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Scheffler P, Fung C, Momjian S, Koessinger D, Häni L, Neidert N, Straehle J, Volz F, Schnell O, Beck J, El Rahal A. Dexamethasone in Patients with Glioblastoma: A Systematic Review and Meta-Analysis. Cancers (Basel) 2024; 16:1393. [PMID: 38611071 PMCID: PMC11011080 DOI: 10.3390/cancers16071393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/27/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
OBJECTIVE Glioblastomas are the most common primary central nervous system (CNS) tumors. Although modern management strategies have modestly improved overall survival, the prognosis remains dismal, with treatment side effects often impinging on the clinical course. Glioblastomas cause neurological dysfunction by infiltrating CNS tissue and via perifocal oedema formation. The administration of steroids such as dexamethasone is thought to alleviate symptoms by reducing oedema. However, despite its widespread use, the evidence for the administration of dexamethasone is limited and conflicting. Therefore, we aimed to review the current evidence concerning the use and outcomes of dexamethasone in patients with glioblastoma. METHODS We performed a systematic review and meta-analysis according to the PRISMA-P guidelines. We performed a restricted search using the keywords "Dexamethasone" and "Glioblastoma" on PubMed, Web of Science, Cochrane Library, and Academic Search Premier. We included studies reporting on overall survival (OS) and progression-free survival (PFS) in glioblastoma patients receiving higher or lower dexamethasone doses. The risk of bias was assessed using ROBINS-I. We performed a meta-analysis using a random effects model for OS and PFS. RESULTS Twenty-two retrospective studies were included. Higher doses of dexamethasone were associated with poorer OS (hazard ratio 1.62, confidence interval 1.40-1.88) and PFS (1.49, 1.23-1.81). OS remained worse even when studies corrected for clinical status (1.52, 1.38-1.67). CONCLUSION Despite the widespread use of dexamethasone in glioblastoma patients, its use is correlated with worse long-term outcomes. Consequently, Dexamethasone administration should be restricted to selected symptomatic patients. Future prospective studies are crucial to confirm these findings.
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Affiliation(s)
- Pierre Scheffler
- Department of Neurosurgery, Medical Center University of Freiburg, 79098 Freiburg, Germany; (P.S.)
| | - Christian Fung
- Department of Neurosurgery, Medical Center University of Freiburg, 79098 Freiburg, Germany; (P.S.)
| | - Shahan Momjian
- Department of Neurosurgery, Geneva University Hospital, Faculty of Medicine of Geneva, 1205 Geneva, Switzerland
| | - Dominik Koessinger
- Department of Neurosurgery, Medical Center University of Freiburg, 79098 Freiburg, Germany; (P.S.)
| | - Levin Häni
- Department of Neurosurgery, Medical Center University of Freiburg, 79098 Freiburg, Germany; (P.S.)
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Nicolas Neidert
- Department of Neurosurgery, Medical Center University of Freiburg, 79098 Freiburg, Germany; (P.S.)
- Berta-Ottenstein Programme, Faculty of Medicine, University of Freiburg, 79098 Freiburg, Germany
| | - Jakob Straehle
- Department of Neurosurgery, Medical Center University of Freiburg, 79098 Freiburg, Germany; (P.S.)
| | - Florian Volz
- Department of Neurosurgery, Medical Center University of Freiburg, 79098 Freiburg, Germany; (P.S.)
| | - Oliver Schnell
- Department of Neurosurgery, Medical Center University of Freiburg, 79098 Freiburg, Germany; (P.S.)
| | - Jürgen Beck
- Department of Neurosurgery, Medical Center University of Freiburg, 79098 Freiburg, Germany; (P.S.)
| | - Amir El Rahal
- Department of Neurosurgery, Medical Center University of Freiburg, 79098 Freiburg, Germany; (P.S.)
- Department of Neurosurgery, Geneva University Hospital, Faculty of Medicine of Geneva, 1205 Geneva, Switzerland
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Baran O, Akgun MY, Kayhan A, Evran S, Ozbek A, Akyoldas G, Samanci MY, Demirel N, Sonmez D, Serin H, Kocak A, Kemerdere R, Tanriverdi T. The association between calreticulin and glucagon-like peptide-1 expressions with prognostic factors in high-grade gliomas. J Cancer Res Ther 2024; 20:25-32. [PMID: 38554294 DOI: 10.4103/jcrt.jcrt_1519_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/26/2022] [Indexed: 04/01/2024]
Abstract
OBJECTIVE The aim of this study is to present the expressions of Calreticulin (CALR) and Glucagon-like peptide-1 (GLP-1) in high-grade gliomas and to further show the relation between the levels of these molecules and Ki-67 index, presence of Isocitrate dehydrogenase (IDH)-1 mutation, and tumor grade. PATIENTS AND METHODS A total of 43 patients who underwent surgical resection due to high-grade gliomas (HGG) (grades III and IV) were included. The control group comprised 27 people who showed no gross pathology in the brain during the autopsy procedures. Adequately sized tumor samples were removed from each patient during surgery, and cerebral tissues were removed from the control subjects during the autopsy procedures. Each sample was stored at -80°C as rapidly as possible until the enzyme assay. RESULTS Patients with high-grade gliomas showed significantly higher levels of CALR and significantly lower levels of GLP-1 when compared to control subjects (P = 0.001). CALR levels were significantly higher, GLP-1 levels were significantly lower in grade IV gliomas than those in grade III gliomas (P = 0.001). Gliomas with negative IDH-1 mutations had significantly higher CALR expressions and gliomas with positive IDH-1 mutations showed significantly higher GLP-1 expressions (P = 0.01). A positive correlation between Ki-67 and CALR and a negative correlation between Ki-67 and GLP-1 expressions were observed in grade IV gliomas (P = 0.001). CONCLUSIONS Our results showed that higher CALR and lower GLP-1 expressions are found in HGGs compared to normal cerebral tissues.
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Affiliation(s)
- Oguz Baran
- Department of Neurosurgery, Koç University Hospital, Istanbul, Turkey
| | | | - Ahmet Kayhan
- Department of Neurosurgery, Haseki Research and Training Hospital, Istanbul, Turkey
| | - Sevket Evran
- Department of Neurosurgery, Haseki Research and Training Hospital, Istanbul, Turkey
| | - Arif Ozbek
- Department of Neurosurgery, Medipol Mega University Hospital, Istanbul, Turkey
| | - Goktug Akyoldas
- Department of Neurosurgery, Koç University Hospital, Istanbul, Turkey
| | | | - Nail Demirel
- Department of Neurosurgery, Istanbul Research and Training Hospital, Istanbul, Turkey
| | - Derya Sonmez
- Clinical Biochemistry Laboratory, Istanbul Research and Training Hospital, Istanbul, Turkey
| | - Huriye Serin
- Clinical Biochemistry Laboratory, Istanbul Research and Training Hospital, Istanbul, Turkey
| | - Ayhan Kocak
- Department of Neurosurgery, Taksim Research and Training Hospital, Istanbul, Turkey
| | - Rahsan Kemerdere
- Department of Neurosurgery, Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Taner Tanriverdi
- Department of Neurosurgery, Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Chen A, Zhao W, Li X, Sun G, Ma Z, Peng L, Shi Z, Li X, Yan J. Comprehensive Oncogenic Features of Coronavirus Receptors in Glioblastoma Multiforme. Front Immunol 2022; 13:840785. [PMID: 35464443 PMCID: PMC9020264 DOI: 10.3389/fimmu.2022.840785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/09/2022] [Indexed: 11/28/2022] Open
Abstract
The COVID-19 pandemic caused by SARS-CoV-2 infection has placed health systems under excessive pressure and especially elderly people with cancer. Glioblastoma multiforme (GBM) is a malignant brain tumor with an increasing incidence in elderly individuals, and thereby GBM patients are a vulnerable population during the COVID-19 outbreak. Accumulating studies have implied that SARS-CoV-2 might invade the brain directly via coronavirus receptors. However, little is known about SARS-CoV-2 infection in the clinical development of GBM. Here, we explored the oncogenic roles of six coronavirus receptors (ACE2, DPP4, ANPEP, AXL, TMPRSS2, and ENPEP) in GBM using bioinformatics and experimental approaches. We found that ANPEP and ENPEP were significantly increased at both the mRNA and protein levels in GBM compared with normal brain tissue. Kaplan-Meier survival curves and Cox regression analysis demonstrated that high expressions of ANPEP and ENPEP are associated with poor prognosis and survival. Moreover, all receptors are positively correlated with the immune infiltration levels of monocyte. Furthermore, we identified 245 genes between COVID-19 and coronavirus receptors-correlated genes in GBM and performed a thorough analysis of their protein-protein interaction network, functional signaling pathway and molecular process. Our work explores for the first time the association of coronavirus receptors with GBM and suggests ANPEP and ENPEP as potential therapeutic targets of GBM irrespective of COVID-19.
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Affiliation(s)
- Anjing Chen
- Department of Neurosurgery, Qilu Hospital, School of Medicine, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
- Shandong Key Laboratory of Brain Function Remodeling and Jinan Microecological Biomedicine Shandong Labotatory, Jinan, China
| | - Wenguo Zhao
- Department of Neurosurgery, Qilu Hospital, School of Medicine, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
- Shandong Key Laboratory of Brain Function Remodeling and Jinan Microecological Biomedicine Shandong Labotatory, Jinan, China
| | - Xiaolong Li
- Ragon Institute of Massachusetts General Hospital (MGH), Massachusetts Institute of Technology (MIT) and Harvard, Cambridge, MA, United States
| | - Guangyu Sun
- Department of Diagnostics, Medical Integration and Practice Center, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zhaoyin Ma
- Department of Diagnostics, Medical Integration and Practice Center, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lingyu Peng
- Department of Diagnostics, Medical Integration and Practice Center, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zhongyang Shi
- Department of Diagnostics, Medical Integration and Practice Center, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xingang Li
- Department of Neurosurgery, Qilu Hospital, School of Medicine, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
- Shandong Key Laboratory of Brain Function Remodeling and Jinan Microecological Biomedicine Shandong Labotatory, Jinan, China
| | - Jie Yan
- Department of Diagnostics, Medical Integration and Practice Center, Cheeloo College of Medicine, Shandong University, Jinan, China
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Advantages and drawbacks of dexamethasone in glioblastoma multiforme. Crit Rev Oncol Hematol 2022; 172:103625. [PMID: 35158070 DOI: 10.1016/j.critrevonc.2022.103625] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 02/01/2022] [Accepted: 02/07/2022] [Indexed: 12/25/2022] Open
Abstract
The most widespread, malignant, and deadliest type of glial tumor is glioblastoma multiforme (GBM). Despite radiation, chemotherapy, and radical surgery, the median survival of afflicted individuals is about 12 months. Unfortunately, existing therapeutic interventions are abysmal. Dexamethasone (Dex), a synthetic glucocorticoid, has been used for many years to treat brain edema and inflammation caused by GBM. Several investigations have recently shown that Dex also exerts antitumoral effects against GBM. On the other hand, more recent disputed findings have questioned the long-held dogma of Dex treatment for GBM. Unfortunately, steroids are associated with various undesirable side effects, including severe immunosuppression and metabolic changes like hyperglycemia, which may impair the survival of GBM patients. Current ideas and concerns about Dex's effects on GBM cerebral edema, cell proliferation, migration, and its clinical outcomes were investigated in this study.
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Wang Z, Wang Y, Yang H, Guo J, Wang Z. Doxycycline Induces Apoptosis of Brucella Suis S2 Strain-Infected HMC3 Microglial Cells by Activating Calreticulin-Dependent JNK/p53 Signaling Pathway. Front Cell Infect Microbiol 2021; 11:640847. [PMID: 33996626 PMCID: PMC8113685 DOI: 10.3389/fcimb.2021.640847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 04/13/2021] [Indexed: 01/18/2023] Open
Abstract
Neurobrucellosis is a chronic complication of human brucellosis that is caused by the presence of Brucella spp in the central nervous system (CNS) and the inflammation play a key role on the pathogenesis. Doxycycline (Dox) is a widely used antibiotic that induces apoptosis of bacteria-infected cells. However, the mechanisms of Brucella inhibition of microglial apoptosis and Dox induction of apoptosis are still poorly understood. In this study, we found that Brucella suis S2 strain (B. suis S2) increased calreticulin (CALR) protein levels and inhbited HMC3 cell apoptosis. Hence, we constructed two HMC3 cell line variants, one with stable overexpression (HMC3-CALR) and one with low expression of CALR (HMC3-sh-CALR). CALR was found to decrease levels of p-JNK and p-p53 proteins, as well as suppress apoptosis in HMC3 cells. These findings suggest that CALR suppresses apoptosis by inhibiting the JNK/p53 signaling pathway. Next, we treated HMC3, HMC3-CALR and HMC3-sh-CALR cell lines with B. suis S2 or Dox. Our results demonstrate that B. suis S2 restrains the JNK/p53 signaling pathway to inhibit HMC3 cell apoptosis via increasing CALR protein expression, while Dox plays the opposite role. Finally, we treated B. suis S2-infected HMC3 cells with Dox. Our results confirm that Dox induces JNK/p53-dependent apoptosis in B. suis S2-infected HMC3 cells through inhibition of CALR protein expression. Taken together, these results reveal that CALR and the JNK/p53 signaling pathway may serve as novel therapeutic targets for treatment of neurobrucellosis.
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Affiliation(s)
- Zhao Wang
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Yanbai Wang
- Cerebrospinal Fluid Laboratory, The General Hospital of Ningxia Medical University, Yinchuan, China
| | - Huan Yang
- Emergency Department, The General Hospital of Ningxia Medical University, Yinchuan, China
| | - Jiayu Guo
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Zhenhai Wang
- Neurology Center, The General Hospital of Ningxia Medical University, Yinchuan, China.,Diagnosis and Treatment Engineering Technology Research Center of Nervous System Diseases of Ningxia Hui Autonomous Region, The General Hospital of Ningxia Medical University, Yinchuan, China
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