824 and κ = 0.867, respectively). Although the difference in the mean enhancement grade of Rathke cleft cysts and cystic craniopharyngiomas was not significant on postcontrast T1WIs, it was significant on postcontrast 3D T2-FLAIR images (P = .0011). The area under the receiver operating characteristic curve of the conventional MR alone and conventional MR with 3D T2-FLAIR readings was 0.879 and 1.0, respectively, though there was no significant difference in the area under the curve between the 2 readings. CONCLUSIONS Contrast-enhanced 3D T2-FLAIR imaging at 3T helps to distinguish a Rathke cleft cyst from cystic craniopharyngioma.
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Affiliation(s)
- M Azuma
- From the Departments of Radiology (M.A., Z.A.K., T.H.) and
| | - Z A Khant
- From the Departments of Radiology (M.A., Z.A.K., T.H.) and
| | - M Kitajima
- Neurosurgery (T.W., K.Y., H.T.), Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - H Uetani
- Neurosurgery (T.W., K.Y., H.T.), Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - T Watanabe
- Department of Diagnostic Radiology (M.K., H.U.), Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan
| | - K Yokogami
- Department of Diagnostic Radiology (M.K., H.U.), Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan
| | - H Takeshima
- Department of Diagnostic Radiology (M.K., H.U.), Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan
| | - T Hirai
- From the Departments of Radiology (M.A., Z.A.K., T.H.) and
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15
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Bönig L, Möhn N, Ahlbrecht J, Wurster U, Raab P, Puppe W, Sühs KW, Stangel M, Skripuletz T, Schwenkenbecher P. Leptomeningeal Metastasis: The Role of Cerebrospinal Fluid Diagnostics. Front Neurol 2019; 10:839. [PMID: 31481919 PMCID: PMC6710356 DOI: 10.3389/fneur.2019.00839] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 07/19/2019] [Indexed: 01/30/2023] Open
Abstract
Background: Metastatic spread into the cerebrospinal fluid (CSF) represents a severe complication of malignant disease with poor prognosis. Although early diagnosis is crucial, broad spectrums of clinical manifestations, and pitfalls of magnetic resonance imaging (MRI) and CSF diagnostics can be challenging. Data are limited how CSF parameters and MRI findings relate to each other in patients with leptomeningeal metastasis. Methods: Patients with malignant cells in CSF cytology examination diagnosed between 1998 and 2016 at the Department of Neurology in the Hannover Medical School were included in this study. Clinical records, MRI findings and CSF parameters were retrospectively analyzed. Results: One hundred thirteen patients with leptomeningeal metastasis were identified. Seventy-six patients (67%) suffered from a solid malignancy while a hematological malignancy was found in 37 patients (33%). Cerebral signs and symptoms were most frequently found (78% in solid vs. 49% in hematological malignancies) followed by cranial nerve impairment (26% in solid vs. 46% in hematological malignancies) and spinal symptoms (26% in solid vs. 27% in hematological malignancies). In patients with malignant cells in CSF MRI detected signs of leptomeningeal metastasis in 62% of patients with solid and in only 33% of patients with hematological malignancies. Investigations of standard CSF parameters revealed a normal CSF cell count in 21% of patients with solid malignancies and in 8% of patients with hematological malignancies. Blood-CSF-barrier dysfunction was found in most patients (80% in solid vs. 92% in hematological malignancies). Elevated CSF lactate levels occurred in 68% of patients in solid and in 48% of patients with hematological malignancies. A high number of patients (30% in solid vs. 26% in hematological malignancies) exhibited oligoclonal bands in CSF. Significant correlations between the presence of leptomeningeal enhancement demonstrated by MRI and CSF parameters (cell count, lactate levels, and CSF/Serum albumin quotient) were not found in both malignancy groups. Conclusion: CSF examination is helpful to detect leptomeningeal metastasis since the diagnosis can be challenging especially when MRI is negative. CSF cytological investigation is mandatory whenever leptomeningeal metastasis is suspected, even when CSF cell count is normal.
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Affiliation(s)
- Lena Bönig
- Department of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Hanover, Germany
| | - Nora Möhn
- Department of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Hanover, Germany
| | - Jonas Ahlbrecht
- Department of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Hanover, Germany
| | - Ulrich Wurster
- Department of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Hanover, Germany
| | - Peter Raab
- Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hanover, Germany
| | - Wolfram Puppe
- Department of Virology, Hannover Medical School, Hanover, Germany
| | - Kurt-Wolfram Sühs
- Department of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Hanover, Germany
| | - Martin Stangel
- Department of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Hanover, Germany
| | - Thomas Skripuletz
- Department of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Hanover, Germany
| | - Philipp Schwenkenbecher
- Department of Neurology, Clinical Neuroimmunology and Neurochemistry, Hannover Medical School, Hanover, Germany
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16
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Delivery of a peptide-drug conjugate targeting the blood brain barrier improved the efficacy of paclitaxel against glioma. Oncotarget 2018; 7:79401-79407. [PMID: 27765902 PMCID: PMC5346723 DOI: 10.18632/oncotarget.12708] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 09/29/2016] [Indexed: 11/26/2022] Open
Abstract
The challenge of effectively delivering therapeutic agents to the brain has created an entire field of active research devoted to overcoming the blood brain barrier (BBB) and efficiently delivering drugs to the brain. Angiopep-2 can trigger transcytosis and traverse the BBB by recognizing low-density lipoprotein related protein-1 (LRP-1) expressed on the brain capillary endothelial cells. Here, we designed a novel strategy for the delivery of drugs to the brain. The novel drug delivery system was a combination of a receptor-targeting ligand, such as low-density lipoprotein related protein 1, and a cell-penetrating peptide (CPP). It was hypothesized that this conjugate will enhance the delivery of associated therapeutic cargo across the BBB and increase the permeability of a solid tumor. Our findings indicate that the combination of these two agents in a delivery vehicle significantly improved translocation of small molecules (paclitaxel) into the brain compared to the vehicle treatment, which contained only receptor-targeting ligand. The application of this strategy could potentially expand the horizons for the treatment of central nervous system disorders.
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17
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Maritaz C, Lemare F, Laplanche A, Demirdjian S, Valteau-Couanet D, Dufour C. High-dose thiotepa-related neurotoxicity and the role of tramadol in children. BMC Cancer 2018; 18:177. [PMID: 29433564 PMCID: PMC5809829 DOI: 10.1186/s12885-018-4090-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 02/05/2018] [Indexed: 11/10/2022] Open
Abstract
Background Serious neurological adverse events (NAE) have occurred during treatment with high-dose thiotepa regimens of children with high-risk solid tumours. The objective was to assess the incidence of NAE related to high-dose thiotepa and to identify potential contributing factors that could exacerbate the occurrence of this neurotoxicity. Methods From May 1987 to March 2011, children with solid tumours treated with high-dose thiotepa were retrospectively identified. Each NAE detected led to an independent case analysis. Potential contributing factors were pre-specified and univariate/multivariable analyses were performed. Results Three hundred seven courses of thiotepa (251 patients) were identified. The total dose per treatment ranged from 600 to 900 mg/m2. 81 NAE (26%) were identified. 46 NAE were related to high-dose thiotepa during the first course (18.3%) and 11 during the second course (19.6%). The symptoms appeared in a median time of 2 days after the introduction of thiotepa. Central and peripheral symptoms were headaches, tremors, confusion, seizures, cerebellar syndrome, and coma. High-dose thiotepa was reintroduced in 18 cases and symptoms reappeared in 5 children. For 3 patients who had seizures during the first course, premedication with clonazepam for the second course has prevented recurrence of NAE. As contributing factors, brain tumour and tramadol treatment increased the risk of thiotepa-related neurotoxicity by 2 to 6 times respectively. Conclusions The incidence of neurotoxicity was 18.3%. Brain tumours and tramadol treatment are risk factors to consider when using high-dose thiotepa. The outcome of patients was favourable without sequelae in all cases and rechallenge with thiotepa was possible.
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Affiliation(s)
- Christophe Maritaz
- Department of Clinical Pharmacy, Gustave-Roussy cancer campus, 114 Rue Edouard Vaillant, 94805, Villejuif, France.
| | - Francois Lemare
- Department of Clinical Pharmacy, Gustave-Roussy cancer campus, 114 Rue Edouard Vaillant, 94805, Villejuif, France.,Faculty of Pharmacy of Paris, Sorbonne-Paris University, 75 006, Paris, France.,EA 7348 MOS, Ecole des Hautes Etudes en Santé Publique, 35000, Rennes, France
| | - Agnes Laplanche
- Department of Biostatistics and Epidemiology, Gustave-Roussy, Villejuif, France
| | - Sylvie Demirdjian
- Department of Clinical Pharmacy, Gustave-Roussy cancer campus, 114 Rue Edouard Vaillant, 94805, Villejuif, France
| | | | - Christelle Dufour
- Department of Pediatric and Adolescent Oncology, Gustave-Roussy, Villejuif, France
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18
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Di N, Yao C, Cheng W, Ren Y, Qu J, Wang B, Yao Z. Correlation of dynamic contrast-enhanced MRI derived volume transfer constant with histological angiogenic markers in high-grade gliomas. J Med Imaging Radiat Oncol 2018; 62:464-470. [PMID: 29330968 DOI: 10.1111/1754-9485.12701] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 12/12/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION To ascertain if the volume transfer constant (Ktrans ) derived from T1 dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) correlates with the immunohistological markers of angiogenesis in high-grade gliomas. METHODS Fifty-one image-guided biopsy specimens in 34 patients with newly presenting high-grade gliomas (grade III = 16; grade IV = 18) underwent preoperative imaging (conventional imaging and T1 DCE-MRI). We correlated vascular endothelial growth factor (VEGF) expression and the microvessel density (MVD) of MRI-guided biopsy specimens with the corresponding DCE-derived Ktrans . Histological sections were stained with VEGF and CD34, and examined under light microscopy. These histological and molecular markers of angiogenesis were correlated with the Ktrans of the region of interest corresponding to the biopsy specimen. RESULTS The Ktrans showed a significant positive correlation with VEGF expression (ρ = 0.582, P = 0.001) but not with MVD stained with CD34 antibody (ρ = 0.328, P = 0.072). CONCLUSION The Ktrans derived from DCE-MRI can reflect the VEGF expression of high-grade gliomas but not the MVD.
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Affiliation(s)
- Ningning Di
- Department of Radiology, Binzhou Medical University Hospital, Binzhou, China
- Department of Radiology, Huashan Hospital Fudan University, Shanghai, China
| | - Chenjun Yao
- Department of Neurosurgery, Huashan Hospital Fudan University, Shanghai, China
| | - Wenna Cheng
- Department of Pharmacy, Binzhou Medical University Affiliated Hospital, Binzhou, China
| | - Yan Ren
- Department of Radiology, Huashan Hospital Fudan University, Shanghai, China
| | | | - Bin Wang
- Department of Medical Imaging and Nuclear Medicine, Binzhou Medical University, Yantai, China
| | - Zhenwei Yao
- Department of Radiology, Huashan Hospital Fudan University, Shanghai, China
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19
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Detection of residual metastatic tumor in the brain following Gamma Knife radiosurgery using a single or a series of magnetic resonance imaging scans: An autopsy study. Oncol Lett 2017; 14:2033-2040. [PMID: 28789434 PMCID: PMC5530089 DOI: 10.3892/ol.2017.6359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 03/24/2017] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to investigate the usefulness of magnetic resonance image (MRI) for the detection of residual tumors following Gamma Knife radiosurgery (GKR) for brain metastases based on autopsy cases. The study investigated two hypotheses: i) Whether a single MRI may detect the existence of a tumor; and ii) whether a series of MRIs may detect the existence of a tumor. The study is a retrospective case series in a single institution. A total of 11 brain metastases in 6 patients were treated with GKR between 2002 and 2011. Histopathological specimens from autopsy were compared with reconstructed follow-up MRIs. The maximum diameters of the lesions on MRI series were measured, and the size changes classified. The primary sites in the patients were the kidneys (n=2), lung (n=1), breast (n=1) and colon (n=1), as well as 1 adenocarcinoma of unknown origin. The median prescribed dose for radiosurgery was 20 Gy (range, 18-20 Gy), and median time interval between GKR and autopsy was 10 months (range, 1.6-20 months). The pathological outcomes included 7 remissions and 4 failures. Enhanced areas on gadolinium-enhanced MRI contained various components: Viable tumor cells, tumor necrosis, hemorrhage, inflammation and vessels. Regarding the first hypothesis, it was impossible to distinguish pathological failure from remission with a single MRI scan due to the presence of various components. Conversely, in treatment response (remission or failure), on time-volume curves of MRI scans were in agreement with pathological findings, with the exception of progressive disease in the acute phase (0-3 months). Thus, regarding the second hypothesis, time-volume curves were useful for predicting treatment responses. In conclusion, it was difficult to predict treatment response using a single MRI, and a series of MRI scans were required to detect the existence of a tumor.
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20
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Jeevanandham B, Kalyanpur T, Gupta P, Cherian M. Comparison of post-contrast 3D-T 1-MPRAGE, 3D-T 1-SPACE and 3D-T 2-FLAIR MR images in evaluation of meningeal abnormalities at 3-T MRI. Br J Radiol 2017; 90:20160834. [PMID: 28375660 DOI: 10.1259/bjr.20160834] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE This study was to assess the usefulness of newer three-dimensional (3D)-T1 sampling perfection with application optimized contrast using different flip-angle evolutions (SPACE) and 3D-T2 fluid-attenuated inversion recovery (FLAIR) sequences in evaluation of meningeal abnormalities. METHODS 78 patients who presented with high suspicion of meningeal abnormalities were evaluated using post-contrast 3D-T2-FLAIR, 3D-T1 magnetization-prepared rapid gradient-echo (MPRAGE) and 3D-T1-SPACE sequences. The images were evaluated independently by two radiologists for cortical gyral, sulcal space, basal cisterns and dural enhancement. The diagnoses were confirmed by further investigations including histopathology. RESULTS Post-contrast 3D-T1-SPACE and 3D-T2-FLAIR images yielded significantly more information than MPRAGE images (p < 0.05 for both SPACE and FLAIR images) in detection of meningeal abnormalities. SPACE images best demonstrated abnormalities in dural and sulcal spaces, whereas FLAIR was useful for basal cisterns enhancement. Both SPACE and FLAIR performed equally well in detection of gyral enhancement. In all 10 patients, where both SPACE and T2-FLAIR images failed to demonstrate any abnormality, further analysis was also negative. CONCLUSION The 3D-T1-SPACE sequence best demonstrated abnormalities in dural and sulcal spaces, whereas FLAIR was useful for abnormalities in basal cisterns. Both SPACE and FLAIR performed holds good for detection of gyral enhancement. Post-contrast SPACE and FLAIR sequences are superior to the MPRAGE sequence for evaluation of meningeal abnormalities and when used in combination have the maximum sensitivity for leptomeningeal abnormalities. The negative-predictive value is nearly 100%, where no leptomeningeal abnormality was detected on these sequences. Advances in knowledge: Post-contrast 3D-T1-SPACE and 3D-T2-FLAIR images are more useful than 3D-T1-MPRAGE images in evaluation of meningeal abnormalities.
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Affiliation(s)
- Balaji Jeevanandham
- Department of Radiology, Kovai Medical Centre and Hospital, Coimbatore, India
| | - Tejas Kalyanpur
- Department of Radiology, Kovai Medical Centre and Hospital, Coimbatore, India
| | - Prashant Gupta
- Department of Radiology, Kovai Medical Centre and Hospital, Coimbatore, India
| | - Mathew Cherian
- Department of Radiology, Kovai Medical Centre and Hospital, Coimbatore, India
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21
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Keil VC, Pintea B, Gielen GH, Greschus S, Fimmers R, Gieseke J, Simon M, Schild HH, Hadizadeh DR. Biopsy targeting with dynamic contrast-enhanced versus standard neuronavigation MRI in glioma: a prospective double-blinded evaluation of selection benefits. J Neurooncol 2017; 133:155-163. [PMID: 28425048 DOI: 10.1007/s11060-017-2424-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 04/11/2017] [Indexed: 12/30/2022]
Abstract
Current biopsy planning based on contrast-enhanced T1W (CET1W) or FLAIR sequences frequently delivers biopsy samples that are not in concordance with the gross tumor diagnosis. This study investigates whether the quantitative information of transfer constant Ktrans maps derived from T1W dynamic contrast-enhanced MRI (DCE-MRI) can help enhance the quality of biopsy target selection in glioma. 28 patients with suspected glioma received MRI including DCE-MRI and a standard neuronavigation protocol of 3D FLAIR- and CET1W data sets (0.1 mmol/kg gadobutrol) at 3.0 T. After exclusion of five cases with no Ktrans-elevation, 2-6 biopsy targets were independently selected by a neurosurgeon (samples based on standard imaging) and a neuroradiologist (samples based on kinetic parameter Ktrans) per case and tissue samples corresponding to these targets were collected by a separate independent neurosurgeon. Standard technique and Ktrans-based samples were rated for diagnostic concordance with the gross tumor resection reference diagnosis (67 WHO IV; 24 WHO III and II) by a neuropathologist blinded for selection mode. Ktrans-based sample targets differed from standard technique sample targets in 90/91 cases. More Ktrans-based than standard imaging-based samples could be extracted. Diagnoses from Ktrans-based samples were more frequently concordant with the reference gross tumor diagnoses than those from standard imaging-based samples (WHO IV: 30/39 vs. 11/20; p = 0.08; WHO III/II: 12/13 vs. 6/11; p = 0.06). In 4/5 non-contrast-enhancing gliomas, Ktrans-based selection revealed significantly more accurate samples than standard technique sample-selection (10/12 vs. 2/8 samples; p = 0.02). If Ktrans elevation is present, Ktrans-based biopsy targeting provides significantly more diagnostic tissue samples in non-contrast-enhancing glioma than selection based on CET1W and FLAIR-weighted images alone.
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Affiliation(s)
- Vera C Keil
- Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany
| | - Bogdan Pintea
- Department of Neurosurgery, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany
| | - Gerrit H Gielen
- Department of Neuropathology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany
| | - Susanne Greschus
- Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany
| | - Rolf Fimmers
- University Hospital Bonn, IMBIE, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany
| | - Jürgen Gieseke
- Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany.,PHILIPS Healthcare, Lübeckertordamm 1-3, 20099, Hamburg, Germany
| | - Matthias Simon
- Department of Neurosurgery, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany.,Department of Neurosurgery, Ev. Krankenhaus Bielefeld, Kantensiek 11, 33617, Bielefeld, Germany
| | - Hans H Schild
- Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany
| | - Dariusch R Hadizadeh
- Department of Radiology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany.
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22
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Lobacz MA, Serra F, Hammond G, Oevermann A, Haley AC. IMAGING DIAGNOSIS-MAGNETIC RESONANCE IMAGING OF DIFFUSE LEPTOMENINGEAL OLIGODENDROGLIOMATOSIS IN A DOG WITH "DURAL TAIL SIGN". Vet Radiol Ultrasound 2016; 59:E1-E6. [PMID: 27813316 DOI: 10.1111/vru.12441] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 09/11/2016] [Accepted: 09/13/2016] [Indexed: 11/27/2022] Open
Abstract
A case of diffuse leptomeningeal oligodendrogliomatosis affecting the brain and spinal cord of a dog is presented. A 7.5-year old, male neutered Staffordshire bull terrier presented for evaluation of a chronic history of tetraparesis and seizures, with a multifocal neuroanatomical localization was determined. Extra-axial intradural lesions with an atypical presentation of a dural tail sign were seen on MRI. Histologically, the lesions were consistent with leptomeningeal oligodendrogliomatosis. To the authors' knowledge, a dural tail sign has not previously been reported as an MRI characteristic of diffuse leptomeningeal oligodendrogliomatosis in dogs.
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Affiliation(s)
- Monika Anna Lobacz
- School of Veterinary Medicine, College of Medicine, Veterinary Medicine and Life Sciences, University of Glasgow, Glasgow, G61 1QH, UK
| | - Fabienne Serra
- Division of Neurological Sciences, DCR-VPH, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Gawain Hammond
- School of Veterinary Medicine, College of Medicine, Veterinary Medicine and Life Sciences, University of Glasgow, Glasgow, G61 1QH, UK
| | - Anna Oevermann
- Division of Neurological Sciences, DCR-VPH, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Allison C Haley
- Department of Small Animal Medicine & Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602
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Freitag MT, Maier-Hein KH, Binczyk F, Laun FB, Weber C, Bonekamp D, Tarnawski R, Bobek-Billewicz B, Polanska J, Majchrzak H, Stieltjes B. Early Detection of Malignant Transformation in Resected WHO II Low-Grade Glioma Using Diffusion Tensor-Derived Quantitative Measures. PLoS One 2016; 11:e0164679. [PMID: 27741525 PMCID: PMC5065360 DOI: 10.1371/journal.pone.0164679] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 09/29/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Here, we retrospectively investigate the value of voxel-wisely plotted diffusion tensor-derived (DTI) axial, radial and mean diffusivity for the early detection of malignant transformation (MT) in WHO II glioma compared to contrast-enhanced images. MATERIALS AND METHODS Forty-seven patients underwent brain magnetic resonance imaging follow-up between 2006-2014 after gross-tumor resection of intra-axial WHO II glioma. Axial/Mean/Radial diffusivity maps (AD/MD/RD) were generated from DTI data. ADmin/MDmin/RDmin values were quantified within tumor regions-of-interest generated by two independent readers including tumor contrast-to-noise (CNR). Sensitivity/specificity and area-under-the-curve (AUC) were calculated using receiver-operating-characteristic analysis. Inter-reader agreement was assessed (Cohen's kappa). RESULTS Eighteen patients demonstrated malignant transformation (MT) confirmed in 8/18 by histopathology and in 10/18 through imaging follow-up. Twelve of 18 patients (66.6%) with MT showed diffusion restriction timely coincidental with contrast-enhancement (CE). In the remaining six patients (33.3%), the diffusion restriction preceded the CE. The mean gain in detection time using DTI was (0.8±0.5 years, p = 0.028). Compared to MDmin and RDmin, ROC-analysis showed best diagnostic value for ADmin (sensitivity/specificity 94.94%/89.7%, AUC 0.96; p<0.0001) to detect MT. CNR was highest for AD (1.83±0.14), compared to MD (1.31±0.19; p<0.003) and RD (0.90±0.23; p<0.0001). Cohen's Kappa was 0.77 for ADmin, 0.71 for MDmin and 0.65 for RDmin (p<0.0001, respectively). CONCLUSION MT is detectable at the same time point or earlier compared to T1w-CE by diffusion restriction in diffusion-tensor-derived maps. AD demonstrated highest sensitivity/specificity/tumor-contrast compared to radial or mean diffusivity (= apparent diffusion coefficient) to detect MT.
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Affiliation(s)
- Martin T. Freitag
- Quantitative Imaging-based Disease Characterization, German Cancer Research Center, Heidelberg, Germany
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Klaus H. Maier-Hein
- Junior Group Medical Image Computing, German Cancer Research Center, Heidelberg, Germany
| | | | - Frederik B. Laun
- Division of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Christian Weber
- Junior Group Medical Image Computing, German Cancer Research Center, Heidelberg, Germany
| | - David Bonekamp
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Rafal Tarnawski
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Department of Radiology, Gliwice, Poland
| | - Barbara Bobek-Billewicz
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Department of Radiology, Gliwice, Poland
| | - Joanna Polanska
- Silesian University of Technology, Data Mining Group, Gliwice, Poland
| | - Henryk Majchrzak
- Department of Neurosurgery, Medical University of Silesia, Sosnowiec, Katowice, Poland
| | - Bram Stieltjes
- Quantitative Imaging-based Disease Characterization, German Cancer Research Center, Heidelberg, Germany
- Department of Radiology, University Hospital Basel, Basel, Switzerland
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Khalilov VS, Kholin AA, Medvedeva NA, Vasiliev IG, Rasskazchikova IV, Ismailova RR, Kislyakov AN, Demushkina AA, Alikhanov AA. [MRI-characteristics of epileptogenic supratentorial brain tumors in children]. Zh Nevrol Psikhiatr Im S S Korsakova 2016; 116:56-63. [PMID: 26977627 DOI: 10.17116/jnevro20161161156-63] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To analyze MR-images in patients with symptomatic epilepsy associated with the brain tumor. MATERIAL AND METHODS MRI results of 52 patients with symptomatic epilepsy operated for tumors of supratentorial localization were analyzed. The most epileptogenic tumors with atypical MRI signs and subtle clinical presentation were identified. All patients with tumors were operated using different methods of surgical intervention. RESULTS Dysembryoplastic neuroepithelial tumors (DNET), diffuse astrocytomas (DA) and gangliogliomas (GG) were the most frequent epileptogenic tumors. In all the cases of DNET and in 4 patients with GG, epileptic seizures were the first, and in 4 of 5 cases of DIO were the only clinical sign of tumor presence. In DNET, DA and GG, there was an iso- or hypointensive signal on T1 WI and a signal varying in intensity from moderate to hyperintense in T2 and FLAIR WI, while in cases with DNET and GG, no mass effect and perifocal edema was practically seen. The so-called «spume-like» (multicystic) structure was most clearly observed in FLAIR WI. No significant changes in the dimensions of the DNET and GG were identified. The combination of DNET with focal cortical dysplasia was noted in one case. In DA, it was difficult to distinguish the perifocal edema from tumorous tissue and normal brain tissues, and the growth potential of malformation was slow. CONCLUSION Epileptogenic tumors can imitate the x-ray characteristics of each other, and mimicry to gangliogliomas, oligodendrogliomas and astrocytomas Gr I, II, and others. They are the most frequent causes of symptomatic focal epilepsy. The presence of these malformations is necessary to exclude first of all in all cases of pharmacoresistant epilepsy.
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Affiliation(s)
- V S Khalilov
- FGBUZ 'Tsentral'naja detskaja klinicheskaja bol'nitsa' FMBA Rossii, Moskva
| | - A A Kholin
- GBOU VPO 'Rossijskij natsional'nyj issledovatel'skij meditsinskij universitet im. N.I. Pirogova' Minzdrava RF, Moskva; FGBU 'Rossijskaja detskaja klinicheskaja bol'nitsa' Minzdrava RF, Moskva
| | - N A Medvedeva
- FGBUZ 'Tsentral'naja detskaja klinicheskaja bol'nitsa' FMBA Rossii, Moskva
| | - I G Vasiliev
- FGBU 'Rossijskaja detskaja klinicheskaja bol'nitsa' Minzdrava RF, Moskva
| | - I V Rasskazchikova
- FGBU 'Rossijskaja detskaja klinicheskaja bol'nitsa' Minzdrava RF, Moskva
| | - R R Ismailova
- GBOU VPO 'Rossijskij natsional'nyj issledovatel'skij meditsinskij universitet im. N.I. Pirogova' Minzdrava RF, Moskva
| | - A N Kislyakov
- FGBU 'Morozovskaja detskaja gorodskaja klinicheskaja bol'nitsa' Departamenta zdravoohranenija Moskvy, Moskva
| | - A A Demushkina
- FGBU 'Rossijskaja detskaja klinicheskaja bol'nitsa' Minzdrava RF, Moskva
| | - A A Alikhanov
- FGBU 'Rossijskaja detskaja klinicheskaja bol'nitsa' Minzdrava RF, Moskva
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Lou E, Sperduto PW. Integrating bevacizumab and radiation treatment of brain metastasis: is there sense and sensibility in this approach? ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:36. [PMID: 26889489 DOI: 10.3978/j.issn.2305-5839.2015.12.42] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The incidence of brain metastasis has increased over the past decade. Standard treatment options for brain metastases include whole brain radiation therapy (WBRT), stereotactic radiosurgery (SRS) and surgery for patients with operable lesions and either mass effect or need for histologic confirmation of the diagnosis. Patients are living longer due to improvements in systemic therapeutic approaches, included targeted therapies such as inhibition of vascular endothelial growth factor (VEGF) using the monoclonal antibody bevacizumab (Bev). A recent phase I trial (REBECA) investigated adding Bev to whole-brain radiation for patients with brain metastasis from solid tumors. In this Perspectives article, we discuss the results of the REBECA trial in context of advancements in radiation and medical oncology in the era of targeted therapies, and discuss pertinent questions of interest in this field.
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Affiliation(s)
- Emil Lou
- 1 Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN 55455, USA ; 2 Minneapolis Radiation Oncology & University of Minnesota Gamma Knife Center, Minneapolis, MN 55455, USA
| | - Paul W Sperduto
- 1 Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN 55455, USA ; 2 Minneapolis Radiation Oncology & University of Minnesota Gamma Knife Center, Minneapolis, MN 55455, USA
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26
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Xuan S, Zhao N, Zhou Z, Fronczek FR, Vicente MGH. Synthesis and in Vitro Studies of a Series of Carborane-Containing Boron Dipyrromethenes (BODIPYs). J Med Chem 2016; 59:2109-17. [PMID: 26849474 DOI: 10.1021/acs.jmedchem.5b01783] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A series of seven BODIPYs functionalized with ortho-carborane groups at the 8(meso) or 3/5(α) position were synthesized and characterized by NMR, HRMS, HPLC, and in the cases of 2b and 5b, by X-ray analysis. The BODIPYs exhibited low dark toxicity and phototoxicity toward human glioma T98G cells, and their cellular uptake varied significantly, with 5b accumulating the most and 7 the least. All BODIPYs localized mainly within the cell ER. The BODIPYs showed higher permeabilities than lucifer yellow across human hCMEC/D3 brain endothelial cell monolayers as the BBB model. Among this series, 1b showed the highest BBB permeability (Pe = 16.4 × 10(-5) cm/s), probably as a result of its lower MW (366 Da) and favorable hydrophobicity (log P = 1.5). The combination of low cytotoxicity, amphiphilicity, high boron content, high cellular uptake, and moderate BBB permeability renders these compounds promising boron delivery agents for the BNCT of brain tumors.
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Affiliation(s)
- Sunting Xuan
- Department of Chemistry, Louisiana State University , Baton Rouge, Louisiana 70803, United States
| | - Ning Zhao
- Department of Chemistry, Louisiana State University , Baton Rouge, Louisiana 70803, United States
| | - Zehua Zhou
- Department of Chemistry, Louisiana State University , Baton Rouge, Louisiana 70803, United States
| | - Frank R Fronczek
- Department of Chemistry, Louisiana State University , Baton Rouge, Louisiana 70803, United States
| | - M Graça H Vicente
- Department of Chemistry, Louisiana State University , Baton Rouge, Louisiana 70803, United States
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Hypoxia and Inflammation-Induced Disruptions of the Blood-Brain and Blood-Cerebrospinal Fluid Barriers Assessed Using a Novel T1-Based MRI Method. ACTA NEUROCHIRURGICA SUPPLEMENT 2016; 121:23-8. [DOI: 10.1007/978-3-319-18497-5_5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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28
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Berghoff AS, Preusser M. The future of targeted therapies for brain metastases. Future Oncol 2015; 11:2315-27. [DOI: 10.2217/fon.15.127] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Brain metastases (BM) are an increasing challenge in the management of patients with advanced cancer. Treatment options for BM are limited and mainly focus on the application of local therapies. Systemic therapies including targeted therapies are only poorly investigated, as patients with BM were frequently excluded from clinical trials. Several targeted therapies have shown promising activity in patients with BM. In the present review we discuss existing and emerging targeted therapies for the most frequent BM primary tumor types. We focus on challenges in the conduction of clinical trials on targeted therapies in BM patients such as patient selection, combination with radiotherapy, the obstacles of the blood–brain barrier and the definition of study end points.
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Affiliation(s)
- Anna S Berghoff
- Department for Medicine I, Comprehensive Cancer Center Central Nervous System Unit (CCC-CNS), Clinical Division of Oncology, Medical University of Vienna, Vienna, Austria
- Comprehensive Cancer Center – CNS Tumors Unit, Medical University of Vienna, Vienna, Austria
| | - Matthias Preusser
- Department for Medicine I, Comprehensive Cancer Center Central Nervous System Unit (CCC-CNS), Clinical Division of Oncology, Medical University of Vienna, Vienna, Austria
- Comprehensive Cancer Center – CNS Tumors Unit, Medical University of Vienna, Vienna, Austria
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Bhowmik A, Khan R, Ghosh MK. Blood brain barrier: a challenge for effectual therapy of brain tumors. BIOMED RESEARCH INTERNATIONAL 2015; 2015:320941. [PMID: 25866775 PMCID: PMC4383356 DOI: 10.1155/2015/320941] [Citation(s) in RCA: 163] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 10/27/2014] [Accepted: 11/04/2014] [Indexed: 01/01/2023]
Abstract
Brain tumors are one of the most formidable diseases of mankind. They have only a fair to poor prognosis and high relapse rate. One of the major causes of extreme difficulty in brain tumor treatment is the presence of blood brain barrier (BBB). BBB comprises different molecular components and transport systems, which in turn create efflux machinery or hindrance for the entry of several drugs in brain. Thus, along with the conventional techniques, successful modification of drug delivery and novel therapeutic strategies are needed to overcome this obstacle for treatment of brain tumors. In this review, we have elucidated some critical insights into the composition and function of BBB and along with it we have discussed the effective methods for delivery of drugs to the brain and therapeutic strategies overcoming the barrier.
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Affiliation(s)
- Arijit Bhowmik
- Signal Transduction in Cancer and Stem Cells Laboratory, Division of Cancer Biology and Inflammatory Disorder, Council of Scientific and Industrial Research-Indian Institute of Chemical Biology (CSIR-IICB), 4 Raja S.C. Mullick Road, Jadavpur, Kolkata 700 032, India
| | - Rajni Khan
- Signal Transduction in Cancer and Stem Cells Laboratory, Division of Cancer Biology and Inflammatory Disorder, Council of Scientific and Industrial Research-Indian Institute of Chemical Biology (CSIR-IICB), 4 Raja S.C. Mullick Road, Jadavpur, Kolkata 700 032, India
| | - Mrinal Kanti Ghosh
- Signal Transduction in Cancer and Stem Cells Laboratory, Division of Cancer Biology and Inflammatory Disorder, Council of Scientific and Industrial Research-Indian Institute of Chemical Biology (CSIR-IICB), 4 Raja S.C. Mullick Road, Jadavpur, Kolkata 700 032, India
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30
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Bhupathiraju NVDK, Hu X, Zhou Z, Fronczek FR, Couraud PO, Romero IA, Weksler B, Vicente MGH. Synthesis and in vitro evaluation of BBB permeability, tumor cell uptake, and cytotoxicity of a series of carboranylporphyrin conjugates. J Med Chem 2014; 57:6718-28. [PMID: 25029034 PMCID: PMC4136688 DOI: 10.1021/jm500786c] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Indexed: 01/12/2023]
Abstract
A series of tri[(p-carboranylmethylthio)tetrafluorophenyl]porphyrin conjugates of linear and branched polyamines, glucose, arginine, tri(ethylene glycol), and Tyr-D-Arg-Phe-β-Ala (YRFA) peptide were synthesized. These conjugates were investigated for their BBB permeability in human hCMEC/D3 brain endothelial cells, and their cytotoxicity and uptake were assessed using human glioma T98G cells. For comparison purposes, a symmetric tetra[(p-carboranylmethylthio)tetrafluorophenyl]porphyrin was also synthesized, and its crystal structure was obtained. All porphyrin conjugates show low dark cytotoxicity (IC50>400 μM) and low phototoxicity (IC50>100 μM at 1.5 J/cm2) toward T98G cells. All conjugates were efficiently taken up by T98G cells, particularly the cationic polyamine and arginine conjugates, and were localized in multiple cellular organelles, including mitochondria and lysosomes. All compounds showed relatively low in vitro BBB permeability compared with that of lucifer yellow because of their higher molecular weight, hydrophobicity, and tendency for aggregation in solution. Within this series, the branched polyamine and YRFA conjugates showed the highest permeability coefficient, whereas the glucose conjugate showed the lowest permeability coefficient.
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Affiliation(s)
| | - Xiaoke Hu
- Department
of Chemistry, Louisiana State University, Baton Rouge, Louisiana 70803, United States
| | - Zehua Zhou
- Department
of Chemistry, Louisiana State University, Baton Rouge, Louisiana 70803, United States
| | - Frank R. Fronczek
- Department
of Chemistry, Louisiana State University, Baton Rouge, Louisiana 70803, United States
| | - Pierre-Olivier Couraud
- Institut
COCHIN, INSERM U1016, CNRS UMR 8104, Université Paris Descartes, 75014 Paris, France
| | - Ignacio A. Romero
- Institut
COCHIN, INSERM U1016, CNRS UMR 8104, Université Paris Descartes, 75014 Paris, France
| | - Babette Weksler
- Institut
COCHIN, INSERM U1016, CNRS UMR 8104, Université Paris Descartes, 75014 Paris, France
| | - M. Graça H. Vicente
- Department
of Chemistry, Louisiana State University, Baton Rouge, Louisiana 70803, United States
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Abstract
While traditional computed tomography (CT) and magnetic resonance (MR) imaging illustrate the structural morphology of brain pathology, newer, dynamic imaging techniques are able to show the movement of contrast throughout the brain parenchyma and across the blood-brain barrier (BBB). These data, in combination with pharmacokinetic models, can be used to investigate BBB permeability, which has wide-ranging applications in the diagnosis and management of central nervous system (CNS) tumors in children. In the first part of this paper, we review the technical principles underlying four imaging modalities used to evaluate BBB permeability: PET, dynamic CT, dynamic T1-weighted contrast-enhanced MR imaging, and dynamic T2-weighted susceptibility contrast MR. We describe the data that can be derived from each method, provide some caveats to data interpretation, and compare the advantages and disadvantages of the different techniques. In the second part of this paper, we review the clinical applications that have been reported with permeability imaging data, including diagnosing the nature of a lesion found on imaging (neoplastic versus non-neoplastic, tumor type, tumor grade, recurrence versus pseudoprogression), predicting the natural history of a tumor, monitoring angiogenesis and tracking response to anti-angiogenic agents, optimizing chemotherapy agent selection, and aiding in the development of new antineoplastic drugs and methods to increase local delivery of chemotherapeutics.
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Affiliation(s)
- Sandi Lam
- 1 Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA ; 2 Functional and Stereotactic Neurosurgery, Department of Surgery, University of Chicago, Chicago, Illinois, USA
| | - Yimo Lin
- 1 Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA ; 2 Functional and Stereotactic Neurosurgery, Department of Surgery, University of Chicago, Chicago, Illinois, USA
| | - Peter C Warnke
- 1 Department of Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA ; 2 Functional and Stereotactic Neurosurgery, Department of Surgery, University of Chicago, Chicago, Illinois, USA
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Lamb CR, Lam R, Keenihan EK, Frean S. Appearance of the canine meninges in subtraction magnetic resonance images. Vet Radiol Ultrasound 2014; 55:607-13. [PMID: 24833219 DOI: 10.1111/vru.12166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 01/27/2014] [Indexed: 11/28/2022] Open
Abstract
The canine meninges are not visible as discrete structures in noncontrast magnetic resonance (MR) images, and are incompletely visualized in T1-weighted, postgadolinium images, reportedly appearing as short, thin curvilinear segments with minimal enhancement. Subtraction imaging facilitates detection of enhancement of tissues, hence may increase the conspicuity of meninges. The aim of the present study was to describe qualitatively the appearance of canine meninges in subtraction MR images obtained using a dynamic technique. Images were reviewed of 10 consecutive dogs that had dynamic pre- and postgadolinium T1W imaging of the brain that was interpreted as normal, and had normal cerebrospinal fluid. Image-anatomic correlation was facilitated by dissection and histologic examination of two canine cadavers. Meningeal enhancement was relatively inconspicuous in postgadolinium T1-weighted images, but was clearly visible in subtraction images of all dogs. Enhancement was visible as faint, small-rounded foci compatible with vessels seen end on within the sulci, a series of larger rounded foci compatible with vessels of variable caliber on the dorsal aspect of the cerebral cortex, and a continuous thin zone of moderate enhancement around the brain. Superimposition of color-encoded subtraction images on pregadolinium T1- and T2-weighted images facilitated localization of the origin of enhancement, which appeared to be predominantly dural, with relatively few leptomeningeal structures visible. Dynamic subtraction MR imaging should be considered for inclusion in clinical brain MR protocols because of the possibility that its use may increase sensitivity for lesions affecting the meninges.
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Affiliation(s)
- Christopher R Lamb
- Department of Clinical Sciences and Services, The Royal Veterinary College, University of London, North Mymms, Hertfordshire AL9 7TA, UK
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Assessment of irradiated brain metastases using dynamic contrast-enhanced magnetic resonance imaging. Neuroradiology 2014; 56:437-43. [PMID: 24652530 DOI: 10.1007/s00234-014-1344-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 02/14/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate the effect of stereotactic radiosurgery (SRS) on cerebral metastases using the transfer constant (K trans) assessed by dynamic contrast-enhanced (DCE) MRI. Furthermore, we aimed to evaluate the ability of K trans measurements to predict midterm tumor outcomes after SRS. METHODS The study received institutional review board approval, and informed consent was obtained from all subjects. Twenty-six adult patients with a total of 34 cerebral metastases underwent T1-weighted DCE MRI in a 1.5-T magnet at baseline (prior to SRS) and 4-8 weeks after treatment. Quantitative analysis of DCE MRI was performed by generating K trans parametric maps, and region-of-interest-based measurements were acquired for each metastasis. Conventional MRI was performed at least 16 weeks after SRS to assess midterm tumor outcome using volume variation. RESULTS The mean (±SD) K trans value was 0.13 ± 0.11 min(-1) at baseline and 0.08 ± 0.07 min(-1) after 4-8 weeks post-treatment (p < 0.001). The mean (±SD) total follow-up time was 7.9 ± 4.7 months. Seventeen patients (22 lesions) underwent midterm MRI. Of those, nine (41 %) lesions had progressed at the midterm follow-up. An increase in K trans after SRS was predictive of tumor progression (hazard ratio = 1.50; 95 % CI = 1.16-1.70, p < 0.001). An increase of 15 % in K trans showed a sensitivity of 78 % and a specificity of 85 % for the prediction of progression at midterm follow-up. CONCLUSION SRS was associated with a reduction of K trans values of the cerebral metastases in the early post-treatment period. Furthermore, K trans variation as assessed using DCE MRI may be helpful to predict midterm outcomes after SRS.
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Neoplastic meningitis: How MRI and CSF cytology are influenced by CSF cell count and tumor type. ScientificWorldJournal 2013; 2013:248072. [PMID: 24453817 PMCID: PMC3881671 DOI: 10.1155/2013/248072] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 09/30/2013] [Indexed: 11/17/2022] Open
Abstract
Background. Although CSF cytology and MRI are standard methods to diagnose neoplastic meningitis (NM), this complication of neoplastic disease remains difficult to detect. We therefore reevaluated the sensitivity of gadolinium (GD)-enhanced MRI and cerebrospinal-fluid (CSF)-cytology and the relevance of tumor type and CSF cell count. Methods. We retrospectively identified 111 cases of NM diagnosed in our CSF laboratory since 1990 with complete documentation of both MRI and CSF cytology. 37 had haematological and 74 solid neoplasms. CSF cell counts were increased in 74 and normal in 37 patients. Results. In hematological neoplasms, MRI was positive in 49% and CSF cytology in 97%. In solid tumors, the sensitivity of MRI was 80% and of cytology 78%. With normal CSF cell counts, MRI was positive in 59% (50% hematological, 72% solid malignancies) and CSF cytology in 76% (92% in hematological, 68% in solid neoplasms). In cases of elevated cell counts, the sensitivity of MRI was 72% (50% for hematological, 83% for solid malignancies) and of CSF cytology 91% (100% for haematological and 85% for solid neoplasms). 91% of cytologically positive cases were diagnosed at first and another 7% at second lumbar puncture. Routine protein analyses had a low sensitivity in detecting NM. Conclusions. The high overall sensitivity of MRI was only confirmed for NM from solid tumors and for elevated CSF cell counts. With normal cell counts and haematological neoplasms, CSF-cytology was superior to MRI. None of the analysed routine CSF proteins had an acceptable sensitivity and specificity in detecting leptomeningeal disease.
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Huang APH, Tsai JC, Kuo LT, Lee CW, Lai HS, Tsai LK, Huang SJ, Chen CM, Chen YS, Chuang HY, Wintermark M. Clinical application of perfusion computed tomography in neurosurgery. J Neurosurg 2013; 120:473-88. [PMID: 24266541 DOI: 10.3171/2013.10.jns13103] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECT Currently, perfusion CT (PCT) is a valuable imaging technique that has been successfully applied to the clinical management of patients with ischemic stroke and aneurysmal subarachnoid hemorrhage (SAH). However, recent literature and the authors' experience have shown that PCT has many more important clinical applications in a variety of neurosurgical conditions. Therefore, the authors share their experiences of its application in various diseases of the cerebrovascular, neurotraumatology, and neurooncology fields and review the pertinent literature regarding expanding PCT applications for neurosurgical conditions, including pitfalls and future developments. METHODS A pertinent literature search was conducted of English-language articles describing original research, case series, and case reports from 1990 to 2011 involving PCT and with relevance and applicability to neurosurgical disorders. RESULTS In the cerebrovascular field, PCT is already in use as a diagnostic tool for patients suspected of having an ischemic stroke. Perfusion CT can be used to identify and define the extent of the infarct core and ischemic penumbra core, and thus aid patient selection for acute reperfusion therapy. For patients with aneurysmal SAH, PCT provides assessment of early brain injury, cerebral ischemia, and infarction, in addition to vasospasm. It may also be used to aid case selection for aggressive treatment of patients with poor SAH grade. In terms of oncological applications, PCT can be used as an imaging biomarker to assess angiogenesis and response to antiangiogenetic treatments, differentiate between glioma grades, and distinguish recurrent tumor from radiation necrosis. In the setting of traumatic brain injury, PCT can detect and delineate contusions at an early stage. In patients with mild head injury, PCT results have been shown to correlate with the severity and duration of postconcussion syndrome. In patients with moderate or severe head injury, PCT results have been shown to correlate with patients' functional outcome. CONCLUSIONS Perfusion CT provides quantitative and qualitative data that can add diagnostic and prognostic value in a number of neurosurgical disorders, and also help with clinical decision making. With emerging new technical developments in PCT, such as characterization of blood-brain barrier permeability and whole-brain PCT, this technique is expected to provide more and more insight into the pathophysiology of many neurosurgical conditions.
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Influence of Short-Chain Cell-Penetrating Peptides on Transport of Doxorubicin Encapsulating Receptor-Targeted Liposomes Across Brain Endothelial Barrier. Pharm Res 2013; 31:1194-209. [DOI: 10.1007/s11095-013-1242-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 10/20/2013] [Indexed: 12/24/2022]
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Jaffer H, Adjei IM, Labhasetwar V. Optical imaging to map blood-brain barrier leakage. Sci Rep 2013; 3:3117. [PMID: 24178124 PMCID: PMC3814906 DOI: 10.1038/srep03117] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 10/17/2013] [Indexed: 11/22/2022] Open
Abstract
Vascular leakage in the brain is a major complication associated with brain injuries and certain pathological conditions due to disruption of the blood-brain barrier (BBB). We have developed an optical imaging method, based on excitation and emission spectra of Evans Blue dye, that is >1000-fold more sensitive than conventional ultraviolet spectrophotometry. We used a rat thromboembolic stroke model to validate the usefulness of our method for vascular leakage. Optical imaging data show that vascular leakage varies in different areas of the post-stroke brain and that administering tissue plasminogen activator causes further leakage. The new method is quantitative, simple to use, requires no tissue processing, and can map the degree of vascular leakage in different brain locations. The high sensitivity of our method could potentially provide new opportunities to study BBB leakage in different pathological conditions and to test the efficacy of various therapeutic strategies to protect the BBB.
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Affiliation(s)
- Hayder Jaffer
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195
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Jain R. Measurements of tumor vascular leakiness using DCE in brain tumors: clinical applications. NMR IN BIOMEDICINE 2013; 26:1042-1049. [PMID: 23832526 DOI: 10.1002/nbm.2994] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 06/05/2013] [Accepted: 06/06/2013] [Indexed: 06/02/2023]
Abstract
Various imaging techniques have been employed to evaluate blood-brain-barrier leakiness in brain tumors, as higher tumor vascular leakiness is known to be associated with higher grade and malignant potential of the tumor, and hence can help provide additional diagnostic and prognostic information. These imaging techniques range from routine post-contrast T1 -weighted images that highlight degree of contrast enhancement to absolute measurement of quantitative metrics of vascular leakiness employing complex pharmacokinetic modeling. The purpose of this article is to discuss the clinical applications of available imaging techniques, and in particular dynamic contrast-enhanced T1 -weighted MR imaging (DCE-MRI), to evaluate tumor vascular leakiness.
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Affiliation(s)
- Rajan Jain
- Department of Radiology, Division of Neuroradiology, Henry Ford Health System, Detroit, MI 48202, USA.
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Piao H, Kuan CT, Chandramohan V, Keir ST, Pegram CN, Bao X, Månsson JE, Pastan IH, Bigner DD. Affinity-matured recombinant immunotoxin targeting gangliosides 3'-isoLM1 and 3',6'-isoLD1 on malignant gliomas. MAbs 2013; 5:748-62. [PMID: 23924792 DOI: 10.4161/mabs.25860] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
About 60 percent of glioblastomas highly express the gangliosides 3'-isoLM1 and 3',6'-isoLD1 on the cell surface, providing ideal targets for brain tumor immunotherapy. A novel recombinant immunotoxin, DmAb14m-(scFv)-PE38KDEL (DmAb14m-IT), specific for the gangliosides 3'-isoLM1 and 3',6'-isoLD1, was constructed with improved affinity and increased cytotoxicity for immunotherapeutic targeting of glioblastoma. We isolated an scFv parental clone from a previously established murine hybridoma, DmAb14, that is specific to both 3'-isoLM1 and 3',6'-isoLD1. We then performed in vitro affinity maturation by CDR hotspot random mutagenesis. The binding affinity and specificity of affinity-matured DmAb14m-IT were measured by surface-plasmon resonance, flow cytometry, and immunohistochemical analysis. In vitro cytotoxicity of DmAb14m-IT was measured by protein synthesis inhibition and cell death assays in human cell lines expressing gangliosides 3'-isoLM1 and 3',6'-isoLD1 (D54MG and D336MG) and xenograft-derived cells (D2224MG). As a result, the KD of DmAb14m-IT for gangliosides 3'-isoLM1 and 3',6'-isoLD1 was 2.6 × 10(-9)M. Also, DmAb14m-IT showed a significantly higher internalization rate in cells expressing 3'-isoLM1 and 3',6'-isoLD1. The DmAb14m-IT IC 50 was 80 ng/mL (1194 pM) on the D54MG cell line, 5 ng/ml (75 pM) on the D336MG cell line, and 0.5 ng/ml (7.5 pM) on the D2224MG xenograft-derived cells. There was no cytotoxicity on ganglioside-negative HEK293 cells. Immunohistochemical analysis confirmed the specific apparent affinity of DmAb14m-IT with 3'-isoLM1 and 3',6'-isoLD1. In conclusion, DmAb14m-IT showed specific binding affinity, a significantly high internalization rate, and selective cytotoxicity on glioma cell lines and xenograft-derived cells expressing 3'-isoLM1 and 3',6'-isoLD1, thereby displaying robust therapeutic potential for testing the antitumor efficacy of DmAb14m-IT at the preclinical level and eventually in the clinical setting.
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Affiliation(s)
- Hailan Piao
- Preston Robert Tisch Brain Tumor Center at Duke and Department of Pathology; Duke University Medical Center; Durham, NC USA
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Keenihan E, Summers B, David F, Lamb C. CANINE MENINGEAL DISEASE: ASSOCIATIONS BETWEEN MAGNETIC RESONANCE IMAGING SIGNS AND HISTOLOGIC FINDINGS. Vet Radiol Ultrasound 2013; 54:504-15. [DOI: 10.1111/vru.12055] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 04/25/2013] [Indexed: 11/29/2022] Open
Affiliation(s)
- E.K. Keenihan
- Department of Clinical Sciences and Services; The Royal Veterinary College, University of London; Hertfordshire; AL9 7TA; United Kingdom
| | - B.A. Summers
- Department of Pathology and Pathogen Biology; The Royal Veterinary College, University of London; Hertfordshire; AL9 7TA; United Kingdom
| | - F.H. David
- Department of Clinical Sciences and Services; The Royal Veterinary College, University of London; Hertfordshire; AL9 7TA; United Kingdom
| | - C.R. Lamb
- Department of Clinical Sciences and Services; The Royal Veterinary College, University of London; Hertfordshire; AL9 7TA; United Kingdom
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The impact of oxidative stress in thiamine deficiency: a multifactorial targeting issue. Neurochem Int 2013; 62:796-802. [PMID: 23333339 DOI: 10.1016/j.neuint.2013.01.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 12/22/2012] [Accepted: 01/08/2013] [Indexed: 11/23/2022]
Abstract
Thiamine (vitamin B1) deficiency, the underlying cause of Wernicke-Korsakoff syndrome, is associated with the development of focal neuronal loss in vulnerable areas of the brain. Although the actual mechanism(s) that lead to the selective histological lesions characteristic of this disorder remain unresolved, oxidative stress has been shown to play a major role in its pathophysiology. In this review, the multifactorial influence of oxidative stress on a variety of processes known to take part in the development of structural lesions in TD including excitotoxicity, neuroinflammation, blood-brain barrier integrity, mitochondrial integrity, apoptosis, nucleic acid function, and neural stem cells will be discussed, and therapeutic strategies undertaken for treating neurodegeneration examined which may have an impact on the future treatment of this important vitamin deficiency.
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Lee YJ, Ahn KJ, Kim BS, Yoo WJ. Role of perfusion CT in differentiating between various cerebral masses using normalized permeability surface area product and cerebral blood volume. Clin Imaging 2012; 36:680-7. [PMID: 23153995 DOI: 10.1016/j.clinimag.2012.01.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 01/24/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective was to assess usefulness of a combined analysis using the perfusion computed tomography parameters permeability surface area product (PS) and cerebral blood volume (CBV) in the differential grouping of various cerebral masses. METHODS Thirty patients who had a cerebral mass, confirmed by pathologic verification, were included. We classified PS and CBV results for various cerebral masses by visual as well as semiquantitative assessment. To verify statistically significant differences between the groups, one-way analysis of variance was performed. RESULTS Patients were categorized into five groups with statistically significant differences (P<.01). CONCLUSIONS PS and CBV were useful in the differential diagnosis of cerebral masses.
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Affiliation(s)
- Youn-Joo Lee
- Department of Radiology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, South Korea
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Lang S, Müller B, Dominietto MD, Cattin PC, Zanette I, Weitkamp T, Hieber SE. Three-dimensional quantification of capillary networks in healthy and cancerous tissues of two mice. Microvasc Res 2012; 84:314-22. [PMID: 22796313 DOI: 10.1016/j.mvr.2012.07.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 07/03/2012] [Accepted: 07/04/2012] [Indexed: 11/29/2022]
Abstract
A key issue in developing strategies against diseases such as cancer is the analysis of the vessel tree in comparison to the healthy one. In the search for parameters that might be characteristic for tumor capillaries we study the vascularization in mice for cancerous and healthy tissues using synchrotron radiation-based micro computed tomography in absorption and phase contrast modes. Our investigations are based on absorption tomograms of casted healthy and cancerous tissues as well as a phase tomogram of a fixated tumor. We demonstrate how the voxel-based tomography data can be vectorized to assess the capillary networks quantitatively. The processing includes segmentation, skeletonization, and vectorization to finally extract the vessel parameters. The mean diameter of capillaries in healthy and cancerous tissues corresponds to (8.0±1.1) μm and (3.9±1.1) μm, respectively. Further evaluated parameters show marginal or no differences between capillaries in healthy and cancerous tissues, namely fractal dimension 2.3±0.3 vs. 2.3±0.2, tortuosity (SOAM) 0.18 rad/μm vs. 0.24 rad/μm and vessel length 20 μm vs. 17 μm. The bifurcation angles exhibit a narrow distribution around 115°. Furthermore, we show that phase tomography is a powerful alternative to absorption tomography of casts for the vessel visualization omitting any invasive specimen preparation procedure.
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Affiliation(s)
- Sabrina Lang
- Biomaterials Science Center, University of Basel, c/o University Hospital, 4031 Basel, Switzerland
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Singh JB, Oevermann A, Lang J, Vandevelde M, Doherr M, Henke D, Gorgas D. Contrast media enhancement of intracranial lesions in magnetic resonance imaging does not reflect histopathologic findings consistently. Vet Radiol Ultrasound 2012; 52:619-26. [PMID: 21777330 DOI: 10.1111/j.1740-8261.2011.01848.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Certain magnetic resonance (MR) enhancement patterns are often considered to be associated with a specific diagnosis but experience shows that this association is not always consistent. Therefore, it is not clear how reliably contrast enhancement patterns correlate with specific tissue changes. We investigated the detailed histomorphologic findings of intracranial lesions in relation to Gadodiamide contrast enhancement in 55 lesions from 55 patients, nine cats, and 46 dogs. Lesions were divided into areas according to their contrast enhancement; therefore 81 areas resulted from the 55 lesions which were directly compared with histopathology. In 40 of 55 lesions (73%), the histomorphologic features explained the contrast enhancement pattern. In particular, vascular proliferation and dilated vessels occurred significantly more often in areas with enhancement than in areas without enhancement (P = 0.044). In 15 lesions, there was no association between MR images and histologic findings. In particular, contrast enhancement was found within necrotic areas (10 areas) and ring enhancement was seen in lesions without central necrosis (five lesions). These findings imply that necrosis cannot be differentiated reliably from viable tissue based on postcontrast images. Diffusion of contrast medium within lesions and time delays after contrast medium administration probably play important roles in the presence and patterns of contrast enhancement. Thus, histologic features of lesions cannot be predicted solely by contrast enhancement patterns.
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Zhang N, Zhang L, Qiu B, Meng L, Wang X, Hou BL. Correlation of volume transfer coefficient Ktrans with histopathologic grades of gliomas. J Magn Reson Imaging 2012; 36:355-63. [PMID: 22581762 DOI: 10.1002/jmri.23675] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Accepted: 03/09/2012] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To evaluate the roles of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and optimum tracer kinetic parameters in the noninvasive grading of the glial brain tumors with histopathological grades (I-IV). MATERIALS AND METHODS Twenty-eight patients with histopathologically graded gliomas were imaged. Images with five flip angles were acquired before injection of gadolinium-DTPA and were processed to calculate the T(1) value of each region of interest (ROI). All the DCE-MRI data acquired during the injection were processed based on the MRI signal and pharmacokinetic models to establish concentration-time curves in the ROIs drawn within the tumors, contralateral normal areas, and area of the individual artery input functions (iAIF) of each patient. A nonlinear least-square-fitting method was used to obtain tracer kinetic parameters. Kruskal-Wallis H-test and Mann-Whitney U-test were applied to these parameters in different histopathological grade groups for statistical differences (P < 0.05). RESULTS Volume transfer coefficient (K(trans) ) and extravascular extracellular space volume fraction (V(e) ) calculated using iAIFs can be used not only to distinguish the low (ie, I and II) from the high (ie, III and IV) grade gliomas (P( Ktrans) < 0.001 and P(Ve) < 0.001), but also grade II from III (P( Ktrans) = 0.016 and P(Ve) = 0.033). CONCLUSION K(trans) is the most sensitive and specific parameter in noninvasive grading, distinguishing the high (III and IV) from the low (I and II) grade and high grade III from low grade II gliomas.
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Affiliation(s)
- Na Zhang
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Key laboratory for MRI, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
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Omidi Y, Barar J. Impacts of blood-brain barrier in drug delivery and targeting of brain tumors. BIOIMPACTS : BI 2012; 2:5-22. [PMID: 23678437 DOI: 10.5681/bi.2012.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/03/2011] [Revised: 11/26/2011] [Accepted: 12/20/2011] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Entry of blood circulating agents into the brain is highly selectively con-trolled by specific transport machineries at the blood brain barrier (BBB), whose excellent barrier restrictiveness make brain drug delivery and targeting very challenging. METHODS Essential information on BBB cellular microenvironment were reviewed and discussed towards impacts of BBB on brain drug delivery and targeting. RESULTS Brain capillary endothelial cells (BCECs) form unique biological structure and architecture in association with astrocytes and pericytes, in which microenvironment the BCECs express restrictive tight junctional complexes that block the paracellular inward/outward traverse of biomolecules/compounds. These cells selectively/specifically control the transportation process through carrier and/or receptor mediated transport machineries that can also be exploited for the delivery of pharmaceuticals into the brain. Intelligent molecular therapies should be designed using such transport machineries for the efficient delivery of designated drugs into the brain. For better clinical outcomes, these smart pharmaceuticals should be engineered as seamless nanosystems to provide simultaneous imaging and therapy (multimodal theranostics). CONCLUSION The exceptional functional presence of BBB selectively controls inward and outward transportation mechanisms, thus advanced smart multifunctional nanomedicines are needed for the effective brain drug delivery and targeting. Fully understanding the biofunctions of BBB appears to be a central step for engineering of intelligent seamless therapeutics consisting of homing device for targeting, imaging moiety for detecting, and stimuli responsive device for on-demand liberation of therapeutic agent.
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Affiliation(s)
- Yadollah Omidi
- Research Center for Pharmaceutical Nanotechnology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran ; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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Prediction of glioblastoma multiform response to bevacizumab treatment using multi-parametric MRI. PLoS One 2012; 7:e29945. [PMID: 22253835 PMCID: PMC3256204 DOI: 10.1371/journal.pone.0029945] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Accepted: 12/08/2011] [Indexed: 11/26/2022] Open
Abstract
Glioblastoma multiform (GBM) is a highly malignant brain tumor. Bevacizumab is a recent therapy for stopping tumor growth and even shrinking tumor through inhibition of vascular development (angiogenesis). This paper presents a non-invasive approach based on image analysis of multi-parametric magnetic resonance images (MRI) to predict response of GBM to this treatment. The resulting prediction system has potential to be used by physicians to optimize treatment plans of the GBM patients. The proposed method applies signal decomposition and histogram analysis methods to extract statistical features from Gd-enhanced regions of tumor that quantify its microstructural characteristics. MRI studies of 12 patients at multiple time points before and up to four months after treatment are used in this work. Changes in the Gd-enhancement as well as necrosis and edema after treatment are used to evaluate the response. Leave-one-out cross validation method is applied to evaluate prediction quality of the models. Predictive models developed in this work have large regression coefficients (maximum R2 = 0.95) indicating their capability to predict response to therapy.
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Flanigan JC, Jilaveanu LB, Faries M, Sznol M, Ariyan S, Yu JB, Knisely JPS, Chiang VL, Kluger HM. Melanoma brain metastases: is it time to reassess the bias? Curr Probl Cancer 2011; 35:200-10. [PMID: 21911183 DOI: 10.1016/j.currproblcancer.2011.07.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Trapani A, Denora N, Iacobellis G, Sitterberg J, Bakowsky U, Kissel T. Methotrexate-loaded chitosan- and glycol chitosan-based nanoparticles: a promising strategy for the administration of the anticancer drug to brain tumors. AAPS PharmSciTech 2011; 12:1302-11. [PMID: 21948322 DOI: 10.1208/s12249-011-9695-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Accepted: 09/12/2011] [Indexed: 11/30/2022] Open
Abstract
Brain tumor treatment employing methotrexate (MTX) is limited by the efflux mechanism of Pg-p on the blood-brain barrier. We aimed to investigate MTX-loaded chitosan or glycol chitosan (GCS) nanoparticles (NPs) in the presence and in the absence of a coating layer of Tween 80 for brain delivery of MTX. The effect of a low Tween 80 concentration was evaluated. MTX NPs were formulated following the ionic gelation technique and size and zeta potential measurements were acquired. Transport across MDCKII-MDR1 monolayer and cytotoxicity studies against C6 glioma cell line were also performed. Cell/particles interaction was visualized by confocal microscopy. The particles were shown to be cytotoxic against C6 cells line and able to overcome MDCKII-MDR1 cell barrier. GCS-based NPs were the most cytotoxic NPs. Confocal observations highlighted the internalization of Tween 80-coated fluorescent NPs more than Tween 80-uncoated NPs. The results suggest that even a low concentration of Tween 80 is sufficient for enhancing the transport of MTX from the NPs across MDCKII-MDR1 cells. The nanocarriers represent a promising strategy for the administration of MTX to brain tumors which merits further investigations under in vivo conditions.
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Bertrand Y, Currie JC, Poirier J, Demeule M, Abulrob A, Fatehi D, Stanimirovic D, Sartelet H, Castaigne JP, Béliveau R. Influence of glioma tumour microenvironment on the transport of ANG1005 via low-density lipoprotein receptor-related protein 1. Br J Cancer 2011; 105:1697-707. [PMID: 22027709 PMCID: PMC3242593 DOI: 10.1038/bjc.2011.427] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND ANG1005 consists of three molecules of paclitaxel conjugated via ester bonds to the 19-amino-acid peptide Angiopep-2. The new chemical agent has been shown to cross the blood-brain barrier (BBB) by receptor-mediated transcytosis via low-density lipoprotein receptor-related protein 1 (LRP1). The experiments here examined the role of LRP1 in the subsequent endocytosis of drug into cancer cells. METHODS Localisation of ANG1005 and Angiopep-2 was examined by immunohistochemistry and in-vivo near-infrared fluorescence imaging in mice carrying orthotopic glioma tumours. Transport of ANG1005 and Angiopep-2 was examined in U87 glioblastoma cell lines. RESULTS Systemically administered ANG1005 and Cy5.5Angiopep-2 localised to orthotopic glioma tumours in mice. The glioma transplants correlated with high expression levels of LRP1. Decreasing LRP1 activity, by RNA silencing or LRP1 competitors, decreased uptake of ANG1005 and Angiopep-2 into U87 glioblastoma cells. Conversely, LRP1 expression and endocytosis rates for ANG1005 and Angiopep-2 increased in U87 cells under conditions that mimicked the microenvironment near aggressive tumours, that is, hypoxic and acidic conditions. CONCLUSION ANG1005 might be a particularly effective chemotherapeutic agent for the wide array of known LRP1-expressing brain and non-brain cancers, in particular those with an aggressive phenotype.
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Affiliation(s)
- Y Bertrand
- Laboratoire de Médecine Moléculaire, Chemistry Department, Université du Québec à Montréal, C.P. 8888, Succ. Centre-Ville, Montréal, QC, Canada
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