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Sun R, Shao X, Akter F, Zahid KR, Yao S, Ma L, Xu G. PRIM2: A Marker of MYC-driven Hyper-proliferation, Disease Progression, Tumor Aggressiveness and Poor Survival in Glioma Patients. Cancer Genomics Proteomics 2024; 21:186-202. [PMID: 38423596 PMCID: PMC10905270 DOI: 10.21873/cgp.20440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND/AIM Gliomas are the most prevalent brain tumors with metabolic alterations playing a pivotal role in disease progression. However, the precise coordination of metabolic alterations with tumor-promoting cellular mechanisms, leading to tumor initiation, progression, and aggressiveness, resulting in poor outcomes, remains poorly understood in gliomas. MATERIALS AND METHODS We conducted a metabolism-targeted differential gene expression analysis using glioma patients' expression profiling data from The Cancer Genome Atlas (TCGA) database. In addition, pathway enrichment analysis, gene set enrichment analysis (GSEA), transcription factor prediction, network construction, and correlation analyses were performed. Survival analyses were performed in R. All results were validated using independent GEO expression datasets. RESULTS Metabolism-targeted analysis identified 5 hits involved in diverse metabolic processes linking them to disease aggressiveness in gliomas. Subsequently, we established that cell cycle progression and hyper-proliferation are key drivers of tumor progression and aggressiveness in gliomas. One of the identified metabolic hits, DNA primase 2 (PRIM2), a gene involved in DNA replication was found directly associated with cell cycle progression in gliomas. Furthermore, our analysis indicated that PRIM2, along with other cell cycle-related genes, is under the control of and regulated by the oncogenic MYC transcription factor in gliomas. In addition, PRIM2 expression alone is enough to predict MYC-driven cell cycle progression and is associated with tumor progression, aggressive disease state, and poor survival in glioma patients. CONCLUSION Our findings highlight PRIM2 as a marker of MYC-driven cell cycle progression and hyper-proliferation, disease onset and progression, tumor aggressiveness, and poor survival in glioma patients.
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Affiliation(s)
- Ronghui Sun
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, P.R. China
- Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan, P.R. China
| | - Xiaodong Shao
- Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
| | - Farhana Akter
- Faculty of Arts and Sciences, Harvard University, Cambridge, MA, U.S.A
| | - Kashif Rafiq Zahid
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, U.S.A
| | - Shun Yao
- Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
| | - Lianting Ma
- Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan, P.R. China
| | - Guozheng Xu
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, P.R. China;
- Department of Neurosurgery, The General Hospital of Chinese PLA Central Theater Command, Wuhan, P.R. China
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2
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Rosager AM, Dahlrot RH, Sørensen MD, Bangsø JA, Hansen S, Kristensen BW. The Epigenetic Regulator Jumonji Domain-Containing Protein 6 (JMJD6) Is Highly Expressed but Not Prognostic in IDH-Wildtype Glioblastoma Patients. J Neuropathol Exp Neurol 2021; 81:54-60. [PMID: 34875075 DOI: 10.1093/jnen/nlab124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Patients with IDH-wildtype glioblastoma (GBM) generally have a poor prognosis. However, there is an increasing need of novel robust biomarkers in the daily clinico-pathological setting to identify and support treatment in patients who become long-time survivors. Jumonji domain-containing protein 6 (JMJD6) is involved in epigenetic regulation of demethylation of histones and has been associated with GBM aggressiveness. We investigated the expression and prognostic potential of JMJD6 tumor fraction score in 184 IDH-wildtype GBMs. Whole-slides were double-stained with an antibody against JMJD6 and an exclusion-cocktail consisting of 4 antibodies (CD31, SMA, CD45, and Iba-1), enabling evaluation of tumor cells only. Stainings were quantified with a combined software- and scoring-based approach. For comparison, IDH-mutated WHO grade II, III and IV astrocytic gliomas were also stained, and the JMJD6 tumor fraction score increased with increasing WHO grade, although not significantly. In multivariate analysis including age, gender, performance status and post-surgical treatment high JMJD6 tumor fraction score was associated with longer overall survival in IDH-wildtype GBMs (p = 0.03), but the effect disappeared when MGMT promoter status was included (p = 0.34). We conclude that JMJD6 is highly expressed in IDH-wildtype GBM but it has no independent prognostic value.
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Affiliation(s)
- Ann Mari Rosager
- From the Department of Pathology, Odense University Hospital, Odense, Denmark (AMR, MDS, JAB, BWK); Department of Clinical Research, University of Southern Denmark, Odense, Denmark (AMR, RHD, MDS, JAB, SH, BWK); Department of Oncology, Odense University Hospital, Odense, Denmark (RHD, SH); Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (BWK); Department of Clinical Medicine and Biotech Research and Innovation Center (BRIC), University of Copenhagen, Copenhagen, Denmark (BWK)
| | - Rikke H Dahlrot
- From the Department of Pathology, Odense University Hospital, Odense, Denmark (AMR, MDS, JAB, BWK); Department of Clinical Research, University of Southern Denmark, Odense, Denmark (AMR, RHD, MDS, JAB, SH, BWK); Department of Oncology, Odense University Hospital, Odense, Denmark (RHD, SH); Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (BWK); Department of Clinical Medicine and Biotech Research and Innovation Center (BRIC), University of Copenhagen, Copenhagen, Denmark (BWK)
| | - Mia D Sørensen
- From the Department of Pathology, Odense University Hospital, Odense, Denmark (AMR, MDS, JAB, BWK); Department of Clinical Research, University of Southern Denmark, Odense, Denmark (AMR, RHD, MDS, JAB, SH, BWK); Department of Oncology, Odense University Hospital, Odense, Denmark (RHD, SH); Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (BWK); Department of Clinical Medicine and Biotech Research and Innovation Center (BRIC), University of Copenhagen, Copenhagen, Denmark (BWK)
| | - Julie A Bangsø
- From the Department of Pathology, Odense University Hospital, Odense, Denmark (AMR, MDS, JAB, BWK); Department of Clinical Research, University of Southern Denmark, Odense, Denmark (AMR, RHD, MDS, JAB, SH, BWK); Department of Oncology, Odense University Hospital, Odense, Denmark (RHD, SH); Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (BWK); Department of Clinical Medicine and Biotech Research and Innovation Center (BRIC), University of Copenhagen, Copenhagen, Denmark (BWK)
| | - Steinbjørn Hansen
- From the Department of Pathology, Odense University Hospital, Odense, Denmark (AMR, MDS, JAB, BWK); Department of Clinical Research, University of Southern Denmark, Odense, Denmark (AMR, RHD, MDS, JAB, SH, BWK); Department of Oncology, Odense University Hospital, Odense, Denmark (RHD, SH); Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (BWK); Department of Clinical Medicine and Biotech Research and Innovation Center (BRIC), University of Copenhagen, Copenhagen, Denmark (BWK)
| | - Bjarne W Kristensen
- From the Department of Pathology, Odense University Hospital, Odense, Denmark (AMR, MDS, JAB, BWK); Department of Clinical Research, University of Southern Denmark, Odense, Denmark (AMR, RHD, MDS, JAB, SH, BWK); Department of Oncology, Odense University Hospital, Odense, Denmark (RHD, SH); Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (BWK); Department of Clinical Medicine and Biotech Research and Innovation Center (BRIC), University of Copenhagen, Copenhagen, Denmark (BWK)
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3
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Sorribes IC, Handelman SK, Jain HV. Mitigating temozolomide resistance in glioblastoma via DNA damage-repair inhibition. J R Soc Interface 2020; 17:20190722. [PMID: 31964274 DOI: 10.1098/rsif.2019.0722] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Glioblastomas are among the most lethal cancers, with a 5 year survival rate below 25%. Temozolomide is typically used in glioblastoma treatment; however, the enzymes alkylpurine-DNA-N-glycosylase (APNG) and methylguanine-DNA-methyltransferase (MGMT) efficiently mediate the repair of DNA damage caused by temozolomide, reducing treatment efficacy. Consequently, APNG and MGMT inhibition has been proposed as a way of overcoming chemotherapy resistance. Here, we develop a mechanistic mathematical model that explicitly incorporates the effects of chemotherapy on tumour cells, including the processes of DNA damage induction, cell arrest and DNA repair. Our model is carefully parametrized and validated, and then used to virtually recreate the response of heteroclonal glioblastomas to dual treatment with temozolomide and inhibitors of APNG/MGMT. Using our mechanistic model, we identify four combination treatment strategies optimized by tumour cell phenotype, and isolate the strategy most likely to succeed in a pre-clinical and clinical setting. If confirmed in clinical trials, these strategies have the potential to offset chemotherapy resistance in patients with glioblastoma and improve overall survival.
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Affiliation(s)
| | - Samuel K Handelman
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Harsh V Jain
- Department of Mathematics, Florida State University, Tallahassee, FL 32306, USA
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4
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Rosenberg T, Aaberg-Jessen C, Petterson SA, Kristensen BW. Heterogenic expression of stem cell markers in patient-derived glioblastoma spheroid cultures exposed to long-term hypoxia. CNS Oncol 2018; 7:CNS15. [PMID: 29708435 PMCID: PMC5977272 DOI: 10.2217/cns-2017-0034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Aim: To investigate the time profile of hypoxia and stem cell markers in glioblastoma spheroids of known molecular subtype. Materials & methods: Patient-derived glioblastoma spheroids were cultured up to 7 days in either 2% or 21% oxygen. Levels of proliferation (Ki-67), hypoxia (HIF-1α, CA9 and VEGF) and stem cell markers (CD133, nestin and musashi-1) were investigated by immunohistochemistry. Results: Hypoxia markers as well as CD133 and partially nestin increased in long-term hypoxia. The proliferation rate and spheroid size were highest in normoxia. Conclusion: We found differences in hypoxia and stem cell marker profiles between the patient-derived glioblastoma cultures. This heterogeneity should be taken into consideration in development of future therapeutic strategies.
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Affiliation(s)
- Tine Rosenberg
- Department of Pathology, Odense University Hospital, Odense 5000, Denmark.,Department of ORL - Head & Neck Surgery, Odense University Hospital, Odense 5000, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense 5000, Denmark
| | - Charlotte Aaberg-Jessen
- Department of Pathology, Odense University Hospital, Odense 5000, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense 5000, Denmark.,Department of Nuclear Medicine, Odense University Hospital, Odense 5000, Denmark
| | - Stine Asferg Petterson
- Department of Pathology, Odense University Hospital, Odense 5000, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense 5000, Denmark
| | - Bjarne Winther Kristensen
- Department of Pathology, Odense University Hospital, Odense 5000, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense 5000, Denmark
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5
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Dahlrot RH, Dowsett J, Fosmark S, Malmström A, Henriksson R, Boldt H, de Stricker K, Sørensen MD, Poulsen HS, Lysiak M, Söderkvist P, Rosell J, Hansen S, Kristensen BW. Prognostic value of O-6-methylguanine-DNA methyltransferase (MGMT) protein expression in glioblastoma excluding nontumour cells from the analysis. Neuropathol Appl Neurobiol 2018; 44:172-184. [PMID: 28574607 DOI: 10.1111/nan.12415] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 05/26/2017] [Accepted: 06/02/2017] [Indexed: 01/20/2023]
Abstract
AIMS It is important to predict response to treatment with temozolomide (TMZ) in glioblastoma (GBM) patients. Both MGMT protein expression and MGMT promoter methylation status have been reported to predict the response to TMZ. We investigated the prognostic value of quantified MGMT protein levels in tumour cells and the prognostic importance of combining information of MGMT protein level and MGMT promoter methylation status. METHODS MGMT protein expression was quantified in tumour cells in 171 GBMs from the population-based Region of Southern Denmark (RSD)-cohort using a double immunofluorescence approach. Pyrosequencing was performed in 157 patients. For validation we used GBM-patients from a Nordic Study (NS) investigating the effect of radiotherapy and different TMZ schedules. RESULTS When divided at the median, patients with low expression of MGMT protein (AF-low) had the best prognosis (HR = 1.5, P = 0.01). Similar results were observed in the subgroup of patients receiving the Stupp regimen (HR = 2.0, P = 0.001). In the NS-cohort a trend towards superior survival (HR = 1.6, P = 0.08) was seen in patients with AF-low. Including MGMT promoter methylation status, we found for both cohorts that patients with methylated MGMT promoter and AF-low had the best outcome; median OS 23.1 and 20.0 months, respectively. CONCLUSION Our data indicate that MGMT protein expression in tumour cells has an independent prognostic significance. Exclusion of nontumour cells contributed to a more exact analysis of tumour-specific MGMT protein expression. This should be incorporated in future studies evaluating MGMT status before potential integration into clinical practice.
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Affiliation(s)
- R H Dahlrot
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - J Dowsett
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | - S Fosmark
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | - A Malmström
- Department of Advanced Home Care, Linköping University, Linköping, Sweden
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - R Henriksson
- Department of Radiation Sciences & Oncology, Umeå University, Umeå, Sweden
- Regional Cancer Center Stockholm Gotland, Stockholm, Sweden
| | - H Boldt
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | - K de Stricker
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | - M D Sørensen
- Department of Pathology, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - H S Poulsen
- Department of Radiation Biology & Oncology, The Finsen Center, Rigshospitalet, Copenhagen, Denmark
| | - M Lysiak
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - P Söderkvist
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - J Rosell
- Regional Cancer Center South East Sweden and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - S Hansen
- Department of Oncology, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - B W Kristensen
- Department of Pathology, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
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6
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Rosager AM, Sørensen MD, Dahlrot RH, Boldt HB, Hansen S, Lathia JD, Kristensen BW. Expression and prognostic value of JAM-A in gliomas. J Neurooncol 2017; 135:107-117. [PMID: 28677106 PMCID: PMC5658466 DOI: 10.1007/s11060-017-2555-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 06/27/2017] [Indexed: 12/26/2022]
Abstract
Gliomas are among the most lethal cancers, being highly resistant to both chemo- and radiotherapy. The expression of junctional adhesion molecule-A (JAM-A) was recently identified on the surface of stem cell-like brain tumor-initiating cells and suggested to function as a unique glioblastoma niche adhesion factor influencing the tumorigenic potential of brain tumor-initiating cells. We have recently identified high JAM-A expression to be associated with poor outcome in glioblastomas, and our aim was to further investigate the expression of JAM-A in gliomas focusing especially on the prognostic value in WHO grade II and III gliomas. JAM-A protein expression was evaluated by immunohistochemistry and advanced quantitative image analysis with continuous estimates of staining intensity. The JAM-A antibody stained tumor cell membranes and cytoplasm to various extent in different glioma subtypes, and the intensity was higher in glioblastomas than low-grade gliomas. We could not detect an association with overall survival in patients with grade II and III tumors. Double-immunofluorescence stainings in glioblastomas revealed co-expression of JAM-A with CD133, SOX2, nestin, and GFAP in tumor cells as well as some co-expression with the microglial/macrophage marker IBA-1. In conclusion, JAM-A expression was higher in glioblastomas compared to low-grade gliomas and co-localized with recognized stem cell markers suggesting an association of JAM-A with glioma aggressiveness. No significant association between JAM-A expression and overall survival was found in grade II and III gliomas. Further research is needed to determine the function and clinical impact of JAM-A in gliomas.
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Affiliation(s)
- Ann Mari Rosager
- Department of Pathology, Odense University Hospital, Winsløwparken 15, 3rd floor, 5000, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3rd floor, 5000, Odense, Denmark
| | - Mia D Sørensen
- Department of Pathology, Odense University Hospital, Winsløwparken 15, 3rd floor, 5000, Odense, Denmark.
- Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3rd floor, 5000, Odense, Denmark.
| | - Rikke H Dahlrot
- Department of Oncology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense, Denmark
| | - Henning B Boldt
- Department of Pathology, Odense University Hospital, Winsløwparken 15, 3rd floor, 5000, Odense, Denmark
| | - Steinbjørn Hansen
- Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3rd floor, 5000, Odense, Denmark
- Department of Oncology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense, Denmark
| | - Justin D Lathia
- Department of Cellular and Molecular Medicine, Lerner Research Institute, 9500 Euclid Avenue, NC10, Cleveland, OH, 44195, USA
| | - Bjarne W Kristensen
- Department of Pathology, Odense University Hospital, Winsløwparken 15, 3rd floor, 5000, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3rd floor, 5000, Odense, Denmark
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7
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Sørensen MD, Dahlrot RH, Boldt HB, Hansen S, Kristensen BW. Tumour-associated microglia/macrophages predict poor prognosis in high-grade gliomas and correlate with an aggressive tumour subtype. Neuropathol Appl Neurobiol 2017; 44:185-206. [PMID: 28767130 DOI: 10.1111/nan.12428] [Citation(s) in RCA: 166] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 07/27/2017] [Accepted: 08/02/2017] [Indexed: 02/06/2023]
Abstract
AIMS Glioblastomas are highly aggressive and treatment resistant. Increasing evidence suggests that tumour-associated macrophages/microglia (TAMs) facilitate tumour progression by acquiring a M2-like phenotype. Our objective was to investigate the prognostic value of TAMs in gliomas using automated quantitative double immunofluorescence. METHODS Samples from 240 patients with primary glioma were stained with antibodies against ionized calcium-binding adaptor molecule-1 (IBA-1) and cluster of differentiation 204 (CD204) to detect TAMs and M2-like TAMs. The expression levels were quantified by software-based classifiers. The associations between TAMs, gemistocytic cells and glioblastoma subtype were examined with immuno- and haematoxylin-eosin stainings. Three tissue arrays containing glioblastoma specimens were included to study IBA-1/CD204 levels in central tumour and tumour periphery and to characterize CD204+ cells. RESULTS Our data revealed that the amount of especially CD204+ TAMs increases with malignancy grade. In grade III-IV, high CD204 expression was associated with shorter survival, while high IBA-1 intensity correlated with a longer survival. In grade IV, CD204 showed independent prognostic value when adjusting for clinical data and the methylation status of O6-methylguanine-DNA methyltransferase. Our findings were confirmed in two bioinformatics databases. TAMs were more abundant in central tumour tissue, mesenchymal glioblastomas and gliomas with many gemistocytic cells. CD204+ TAMs co-expressed proteins related to tumour aggressiveness including matrix metallopeptidase-14 and hypoxia-inducible factor-1α. CONCLUSIONS This is the first study to use automated quantitative immunofluorescence to determine the prognostic impact of TAMs. Our results suggest that M2-like TAMs hold an unfavourable prognostic value in high-grade gliomas and may contribute to a pro-tumourigenic microenvironment.
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Affiliation(s)
- M D Sørensen
- Department of Pathology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - R H Dahlrot
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - H B Boldt
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | - S Hansen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Oncology, Odense University Hospital, Odense, Denmark
| | - B W Kristensen
- Department of Pathology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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8
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Ramachandran RK, Sørensen MD, Aaberg-Jessen C, Hermansen SK, Kristensen BW. Expression and prognostic impact of matrix metalloproteinase-2 (MMP-2) in astrocytomas. PLoS One 2017; 12:e0172234. [PMID: 28234925 PMCID: PMC5325257 DOI: 10.1371/journal.pone.0172234] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 02/01/2017] [Indexed: 12/04/2022] Open
Abstract
Astrocytomas are the most frequent primary brain tumors in adults, and despite aggressive treatment patients often experience recurrence. Survival decreases with increasing tumor grade, and especially patients with grade IV glioblastoma have poor prognosis due to the aggressive character of this tumor. Matrix metalloproteinase-2 (MMP-2) is an extracellular matrix degrading enzyme which has been shown to play important roles in different cancers. The aim of this study was to investigate the expression and prognostic potential of MMP-2 in astrocytomas. Tissue samples from 89 patients diagnosed with diffuse astrocytoma, anaplastic astrocytoma and glioblastoma were stained immunohistochemically using a monoclonal MMP-2 antibody. The MMP-2 intensity in cytoplasm/membrane was quantified by a trained software-based classifier using systematic random sampling in 10% of the tumor area. We found MMP-2 expression in tumor cells and blood vessels. Measurements of MMP-2 intensity increased with tumor grade, and MMP-2 expression was found to be significantly higher in glioblastomas compared to normal brain tissue (p<0.001), diffuse astrocytomas (p<0.001) and anaplastic astrocytomas (p<0.05). MMP-2 expression was associated with shorter overall survival in patients with grade II-IV astrocytic tumors (HR 1.60; 95% CI 1.03–2.48; p = 0.036). In glioblastoma, high MMP-2 was associated with poorer prognosis in patients who survived longer than 8.5 months independent of age and gender (HR 2.27; 95% CI 1.07–4.81; p = 0.033). We found a positive correlation between MMP-2 and tissue inhibitor of metalloproteinases-1 (TIMP-1), and combined MMP-2 and TIMP-1 had stronger prognostic value than MMP-2 alone also when adjusting for age and gender (HR 2.78; 95% CI 1.30–5.92; p = 0.008). These findings were validated in bioinformatics databases. In conclusion, this study indicates that MMP-2 is associated with aggressiveness in astrocytomas and may hold an unfavorable prognostic value in patients with glioblastoma.
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Affiliation(s)
- Rahimsan K. Ramachandran
- Department of Pathology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Mia D. Sørensen
- Department of Pathology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- * E-mail:
| | - Charlotte Aaberg-Jessen
- Department of Pathology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Simon K. Hermansen
- Department of Pathology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Bjarne W. Kristensen
- Department of Pathology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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9
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Krogh Petersen J, Jensen P, Dahl Sørensen M, Winther Kristensen B. Expression and Prognostic Value of Oct-4 in Astrocytic Brain Tumors. PLoS One 2016; 11:e0169129. [PMID: 28030635 PMCID: PMC5193446 DOI: 10.1371/journal.pone.0169129] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 12/12/2016] [Indexed: 12/19/2022] Open
Abstract
Background Glioblastomas are the most frequent type of malignant primary brain tumor with a median overall survival less than 15 months. Therapy resistance of glioblastomas has been attributed to the presence of tumor initiating stem-like cells (TSCs). TSC-related markers have therefore been suggested to have promising potentials as prognostic markers in gliomas. Methodology/Principal Findings The aim of the present study was to investigate the expression and prognostic impact of the TSC-related marker Oct-4 in astrocytic brain tumors of increasing grade. In total 114 grade II, III and IV astrocytic brain tumors were immunohistochemically stained for Oct-4, and the fraction and intensity of Oct-4 positive cells were determined by morphometric analysis of full tumor sections. Oct-4 was expressed in all tumors, and the Oct-4 positive cell fraction increased with tumor grade (p = 0.045). There was no association between survival and Oct-4 positive cell fraction, neither when combining all tumor grades nor in analysis of individual grades. Oct-4 intensity was not associated with grade, but taking IDH1 status into account we found a tendency for high Oct-4 intensity to be associated with poor prognosis in anaplastic astrocytomas. Double immunofluorescence stainings showed co-localization in the perivascular niches of Oct-4 and two other TSC markers CD133 and nestin in glioblastomas. In some areas Oct-4 was expressed independently of CD133 and nestin. Conclusions In conclusion, high Oct-4 fraction was associated with tumor malignancy, but seemed to be without independent prognostic influence in glioblastomas. Identification of a potential prognostic value in anaplastic astrocytomas requires additional studies using larger patient cohorts.
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Affiliation(s)
| | - Per Jensen
- Department of Pathology, Odense University Hospital, Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Mia Dahl Sørensen
- Department of Pathology, Odense University Hospital, Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Bjarne Winther Kristensen
- Department of Pathology, Odense University Hospital, Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
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10
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Clausen BH, Lambertsen KL, Dagnæs-Hansen F, Babcock AA, von Linstow CU, Meldgaard M, Kristensen BW, Deierborg T, Finsen B. Cell therapy centered on IL-1Ra is neuroprotective in experimental stroke. Acta Neuropathol 2016; 131:775-91. [PMID: 26860727 PMCID: PMC4835531 DOI: 10.1007/s00401-016-1541-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 12/28/2015] [Accepted: 01/25/2016] [Indexed: 12/22/2022]
Abstract
Cell-based therapies are emerging as new promising treatments in stroke. However, their functional mechanism and therapeutic potential during early infarct maturation has so far received little attention. Here, we asked if cell-based delivery of the interleukin-1 receptor antagonist (IL-1Ra), a known neuroprotectant in stroke, can promote neuroprotection, by modulating the detrimental inflammatory response in the tissue at risk. We show by the use of IL-1Ra-overexpressing and IL-1Ra-deficient mice that IL-1Ra is neuroprotective in stroke. Characterization of the cellular and spatiotemporal production of IL-1Ra and IL-1α/β identifies microglia, not infiltrating leukocytes, as the major sources of IL-1Ra after experimental stroke, and shows IL-1Ra and IL-1β to be produced by segregated subsets of microglia with a small proportion of these cells co-expressing IL-1α. Reconstitution of whole body irradiated mice with IL-1Ra-producing bone marrow cells is associated with neuroprotection and recruitment of IL-1Ra-producing leukocytes after stroke. Neuroprotection is also achieved by therapeutic injection of IL-1Ra-producing bone marrow cells 30 min after stroke onset, additionally improving the functional outcome in two different stroke models. The IL-1Ra-producing bone marrow cells increase the number of IL-1Ra-producing microglia, reduce the availability of IL-1β, and modulate mitogen-activated protein kinase (MAPK) signaling in the ischemic cortex. The importance of these results is underlined by demonstration of IL-1Ra-producing cells in the human cortex early after ischemic stroke. Taken together, our results attribute distinct neuroprotective or neurotoxic functions to segregated subsets of microglia and suggest that treatment strategies increasing the production of IL-1Ra by infiltrating leukocytes or microglia may also be neuroprotective if applied early after stroke onset in patients.
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