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Djurich S, Secomb TW. Analysis of potassium ion diffusion from neurons to capillaries: Effects of astrocyte endfeet geometry. Eur J Neurosci 2024; 59:323-332. [PMID: 38123136 PMCID: PMC10872621 DOI: 10.1111/ejn.16232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 11/25/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023]
Abstract
Neurovascular coupling (NVC) refers to a local increase in cerebral blood flow in response to increased neuronal activity. Mechanisms of communication between neurons and blood vessels remain unclear. Astrocyte endfeet almost completely cover cerebral capillaries, suggesting that astrocytes play a role in NVC by releasing vasoactive substances near capillaries. An alternative hypothesis is that direct diffusion through the extracellular space of potassium ions (K+ ) released by neurons contributes to NVC. Here, the goal is to determine whether astrocyte endfeet present a barrier to K+ diffusion from neurons to capillaries. Two simplified 2D geometries of extracellular space, clefts between endfeet, and perivascular space are used: (i) a source 1 μm from a capillary; (ii) a neuron 15 μm from a capillary. K+ release is modelled as a step increase in [K+ ] at the outer boundary of the extracellular space. The time-dependent diffusion equation is solved numerically. In the first geometry, perivascular [K+ ] approaches its final value within 0.05 s. Decreasing endfeet cleft width or increasing perivascular space width slows the rise in [K+ ]. In the second geometry, the increase in perivascular [K+ ] occurs within 0.5 s and is insensitive to changes in cleft width or perivascular space width. Predicted levels of perivascular [K+ ] are sufficient to cause vasodilation, and the rise time is within the time for flow increase in NVC. These results suggest that direct diffusion of K+ through the extracellular space is a possible NVC signalling mechanism.
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Affiliation(s)
- Sara Djurich
- Department of Physiology, University of Arizona, Tucson, Arizona, USA
| | - Timothy W Secomb
- Department of Physiology, University of Arizona, Tucson, Arizona, USA
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Larriva-Sahd J, Martínez-Cabrera G, Lozano-Flores C, Concha L, Varela-Echavarría A. The neurovascular unit of capillary blood vessels in the rat nervous system. A rapid-Golgi electron microscopy study. J Comp Neurol 2023; 532:e25559. [PMID: 38009706 DOI: 10.1002/cne.25559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 06/28/2023] [Accepted: 10/17/2023] [Indexed: 11/29/2023]
Abstract
We describe a pericapillary organ in the rat forebrain and cerebellar cortex. It consists of a series of tripartite synapses with synaptic extensions enveloped by astrocytic endfeet that are linked to the capillary wall by synaptic extensions. Reciprocal specializations of the pericyte-capillary blood vessel (CBV) with such specialized synapses suggest a mechanoreceptor role. In Golgi-impregnated and 3D reconstructions of the cerebral cortex and thalamus, a series of TSs appear to be sequentially ordered in a common dendrite, paralleled by synaptic outgrowths termed golf club synaptic extensions (GCE) opposed to a longitudinal crest (LC) from the capillary basal lamina (BL). Our results show that, in the cerebellar cortex, afferent fibers and interneurons display microanatomical structures that strongly suggest an interaction with the capillary wall. Afferent mossy fiber (MF) rosettes and ascending granule cell axons and their dendrites define the pericapillary passage interactions that are entangled by endfeet. The presence of mRNA of the mechanosensitive channel Piezo1 in the MF rosettes, together with the surrounding end-feet and the capillary wall form mechanosensory units. The ubiquity of such units to modulate synaptic transmission is also supported by Piezo1 mRNA expressing pyramidal isocortical and thalamic neurons. This scenario suggests that ascending impulses to the cerebellar and cortical targets are presynaptically modulated by the reciprocal interaction with the mechanosensory pericapillary organ that ultimately modulates the vasomotor response.
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Affiliation(s)
- Jorge Larriva-Sahd
- Campus Juriquilla, Instituto de Neurobiología Universidad Nacional Autónoma de México, Querétaro, México
| | - Gema Martínez-Cabrera
- Campus Juriquilla, Instituto de Neurobiología Universidad Nacional Autónoma de México, Querétaro, México
| | - Carlos Lozano-Flores
- Campus Juriquilla, Instituto de Neurobiología Universidad Nacional Autónoma de México, Querétaro, México
| | - Luis Concha
- Campus Juriquilla, Instituto de Neurobiología Universidad Nacional Autónoma de México, Querétaro, México
| | - Alfredo Varela-Echavarría
- Campus Juriquilla, Instituto de Neurobiología Universidad Nacional Autónoma de México, Querétaro, México
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Hasanzadeh A, Moghaddam HS, Shakiba M, Jalali AH, Firouznia K. The Role of Multimodal Imaging in Differentiating Vasogenic from Infiltrative Edema: A Systematic Review. Indian J Radiol Imaging 2023; 33:514-521. [PMID: 37811185 PMCID: PMC10556327 DOI: 10.1055/s-0043-1772466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
Background High-grade gliomas (HGGs) are the most prevalent primary malignancy of the central nervous system. The tumor results in vasogenic and infiltrative edema . Exact anatomical differentiation of these edemas is so important for surgical planning. Multimodal imaging could be used to differentiate the edema type. Purpose The aim of this study was to investigate the role of multimodal imaging in the differentiation of vasogenic edema from infiltrative edema in patients with HGG (grade III and grade IV). Data Sources A search on PubMed, EMBASE, Scopus, and ISI Web of Science Core Collection up to June 2022 using terms related to (a) multimodal imaging AND (b) HGG AND (c) edema. (PROSPERO registration number: CRD42022336131) Study Selection Two reviewers screened the articles and independently extracted the data. We included original articles assessing the role of multimodal imaging in differentiating vasogenic from infiltrative edema in patients with HGG. Six high-quality articles remained for the narrative synthesis. Data Synthesis Dynamic susceptibility contrast imaging showed that relative cerebral blood volume and relative cerebral blood flow were higher in the infiltrative edema component than in the vasogenic edema component. Diffusion tensor imaging revealed a dispute on fractional anisotropy. The apparent diffusion coefficient was comparable between the two edematous components. Magnetic resonance spectroscopy exhibited an increment in choline/creatinine ratio and choline/N-acetyl aspartate ratio in the infiltrative edema component. Limitations Strict study selection, low sample size of relevant published studies, and heterogeneity in endpoint variables were the major drawbacks. Conclusions Multimodal imaging, including dynamic susceptibility contrast and magnetic resonance spectroscopy, might help differentiate between vasogenic and infiltrative edema.
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Affiliation(s)
- Alireza Hasanzadeh
- Medical School, Tehran University of Medical Sciences, Tehran, Iran
- Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Sanjari Moghaddam
- Medical School, Tehran University of Medical Sciences, Tehran, Iran
- Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Madjid Shakiba
- Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Jalali
- Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kavous Firouznia
- Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
Astrocyte endfeet enwrap the entire vascular tree within the central nervous system, where they perform important functions in regulating the blood-brain barrier (BBB), cerebral blood flow, nutrient uptake, and waste clearance. Accordingly, astrocyte endfeet contain specialized organelles and proteins, including local protein translation machinery and highly organized scaffold proteins, which anchor channels, transporters, receptors, and enzymes critical for astrocyte-vascular interactions. Many neurological diseases are characterized by the loss of polarization of specific endfoot proteins, vascular dysregulation, BBB disruption, altered waste clearance, or, in extreme cases, loss of endfoot coverage. A role for astrocyte endfeet has been demonstrated or postulated in many of these conditions. This review provides an overview of the development, composition, function, and pathological changes of astrocyte endfeet and highlights the gaps in our knowledge that future research should address.
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Affiliation(s)
- Blanca Díaz-Castro
- UK Dementia Research Institute and Centre for Discovery Brain Sciences, University of Edinburgh, Edinburgh, Scotland, UK;
| | - Stefanie Robel
- Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA;
| | - Anusha Mishra
- Department of Neurology Jungers Center for Neurosciences Research and Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA;
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Scola E, Del Vecchio G, Busto G, Bianchi A, Desideri I, Gadda D, Mancini S, Carlesi E, Moretti M, Desideri I, Muscas G, Della Puppa A, Fainardi E. Conventional and Advanced Magnetic Resonance Imaging Assessment of Non-Enhancing Peritumoral Area in Brain Tumor. Cancers (Basel) 2023; 15:cancers15112992. [PMID: 37296953 DOI: 10.3390/cancers15112992] [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: 05/04/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
The non-enhancing peritumoral area (NEPA) is defined as the hyperintense region in T2-weighted and fluid-attenuated inversion recovery (FLAIR) images surrounding a brain tumor. The NEPA corresponds to different pathological processes, including vasogenic edema and infiltrative edema. The analysis of the NEPA with conventional and advanced magnetic resonance imaging (MRI) was proposed in the differential diagnosis of solid brain tumors, showing higher accuracy than MRI evaluation of the enhancing part of the tumor. In particular, MRI assessment of the NEPA was demonstrated to be a promising tool for distinguishing high-grade gliomas from primary lymphoma and brain metastases. Additionally, the MRI characteristics of the NEPA were found to correlate with prognosis and treatment response. The purpose of this narrative review was to describe MRI features of the NEPA obtained with conventional and advanced MRI techniques to better understand their potential in identifying the different characteristics of high-grade gliomas, primary lymphoma and brain metastases and in predicting clinical outcome and response to surgery and chemo-irradiation. Diffusion and perfusion techniques, such as diffusion tensor imaging (DTI), diffusional kurtosis imaging (DKI), dynamic susceptibility contrast-enhanced (DSC) perfusion imaging, dynamic contrast-enhanced (DCE) perfusion imaging, arterial spin labeling (ASL), spectroscopy and amide proton transfer (APT), were the advanced MRI procedures we reviewed.
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Affiliation(s)
- Elisa Scola
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Guido Del Vecchio
- Radiodiagnostic Unit N. 2, Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy
| | - Giorgio Busto
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Andrea Bianchi
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Ilaria Desideri
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Davide Gadda
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Sara Mancini
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Edoardo Carlesi
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Marco Moretti
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy
| | - Isacco Desideri
- Radiation Oncology, Oncology Department, Careggi University Hospital, University of Florence, 50121 Florence, Italy
| | - Giovanni Muscas
- Neurosurgery Unit, Department of Neuroscience, Psychology, Pharmacology and Child Health, Careggi University Hospital, University of Florence, 50121 Florence, Italy
| | - Alessandro Della Puppa
- Neurosurgery Unit, Department of Neuroscience, Psychology, Pharmacology and Child Health, Careggi University Hospital, University of Florence, 50121 Florence, Italy
| | - Enrico Fainardi
- Neuroradiology Unit, Department of Radiology, Careggi University Hospital, 50134 Florence, Italy
- Neuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, 50121 Florence, Italy
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High-grade glioma and solitary metastasis: differentiation by spectroscopy and advanced magnetic resonance techniques. EGYPTIAN JOURNAL OF NEUROSURGERY 2022. [DOI: 10.1186/s41984-022-00172-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The differentiation by means of magnetic resonance between high-grade gliomas and intracranial solitary single metastasis is of the utmost importance since they condition both surgical and complementary treatment.
Results
Retrospective study that analyzes the parameters of advanced magnetic resonance imaging: spectroscopy, diffusion and perfusion, specifically focused on the differences in the coefficients of the metabolites Cho/Cr, Cho/NAA and NAA/Cr in peritumoral edema between high-grade gliomas and metastases. The data have been statistically analyzed using ROC (receiver operating characteristic) curves, and cutoff values were obtained.
A total of 79 patients with histologically analyzed tumors were analyzed: 49 high-grade gliomas (40 multiform glioblastomas and 9 anaplastic astrocytomas) and 30 metastases. A statistically significant mean difference was obtained in the three metabolite ratios. The area under the curve for the Cho/NAA ratio was 0.958 (CI: 0.903–1), for Cho/Cr 0.922 (CI: 0.859–0.985) and for NAA/Cr 0.163 (CI: 0.068–0.258; p < 0.001). The cutoff values were 1.115 for Cho/NAA (sensitivity 93.87%, specificity 93.33%, global precision 93.67%); 1.18 for the Cho/Cr ratio (sensitivity 89.79%, specificity 93.33% and precision 91.13%) and 1.155 for the NAA/Cr ratio (sensitivity 67.34%, specificity 93.33%, global precision 44.30%).
Conclusion
The results of the study support the premise that spectroscopy at the level of peritumoral edema is able to differentiate between high-grade gliomas and metastases by showing tumor infiltration in peritumoral edema.
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Hu NW, Rodriguez CD, Rey JA, Rozenblum MJ, Courtney CP, Balogh P, Sarntinoranont M, Murfee WL. Estimation of shear stress values along endothelial tip cells past the lumen of capillary sprouts. Microvasc Res 2022; 142:104360. [PMID: 35301025 DOI: 10.1016/j.mvr.2022.104360] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 02/28/2022] [Accepted: 03/09/2022] [Indexed: 11/30/2022]
Abstract
Shear stress is recognized as a regulator of angiogenesis. However, the shear stress experienced by the endothelial cells of capillary sprouts remains unknown. The objective of this study was to estimate shear stress due to local interstitial flow along endothelial tip cells at the end of the capillary sprout lumen. Computational fluid dynamics were used to model flow within a blind-ended vessel, transendothelial flow across the vessel wall, and flow within the surrounding perivascular/interstitial space. Shear stress along the wall of the tip cells was calculated while varying sprout length, perivascular space channel width, and vessel wall hydraulic conductivity. Increasing sprout length, increasing wall hydraulic conductivity, and decreasing perivascular space width increased shear stress magnitude. Wall shear stress magnitude within the lumen ranged from 0.015 to 0.55 dyne/cm2 at the sprout entrance and linearly decreased to near zero at the base of the tip cells. Tip cell wall shear stress magnitude due to interstitial flow ranged from 0.009 to 4.65 dyne/cm2. In 3 out of 8 cases, shear stress magnitude was above 1 dyne/cm2 and considered physiologically relevant. The results provide a framework for discussing the role of local mechanical cues in regulating endothelial cell dynamics involved in angiogenesis. Mainly, interstitial flows may generate physiologically relevant shear stresses on tip cells in certain scenarios. This source of tip cell shear stress has not been previously considered or modeled.
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Affiliation(s)
- Nien-Wen Hu
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA
| | - Camille D Rodriguez
- Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, FL 32611, USA
| | - Julian A Rey
- Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, FL 32611, USA
| | - Maximillian J Rozenblum
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA
| | - Connor P Courtney
- Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, FL 32611, USA
| | - Peter Balogh
- Department of Mechanical and Industrial Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA
| | - Malisa Sarntinoranont
- Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, FL 32611, USA
| | - Walter L Murfee
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA.
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Bozdağ M, Er A, Çinkooğlu A, Ekmekçi S. Diagnostic role of apparent diffusion coefficient combined with intratumoral susceptibility signals in differentiating high-grade gliomas from brain metastases. Neuroradiol J 2020; 34:169-179. [PMID: 33307971 DOI: 10.1177/1971400920980164] [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: 11/15/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess whether tumoral and peritumoral apparent diffusion coefficient values and intratumoral susceptibility signals on susceptibility-weighted imaging could distinguish between high-grade gliomas and brain metastases, and to investigate their associations with the Ki-67 proliferation index. MATERIALS AND METHODS Fifty-seven patients with pathologically confirmed diagnoses of either high-grade glioma or brain metastasis were enrolled in this study (23 with high-grade gliomas and 34 with brain metastases). The minimum and mean apparent diffusion coefficients in the enhancing tumoral region (ADCmin and ADCmean) and the minimum apparent diffusion coefficient in the peritumoral region (ADCedema) were measured from apparent diffusion coefficient maps, and intratumoral susceptibility signal grades acquired by susceptibility-weighted imaging were calculated. Ki-67 proliferation index values were obtained from the hospital database. These parameters were evaluated using the Mann-Whitney U test, independent-sample t-test, Spearman correlation analysis, receiver operating characteristic curve, and logistic regression analyses. RESULTS ADCmean, ADCmin values, and intratumoral susceptibility signal grades in brain metastases were significantly lower than those in high-grade gliomas (all p < 0.05). Ki-67 proliferation index values showed significant correlations with ADCmean, ADCmin, and intratumoral susceptibility signal grade in brain metastases (all p < 0.05), but no correlation was found in high-grade gliomas (all p > 0.05). According to receiver operating characteristic curve analysis, ADCmean achieved the highest diagnostic performance for discriminating high-grade gliomas from brain metastases. Furthermore, the combination of tumoral apparent diffusion coefficient parameters with intratumoral susceptibility signal grade provided a higher area under the curve than univariate parameters. CONCLUSION The combination of tumoral apparent diffusion coefficient with intratumoral susceptibility signal grade can offer better diagnostic performances for differential diagnosis. Apparent diffusion coefficient and intratumoral susceptibility signal may reflect cellular proliferative activity in brain metastases, but not in high-grade gliomas.
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Affiliation(s)
- Mustafa Bozdağ
- Department of Radiology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ali Er
- Department of Radiology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Akın Çinkooğlu
- Department of Radiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Sümeyye Ekmekçi
- Department of Pathology, Tepecik Training and Research Hospital, Izmir, Turkey
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Csutak C, Ștefan PA, Lenghel LM, Moroșanu CO, Lupean RA, Șimonca L, Mihu CM, Lebovici A. Differentiating High-Grade Gliomas from Brain Metastases at Magnetic Resonance: The Role of Texture Analysis of the Peritumoral Zone. Brain Sci 2020; 10:brainsci10090638. [PMID: 32947822 PMCID: PMC7565295 DOI: 10.3390/brainsci10090638] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/03/2020] [Accepted: 09/14/2020] [Indexed: 11/16/2022] Open
Abstract
High-grade gliomas (HGGs) and solitary brain metastases (BMs) have similar imaging appearances, which often leads to misclassification. In HGGs, the surrounding tissues show malignant invasion, while BMs tend to displace the adjacent area. The surrounding edema produced by the two cannot be differentiated by conventional magnetic resonance (MRI) examinations. Forty-two patients with pathology-proven brain tumors who underwent conventional pretreatment MRIs were retrospectively included (HGGs, n = 16; BMs, n = 26). Texture analysis of the peritumoral zone was performed on the T2-weighted sequence using dedicated software. The most discriminative texture features were selected using the Fisher and the probability of classification error and average correlation coefficients. The ability of texture parameters to distinguish between HGGs and BMs was evaluated through univariate, receiver operating, and multivariate analyses. The first percentile and wavelet energy texture parameters were independent predictors of HGGs (75–87.5% sensitivity, 53.85–88.46% specificity). The prediction model consisting of all parameters that showed statistically significant results at the univariate analysis was able to identify HGGs with 100% sensitivity and 66.7% specificity. Texture analysis can provide a quantitative description of the peritumoral zone encountered in solitary brain tumors, that can provide adequate differentiation between HGGs and BMs.
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Affiliation(s)
- Csaba Csutak
- Radiology and Imaging Department, County Emergency Hospital, Cluj-Napoca, Clinicilor Street, Number 5, Cluj-Napoca, 400006 Cluj, Romania; (C.C.); (L.M.L.); (C.M.M.); (A.L.)
- Radiology, Surgical Specialties Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Clinicilor Street, number 3–5, Cluj-Napoca, 400006 Cluj, Romania
| | - Paul-Andrei Ștefan
- Radiology and Imaging Department, County Emergency Hospital, Cluj-Napoca, Clinicilor Street, Number 5, Cluj-Napoca, 400006 Cluj, Romania; (C.C.); (L.M.L.); (C.M.M.); (A.L.)
- Anatomy and Embryology, Morphological Sciences Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Victor Babeș Street, number 8, Cluj-Napoca, 400012 Cluj, Romania
- Correspondence: ; Tel.: +40-743-957-206
| | - Lavinia Manuela Lenghel
- Radiology and Imaging Department, County Emergency Hospital, Cluj-Napoca, Clinicilor Street, Number 5, Cluj-Napoca, 400006 Cluj, Romania; (C.C.); (L.M.L.); (C.M.M.); (A.L.)
- Radiology, Surgical Specialties Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Clinicilor Street, number 3–5, Cluj-Napoca, 400006 Cluj, Romania
| | - Cezar Octavian Moroșanu
- Department of Neurosurgery, North Bristol Trust, Southmead Hospital, Southmead Road, Westbury on Trym, Bristol BS2 8BJ, UK;
| | - Roxana-Adelina Lupean
- Histology, Morphological Sciences Department, “Iuliu Hațieganu” University of Medicine and Pharmacy, Louis Pasteur Street, number 4, Cluj-Napoca, 400349 Cluj, Romania;
| | - Larisa Șimonca
- Department of Paediatric Surgery, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, UK;
| | - Carmen Mihaela Mihu
- Radiology and Imaging Department, County Emergency Hospital, Cluj-Napoca, Clinicilor Street, Number 5, Cluj-Napoca, 400006 Cluj, Romania; (C.C.); (L.M.L.); (C.M.M.); (A.L.)
- Histology, Morphological Sciences Department, “Iuliu Hațieganu” University of Medicine and Pharmacy, Louis Pasteur Street, number 4, Cluj-Napoca, 400349 Cluj, Romania;
| | - Andrei Lebovici
- Radiology and Imaging Department, County Emergency Hospital, Cluj-Napoca, Clinicilor Street, Number 5, Cluj-Napoca, 400006 Cluj, Romania; (C.C.); (L.M.L.); (C.M.M.); (A.L.)
- Radiology, Surgical Specialties Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Clinicilor Street, number 3–5, Cluj-Napoca, 400006 Cluj, Romania
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Li X, Wang D, Liao S, Guo L, Xiao X, Liu X, Xu Y, Hua J, Pillai JJ, Wu Y. Discrimination between Glioblastoma and Solitary Brain Metastasis: Comparison of Inflow-Based Vascular-Space-Occupancy and Dynamic Susceptibility Contrast MR Imaging. AJNR Am J Neuroradiol 2020; 41:583-590. [PMID: 32139428 DOI: 10.3174/ajnr.a6466] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 02/03/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Accurate differentiation between glioblastoma and solitary brain metastasis is of vital importance clinically. This study aimed to investigate the potential value of the inflow-based vascular-space-occupancy MR imaging technique, which has no need for an exogenous contrast agent, in differentiating glioblastoma and solitary brain metastasis and to compare it with DSC MR imaging. MATERIALS AND METHODS Twenty patients with glioblastoma and 22 patients with solitary brain metastasis underwent inflow-based vascular-space-occupancy and DSC MR imaging with a 3T clinical scanner. Two neuroradiologists independently measured the maximum inflow-based vascular-space-occupancy-derived arteriolar CBV and DSC-derived CBV values in intratumoral regions and peritumoral T2-hyperintense regions, which were normalized to the contralateral white matter (relative arteriolar CBV and relative CBV, inflow-based vascular-space-occupancy relative arteriolar CBV, and DSC-relative CBV). The intraclass correlation coefficient, Student t test, or Mann-Whitney U test and receiver operating characteristic analysis were performed. RESULTS All parameters of both regions had good or excellent interobserver reliability (0.74∼0.89). In peritumoral T2-hyperintese regions, DSC-relative CBV (P < .001), inflow-based vascular-space-occupancy arteriolar CBV (P = .001), and relative arteriolar CBV (P = .005) were significantly higher in glioblastoma than in solitary brain metastasis, with areas under the curve of 0.94, 0.83, and 0.72 for discrimination, respectively. In the intratumoral region, both inflow-based vascular-space-occupancy arteriolar CBV and relative arteriolar CBV were significantly higher in glioblastoma than in solitary brain metastasis (both P < .001), with areas under the curve of 0.91 and 0.90, respectively. Intratumoral DSC-relative CBV showed no significant difference (P = .616) between the 2 groups. CONCLUSIONS Inflow-based vascular-space-occupancy has the potential to discriminate glioblastoma from solitary brain metastasis, especially in the intratumoral region.
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Affiliation(s)
- X Li
- From the Department of Medical Imaging (X. Li, S.L., L.G., X.X., X. Liu, Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China
| | - D Wang
- School of Biomedical Engineering (D.W.), Shanghai Jiao Tong University, Shanghai, P.R. China
| | - S Liao
- From the Department of Medical Imaging (X. Li, S.L., L.G., X.X., X. Liu, Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China
- Division of CT and MR, Radiology Department (S.L.), First Affiliated Hospital of Gannan Medical University, Ganzhou, P.R. China
| | - L Guo
- From the Department of Medical Imaging (X. Li, S.L., L.G., X.X., X. Liu, Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China
| | - X Xiao
- From the Department of Medical Imaging (X. Li, S.L., L.G., X.X., X. Liu, Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China
| | - X Liu
- From the Department of Medical Imaging (X. Li, S.L., L.G., X.X., X. Liu, Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China
| | - Y Xu
- From the Department of Medical Imaging (X. Li, S.L., L.G., X.X., X. Liu, Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China
| | - J Hua
- Neurosection, Division of MR Research (J.H.)
- F.M. Kirby Research Center for Functional Brain Imaging (J.H.), Kennedy Krieger Institute, Baltimore, Maryland
| | - J J Pillai
- Division of Neuroradiology (J.P.); Russell H. Morgan Department of Radiology and Radiological Science and
- Department of Neurosurgery (J.P.), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Y Wu
- From the Department of Medical Imaging (X. Li, S.L., L.G., X.X., X. Liu, Y.X., Y.W.), Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China
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Feng Y, Wang J, Tan D, Cheng P, Wu A. Relationship between circulating inflammatory factors and glioma risk and prognosis: A meta-analysis. Cancer Med 2019; 8:7454-7468. [PMID: 31599129 PMCID: PMC6885890 DOI: 10.1002/cam4.2585] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/07/2019] [Accepted: 09/15/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Inflammatory factors have been considered a significant factor contributing to the development and progression of glioma. However, the relationship between circulating inflammatory factors and glioma risk as well as their prognostic values in glioma patients is still inconclusive. Here, we performed a meta-analysis to address this issue. METHODS Relevant articles were identified through PubMed, EMBASE, the Cochrane Library, Web of Science, Wanfang database, and China National Knowledge Infrastructure (CNKI) from inception to February 2019. The weighted mean differences (WMDs) or standard mean differences (SMDs) with 95% confidence intervals (CIs) were used to describe the predictive ability of the levels of circulating inflammatory factors on glioma risk. To evaluate the prognostic values of the circulating inflammatory factors in glioma, hazard ratios (HRs) with 95% CIs were used. RESULTS Thirty-one studies comprising 2587 patients were included. The overall analysis showed that increased circulating interleukin-6 (IL-6) [SMD 0.81 (95% CI: 0.21-1.40; P = .008)], interleukin-8 (IL-8) [SMD 1.01 (95% CI: 0.17-1.84; P = .018)], interleukin-17 (IL-17) [SMD 1.12 (95% CI: 0.26-1.98; P = .011)], tumor necrosis factor-α (TNF-α) [SMD 1.80 (95% CI: 1.03-2.56; P = .000)], transforming growth factor-β (TGF-β) [SMD 10.55 (95% CI: 5.59-15.51; P = .000)], and C-reactive protein (CRP) [SMD 0.95 (95% CI: 0.75-1.15; P = .000)] levels were significantly associated with glioma risk. On the other hand, our results showed that circulating IL-6 [HR 1.10 (95% CI: 1.05-1.16; P = .000)] and CRP [HR 2.02 (95% CI: 1.52-2.68; P = .000)] levels were highly correlated with a poor overall survival (OS) rate in glioma patients. CONCLUSION Our results indicate that increased circulating IL-6, IL-8, IL-17, TNF-α, TGF-β, and CRP levels are significantly associated with increased glioma risk. Moreover, our meta-analysis suggests that circulating IL-6 and CRP may serve as powerful biomarkers for a poor prognosis in glioma patients.
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Affiliation(s)
- Yuan Feng
- Department of NeurosurgeryThe First Hospital of China Medical UniversityShenyangLiaoningPeople's Republic of China
| | - Jia Wang
- Department of NeurosurgeryThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShanxiPeople's Republic of China
- Center of Brain ScienceThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShanxiPeople's Republic of China
| | - Dezhong Tan
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Hospital of China Medical UniversityShenyangLiaoningPeople's Republic of China
| | - Peng Cheng
- Department of NeurosurgeryThe First Hospital of China Medical UniversityShenyangLiaoningPeople's Republic of China
| | - Anhua Wu
- Department of NeurosurgeryThe First Hospital of China Medical UniversityShenyangLiaoningPeople's Republic of China
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Brighi C, Puttick S, Rose S, Whittaker AK. The potential for remodelling the tumour vasculature in glioblastoma. Adv Drug Deliv Rev 2018; 136-137:49-61. [PMID: 30308226 DOI: 10.1016/j.addr.2018.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/04/2018] [Accepted: 10/07/2018] [Indexed: 12/19/2022]
Abstract
Despite significant improvements in the clinical management of glioblastoma, poor delivery of systemic therapies to the entire population of tumour cells remains one of the biggest challenges in the achievement of more effective treatments. On the one hand, the abnormal and dysfunctional tumour vascular network largely limits blood perfusion, resulting in an inhomogeneous delivery of drugs to the tumour. On the other hand, the presence of an intact blood-brain barrier (BBB) in certain regions of the tumour prevents chemotherapeutic drugs from permeating through the tumour vessels and reaching the diseased cells. In this review we analyse in detail the implications of the presence of a dysfunctional vascular network and the impenetrable BBB on drug transport. We discuss advantages and limitations of the currently available strategies for remodelling the tumour vasculature aiming to ameliorate the above mentioned limitations. Finally we review research methods for visualising vascular dysfunction and highlight the power of DCE- and DSC-MRI imaging to assess changes in blood perfusion and BBB permeability.
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13
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Askaner K, Rydelius A, Engelholm S, Knutsson L, Lätt J, Abul-Kasim K, Sundgren PC. Differentiation between glioblastomas and brain metastases and regarding their primary site of malignancy using dynamic susceptibility contrast MRI at 3T. J Neuroradiol 2018; 46:367-372. [PMID: 30389510 DOI: 10.1016/j.neurad.2018.09.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 07/23/2018] [Accepted: 09/26/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Differentiation between glioblastoma and brain metastasis may be challenging in conventional contrast-enhanced MRI. PURPOSE To investigate if perfusion-weighted MRI is able to differentiate glioblastoma from metastasis and, as a second aim was to see if it was possible in the latter group, to predict the primary site of neoplasm. MATERIAL AND METHODS Hundred and fourteen patients with newly discovered tumor lesion (76 metastases and 38 glioblastomas) underwent conventional contrast-enhanced MRI including dynamic susceptibility contrast perfusion sequence. The calculated relative cerebral blood volumes were analyzed in the solid tumor area, peritumoral area, area adjacent to peritumoral area, and normal appearing white matter in contralateral semioval center. The Student t-test was used to detect statistically significant differences in relative cerebral blood volume between glioblastomas and metastases in the aforementioned areas. Furthermore, the metastasis group was divided in four sub groups (lung-, breast-, melanoma-, and gastrointestinal origin) and using one-way ANOVA test. P-values < 0.05 were considered significant. RESULTS Relative cerebral blood volume (rCBV) in the peritumoral edema was significantly higher in glioblastomas than in metastases (mean 3.2 ± 1.4 and mean 0.9 ± 0.7), respectively, (P < 0.0001). No significant differences in the solid tumor area or the area adjacent to edema were found, (P = 0.28 and 0.21 respectively). There were no significant differences among metastases in the four groups. CONCLUSION It is possible to differentiate glioblastomas from metastases by measuring the CBV in the peritumoral edema. It is not possible to differentiate between brain metastases from different primaries (lung-, breast-, melanoma or gastrointestinal) using CBV-measurements in the solid tumor area, peritumoral edema or area adjacent to edema.
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Affiliation(s)
- K Askaner
- Centre for Medical Imaging and Physiology, SUS, Malmoe, Sweden.
| | | | | | - L Knutsson
- Department of Medical Radiation Physics, Lund University, Lund, Sweden; Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, US
| | - J Lätt
- Centre for Medical Imaging and Physiology, SUS, Lund, Sweden
| | - K Abul-Kasim
- Centre for Medical Imaging and Physiology, SUS, Malmoe, Sweden
| | - P C Sundgren
- Institution of Clinical Sciences, Lund University, Lund, Sweden; Department of Radiology, University of Michigan, Ann Arbor, US
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14
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Balça-Silva J, Matias D, Carmo AD, Sarmento-Ribeiro AB, Lopes MC, Moura-Neto V. Cellular and molecular mechanisms of glioblastoma malignancy: Implications in resistance and therapeutic strategies. Semin Cancer Biol 2018; 58:130-141. [PMID: 30266571 DOI: 10.1016/j.semcancer.2018.09.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/12/2018] [Accepted: 09/20/2018] [Indexed: 02/01/2023]
Abstract
Glioblastoma (GB) is the more frequent and malignant brain tumour. In spite of all efforts, the median overall survival of GB patients remains approximately 15 months under therapy. The molecular biology underlying GB is complex, which highlight the need of specific treatment strategies. In fact, the deregulation of several molecular signalling pathways, the existence of the blood-brain barrier (BBB), that makes almost all the chemotherapeutic agents inaccessible to the tumour site, and the existence of a population of stem-like cells known to be responsible for tumour recurrence after therapy, can contribute to GB chemoresistance. In the present review, we summarize the reliable factors responsible for the failure of the most important chemotherapeutic agents in GB. Specifically, we describe the utmost important characteristics of the BBB, as well as the genetic, molecular and transcription factors alterations that lead to tumour malignancy, and ultimately their impact on stem-like cell plasticity modulation. Recently, nanocarriers have attracted increasing attention in brain- and tumour-targeted drug-delivery systems, owing to their potential ability to target cell surface specific molecules and to cross the BBB delivering the drug specifically to the tumour cells, improving efficacy and thus reducing non-specific toxicity. In this sense, we will lastly highlight the therapeutic challenges and improvements regarding GB treatment.
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Affiliation(s)
- Joana Balça-Silva
- Center for Neuroscience and Cell Biology and Institute for Biomedical Imaging and Life Sciences (CNC.IBILI), Coimbra, Portugal; Faculty of Medicine, University of Coimbra (FMUC), Coimbra, Portugal; Instituto Estadual do Cérebro Paulo Niemeyer (IECPN) - Secretaria de Estado de Saúde, Rio de Janeiro, Brazil.
| | - Diana Matias
- Instituto Estadual do Cérebro Paulo Niemeyer (IECPN) - Secretaria de Estado de Saúde, Rio de Janeiro, Brazil; Instituto de Ciências Biomédicas da Universidade Federal do Rio de Janeiro (ICB-UFRJ), Rio de Janeiro, Brazil.
| | - Anália do Carmo
- Clinical Pathology Department, Coimbra Hospital and Universitary Center (CHUC), Coimbra, Portugal; Center for Neuroscience and Cell Biology, Institute for Biomedical Imaging and Life Sciences (CNC.IBILI) Coimbra, Portugal.
| | - Ana Bela Sarmento-Ribeiro
- Faculty of Medicine, University of Coimbra (FMUC) and Coimbra Institute for Clinical and Biomedical Research (iCBR), group of Environment, Genetics and Oncobiology (CIMAGO), Coimbra, Portugal; Centro Hospitalar Universitário de Coimbra (CHUC), Coimbra, Portugal; Center for Neuroscience and Cell Biology (CNC), Coimbra, Portugal.
| | - Maria Celeste Lopes
- Center for Neuroscience and Cell Biology and Institute for Biomedical Imaging and Life Sciences (CNC.IBILI), Coimbra, Portugal; Faculty of Pharmacy, University of Coimbra (FFUC); Coimbra, Portugal.
| | - Vivaldo Moura-Neto
- Instituto Estadual do Cérebro Paulo Niemeyer (IECPN) - Secretaria de Estado de Saúde, Rio de Janeiro, Brazil.
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Shah N, Mohammad AS, Saralkar P, Sprowls SA, Vickers SD, John D, Tallman RM, Lucke-Wold BP, Jarrell KE, Pinti M, Nolan RL, Lockman PR. Investigational chemotherapy and novel pharmacokinetic mechanisms for the treatment of breast cancer brain metastases. Pharmacol Res 2018; 132:47-68. [PMID: 29604436 PMCID: PMC5997530 DOI: 10.1016/j.phrs.2018.03.021] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 03/26/2018] [Accepted: 03/27/2018] [Indexed: 02/08/2023]
Abstract
In women, breast cancer is the most common cancer diagnosis and second most common cause of cancer death. More than half of breast cancer patients will develop metastases to the bone, liver, lung, or brain. Breast cancer brain metastases (BCBM) confers a poor prognosis, as current therapeutic options of surgery, radiation, and chemotherapy rarely significantly extend life and are considered palliative. Within the realm of chemotherapy, the last decade has seen an explosion of novel chemotherapeutics involving targeting agents and unique dosage forms. We provide a historical overview of BCBM chemotherapy, review the mechanisms of new agents such as poly-ADP ribose polymerase inhibitors, cyclin-dependent kinase 4/6 inhibitors, phosphatidyl inositol 3-kinaseinhibitors, estrogen pathway antagonists for hormone-receptor positive BCBM; tyrosine kinase inhibitors, antibodies, and conjugates for HER2+ BCBM; repurposed cytotoxic chemotherapy for triple negative BCBM; and the utilization of these new agents and formulations in ongoing clinical trials. The mechanisms of novel dosage formulations such as nanoparticles, liposomes, pegylation, the concepts of enhanced permeation and retention, and drugs utilizing these concepts involved in clinical trials are also discussed. These new treatments provide a promising outlook in the treatment of BCBM.
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Affiliation(s)
- Neal Shah
- West Virginia University, Health Sciences Center, School of Pharmacy, Department of Basic Pharmaceutical Sciences, Morgantown, WV 26506, USA.
| | - Afroz S Mohammad
- West Virginia University, Health Sciences Center, School of Pharmacy, Department of Basic Pharmaceutical Sciences, Morgantown, WV 26506, USA.
| | - Pushkar Saralkar
- West Virginia University, Health Sciences Center, School of Pharmacy, Department of Basic Pharmaceutical Sciences, Morgantown, WV 26506, USA.
| | - Samuel A Sprowls
- West Virginia University, Health Sciences Center, School of Pharmacy, Department of Basic Pharmaceutical Sciences, Morgantown, WV 26506, USA.
| | - Schuyler D Vickers
- West Virginia University, Health Sciences Center, School of Pharmacy, Department of Basic Pharmaceutical Sciences, Morgantown, WV 26506, USA.
| | - Devin John
- West Virginia University, Health Sciences Center, School of Pharmacy, Department of Basic Pharmaceutical Sciences, Morgantown, WV 26506, USA.
| | - Rachel M Tallman
- West Virginia University, Health Sciences Center, School of Pharmacy, Department of Basic Pharmaceutical Sciences, Morgantown, WV 26506, USA.
| | - Brandon P Lucke-Wold
- West Virginia University, Health Sciences Center, School of Pharmacy, Department of Basic Pharmaceutical Sciences, Morgantown, WV 26506, USA.
| | - Katherine E Jarrell
- West Virginia University, Health Sciences Center, School of Pharmacy, Department of Basic Pharmaceutical Sciences, Morgantown, WV 26506, USA.
| | - Mark Pinti
- West Virginia University, Health Sciences Center, School of Pharmacy, Department of Basic Pharmaceutical Sciences, Morgantown, WV 26506, USA.
| | - Richard L Nolan
- West Virginia University, Health Sciences Center, School of Pharmacy, Department of Basic Pharmaceutical Sciences, Morgantown, WV 26506, USA.
| | - Paul R Lockman
- West Virginia University, Health Sciences Center, School of Pharmacy, Department of Basic Pharmaceutical Sciences, Morgantown, WV 26506, USA.
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16
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Caravan I, Ciortea CA, Contis A, Lebovici A. Diagnostic value of apparent diffusion coefficient in differentiating between high-grade gliomas and brain metastases. Acta Radiol 2018; 59:599-605. [PMID: 28835111 DOI: 10.1177/0284185117727787] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background High-grade gliomas (HGGs) and brain metastases (BMs) can display similar imaging characteristics on conventional MRI. In HGGs, the peritumoral edema may be infiltrated by the malignant cells, which was not observed in BMs. Purpose To determine whether the apparent diffusion coefficient values could differentiate HGGs from BMs. Material and Methods Fifty-seven patients underwent conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) before treatment. The minimum and mean ADC in the enhancing tumor (ADCmin, ADCmean) and the minimum ADC in the peritumoral region (ADCedema) were measured from ADC maps. To determine whether there was a statistical difference between groups, ADC values were compared. A receiver operating characteristic (ROC) curve analysis was used to determine the cutoff ADC value for distinguishing between HGGs and BMs. Results The mean ADCmin values in the intratumoral regions of HGGs were significantly higher than those in BMs. No differences were observed between groups regarding ADCmean values. The mean ADCmin values in the peritumoral edema of HGGs were significantly lower than those in BMs. According to ROC curve analysis, a cutoff value of 1.332 × 10-3 mm2/s for the ADCedema generated the best combination of sensitivity (95%) and specificity (84%) for distinguishing between HGGs and BMs. The same value showed a sensitivity of 95.6% and a specificity of 100% for distinguishing between GBMs and BMs. Conclusion ADC values from DWI were found to distinguish between HGGs and solitary BMs. The peritumoral ADC values are better than the intratumoral ADC values in predicting the tumor type.
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Affiliation(s)
- Ionut Caravan
- “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Alexandra Contis
- “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andrei Lebovici
- “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Department of Radiology, Emergency County Hospital, Cluj-Napoca, Romania
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17
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Lücker A, Secomb TW, Weber B, Jenny P. The Relation Between Capillary Transit Times and Hemoglobin Saturation Heterogeneity. Part 1: Theoretical Models. Front Physiol 2018; 9:420. [PMID: 29755365 PMCID: PMC5932636 DOI: 10.3389/fphys.2018.00420] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 04/04/2018] [Indexed: 12/23/2022] Open
Abstract
Capillary dysfunction impairs oxygen supply to parenchymal cells and often occurs in Alzheimer's disease, diabetes and aging. Disturbed capillary flow patterns have been shown to limit the efficacy of oxygen extraction and can be quantified using capillary transit time heterogeneity (CTH). However, the transit time of red blood cells (RBCs) through the microvasculature is not a direct measure of their capacity for oxygen delivery. Here we examine the relation between CTH and capillary outflow saturation heterogeneity (COSH), which is the heterogeneity of blood oxygen content at the venous end of capillaries. Models for the evolution of hemoglobin saturation heterogeneity (HSH) in capillary networks were developed and validated using a computational model with moving RBCs. Two representative situations were selected: a Krogh cylinder geometry with heterogeneous hemoglobin saturation (HS) at the inflow, and a parallel array of four capillaries. The heterogeneity of HS after converging capillary bifurcations was found to exponentially decrease with a time scale of 0.15-0.21 s due to diffusive interaction between RBCs. Similarly, the HS difference between parallel capillaries also drops exponentially with a time scale of 0.12-0.19 s. These decay times are substantially smaller than measured RBC transit times and only weakly depend on the distance between microvessels. This work shows that diffusive interaction strongly reduces COSH on a small spatial scale. Therefore, we conclude that CTH influences COSH yet does not determine it. The second part of this study will focus on simulations in microvascular networks from the rodent cerebral cortex. Actual estimates of COSH and CTH will then be given.
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Affiliation(s)
- Adrien Lücker
- Department of Mechanical and Process Engineering, Institute of Fluid Dynamics, ETH Zurich, Zurich, Switzerland
| | - Timothy W Secomb
- Department of Physiology, University of Arizona, Tucson, AZ, United States
| | - Bruno Weber
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
| | - Patrick Jenny
- Department of Mechanical and Process Engineering, Institute of Fluid Dynamics, ETH Zurich, Zurich, Switzerland
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18
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Lin L, Xue Y, Duan Q, Sun B, Lin H, Huang X, Chen X. The role of cerebral blood flow gradient in peritumoral edema for differentiation of glioblastomas from solitary metastatic lesions. Oncotarget 2018; 7:69051-69059. [PMID: 27655705 PMCID: PMC5356611 DOI: 10.18632/oncotarget.12053] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 09/02/2016] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Differentiation of glioblastomas from solitary brain metastases using conventional MRI remains an important unsolved problem. In this study, we introduced the conception of the cerebral blood flow (CBF) gradient in peritumoral edema-the difference in CBF values from the proximity of the enhancing tumor to the normal-appearing white matter, and investigated the contribution of perfusion metrics on the discrimination of glioblastoma from a metastatic lesion. MATERIALS AND METHODS Fifty-two consecutive patients with glioblastoma or a solitary metastatic lesion underwent three-dimensional arterial spin labeling (3D-ASL) before surgical resection. The CBF values were measured in the peritumoral edema (near: G1; Intermediate: G2; Far: G3). The CBF gradient was calculated as the subtractions CBFG1 -CBFG3, CBFG1 - CBFG2 and CBFG2 - CBFG3. A receiver operating characteristic (ROC) curve analysis was used to seek for the best cutoff value permitting discrimination between these two tumors. RESULTS The absolute/related CBF values and the CBF gradient in the peritumoral regions of glioblastomas were significantly higher than those in metastases(P < 0.038). ROC curve analysis reveals, a cutoff value of 1.92 ml/100g for the CBF gradient of CBFG1 -CBFG3 generated the best combination of sensitivity (92.86%) and specificity (100.00%) for distinguishing between a glioblastoma and metastasis. CONCLUSION The CBF gradient in peritumoral edema appears to be a more promising ASL perfusion metrics in differentiating high grade glioma from a solitary metastasis.
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Affiliation(s)
- Lin Lin
- Department of Radiology, Union Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Yunjing Xue
- Department of Radiology, Union Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Qing Duan
- Department of Radiology, Union Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Bin Sun
- Department of Radiology, Union Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Hailong Lin
- Department of Radiology, Union Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Xinming Huang
- Department of Radiology, Union Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Xiaodan Chen
- Department of Radiology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian, China
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19
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Lücker A, Secomb TW, Weber B, Jenny P. The relative influence of hematocrit and red blood cell velocity on oxygen transport from capillaries to tissue. Microcirculation 2018; 24. [PMID: 27893186 DOI: 10.1111/micc.12337] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 11/24/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Oxygen transport to parenchymal cells occurs mainly at the microvascular level and depends on convective RBC flux, which is proportional in an individual capillary to the product of capillary hematocrit and RBC velocity. This study investigates the relative influence of these two factors on tissue PO2 . METHODS A simple analytical model is used to quantify the respective influences of hematocrit, RBC velocity, and RBC flow on tissue oxygenation around capillaries. Predicted tissue PO2 levels are compared with a detailed computational model. RESULTS Hematocrit is shown to have a larger influence on tissue PO2 than RBC velocity. The effect of RBC velocity increases with distance from the arterioles. Good agreement between analytical and numerical results is obtained, and the discrepancies are explained. Significant dependence of MTCs on RBC velocity at low hematocrit is demonstrated. CONCLUSIONS For a given RBC flux in a capillary, the PO2 in the surrounding tissue increases with increasing hematocrit, as a consequence of decreasing IVR to diffusive oxygen transport from RBCs to tissue. These results contribute to understanding the effects of blood flow changes on oxygen transport, such as those that occur in functional hyperemia in the brain.
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Affiliation(s)
- Adrien Lücker
- Institute of Fluid Dynamics, ETH Zurich, Zurich, Switzerland
| | - Timothy W Secomb
- Department of Physiology, University of Arizona, Tucson, AZ, USA
| | - Bruno Weber
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
| | - Patrick Jenny
- Institute of Fluid Dynamics, ETH Zurich, Zurich, Switzerland
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Oros-Peusquens A, Loução R, Zimmermann M, Langen KJ, Shah N. Methods for molecular imaging of brain tumours in a hybrid MR-PET context: Water content, T 2 ∗ , diffusion indices and FET-PET. Methods 2017; 130:135-151. [DOI: 10.1016/j.ymeth.2017.07.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/22/2017] [Accepted: 07/27/2017] [Indexed: 11/27/2022] Open
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Loss of Pericytes in Radiation Necrosis after Glioblastoma Treatments. Mol Neurobiol 2017; 55:4918-4926. [PMID: 28770500 DOI: 10.1007/s12035-017-0695-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 07/26/2017] [Indexed: 12/31/2022]
Abstract
Radiation necrosis (RN) in brain tumor patients is often symptomatic, persistent without immediate resolution, and confused with tumor recurrence. Cerebral vascular pericytes are essential for endothelial function, vascular integrity, and angiogenesis. In this study, we showed that the loss of pericytes is involved in the pathogenesis of RN. From a brain tumor tissue repository, we identified three patients since 2011 with pathologically confirmed RN after the standard treatment for glioblastoma (GBM). The RN and their preradiation GBM tissues were serially processed for Western blotting using cell-type-specific antibodies against endothelial (CD31, active RhoA), pericyte [platelet-derived growth factor receptor-beta (PDGFR-β)], alpha-smooth muscle actin (α-SMA), astrocyte (GFAP), myelin sheath protein (MBP), and microglial markers (Iba1). Normal brain tissues from a brain bank were used as normal controls. The expressions of PDGFR-β and α-SMA were remarkably reduced in the RN, compared to those of GBM. However, the levels of CD31 or RhoA were not different between the two groups, which suggest that there was no change in the number of endothelial cells or their cytoskeletal assembly. The RN tissues showed a decreased ratio of pericyte/endothelial markers and an increased level of Iba1 compared to the GBM and even to the normal brain. The levels of GFAP and MBP were not changed in the RN. In the histopathology, the RN tissues showed a loss of markers (PDGFR-β), whereas the GBM tissues had abundant expression of the markers. The loss of pericytes and vascular smooth muscle cells, and the unsupported endothelial cells might be the cause of the leaky blood-brain barrier and tissue necrosis.
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Abstract
Seventy percent of cancer patients have detectable metastases when they receive a diagnosis and 90% of cancer deaths result from metastases. These two facts emphasise the urgency for research to study the mechanisms and processes that enable metastasis. We need to develop a greater understanding of the cellular and molecular mechanisms that cause metastasis and also we need to do more. We must also consider the micro- and macro-environmental factors that influence this disease. Studying this environmental context has led us to update the ‘seed and soil’ hypothesis which dates back to the 19th century. This theory describes cancerous cells as seeds and the substrate as the soil in target organs though this may seem antiquated. Nonetheless, the tissue specificity that researchers have recently observed in metastatic colonisation supports the validity of the seed and soil theory. We now know that the metastatic potential of a tumour cell depends on multiple, reciprocal interactions between the primary tumour and distant sites. These interactions determine tumour progression. Studies of metastasis have allowed us to develop treatments that focus on therapeutic effectiveness. These new treatments account for the frequent metastasis of some tumours to target organs such as bones, lungs, brain, and liver. The purpose of this review is first to describe interactions between the cellular and molecular entities and the target organ tumour environment that enables metastasis. A second aim is to describe the complex mechanisms that mediate these interactions.
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Affiliation(s)
- Francisco Arvelo
- Life Sciences Centre, Institute for Advanced Studies Foundation [Fundación Instituto de Estudios Avanzado]-IDEA, Apartado 17606, Caracas 1015-A, Venezuela; Tumour Biology Culture and Tissue Laboratory, Experimental Biology Institute, Central University of Venezuela, Apartado Apartado 47114, Caracas 1041-A, Venezuela
| | - Felipe Sojo
- Life Sciences Centre, Institute for Advanced Studies Foundation [Fundación Instituto de Estudios Avanzado]-IDEA, Apartado 17606, Caracas 1015-A, Venezuela
| | - Carlos Cotte
- Tumour Biology Culture and Tissue Laboratory, Experimental Biology Institute, Central University of Venezuela, Apartado Apartado 47114, Caracas 1041-A, Venezuela
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Sunwoo L, Yun TJ, You SH, Yoo RE, Kang KM, Choi SH, Kim JH, Sohn CH, Park SW, Jung C, Park CK. Differentiation of Glioblastoma from Brain Metastasis: Qualitative and Quantitative Analysis Using Arterial Spin Labeling MR Imaging. PLoS One 2016; 11:e0166662. [PMID: 27861605 PMCID: PMC5115760 DOI: 10.1371/journal.pone.0166662] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 11/01/2016] [Indexed: 12/27/2022] Open
Abstract
PURPOSE To evaluate the diagnostic performance of cerebral blood flow (CBF) by using arterial spin labeling (ASL) perfusion magnetic resonance (MR) imaging to differentiate glioblastoma (GBM) from brain metastasis. MATERIALS AND METHODS The institutional review board of our hospital approved this retrospective study. The study population consisted of 128 consecutive patients who underwent surgical resection and were diagnosed as either GBM (n = 89) or brain metastasis (n = 39). All participants underwent preoperative MR imaging including ASL. For qualitative analysis, the tumors were visually graded into five categories based on ASL-CBF maps by two blinded reviewers. For quantitative analysis, the reviewers drew regions of interest (ROIs) on ASL-CBF maps upon the most hyperperfused portion within the tumor and upon peritumoral T2 hyperintensity area. Signal intensities of intratumoral and peritumoral ROIs for each subject were normalized by dividing the values by those of contralateral normal gray matter (nCBFintratumoral and nCBFperitumoral, respectively). Visual grading scales and quantitative parameters between GBM and brain metastasis were compared. In addition, the area under the receiver-operating characteristic curve was used to evaluate the diagnostic performance of ASL-driven CBF to differentiate GBM from brain metastasis. RESULTS For qualitative analysis, GBM group showed significantly higher grade compared to metastasis group (p = 0.001). For quantitative analysis, both nCBFintratumoral and nCBFperitumoral in GBM were significantly higher than those in metastasis (both p < 0.001). The areas under the curve were 0.677, 0.714, and 0.835 for visual grading, nCBFintratumoral, and nCBFperitumoral, respectively (all p < 0.001). CONCLUSION ASL perfusion MR imaging can aid in the differentiation of GBM from brain metastasis.
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Affiliation(s)
- Leonard Sunwoo
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae Jin Yun
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
- * E-mail:
| | - Sung-Hye You
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Roh-Eul Yoo
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Koung Mi Kang
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Seung Hong Choi
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Ji-hoon Kim
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Chul-Ho Sohn
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Sun-Won Park
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Department of Radiology, Seoul Metropolitan Government—Seoul National University Boramae Medical Center, Seoul, Korea
| | - Cheolkyu Jung
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
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24
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Mittapalli RK, Adkins CE, Bohn KA, Mohammad AS, Lockman JA, Lockman PR. Quantitative Fluorescence Microscopy Measures Vascular Pore Size in Primary and Metastatic Brain Tumors. Cancer Res 2016; 77:238-246. [PMID: 27815391 DOI: 10.1158/0008-5472.can-16-1711] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 10/26/2016] [Accepted: 10/28/2016] [Indexed: 01/16/2023]
Abstract
Tumors residing in the central nervous system (CNS) compromise the blood-brain barrier (BBB) via increased vascular permeability, with the magnitude of changes dependent on the tumor type and location. Current studies determine penetrability of a cancer therapeutic by administering progressively larger molecules until cutoff is observed where little to no tumor accumulation occurs. However, decades-old experimental work and mathematical modeling document methods to calculate both the size of the vascular opening (pore) with solute permeability values. In this study, we updated this classic mathematical modeling approach with quantitative fluorescence microscopy in two preclinical tumor models, allowing simultaneous administration of multiple sized tracers to determine vascular permeability at a resolution of nearly one micron. We observed that three molecules ranging from 100 Da to 70 kDa permeated into a preclinical glioblastoma model at rates proportional to their diffusion in water. This suggests the solutes freely diffused from blood to glioma across vascular pores without steric restriction, which calculates to a pore size of >140 nm in diameter. In contrast, the calculated pore size of a brain metastasis of breast cancer was approximately 10-fold smaller than glioma vasculature. This difference explains why antibodies are effective against glioblastoma but generally fail in brain metastases of breast cancer. On the basis of our observations, we hypothesize that trastuzumab most likely fails in the treatment of brain metastases of breast cancer because of poor CNS penetration, while the similar sized antibody bevacizumab is effective in the same tumor type not because it penetrates the CNS degree better, but because it scavenges VEGF in the vascular compartment, which reduces edema and permeation. Cancer Res; 77(2); 238-46. ©2016 AACR.
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Affiliation(s)
- Rajendar K Mittapalli
- Department of Pharmaceutical Sciences, School of Pharmacy, Texas Tech University Health Sciences Center, Amarillo, Texas
| | - Chris E Adkins
- Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University Health Sciences Center, Morgantown, West Virginia
| | - Kaci A Bohn
- Department of Pharmaceutical Sciences, School of Pharmacy, Texas Tech University Health Sciences Center, Amarillo, Texas.,Department of Pharmaceutical Sciences, College of Pharmacy, Harding University, Searcy, Arkansas
| | - Afroz S Mohammad
- Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University Health Sciences Center, Morgantown, West Virginia
| | - Julie A Lockman
- Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University Health Sciences Center, Morgantown, West Virginia
| | - Paul R Lockman
- Department of Pharmaceutical Sciences, School of Pharmacy, Texas Tech University Health Sciences Center, Amarillo, Texas. .,Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University Health Sciences Center, Morgantown, West Virginia
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25
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Wiedemair W, Tukovic Z, Jasak H, Poulikakos D, Kurtcuoglu V. The breakup of intravascular microbubbles and its impact on the endothelium. Biomech Model Mechanobiol 2016; 16:611-624. [PMID: 27734169 DOI: 10.1007/s10237-016-0840-z] [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: 11/28/2015] [Accepted: 09/27/2016] [Indexed: 12/26/2022]
Abstract
Encapsulated microbubbles (MBs) serve as endovascular agents in a wide range of medical ultrasound applications. The oscillatory response of these agents to ultrasonic excitation is determined by MB size, gas content, viscoelastic shell properties and geometrical constraints. The viscoelastic parameters of the MB capsule vary during an oscillation cycle and change irreversibly upon shell rupture. The latter results in marked stress changes on the endothelium of capillary blood vessels due to altered MB dynamics. Mechanical effects on microvessels are crucial for safety and efficacy in applications such as focused ultrasound-mediated blood-brain barrier (BBB) opening. Since direct in vivo quantification of vascular stresses is currently not achievable, computational modelling has established itself as an alternative. We have developed a novel computational framework combining fluid-structure coupling and interface tracking to model the nonlinear dynamics of an encapsulated MB in constrained environments. This framework is used to investigate the mechanical stresses at the endothelium resulting from MB shell rupture in three microvessel setups of increasing levels of geometric detail. All configurations predict substantial elevation of up to 150 % for peak wall shear stress upon MB breakup, whereas global peak transmural pressure levels remain unaltered. The presence of red blood cells causes confinement of pressure and shear gradients to the proximity of the MB, and the introduction of endothelial texture creates local modulations of shear stress levels. With regard to safety assessments, the mechanical impact of MB breakup is shown to be more important than taking into account individual red blood cells and endothelial texture. The latter two may prove to be relevant to the actual, complex process of BBB opening induced by MB oscillations.
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Affiliation(s)
- Wolfgang Wiedemair
- Laboratory of Thermodynamics in Emerging Technologies, Department of Mechanical and Process Engineering, ETH Zurich, Sonneggstrasse 3, 8092, Zurich, Switzerland.,The Interface Group, Institute of Physiology, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland
| | - Zeljko Tukovic
- Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Ivana Lucica 5, 10000, Zagreb, Croatia
| | - Hrvoje Jasak
- Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Ivana Lucica 5, 10000, Zagreb, Croatia
| | - Dimos Poulikakos
- Laboratory of Thermodynamics in Emerging Technologies, Department of Mechanical and Process Engineering, ETH Zurich, Sonneggstrasse 3, 8092, Zurich, Switzerland
| | - Vartan Kurtcuoglu
- The Interface Group, Institute of Physiology, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland. .,Zurich Center for Integrative Human Physiology, and Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland.
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26
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Chen C, Gu Y, Tu J, Guo X, Zhang D. Microbubble oscillating in a microvessel filled with viscous fluid: A finite element modeling study. ULTRASONICS 2016; 66:54-64. [PMID: 26651263 DOI: 10.1016/j.ultras.2015.11.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 11/04/2015] [Accepted: 11/08/2015] [Indexed: 06/05/2023]
Abstract
Understanding the dynamics of coated-microbubble oscillating in an elastic microvessel is important for effective and safe applications of ultrasound contrast agents (UCAs) in imaging and therapy. Numerical simulations are performed based on a two-dimensional (2D) asymmetric finite element model to investigate the influences of both acoustic driving parameters (e.g., pressure and frequency) and material properties (vessel size, microbubble shell visco-elastic parameters and fluid viscosity) on the dynamic interactions in the bubble-blood-vessel system. The results show that, the constrained effect of the blood vessel along the radial direction will induce the asymmetric bubble oscillation and vessel deformation, as well as shifting the bubble resonance frequency toward the higher frequency range. For a bubble (1.5-μm radius) activated by 1-MHz ultrasound pulses in a microvessel with a radius varying between 2 and 6.5 μm, up to 26.95 kPa shear stress could be generated on the vessel wall at a driving pressure of 0.2 MPa, which should be high enough to damage the vascular endothelial cells. The asymmetrical oscillation ratio of the bubble can be aggravated from 0.12% to 79.94% with the increasing acoustic driving pressure and blood viscosity, or the decreasing vessel size and microbubble shell visco-elastic properties. The maximum compression velocity on the bubble shell will be enhanced from 0.19 to 22.79 m/s by the increasing vessel size and acoustic pressure, or the decreasing microbubble shell visco-elasticity and blood viscosity. As the results, the peak values of microstreaming-induced shear stress on the vessel wall increases from 0.003 to 26.95 kPa and the deformation degree of vessel is raised from 1.01 to 1.49, due to the enhanced acoustic amplitude, or the decreasing vessel size, blood viscosity and microbubble shell visco-elasticity. Moreover, it also suggests that, among above impact parameters, microbubble resonance frequency and UCA shell elasticity might play more dominant roles in dynamic interactions of the bubble-blood-vessel system.
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Affiliation(s)
- Chuyi Chen
- Key Laboratory of Modern Acoustics (MOE), Department of Physics, Collaborative Innovation Center of Advanced Microstructure, Nanjing University, Nanjing 210093, China
| | - Yuyang Gu
- Key Laboratory of Modern Acoustics (MOE), Department of Physics, Collaborative Innovation Center of Advanced Microstructure, Nanjing University, Nanjing 210093, China
| | - Juan Tu
- Key Laboratory of Modern Acoustics (MOE), Department of Physics, Collaborative Innovation Center of Advanced Microstructure, Nanjing University, Nanjing 210093, China.
| | - Xiasheng Guo
- Key Laboratory of Modern Acoustics (MOE), Department of Physics, Collaborative Innovation Center of Advanced Microstructure, Nanjing University, Nanjing 210093, China
| | - Dong Zhang
- Key Laboratory of Modern Acoustics (MOE), Department of Physics, Collaborative Innovation Center of Advanced Microstructure, Nanjing University, Nanjing 210093, China; The State Key Laboratory of Acoustics, Chinese Academy of Science, Beijing 10080, China.
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27
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Karnati HK, Panigrahi M, Shaik NA, Greig NH, Bagadi SAR, Kamal MA, Kapalavayi N. Down regulated expression of Claudin-1 and Claudin-5 and up regulation of β-catenin: association with human glioma progression. CNS & NEUROLOGICAL DISORDERS-DRUG TARGETS 2015; 13:1413-26. [PMID: 25345514 DOI: 10.2174/1871527313666141023121550] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 06/24/2014] [Accepted: 07/02/2014] [Indexed: 12/21/2022]
Abstract
Glioblastoma multiforme is the most common form of intracranial malignancy in humans, and is characterized by aggressive tumor growth, tissue invasion and neurodegenerative properties. The present study investigated the expression status of tight junction associated Claudin 1 (CLDN1), Claudin 5 (CLDN5) and Adheren junction associated β-catenin genes in the light of their critical role in the progression of both low- and high-grade human gliomas. Using quantitative PCR and Western blot methods the mRNA and protein status of CLDN1, CLDN5 and β-catenin genes were studied in a total of 25 human gliomas of World Health Organization (WHO) grades I-IV, non-cancerous control brain tissues and their corresponding model cell lines (C6, U373, U118, T98 and U87MG). Quantitative analysis of the transcript and protein expression data showed that CLDN1 and CLDN5 were significantly down regulated (p=<0.001) in tumors of all four grades and model cell lines. This decrease in expression pattern was in accordance with the increasing grade of the tumor. A 4-fold stronger reduction of CLDN1 when compared to CLDN5 was evident in high-grade tumors. Interestingly, β-catenin was up regulated in all tumor types we studied (p=<0.005). Our findings, suggest that down regulated CLDN1 and CLDN5 genes have potential relevance in relation to the progression of glioblastoma multiforme. Hence, their therapeutic targeting may provide both insight and leads to control the cellular proliferation and subsequent invasiveness among affected individuals.
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Affiliation(s)
| | | | | | | | | | | | - Nagaiah Kapalavayi
- (Nagaiah Kapalavayi) Department of Biotechnology, Gland Pharma Limited, Dundigal, Gandimaisamma X Roads, Hyderabad - 500 043, Andhra Pradesh, India.
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28
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Abstract
This review summarizes patent applications in the past 5 years for the management of brain tumors and metastases. Most of the recent patents discuss one of the following strategies: the development of new drug entities that specifically target the brain cells, the blood-brain barrier and the tumor cells, tailor-designing a novel carrier system that is able to perform multitasks and multifunction as a drug carrier, targeting vehicle and even as a diagnostic tool, direct conjugation of a US FDA approved drug with a targeting moiety, diagnostic moiety or PK modifying moiety, or the use of innovative nontraditional approaches such as genetic engineering, stem cells and vaccinations. Until now, there has been no optimal strategy to deliver therapeutic agents to the CNS for the treatment of brain tumors and metastases. Intensive research efforts are actively ongoing to take brain tumor targeting, and novel and targeted CNS delivery systems to potential clinical application.
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29
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Dubois LG, Campanati L, Righy C, D'Andrea-Meira I, Spohr TCLDSE, Porto-Carreiro I, Pereira CM, Balça-Silva J, Kahn SA, DosSantos MF, Oliveira MDAR, Ximenes-da-Silva A, Lopes MC, Faveret E, Gasparetto EL, Moura-Neto V. Gliomas and the vascular fragility of the blood brain barrier. Front Cell Neurosci 2014; 8:418. [PMID: 25565956 PMCID: PMC4264502 DOI: 10.3389/fncel.2014.00418] [Citation(s) in RCA: 201] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 11/18/2014] [Indexed: 12/22/2022] Open
Abstract
Astrocytes, members of the glial family, interact through the exchange of soluble factors or by directly contacting neurons and other brain cells, such as microglia and endothelial cells. Astrocytic projections interact with vessels and act as additional elements of the Blood Brain Barrier (BBB). By mechanisms not fully understood, astrocytes can undergo oncogenic transformation and give rise to gliomas. The tumors take advantage of the BBB to ensure survival and continuous growth. A glioma can develop into a very aggressive tumor, the glioblastoma (GBM), characterized by a highly heterogeneous cell population (including tumor stem cells), extensive proliferation and migration. Nevertheless, gliomas can also give rise to slow growing tumors and in both cases, the afflux of blood, via BBB is crucial. Glioma cells migrate to different regions of the brain guided by the extension of blood vessels, colonizing the healthy adjacent tissue. In the clinical context, GBM can lead to tumor-derived seizures, which represent a challenge to patients and clinicians, since drugs used for its treatment must be able to cross the BBB. Uncontrolled and fast growth also leads to the disruption of the chimeric and fragile vessels in the tumor mass resulting in peritumoral edema. Although hormonal therapy is currently used to control the edema, it is not always efficient. In this review we comment the points cited above, considering the importance of the BBB and the concerns that arise when this barrier is affected.
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Affiliation(s)
- Luiz Gustavo Dubois
- Instituto Estadual do Cérebro Paulo Niemeyer, Rua do Rezende Rio de Janeiro, Brazil
| | - Loraine Campanati
- Laboratório de Morfogênese Celular, Instituto de Ciências Biomédicas da, Universidade Federal do Rio de Janeiro Rio de Janeiro, Brazil
| | - Cassia Righy
- Instituto Estadual do Cérebro Paulo Niemeyer, Rua do Rezende Rio de Janeiro, Brazil
| | | | | | | | - Claudia Maria Pereira
- Programa de Pós-Graduação em Odontologia, Escola de Ciências da Saúde (ECS), Universidade do Grande Rio (UNIGRANRIO) Duque de Caxias, Brazil
| | - Joana Balça-Silva
- Centro de Neurociência e Biologia Celular, Faculdade de Medicina, Universidade de Coimbra Coimbra, Portugal
| | - Suzana Assad Kahn
- Instituto Estadual do Cérebro Paulo Niemeyer, Rua do Rezende Rio de Janeiro, Brazil
| | - Marcos F DosSantos
- Laboratório de Morfogênese Celular, Instituto de Ciências Biomédicas da, Universidade Federal do Rio de Janeiro Rio de Janeiro, Brazil
| | | | - Adriana Ximenes-da-Silva
- Instituto de Ciências Biológicas e da Saúde, Universidade Federal de Alagoas, Maceió Alagoas, Brazil
| | - Maria Celeste Lopes
- Centro de Neurociência e Biologia Celular, Faculdade de Medicina, Universidade de Coimbra Coimbra, Portugal
| | - Eduardo Faveret
- Instituto Estadual do Cérebro Paulo Niemeyer, Rua do Rezende Rio de Janeiro, Brazil
| | | | - Vivaldo Moura-Neto
- Instituto Estadual do Cérebro Paulo Niemeyer, Rua do Rezende Rio de Janeiro, Brazil ; Laboratório de Morfogênese Celular, Instituto de Ciências Biomédicas da, Universidade Federal do Rio de Janeiro Rio de Janeiro, Brazil
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30
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Lücker A, Weber B, Jenny P. A dynamic model of oxygen transport from capillaries to tissue with moving red blood cells. Am J Physiol Heart Circ Physiol 2014; 308:H206-16. [PMID: 25398979 DOI: 10.1152/ajpheart.00447.2014] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Most oxygen required to support the energy needs of vertebrate tissues is delivered by diffusion from microvessels. The presence of red blood cells (RBCs) makes blood flow in the microcirculation highly heterogeneous. Additionally, flow regulation mechanisms dynamically respond to changes in tissue energy demand. These spatiotemporal variations directly affect the supply of oxygen to parenchymal cells. Due to various limiting assumptions, current models of oxygen transport cannot fully capture the consequences of complex hemodynamic effects on tissue oxygenation and are often not suitable for studying unsteady phenomena. With our new approach based on moving RBCs, the impact of blood flow heterogeneity on oxygen partial pressure (Po2) in the tissue can be quantified. Oxygen transport was simulated using parachute-shaped solid RBCs flowing through a capillary. With the use of a conical tissue domain with radii 19 and 13 μm, respectively, our computations indicate that Po2 at the RBC membrane exceeds Po2 between RBCs by 30 mmHg on average and that the mean plasma Po2 decreases by 9 mmHg over 50 μm. These results reproduce well recent intravascular Po2 measurements in the rodent brain. We also demonstrate that instantaneous variations of capillary hematocrit cause associated fluctuations of tissue Po2. Furthermore, our results suggest that homogeneous tissue oxygenation requires capillary networks to be denser on venular side than on arteriolar side. Our new model for oxygen transport will make it possible to quantify in detail the effects of blood flow heterogeneity on tissue oxygenation in realistic capillary networks.
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Affiliation(s)
- Adrien Lücker
- Institute of Fluid Dynamics, ETH Zurich, Zurich, Switzerland; and
| | - Bruno Weber
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
| | - Patrick Jenny
- Institute of Fluid Dynamics, ETH Zurich, Zurich, Switzerland; and
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31
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Svolos P, Kousi E, Kapsalaki E, Theodorou K, Fezoulidis I, Kappas C, Tsougos I. The role of diffusion and perfusion weighted imaging in the differential diagnosis of cerebral tumors: a review and future perspectives. Cancer Imaging 2014; 14:20. [PMID: 25609475 PMCID: PMC4331825 DOI: 10.1186/1470-7330-14-20] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 03/20/2014] [Indexed: 12/31/2022] Open
Abstract
The role of conventional Magnetic Resonance Imaging (MRI) in the detection of cerebral tumors has been well established. However its excellent soft tissue visualization and variety of imaging sequences are in many cases non-specific for the assessment of brain tumor grading. Hence, advanced MRI techniques, like Diffusion-Weighted Imaging (DWI), Diffusion Tensor Imaging (DTI) and Dynamic-Susceptibility Contrast Imaging (DSCI), which are based on different contrast principles, have been used in the clinical routine to improve diagnostic accuracy. The variety of quantitative information derived from these techniques provides significant structural and functional information in a cellular level, highlighting aspects of the underlying brain pathophysiology. The present work, reviews physical principles and recent results obtained using DWI/DTI and DSCI, in tumor characterization and grading of the most common cerebral neoplasms, and discusses how the available MR quantitative data can be utilized through advanced methods of analysis, in order to optimize clinical decision making.
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32
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Pabst AM, Ackermann M, Wagner W, Haberthür D, Ziebart T, Konerding MA. Imaging angiogenesis: perspectives and opportunities in tumour research - a method display. J Craniomaxillofac Surg 2014; 42:915-23. [PMID: 24518362 DOI: 10.1016/j.jcms.2014.01.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 09/18/2013] [Accepted: 01/03/2014] [Indexed: 11/16/2022] Open
Abstract
The growth of solid tumours necessitates angiogenesis. The aim of this paper is the presentation and evaluation of different ex vivo methods for analysing tumour angiogenesis. Oral squamous cell carcinomas (SCC) were induced in mice by subcutaneous injection of tumour cells in the groin region and processed for histology and microvascular corrosion casting. Vascularization was analysed light microscopically using CD31 immunochemistry. Corrosion casts were analysed by scanning electron microscopy (SEM), micro computed tomography (μCT) and synchrotron radiation-based micro computed tomography (SRμCT). Immunochemistry allows for a simple and authentic detection and stereological quantification of the SCC vascularization. μCT imaging of the corrosion casts gives a high-quality overview over the three-dimensional (3D) microvascular architecture. SEM and SRμCT allow a high-definition display of the vessel morphology, providing magnificent detail recognition down to the capillary level enabling imaging of different forms of tumour angiogenesis, e.g., sprouting and intussusceptive angiogenesis. Immunochemistry and SEM are regarded as suitable for most of the morphometrical and morphological assessments because of the simple procedure and the high explanatory power, especially in combination with each other. High resolution SRμCT helps answering specialized questions, however, requires sophisticated data processing for visualization and is of limited availability.
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Affiliation(s)
- Andreas Max Pabst
- Institute of Functional and Clinical Anatomy, University Medical Center Mainz (Head: Univ.-Prof. Dr. E. Schulte), Becherweg 13, 55099 Mainz, Germany; Department of Oral and Maxillofacial Surgery, University Medical Center Mainz (Head: Univ.-Prof. Dr. Dr. W. Wagner), Augustusplatz 2, 55131 Mainz, Germany
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center Mainz (Head: Univ.-Prof. Dr. E. Schulte), Becherweg 13, 55099 Mainz, Germany
| | - Willi Wagner
- Institute of Functional and Clinical Anatomy, University Medical Center Mainz (Head: Univ.-Prof. Dr. E. Schulte), Becherweg 13, 55099 Mainz, Germany
| | - David Haberthür
- Swiss Light Source, Paul Scherrer Institute (Beamline Head: Prof. Dr. M. Stampanoni), 5232 Villigen PSI, Switzerland
| | - Thomas Ziebart
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz (Head: Univ.-Prof. Dr. Dr. W. Wagner), Augustusplatz 2, 55131 Mainz, Germany
| | - Moritz Anton Konerding
- Institute of Functional and Clinical Anatomy, University Medical Center Mainz (Head: Univ.-Prof. Dr. E. Schulte), Becherweg 13, 55099 Mainz, Germany.
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Lutz K, Wiestler B, Graf M, Bäumer P, Floca R, Schlemmer HP, Heiland S, Wick W, Bendszus M, Radbruch A. Infiltrative patterns of glioblastoma: Identification of tumor progress using apparent diffusion coefficient histograms. J Magn Reson Imaging 2013; 39:1096-103. [DOI: 10.1002/jmri.24258] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 05/15/2013] [Indexed: 11/05/2022] Open
Affiliation(s)
- Kira Lutz
- Department of Neuroradiology; University of Heidelberg, Medical Center; Heidelberg Germany
| | - Benedikt Wiestler
- Department of Neurooncology; University of Heidelberg, Medical Center; Heidelberg Germany
| | - Markus Graf
- German Cancer Research Center Heidelberg; Department for Radiology; Heidelberg Germany
| | - Philipp Bäumer
- Department of Neuroradiology; University of Heidelberg, Medical Center; Heidelberg Germany
| | - Ralf Floca
- German Cancer Research Center Heidelberg; Department for Radiology; Heidelberg Germany
| | - Heinz-Peter Schlemmer
- German Cancer Research Center Heidelberg; Department for Radiology; Heidelberg Germany
| | - Sabine Heiland
- Department of Neuroradiology; University of Heidelberg, Medical Center; Heidelberg Germany
| | - Wolfgang Wick
- Department of Neurooncology; University of Heidelberg, Medical Center; Heidelberg Germany
| | - Martin Bendszus
- Department of Neuroradiology; University of Heidelberg, Medical Center; Heidelberg Germany
| | - Alexander Radbruch
- Department of Neuroradiology; University of Heidelberg, Medical Center; Heidelberg Germany
- German Cancer Research Center Heidelberg; Neuro-oncologic Imaging (E012) Heidelberg Germany
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Caivano R, Lotumolo A, Rabasco P, Zandolino A, D'Antuono F, Villonio A, Lancellotti MI, Macarini L, Cammarota A. 3 Tesla magnetic resonance spectroscopy: cerebral gliomas vs. metastatic brain tumors. Our experience and review of the literature. Int J Neurosci 2013; 123:537-43. [PMID: 23390934 DOI: 10.3109/00207454.2013.774395] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of the present study is to report about the value of magnetic resonance spectroscopy (MRS) in differentiating brain metastases, primary high-grade gliomas (HGG) and low-grade gliomas (LGG). MRI (magnetic resonance imaging) and MRS were performed in 60 patients with histologically verified brain tumors: 32 patients with HGG (28 glioblastomas multiforme [GBM] and 4 anaplastic astrocytomas), 14 patients with LGG (9 astrocytomas and 5 oligodendrogliomas) and 14 patients with metastatic brain tumors. The Cho/Cr (choline-containing compounds/creatine-phosphocreatine complex), Cho/NAA (N-acetyl aspartate) and NAA/Cr ratios were assessed from spectral maps in the tumoral core and peritumoral edema. The differences in the metabolite ratios between LGG, HGG and metastases were analyzed statistically. Lipids/lactate contents were also analyzed. Significant differences were noted in the tumoral and peritumoral Cho/Cr, Cho/NAA and NAA/Cr ratios between LGG, HGG and metastases. Lipids and lactate content revealed to be useful for discriminating gliomas and metastases. The results of this study demonstrate that MRS can differentiate LGG, HGG and metastases, therefore diagnosis could be allowed even in those patients who cannot undergo biopsy.
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Affiliation(s)
- R Caivano
- Radiology Department, I.R.C.C.S. -C.R.O.B., Rionero in Vulture, Potenza, Italy.
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Abstract
The incidence of brain metastases (BM) in breast cancer patients has increased over the last decade, presumably due to advances in systemic treatment. Today, breast cancer is the second most common cause of BM among all solid malignancies, second only to lung cancer; furthermore, it is the most common cause of leptomeningeal carcinomatosis. The HER2-positive subtype was consistently shown to have a higher risk for BM as compared with HER2-negative disease. More recently, however, it was shown that a similar incidence exists in triple-negative tumours. Local treatment options, radiotherapy and neurosurgical resection, remain the mainstay of therapy for BM. While some studies have suggested a direct effect of conventional chemotherapy on BM, the main beneficial aspect of systemic treatment is rather due to control of non-CNS systemic disease. Importantly, in patients with HER2-positive breast cancer receiving HER2-targeted therapy after local treatment for BM, superior survival outcomes were reported. Leptomeningeal carcinomatosis has a dismal prognosis. Survival with whole brain radiotherapy alone remains short and the potential additional benefit of intrathecal chemotherapy is still disputed. According to case reports, intrathecal administration of trastuzumab appears to be a promising strategy in patients with HER2-positive leptomeningeal carcinomatosis. In conclusion, while the outcome of breast cancer patients with BM has improved especially in the HER2-positive subtype, the prognosis for the majority of patients remains poor. Therefore, development of novel systemic treatment options offering activity within the brain is urgently warranted. Novel insights into the pathobiology of BM formation may offer the possibility for targeted drug prophylaxis of CNS involvement in high-risk patients.
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Tsougos I, Svolos P, Kousi E, Fountas K, Theodorou K, Fezoulidis I, Kapsalaki E. Differentiation of glioblastoma multiforme from metastatic brain tumor using proton magnetic resonance spectroscopy, diffusion and perfusion metrics at 3 T. Cancer Imaging 2012; 12:423-36. [PMID: 23108208 PMCID: PMC3494384 DOI: 10.1102/1470-7330.2012.0038] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Purpose: To assess the contribution of 1H-magnetic resonance spectroscopy (1H-MRS), diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI) and dynamic susceptibility contrast-enhanced (DSCE) imaging metrics in the differentiation of glioblastomas from solitary metastasis, and particularly to clarify the controversial reports regarding the hypothesis that there should be a significant differentiation between the intratumoral and peritumoral areas. Methods: Conventional MR imaging, 1H-MRS, DWI, DTI and DSCE MRI was performed on 49 patients (35 glioblastomas multiforme, 14 metastases) using a 3.0-T MR unit. Metabolite ratios, apparent diffusion coefficient (ADC), fractional anisotropy (FA) and relative cerebral blood volume (rCBV) were measured in the intratumoral and peritumoral regions of the lesions. Receiver-operating characteristic analysis was used to obtain the cut-off values for the parameters presenting a statistical difference between the two tumor groups. Furthermore, we investigated the potential effect of the region of interest (ROI) size on the quantification of diffusion properties in the intratumoral region of the lesions, by applying two different ROI methods. Results: Peritumoral N-acetylaspartate (NAA)/creatine (Cr), choline (Cho)/Cr, Cho/NAA and rCBV significantly differentiated glioblastomas from intracranial metastases. ADC and FA presented no significant difference between the two tumor groups. Conclusions:1H-MRS and dynamic susceptibility measurements in the peritumoral regions may definitely aid in the differentiation of glioblastomas and solitary metastases. The quantification of the diffusion properties in the intratumoral region is independent of the ROI size placed.
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Affiliation(s)
- Ioannis Tsougos
- Medical Physics Department, University of Thessaly, Biopolis, 41110 Larissa, Greece.
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The disturbed blood–brain barrier in human glioblastoma. Mol Aspects Med 2012; 33:579-89. [DOI: 10.1016/j.mam.2012.02.003] [Citation(s) in RCA: 181] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 02/09/2012] [Accepted: 02/14/2012] [Indexed: 12/15/2022]
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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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Gu X, Liu XY, Fagan A, Gonzalez-Toledo ME, Zhao LR. Ultrastructural changes in cerebral capillary pericytes in aged Notch3 mutant transgenic mice. Ultrastruct Pathol 2012; 36:48-55. [PMID: 22292737 DOI: 10.3109/01913123.2011.620220] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Pericytes, the specialized vascular smooth muscle cells (VSMCs), play an important role in supporting and maintaining the structure of capillaries. Pericytes show biochemical and physiologic features similar to VSMC, usually containing smooth muscle actin fibers and rich endoplasm reticulum. Studies have indicated that degeneration of VSMCs due to Notch3 mutations is the cause of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). However, it remains unclear whether the Notch3 mutation also affects cerebral cortex capillary pericytes. In this ultrastructural morphologic study, the authors have observed pathological changes in the cerebral cortex capillary pericytes in aged mice that carry human mutant Notch3 genes. The number of abnormal pericytes in the cerebral cortex in Notch3 gene mutant mice was slightly increased when compared to an age-matched control group. Morphologically, the pericytes in the brains of Notch3 gene mutant mice showed more severe cellular injury, such as the presence of damaged mitochondria, secondary lysosomes, and large cytoplasmic vesicles. In addition, morphologic structures related to autophagy were also present in the pericytes of Notch3 gene mutant group. These ultrastructural morphologic alterations suggest that Notch3 mutation precipitates age-related pericytic degeneration that might result in cellular injury and trigger autophagic apoptosis. Microvascular dysfunction due to pericyte degeneration could initiate secondary neurodegenerative changes in brain parenchyma. These findings provide new insight into understanding the role of pericyte degeneration in the phathogenesis of CADASIL disease.
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Affiliation(s)
- Xin Gu
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, LA 71130-3932, USA.
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Lacy J, Saadati H, Yu JB. Complications of brain tumors and their treatment. Hematol Oncol Clin North Am 2012; 26:779-96. [PMID: 22794283 DOI: 10.1016/j.hoc.2012.04.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The diverse medical and neurologic complications of central nervous system (CNS) neoplasms or their treatment cause significant morbidity and mortality. Thus, their recognition and appropriate management by all members of the interdisciplinary team engaged in the care of patients with brain tumors is essential in optimizing quality of life and extending survival. Recognition of the acute, early delayed, and late complications of brain irradiation is essential to optimize management and mitigate their clinical impact.
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Affiliation(s)
- Jill Lacy
- Section of Medical Oncology, Department of Medicine, Yale University School of Medicine, New Haven, CT 06510, USA.
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Tucker IG, Yang L, Mujoo H. Delivery of drugs to the brain via the blood brain barrier using colloidal carriers. J Microencapsul 2012; 29:475-86. [PMID: 22563886 DOI: 10.3109/02652048.2012.658445] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Delivering drugs to the brain is challenging given the selective permeability of the blood brain barrier (BBB). Targeted colloidal carriers containing drug payloads offer some promise for enhanced and perhaps selective delivery to brain. This review examines the recent literature and identifies issues to be addressed if these systems are to be rationally designed. These include opsonization of nanoparticles and off-target clearance; the cerebral microvasculature, flow of nanoparticles in capillaries and binding to the capillary wall; and transcytosis. Capillary architecture, blood flow and BBB permeability are affected by disease and age and there are species differences. These complexities caution against making extravagant claims for a particular nanosystem but they also highlight the rich opportunities and need for critical research in this field.
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Affiliation(s)
- Ian G Tucker
- School of Pharmacy, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
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Leitner DF, Connor JR. Functional roles of transferrin in the brain. Biochim Biophys Acta Gen Subj 2011; 1820:393-402. [PMID: 22138408 DOI: 10.1016/j.bbagen.2011.10.016] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Revised: 10/13/2011] [Accepted: 10/24/2011] [Indexed: 12/11/2022]
Abstract
BACKGROUND Transferrin is synthesized in the brain by choroid plexus and oligodendrocytes, but only that in the choroid plexus is secreted. Transferrin is a major iron delivery protein to the brain, but the amount transcytosed across the brain microvasculature is minimal. Transferrin is the major source of iron delivery to neurons. It may deliver iron to immature oligodendrocytes but this trophic effect declines over time while iron requirements for maintaining myelination continue. Finally, transferrin may play an important role in neurodegenerative diseases through its ability to mobilize iron. SCOPE OF REVIEW The role of transferrin in maintaining brain iron homeostasis and the mechanism by which it enters the brain and delivers iron will be discussed. Its relevance to neurological disorders will also be addressed. MAJOR CONCLUSIONS Transferrin is the major iron delivery protein for neurons and the microvasculature, but has a limited role for glial cells. The main source of transferrin in the brain is likely from the choroid plexus although the concentration of transferrin at any given time in the brain includes that synthesized in oligodendrocytes. Little is known about brain iron egress or the role of transferrin in this process. GENERAL SIGNIFICANCE Neuron survival requires iron, which is predominantly delivered by transferrin. The concentration of transferrin in the cerebrospinal fluid is reflective of brain iron availability and can function as a biomarker in disease. Accumulation of iron in the brain contributes to neurodegenerative processes, thus an understanding of the role that transferrin plays in regulating brain iron homeostasis is essential. This article is part of a Special Issue entitled Transferrins: Molecular mechanisms of iron transport and disorders.
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Affiliation(s)
- Dominique F Leitner
- Department of Neurosurgery, Penn State University, M.S. Hershey Medical Center, 500 University Dr., Hershey, PA 17033-0850, USA
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Proton magnetic resonance spectroscopy in differentiating glioblastomas from primary cerebral lymphomas and brain metastases. J Comput Assist Tomogr 2011; 34:836-41. [PMID: 21084897 DOI: 10.1097/rct.0b013e3181ec554e] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To differentiate glioblastomas, primary cerebral lymphomas (PCLs), and brain metastases using multivoxel proton magnetic resonance (MR) spectroscopic imaging. METHODS A total of 56 patients with brain neoplasms underwent MR imaging and proton MR spectroscopic imaging. The data were analyzed from contrast-enhancing and peritumoral regions (PTR). N-acetylaspartate/creatine (Cr), choline (Cho)/Cr, glutamate+glutamine/Cr, myo-inositol/Cr, and lipids+lactate/Cr ratios were computed, and pairwise comparisons between neoplasms were made using Mann-Whitney U tests. RESULTS The PTR demonstrated most significant differences in metabolite ratios. The Cho/Cr ratio in glioblastomas (0.46 [0.01]) was significantly higher than that in metastases (0.38 [0.02], P = 0.01). Significantly elevated Cho/Cr levels were also noted in PCLs (0.48 [0.03]) compared with those in metastases (P = 0.04). In addition, PCLs also demonstrated significantly higher lipids+lactate/Cr levels (11.83 [2.59]) compared with glioblastomas (4.50 [0.59], P = 0.003) and metastases (2.79 [0.33], P = 0.001). CONCLUSIONS Proton MR spectroscopic imaging from PTR may assist in the differentiation of glioblastomas, metastases, and PCLs.
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Mathiisen TM, Lehre KP, Danbolt NC, Ottersen OP. The perivascular astroglial sheath provides a complete covering of the brain microvessels: an electron microscopic 3D reconstruction. Glia 2010; 58:1094-103. [PMID: 20468051 DOI: 10.1002/glia.20990] [Citation(s) in RCA: 606] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The unravelling of the polarized distribution of AQP4 in perivascular astrocytic endfeet has revitalized the interest in the role of astrocytes in controlling water and ion exchange at the brain-blood interface. The importance of the endfeet is based on the premise that they constitute a complete coverage of the vessel wall. Despite a number of studies based on different microscopic techniques this question has yet to be resolved. We have made an electron microscopic 3D reconstruction of perivascular endfeet in CA1 (stratum moleculare) of rat hippocampus. The endfeet interdigitate and overlap, leaving no slits between them. Only in a few sites do processes--tentatively classified as processes of microglia--extend through the perivascular glial sheath to establish direct contact with the endothelial basal lamina. In contrast to the endfoot covering of the endothelial tube, the endfoot covering of the pericyte is incomplete, allowing neuropil elements to touch the basal lamina that enwraps this type of cell. The 3D reconstruction also revealed large bundles of mitochondria in the endfoot processes that came in close apposition to the perivascular endfoot membrane. Our data support the idea that in pathophysiological conditions, the perivascular astrocytic covering may control the exchange of water and solutes between blood and brain and that free diffusion is limited to narrow clefts between overlapping endfeet.
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Affiliation(s)
- Thomas Misje Mathiisen
- Centre for Molecular Biology and Neuroscience, Department of Anatomy, Institute of Basic Medical Sciences, University of Oslo, N-0317 Oslo, Norway
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Diagnostic examination performance by using microvascular leakage, cerebral blood volume, and blood flow derived from 3-T dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging in the differentiation of glioblastoma multiforme and brain metastasis. Neuroradiology 2010; 53:319-30. [PMID: 20625709 DOI: 10.1007/s00234-010-0740-3] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Accepted: 06/23/2010] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Conventional magnetic resonance (MR) imaging has limited capacity to differentiate between glioblastoma multiforme (GBM) and metastasis. The purposes of this study were: (1) to compare microvascular leakage (MVL), cerebral blood volume (CBV), and blood flow (CBF) in the distinction of metastasis from GBM using dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging (DSC-MRI), and (2) to estimate the diagnostic accuracy of perfusion and permeability MR imaging. METHODS A prospective study of 61 patients (40 GBMs and 21 metastases) was performed at 3 T using DSC-MRI. Normalized rCBV and rCBF from tumoral (rCBVt, rCBFt), peri-enhancing region (rCBVe, rCBFe), and by dividing the value in the tumor by the value in the peri-enhancing region (rCBVt/e, rCBFt/e), as well as MVL were calculated. Hemodynamic and histopathologic variables were analyzed statistically and Spearman/Pearson correlations. Receiver operating characteristic curve analysis was performed for each of the variables. RESULTS The rCBVe, rCBFe, and MVL were significantly greater in GBMs compared with those of metastases. The optimal cutoff value for differentiating GBM from metastasis was 0.80 which implies a sensitivity of 95%, a specificity of 92%, a positive predictive value of 86%, and a negative predictive value of 97% for rCBVe ratio. We found a modest correlation between rCBVt and rCBFt ratios. CONCLUSION MVL measurements in GBMs are significantly higher than those in metastases. Statistically, both rCBVe, rCBVt/e and rCBFe, rCBFt/e were useful in differentiating between GBMs and metastases, supporting the hypothesis that perfusion MR imaging can detect infiltration of tumor cells in the peri-enhancing region.
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Mustafa D, van der Weiden M, Zheng P, Nigg A, Luider TM, Kros JM. Expression sites of colligin 2 in glioma blood vessels. Brain Pathol 2009; 20:50-65. [PMID: 19067716 PMCID: PMC2805918 DOI: 10.1111/j.1750-3639.2008.00248.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
In a previous study using state-of-the-art proteomic techniques, we identified colligin 2 (HSP47) as a glioma blood vessel-specific protein. In the present study we precisely localized the expression of colligin 2 in the blood vessels of diffusely infiltrating gliomas and relate the expression to the distinct cellular components of the vessels by using multiple immunolabeling and confocal microscopy. We grouped the glioma blood vessels into morphological categories ranging from normal looking capillaries to vessels with hypertrophic and sclerotic changes. The expression patterns of various markers of endothelial and pericytic differentiation were correlated with the position of the cells in the vessels and the expression of colligin 2. We found that colligin 2 is expressed in all categories of glioma blood vessels in cells with endothelial and pericytic lineage. Expression of colligin 2 was also found in cells scattered around blood vessels and in few glial fibrillary acidic protein-positive cells within the blood vessels. There is overlap in the expression of colligin 2 and the collagens type I and IV for which colligin 2 is a chaperon. We conclude that colligin 2 is expressed in all cellular components of glioma blood vessels and may serve as a general marker for active angiogenesis.
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Affiliation(s)
- Dana Mustafa
- Department of Pathology and Laboratory of Neuro-oncology and Clinical Proteomics, Erasmus Medical Center, Dr. Molewaterplein 50, 3015 GD Rotterdam, The Netherlands
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Nico B, Mangieri D, Tamma R, Longo V, Annese T, Crivellato E, Pollo B, Maderna E, Ribatti D, Salmaggi A. Aquaporin-4 contributes to the resolution of peritumoural brain oedema in human glioblastoma multiforme after combined chemotherapy and radiotherapy. Eur J Cancer 2009; 45:3315-25. [DOI: 10.1016/j.ejca.2009.09.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Revised: 09/14/2009] [Accepted: 09/17/2009] [Indexed: 10/20/2022]
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Winkler F, Kienast Y, Fuhrmann M, Von Baumgarten L, Burgold S, Mitteregger G, Kretzschmar H, Herms J. Imaging glioma cell invasion in vivo reveals mechanisms of dissemination and peritumoral angiogenesis. Glia 2009; 57:1306-15. [PMID: 19191326 DOI: 10.1002/glia.20850] [Citation(s) in RCA: 157] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Infiltration of cancer cells into normal tissue is a hallmark of malignant gliomas and compromises treatment options. A lack of appropriate models limits the study of this invasion in vivo, which makes it difficult to fully understand its anatomy and the role of dynamic interactions with structures of the normal brain. We developed a novel methodology by utilizing multiphoton laser scanning microscopy (MPLSM) to image the movement of glioma cells deep within the normal brain of live mice in real time. This allowed us to track the invasion of individual RFP-expressing GL261 cells in relation to perfused vasculature or GFP-labeled endothelial cells repetitively over days, up to a depth of 0.5 mm. Glioma cells moved faster and more efficiently when the abluminal site of a blood vessel was utilized for invasion. Cells that invaded perivascularly were frequently found next to (a) multiple capillary structures where microvessels run parallel to each other, (b) capillary loops or glomeruloid-like bodies, and (c) dilated capillaries. Dynamic MPLSM for more than 48 h revealed that single invasive glioma cells induced intussusceptive microvascular growth and capillary loop formation, specifically at the microvascular site with which they had contact. As the main tumor grew by cooption of existing brain vessels, these peritumoral vascular changes may create a beneficial environment for glioma growth. In conclusion, our study revealed new mechanisms of peritumoral angiogenesis and invasion in gliomas, providing an explanation for their interdependence.
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Affiliation(s)
- Frank Winkler
- Department of Neurology, Ludwig-Maximilians University, Munich, Germany.
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Gerstner ER, Duda DG, di Tomaso E, Ryg PA, Loeffler JS, Sorensen AG, Ivy P, Jain RK, Batchelor TT. VEGF inhibitors in the treatment of cerebral edema in patients with brain cancer. Nat Rev Clin Oncol 2009; 6:229-36. [PMID: 19333229 DOI: 10.1038/nrclinonc.2009.14] [Citation(s) in RCA: 147] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Most brain tumors oversecrete vascular endothelial growth factor (VEGF), which leads to an abnormally permeable tumor vasculature. This hyperpermeability allows fluid to leak from the intravascular space into the brain parenchyma, which causes vasogenic cerebral edema and increased interstitial fluid pressure. Increased interstitial fluid pressure has an important role in treatment resistance by contributing to tumor hypoxia and preventing adequate tumor penetration of chemotherapy agents. In addition, edema and the corticosteroids needed to control cerebral edema cause significant morbidity and mortality. Agents that block the VEGF pathway are able to decrease vascular permeability and, thus, cerebral edema, by restoring the abnormal tumor vasculature to a more normal state. Decreasing cerebral edema minimizes the adverse effects of corticosteroids and could improve clinical outcomes. Anti-VEGF agents might also be useful in other cancer-related conditions that increase vascular permeability, such as malignant pleural effusions or ascites.
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Affiliation(s)
- Elizabeth R Gerstner
- Department of Neurology, Massachusetts General Hospital Cancer Center, Boston, MA, USA
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Rolland Y, Demeule M, Fenart L, Béliveau R. Inhibition of melanoma brain metastasis by targeting melanotransferrin at the cell surface. Pigment Cell Melanoma Res 2009; 22:86-98. [DOI: 10.1111/j.1755-148x.2008.00525.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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