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Nieland L, van Solinge TS, Cheah PS, Morsett LM, El Khoury J, Rissman JI, Kleinstiver BP, Broekman ML, Breakefield XO, Abels ER. CRISPR-Cas knockout of miR21 reduces glioma growth. Mol Ther Oncolytics 2022; 25:121-136. [PMID: 35572197 PMCID: PMC9052041 DOI: 10.1016/j.omto.2022.04.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 04/04/2022] [Indexed: 12/21/2022] Open
Abstract
Non-coding RNAs, including microRNAs (miRNAs), support the progression of glioma. miR-21 is a small, non-coding transcript involved in regulating gene expression in multiple cellular pathways, including the regulation of proliferation. High expression of miR-21 has been shown to be a major driver of glioma growth. Manipulating the expression of miRNAs is a novel strategy in the development of therapeutics in cancer. In this study we aimed to target miR-21. Using CRISPR genome-editing technology, we disrupted the miR-21 coding sequences in glioma cells. Depletion of this miRNA resulted in the upregulation of many downstream miR-21 target mRNAs involved in proliferation. Phenotypically, CRISPR-edited glioma cells showed reduced migration, invasion, and proliferation in vitro. In immunocompetent mouse models, miR-21 knockout tumors showed reduced growth resulting in an increased overall survival. In summary, we show that by knocking out a key miRNA in glioma, these cells have decreased proliferation capacity both in vitro and in vivo. Overall, we identified miR-21 as a potential target for CRISPR-based therapeutics in glioma.
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Affiliation(s)
- Lisa Nieland
- Departments of Neurology and Radiology, Massachusetts General Hospital, Neuroscience Program, Harvard Medical School, Boston, MA 02129, USA
- Department of Neurosurgery, Leiden University Medical Center, 2300 RC Leiden, the Netherlands
| | - Thomas S. van Solinge
- Departments of Neurology and Radiology, Massachusetts General Hospital, Neuroscience Program, Harvard Medical School, Boston, MA 02129, USA
| | - Pike See Cheah
- Departments of Neurology and Radiology, Massachusetts General Hospital, Neuroscience Program, Harvard Medical School, Boston, MA 02129, USA
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang 43400, Malaysia
| | - Liza M. Morsett
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02129, USA
| | - Joseph El Khoury
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02129, USA
| | - Joseph I. Rissman
- Center for Genomic Medicine and Department of Pathology, Massachusetts General Hospital, Boston, MA 02115, USA
| | - Benjamin P. Kleinstiver
- Center for Genomic Medicine and Department of Pathology, Massachusetts General Hospital, Boston, MA 02115, USA
- Department of Pathology, Harvard Medical School, Boston, MA 02114, USA
| | - Marike L.D. Broekman
- Departments of Neurology and Radiology, Massachusetts General Hospital, Neuroscience Program, Harvard Medical School, Boston, MA 02129, USA
- Department of Neurosurgery, Leiden University Medical Center, 2300 RC Leiden, the Netherlands
- Department of Neurosurgery, Haaglanden Medical Center, 2512 VA The Hague, the Netherlands
| | - Xandra O. Breakefield
- Departments of Neurology and Radiology, Massachusetts General Hospital, Neuroscience Program, Harvard Medical School, Boston, MA 02129, USA
| | - Erik R. Abels
- Departments of Neurology and Radiology, Massachusetts General Hospital, Neuroscience Program, Harvard Medical School, Boston, MA 02129, USA
- Department of Cell and Chemical Biology, Leiden University Medical Center, 2300 RC Leiden, the Netherlands
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2
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Nieland L, Morsett LM, Broekman MLD, Breakefield XO, Abels ER. Extracellular Vesicle-Mediated Bilateral Communication between Glioblastoma and Astrocytes. Trends Neurosci 2020; 44:215-226. [PMID: 33234347 DOI: 10.1016/j.tins.2020.10.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/09/2020] [Accepted: 10/27/2020] [Indexed: 02/07/2023]
Abstract
Glioblastoma the most aggressive form of brain cancer, comprises a complex mixture of tumor cells and nonmalignant stromal cells, including neurons, astrocytes, microglia, infiltrating monocytes/macrophages, lymphocytes, and other cell types. All nonmalignant cells within and surrounding the tumor are affected by the presence of glioblastoma. Astrocytes use multiple modes of communication to interact with neighboring cells. Extracellular vesicle-directed intercellular communication has been found to be an important component of signaling between astrocytes and glioblastoma in tumor progression. In this review, we focus on recent findings on extracellular vesicle-mediated bilateral crosstalk, between glioblastoma cells and astrocytes, highlighting the protumor and antitumor roles of astrocytes in glioblastoma development.
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Affiliation(s)
- Lisa Nieland
- Departments of Neurology and Radiology, Massachusetts General Hospital, and NeuroDiscovery Center, Harvard Medical School, Boston, MA, 02129, USA
| | - Liza M Morsett
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02129, USA
| | - Marike L D Broekman
- Departments of Neurology and Radiology, Massachusetts General Hospital, and NeuroDiscovery Center, Harvard Medical School, Boston, MA, 02129, USA; Department of Neurosurgery, Leiden University Medical Center, 2300 RC, Leiden, The Netherlands; Department of Neurosurgery, Haaglanden Medical Center, 2512 VA, The Hague, The Netherlands
| | - Xandra O Breakefield
- Departments of Neurology and Radiology, Massachusetts General Hospital, and NeuroDiscovery Center, Harvard Medical School, Boston, MA, 02129, USA
| | - Erik R Abels
- Departments of Neurology and Radiology, Massachusetts General Hospital, and NeuroDiscovery Center, Harvard Medical School, Boston, MA, 02129, USA; Department of Neurosurgery, Leiden University Medical Center, 2300 RC, Leiden, The Netherlands.
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3
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van Solinge TS, Abels ER, van de Haar LL, Hanlon KS, Maas SLN, Schnoor R, de Vrij J, Breakefield XO, Broekman MLD. Versatile Role of Rab27a in Glioma: Effects on Release of Extracellular Vesicles, Cell Viability, and Tumor Progression. Front Mol Biosci 2020; 7:554649. [PMID: 33282910 PMCID: PMC7691322 DOI: 10.3389/fmolb.2020.554649] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 10/13/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction: Glioma cells exert influence over the tumor-microenvironment in part through the release of extracellular vesicles (EVs), membrane-enclosed structures containing proteins, lipids, and RNAs. In this study, we evaluated the function of Ras-associated protein 27a (Rab27a) in glioma and evaluated the feasibility of assessing its role in EV release in glioma cells in vitro and in vivo. Methods: Rab27a was knocked down via a short hairpin RNA (shRNA) stably expressed in mouse glioma cell line GL261, with a scrambled shRNA as control. EVs were isolated by ultracentrifugation and quantified with Nanoparticle Tracking Analysis (NTA) and Tunable Resistive Pulse Sensing (TRPS). CellTiter-Glo viability assays and cytokine arrays were used to evaluate the impact of Rab27a knockdown. GL261.shRab27a cells and GL261.shControl were implanted into the left striatum of eight mice to assess tumor growth and changes in the tumor microenvironment. Results: Knockdown of Rab27a in GL261 glioma cells decreased the release of small EVs isolated at 100,000 × g in vitro (p = 0.005), but not the release of larger EVs, isolated at 10,000 × g. GL261.shRab27a cells were less viable compared to the scramble control in vitro (p < 0.005). A significant increase in CCL2 expression in shRab27a GL261 cells was also observed (p < 0.001). However, in vivo there was no difference in tumor growth or overall survival between the two groups, while shRab27a tumors showed lower proliferation at the tumor borders. Decreased infiltration of IBA1 positive macrophages and microglia, but not FoxP3 positive regulatory T cells was observed. Conclusion: Rab27a plays an important role in the release of small EVs from glioma cells, and also in their viability and expression of CCL2 in vitro. As interference in Rab27a expression influences glioma cell viability and expression profiles, future studies should be cautious in using the knockdown of Rab27a as a means of studying the role of small EVs in glioma growth.
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Affiliation(s)
- Thomas S van Solinge
- Department of Neurology and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,NeuroDiscovery Center, Harvard Medical School, Boston, MA, United States.,Department of Neurosurgery, Leiden University Medical Center, Leiden, Netherlands
| | - Erik R Abels
- Department of Neurology and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,NeuroDiscovery Center, Harvard Medical School, Boston, MA, United States
| | - Lieke L van de Haar
- Department of Neurology and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,NeuroDiscovery Center, Harvard Medical School, Boston, MA, United States
| | - Killian S Hanlon
- Department of Neurobiology, Harvard Medical School, Boston, MA, United States.,Molecular Neurogenetics Unit, Department of Neurology, Massachusetts General Hospital, Charlestown, MA, United States
| | - Sybren L N Maas
- Department of Neurosurgery, UMC Utrecht Brain Center, Utrecht University, Utrecht, Netherlands.,Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Rosalie Schnoor
- Department of Neurosurgery, UMC Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
| | - Jeroen de Vrij
- Department of Neurosurgery, Brain Tumor Center, Erasmus Medical Center, Rotterdam, Netherlands
| | - Xandra O Breakefield
- Department of Neurology and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,NeuroDiscovery Center, Harvard Medical School, Boston, MA, United States
| | - Marike L D Broekman
- Department of Neurology and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.,NeuroDiscovery Center, Harvard Medical School, Boston, MA, United States.,Department of Neurosurgery, Leiden University Medical Center, Leiden, Netherlands.,Department of Neurosurgery, Haaglanden Medical Center, The Hague, Netherlands
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4
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Abels ER, Maas SLN, Nieland L, Wei Z, Cheah PS, Tai E, Kolsteeg CJ, Dusoswa SA, Ting DT, Hickman S, El Khoury J, Krichevsky AM, Broekman MLD, Breakefield XO. Glioblastoma-Associated Microglia Reprogramming Is Mediated by Functional Transfer of Extracellular miR-21. Cell Rep 2020; 28:3105-3119.e7. [PMID: 31533034 PMCID: PMC6817978 DOI: 10.1016/j.celrep.2019.08.036] [Citation(s) in RCA: 130] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/09/2019] [Accepted: 08/09/2019] [Indexed: 12/21/2022] Open
Abstract
Gliomas are primary, diffusely infiltrating brain tumors. Microglia are innate immune cells in the CNS and make up a substantial portion of the tumor mass. Glioma cells shape their microenvironment, communicating with and reprogramming surrounding cells, resulting in enhanced angiogenesis, immune suppression, and remodeling of the extracellular matrix. Glioma cells communicate with microglia, in part by releasing extracellular vesicles (EVs). Mouse glioma cells stably expressing a palmitoylated GFP to label EVs were implanted intracranially into syngeneic miR-21-null mice. Here, we demonstrate functional delivery of miR-21, regulating specific downstream mRNA targets in microglia after uptake of tumor-derived EVs. These findings attest to EV-dependent microRNA delivery as studied in an in vivo-based model and provide insight into the reprograming of microglial cells by tumor cells to create a favorable microenvironment for cancer progression.
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Affiliation(s)
- Erik R Abels
- Departments of Neurology and Radiology, Massachusetts General Hospital, and NeuroDiscovery Center, Harvard Medical School, Boston, MA 02129, USA.
| | - Sybren L N Maas
- Department of Neurosurgery, UMC Utrecht Brain Center, University Medical Center, Utrecht University, 3584 CX Utrecht, the Netherlands
| | - Lisa Nieland
- Departments of Neurology and Radiology, Massachusetts General Hospital, and NeuroDiscovery Center, Harvard Medical School, Boston, MA 02129, USA
| | - Zhiyun Wei
- Department of Neurology, Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Pike See Cheah
- Departments of Neurology and Radiology, Massachusetts General Hospital, and NeuroDiscovery Center, Harvard Medical School, Boston, MA 02129, USA; Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia
| | - Eric Tai
- Cancer Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Christy-Joy Kolsteeg
- Departments of Neurology and Radiology, Massachusetts General Hospital, and NeuroDiscovery Center, Harvard Medical School, Boston, MA 02129, USA
| | - Sophie A Dusoswa
- Department of Molecular Cell Biology and Immunology, Amsterdam Infection & Immunology Institute and Cancer Center Amsterdam, Amsterdam UMC, 1081 HZ Amsterdam, the Netherlands
| | - David T Ting
- Cancer Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Suzanne Hickman
- Center for Immunology & Inflammatory Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02129, USA
| | - Joseph El Khoury
- Center for Immunology & Inflammatory Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02129, USA
| | - Anna M Krichevsky
- Department of Neurology, Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Marike L D Broekman
- Department of Neurosurgery, Leiden University Medical Center, 2300 RC Leiden, the Netherlands; Department of Neurosurgery, Haaglanden Medical Center, 2512 VA The Hague, the Netherlands
| | - Xandra O Breakefield
- Departments of Neurology and Radiology, Massachusetts General Hospital, and NeuroDiscovery Center, Harvard Medical School, Boston, MA 02129, USA.
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5
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Maas SLN, Abels ER, Van De Haar LL, Zhang X, Morsett L, Sil S, Guedes J, Sen P, Prabhakar S, Hickman SE, Lai CP, Ting DT, Breakefield XO, Broekman MLD, El Khoury J. Glioblastoma hijacks microglial gene expression to support tumor growth. J Neuroinflammation 2020; 17:120. [PMID: 32299465 PMCID: PMC7164149 DOI: 10.1186/s12974-020-01797-2] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 03/31/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Glioblastomas are the most common and lethal primary brain tumors. Microglia, the resident immune cells of the brain, survey their environment and respond to pathogens, toxins, and tumors. Glioblastoma cells communicate with microglia, in part by releasing extracellular vesicles (EVs). Despite the presence of large numbers of microglia in glioblastoma, the tumors continue to grow, and these neuroimmune cells appear incapable of keeping the tumor in check. To understand this process, we analyzed gene expression in microglia interacting with glioblastoma cells. METHODS We used RNASeq of isolated microglia to analyze the expression patterns of genes involved in key microglial functions in mice with glioblastoma. We focused on microglia that had taken up tumor-derived EVs and therefore were within and immediately adjacent to the tumor. RESULTS We show that these microglia have downregulated expression of genes involved in sensing tumor cells and tumor-derived danger signals, as well as genes used for tumor killing. In contrast, expression of genes involved in facilitating tumor spread was upregulated. These changes appear to be in part EV-mediated, since intracranial injection of EVs in normal mice led to similar transcriptional changes in microglia. We observed a similar microglial transcriptomic signature when we analyzed datasets from human patients with glioblastoma. CONCLUSION Our data define a microgliaGlioblastoma specific phenotype, whereby glioblastomas have hijacked gene expression in the neuroimmune system to favor avoiding tumor sensing, suppressing the immune response, clearing a path for invasion, and enhancing tumor propagation. For further exploration, we developed an interactive online tool at http://www.glioma-microglia.com with all expression data and additional functional and pathway information for each gene.
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Affiliation(s)
- Sybren L N Maas
- Departments of Neurology and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA.,Department of Neurosurgery, UMC Utrecht Brain Center, University Medical Center, Utrecht University, 3584 CX, Utrecht, The Netherlands
| | - Erik R Abels
- Departments of Neurology and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA
| | - Lieke L Van De Haar
- Departments of Neurology and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA
| | - Xuan Zhang
- Departments of Neurology and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA
| | - Liza Morsett
- Center for Immunology & Inflammatory Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA
| | - Srinjoy Sil
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA
| | - Joana Guedes
- Center for Immunology & Inflammatory Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA.,Center for Neuroscience and Cell Biology, University of Coimbra, 3004-517, Coimbra, Portugal
| | - Pritha Sen
- Center for Immunology & Inflammatory Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA
| | - Shilpa Prabhakar
- Departments of Neurology and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA
| | - Suzanne E Hickman
- Center for Immunology & Inflammatory Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA.,Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA
| | - Charles P Lai
- Departments of Neurology and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA.,Institute of Atomic and Molecular Sciences/Academia Sinica, 10617, Taipei, Taiwan
| | - David T Ting
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA
| | - Xandra O Breakefield
- Departments of Neurology and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA
| | - Marike L D Broekman
- Departments of Neurology and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA.,Department of Neurosurgery, Leiden University Medical Center, 2300 RC, Leiden, The Netherlands.,Department of Neurosurgery, Haaglanden Medical Center, 2512 VA, The Hague, The Netherlands
| | - Joseph El Khoury
- Center for Immunology & Inflammatory Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA. .,Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA.
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6
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Sen P, Wilkie AR, Ji F, Yang Y, Taylor IJ, Velazquez-Palafox M, Vanni EAH, Pesola JM, Fernandez R, Chen H, Morsett LM, Abels ER, Piper M, Lane RJ, Hickman SE, Means TK, Rosenberg ES, Sadreyev RI, Li B, Coen DM, Fishman JA, El Khoury J. Linking indirect effects of cytomegalovirus in transplantation to modulation of monocyte innate immune function. Sci Adv 2020; 6:eaax9856. [PMID: 32494628 PMCID: PMC7176434 DOI: 10.1126/sciadv.aax9856] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 01/30/2020] [Indexed: 05/08/2023]
Abstract
Cytomegalovirus (CMV) is an important cause of morbidity and mortality in the immunocompromised host. In transplant recipients, a variety of clinically important "indirect effects" are attributed to immune modulation by CMV, including increased mortality from fungal disease, allograft dysfunction and rejection in solid organ transplantation, and graft-versus-host-disease in stem cell transplantation. Monocytes, key cellular targets of CMV, are permissive to primary, latent and reactivated CMV infection. Here, pairing unbiased bulk and single cell transcriptomics with functional analyses we demonstrate that human monocytes infected with CMV do not effectively phagocytose fungal pathogens, a functional deficit which occurs with decreased expression of fungal recognition receptors. Simultaneously, CMV-infected monocytes upregulate antiviral, pro-inflammatory chemokine, and inflammasome responses associated with allograft rejection and graft-versus-host disease. Our study demonstrates that CMV modulates both immunosuppressive and immunostimulatory monocyte phenotypes, explaining in part, its paradoxical "indirect effects" in transplantation. These data could provide innate immune targets for the stratification and treatment of CMV disease.
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Affiliation(s)
- Pritha Sen
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Transplant Infectious Disease and Compromised Host Program, Division of Infectious Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Adrian R. Wilkie
- Department of Biological Chemistry and Molecular Pharmacology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Fei Ji
- Department of Molecular Biology and Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Yiming Yang
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | | | | | - Emilia A. H. Vanni
- Department of Biological Chemistry and Molecular Pharmacology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Jean M. Pesola
- Department of Biological Chemistry and Molecular Pharmacology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Rosio Fernandez
- Department of Biological Chemistry and Molecular Pharmacology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Han Chen
- Department of Biological Chemistry and Molecular Pharmacology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Liza M. Morsett
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Erik R. Abels
- Department of Neurology and Center for Molecular Imaging Research, Department of Radiology, Massachusetts General Hospital and Program in Neuroscience, Harvard Medical School, Boston, MA, USA
| | - Mary Piper
- Harvard Bioinformatics Core, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Rebekah J. Lane
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Transplant Infectious Disease and Compromised Host Program, Division of Infectious Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Suzanne E. Hickman
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Terry K. Means
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Autoimmunity Cluster, Immunology and Inflammation Research Therapeutic Area, Sanofi, Cambridge, MA, USA
| | - Eric S. Rosenberg
- Transplant Infectious Disease and Compromised Host Program, Division of Infectious Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Ruslan I. Sadreyev
- Department of Molecular Biology and Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Bo Li
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Donald M. Coen
- Department of Biological Chemistry and Molecular Pharmacology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Jay A. Fishman
- Transplant Infectious Disease and Compromised Host Program, Division of Infectious Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Joseph El Khoury
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Transplant Infectious Disease and Compromised Host Program, Division of Infectious Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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7
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Broekman ML, Maas SLN, Abels ER, Mempel TR, Krichevsky AM, Breakefield XO. Multidimensional communication in the microenvirons of glioblastoma. Nat Rev Neurol 2019; 14:482-495. [PMID: 29985475 DOI: 10.1038/s41582-018-0025-8] [Citation(s) in RCA: 329] [Impact Index Per Article: 65.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Glioblastomas are heterogeneous and invariably lethal tumours. They are characterized by genetic and epigenetic variations among tumour cells, which makes the development of therapies that eradicate all tumour cells challenging and currently impossible. An important component of glioblastoma growth is communication with and manipulation of other cells in the brain environs, which supports tumour progression and resistance to therapy. Glioblastoma cells recruit innate immune cells and change their phenotype to support tumour growth. Tumour cells also suppress adaptive immune responses, and our increasing understanding of how T cells access the brain and how the tumour thwarts the immune response offers new strategies for mobilizing an antitumour response. Tumours also subvert normal brain cells - including endothelial cells, neurons and astrocytes - to create a microenviron that favours tumour success. Overall, after glioblastoma-induced phenotypic modifications, normal cells cooperate with tumour cells to promote tumour proliferation, invasion of the brain, immune suppression and angiogenesis. This glioblastoma takeover of the brain involves multiple modes of communication, including soluble factors such as chemokines and cytokines, direct cell-cell contact, extracellular vesicles (including exosomes and microvesicles) and connecting nanotubes and microtubes. Understanding these multidimensional communications between the tumour and the cells in its environs could open new avenues for therapy.
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Affiliation(s)
- Marike L Broekman
- Department of Neurology and Center for Molecular Imaging Research, Department of Radiology, Massachusetts General Hospital and Program in Neuroscience, Harvard Medical School, Boston, MA, USA. .,Department of Neurosurgery, Brain Center Rudolf Magnus, Institute of Neurosciences, University Medical Center, Heidelberglaan, Utrecht, Netherlands.
| | - Sybren L N Maas
- Department of Neurology and Center for Molecular Imaging Research, Department of Radiology, Massachusetts General Hospital and Program in Neuroscience, Harvard Medical School, Boston, MA, USA.,Department of Neurosurgery, Brain Center Rudolf Magnus, Institute of Neurosciences, University Medical Center, Heidelberglaan, Utrecht, Netherlands
| | - Erik R Abels
- Department of Neurology and Center for Molecular Imaging Research, Department of Radiology, Massachusetts General Hospital and Program in Neuroscience, Harvard Medical School, Boston, MA, USA
| | - Thorsten R Mempel
- The Center for Immunology and Inflammatory Diseases and Department of Medicine, Massachusetts General Hospital, Charlestown, MA, USA.,Program in Immunology, Harvard Medical School, Boston, MA, USA
| | - Anna M Krichevsky
- Department of Neurology, Ann Romney Center for Neurologic Diseases, Initiative for RNA Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Xandra O Breakefield
- Department of Neurology and Center for Molecular Imaging Research, Department of Radiology, Massachusetts General Hospital and Program in Neuroscience, Harvard Medical School, Boston, MA, USA.
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8
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Alieva M, Margarido AS, Wieles T, Abels ER, Colak B, Boquetale C, Jan Noordmans H, Snijders TJ, Broekman ML, van Rheenen J. Preventing inflammation inhibits biopsy-mediated changes in tumor cell behavior. Sci Rep 2017; 7:7529. [PMID: 28790339 PMCID: PMC5548904 DOI: 10.1038/s41598-017-07660-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 07/06/2017] [Indexed: 02/03/2023] Open
Abstract
Although biopsies and tumor resection are prognostically beneficial for glioblastomas (GBM), potential negative effects have also been suggested. Here, using retrospective study of patients and intravital imaging of mice, we identify some of these negative aspects, including stimulation of proliferation and migration of non-resected tumor cells, and provide a strategy to prevent these adverse effects. By repeated high-resolution intravital microscopy, we show that biopsy-like injury in GBM induces migration and proliferation of tumor cells through chemokine (C-C motif) ligand 2 (CCL-2)-dependent recruitment of macrophages. Blocking macrophage recruitment or administrating dexamethasone, a commonly used glucocorticoid to prevent brain edema in GBM patients, suppressed the observed inflammatory response and subsequent tumor growth upon biopsy both in mice and in multifocal GBM patients. Taken together, our study suggests that inhibiting CCL-2-dependent recruitment of macrophages may further increase the clinical benefits from surgical and biopsy procedures.
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Affiliation(s)
- Maria Alieva
- Cancer Genomics Netherlands, Hubrecht Institute-KNAW & University Medical Center Utrecht, Uppsalalaan 8, 3584CT, Utrecht, The Netherlands
| | - Andreia S Margarido
- Cancer Genomics Netherlands, Hubrecht Institute-KNAW & University Medical Center Utrecht, Uppsalalaan 8, 3584CT, Utrecht, The Netherlands
| | - Tamara Wieles
- Cancer Genomics Netherlands, Hubrecht Institute-KNAW & University Medical Center Utrecht, Uppsalalaan 8, 3584CT, Utrecht, The Netherlands
| | - Erik R Abels
- Departments of Neurology, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Boston, MA, 02129, USA
| | - Burcin Colak
- Cancer Genomics Netherlands, Hubrecht Institute-KNAW & University Medical Center Utrecht, Uppsalalaan 8, 3584CT, Utrecht, The Netherlands
| | - Carla Boquetale
- Cancer Genomics Netherlands, Hubrecht Institute-KNAW & University Medical Center Utrecht, Uppsalalaan 8, 3584CT, Utrecht, The Netherlands
| | - Herke Jan Noordmans
- Medical Technology and Clinical Physics, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Tom J Snijders
- Department of Neurology & Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Marike L Broekman
- Departments of Neurology, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Boston, MA, 02129, USA.,Department of Neurology & Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Jacco van Rheenen
- Cancer Genomics Netherlands, Hubrecht Institute-KNAW & University Medical Center Utrecht, Uppsalalaan 8, 3584CT, Utrecht, The Netherlands.
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9
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Abels ER, Breakefield XO. Introduction to Extracellular Vesicles: Biogenesis, RNA Cargo Selection, Content, Release, and Uptake. Cell Mol Neurobiol 2016; 36:301-12. [PMID: 27053351 DOI: 10.1007/s10571-016-0366-z] [Citation(s) in RCA: 1018] [Impact Index Per Article: 127.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 03/21/2016] [Indexed: 12/13/2022]
Abstract
Extracellular vesicles are a heterogeneous group of membrane-limited vesicles loaded with various proteins, lipids, and nucleic acids. Release of extracellular vesicles from its cell of origin occurs either through the outward budding of the plasma membrane or through the inward budding of the endosomal membrane, resulting in the formation of multivesicular bodies, which release vesicles upon fusion with the plasma membrane. The release of vesicles can facilitate intercellular communication by contact with or by internalization of contents, either by fusion with the plasma membrane or by endocytosis into "recipient" cells. Although the interest in extracellular vesicle research is increasing, there are still no real standards in place to separate or classify the different types of vesicles. This review provides an introduction into this expanding and complex field of research focusing on the biogenesis, nucleic acid cargo loading, content, release, and uptake of extracellular vesicles.
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Affiliation(s)
- Erik R Abels
- Departments of Neurology and Radiology, Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, MA, 02114, USA. .,Department of Neurosurgery, Neuro-Oncology Research Group, VU University Medical Center, 1007MB, Amsterdam, The Netherlands.
| | - Xandra O Breakefield
- Departments of Neurology and Radiology, Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, MA, 02114, USA
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10
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Zhang X, Abels ER, Redzic JS, Margulis J, Finkbeiner S, Breakefield XO. Potential Transfer of Polyglutamine and CAG-Repeat RNA in Extracellular Vesicles in Huntington's Disease: Background and Evaluation in Cell Culture. Cell Mol Neurobiol 2016; 36:459-70. [PMID: 26951563 DOI: 10.1007/s10571-016-0350-7] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 02/13/2016] [Indexed: 12/31/2022]
Abstract
In Huntington's disease (HD) the imperfect expanded CAG repeat in the first exon of the HTT gene leads to the generation of a polyglutamine (polyQ) protein, which has some neuronal toxicity, potentially mollified by formation of aggregates. Accumulated research, reviewed here, implicates both the polyQ protein and the expanded repeat RNA in causing toxicity leading to neurodegeneration in HD. Different theories have emerged as to how the neurodegeneration spreads throughout the brain, with one possibility being the transport of toxic protein and RNA in extracellular vesicles (EVs). Most cell types in the brain release EVs and these have been shown to contain neurodegenerative proteins in the case of prion protein and amyloid-beta peptide. In this study, we used a model culture system with an overexpression of HTT-exon 1 polyQ-GFP constructs in human 293T cells and found that the EVs did incorporate both the polyQ-GFP protein and expanded repeat RNA. Striatal mouse neural cells were able to take up these EVs with a consequent increase in the green fluorescent protein (GFP) and polyQ-GFP RNAs, but with no evidence of uptake of polyQ-GFP protein or any apparent toxicity, at least over a relatively short period of exposure. A differentiated striatal cell line expressing endogenous levels of Hdh mRNA containing the expanded repeat incorporated more of this mRNA into EVs as compared to similar cells expressing this mRNA with a normal repeat length. These findings support the potential of EVs to deliver toxic expanded trinucleotide repeat RNAs from one cell to another, but further work will be needed to evaluate potential EV and cell-type specificity of transfer and effects of long-term exposure. It seems likely that expanded HD-associated repeat RNA may appear in biofluids and may have use as biomarkers of disease state and response to therapy.
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Affiliation(s)
- Xuan Zhang
- Molecular Neurogenetics Unit, Department of Neurology, Massachusetts General Hospital-East, 13th Street, Building 149, Charlestown, MA, 02129, USA.,Center for Molecular Imaging Research, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Center for NeuroDiscovery, Harvard Medical School, Boston, MA, USA
| | - Erik R Abels
- Molecular Neurogenetics Unit, Department of Neurology, Massachusetts General Hospital-East, 13th Street, Building 149, Charlestown, MA, 02129, USA.,Center for Molecular Imaging Research, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Center for NeuroDiscovery, Harvard Medical School, Boston, MA, USA
| | - Jasmina S Redzic
- Department of Pharmaceutical Sciences, University of Colorado Denver Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA
| | - Julia Margulis
- Gladstone Institute of Neurological Disease and the Departments of Neurology and Physiology, University of California San Francisco, San Francisco, CA, USA
| | - Steve Finkbeiner
- Gladstone Institute of Neurological Disease and the Departments of Neurology and Physiology, University of California San Francisco, San Francisco, CA, USA
| | - Xandra O Breakefield
- Molecular Neurogenetics Unit, Department of Neurology, Massachusetts General Hospital-East, 13th Street, Building 149, Charlestown, MA, 02129, USA. .,Center for Molecular Imaging Research, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA. .,Center for NeuroDiscovery, Harvard Medical School, Boston, MA, USA.
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11
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van der Vos KE, Abels ER, Zhang X, Lai C, Carrizosa E, Oakley D, Prabhakar S, Mardini O, Crommentuijn MHW, Skog J, Krichevsky AM, Stemmer-Rachamimov A, Mempel TR, El Khoury J, Hickman SE, Breakefield XO. Directly visualized glioblastoma-derived extracellular vesicles transfer RNA to microglia/macrophages in the brain. Neuro Oncol 2015; 18:58-69. [PMID: 26433199 DOI: 10.1093/neuonc/nov244] [Citation(s) in RCA: 219] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 09/01/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND To understand the ability of gliomas to manipulate their microenvironment, we visualized the transfer of vesicles and the effects of tumor-released extracellular RNA on the phenotype of microglia in culture and in vivo. METHODS Extracellular vesicles (EVs) released from primary human glioblastoma (GBM) cells were isolated and microRNAs (miRNAs) were analyzed. Primary mouse microglia were exposed to GBM-EVs, and their uptake and effect on proliferation and levels of specific miRNAs, mRNAs, and proteins were analyzed. For in vivo analysis, mouse glioma cells were implanted in the brains of mice, and EV release and uptake by microglia and monocytes/macrophages were monitored by intravital 2-photon microscopy, immunohistochemistry, and fluorescence activated cell sorting analysis, as well as RNA and protein levels. RESULTS Microglia avidly took up GBM-EVs, leading to increased proliferation and shifting of their cytokine profile toward immune suppression. High levels of miR-451/miR-21 in GBM-EVs were transferred to microglia with a decrease in the miR-451/miR-21 target c-Myc mRNA. In in vivo analysis, we directly visualized release of EVs from glioma cells and their uptake by microglia and monocytes/macrophages in brain. Dissociated microglia and monocytes/macrophages from tumor-bearing brains revealed increased levels of miR-21 and reduced levels of c-Myc mRNA. CONCLUSIONS Intravital microscopy confirms the release of EVs from gliomas and their uptake into microglia and monocytes/macrophages within the brain. Our studies also support functional effects of GBM-released EVs following uptake into microglia, associated in part with increased miRNA levels, decreased target mRNAs, and encoded proteins, presumably as a means for the tumor to manipulate its environs.
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Affiliation(s)
- Kristan E van der Vos
- Departments of Neurology and Radiology, Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, Massachusetts (K.E.v.d.V., E.R.A., X.Z., C.L., S.P., O.M., M.H.W.C., J.S., X.O.B.); Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, Massachusetts (E.C., T.R.M., J.E.K., S.E.H.); Neuropathology Service, Massachusetts General Hospital and Department of Pathology, Harvard Medical School, Boston, Massachusetts (D.O., A.S-R.); Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (A.M.K.); Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands (K.E.v.d.V.)
| | - Erik R Abels
- Departments of Neurology and Radiology, Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, Massachusetts (K.E.v.d.V., E.R.A., X.Z., C.L., S.P., O.M., M.H.W.C., J.S., X.O.B.); Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, Massachusetts (E.C., T.R.M., J.E.K., S.E.H.); Neuropathology Service, Massachusetts General Hospital and Department of Pathology, Harvard Medical School, Boston, Massachusetts (D.O., A.S-R.); Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (A.M.K.); Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands (K.E.v.d.V.)
| | - Xuan Zhang
- Departments of Neurology and Radiology, Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, Massachusetts (K.E.v.d.V., E.R.A., X.Z., C.L., S.P., O.M., M.H.W.C., J.S., X.O.B.); Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, Massachusetts (E.C., T.R.M., J.E.K., S.E.H.); Neuropathology Service, Massachusetts General Hospital and Department of Pathology, Harvard Medical School, Boston, Massachusetts (D.O., A.S-R.); Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (A.M.K.); Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands (K.E.v.d.V.)
| | - Charles Lai
- Departments of Neurology and Radiology, Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, Massachusetts (K.E.v.d.V., E.R.A., X.Z., C.L., S.P., O.M., M.H.W.C., J.S., X.O.B.); Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, Massachusetts (E.C., T.R.M., J.E.K., S.E.H.); Neuropathology Service, Massachusetts General Hospital and Department of Pathology, Harvard Medical School, Boston, Massachusetts (D.O., A.S-R.); Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (A.M.K.); Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands (K.E.v.d.V.)
| | - Esteban Carrizosa
- Departments of Neurology and Radiology, Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, Massachusetts (K.E.v.d.V., E.R.A., X.Z., C.L., S.P., O.M., M.H.W.C., J.S., X.O.B.); Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, Massachusetts (E.C., T.R.M., J.E.K., S.E.H.); Neuropathology Service, Massachusetts General Hospital and Department of Pathology, Harvard Medical School, Boston, Massachusetts (D.O., A.S-R.); Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (A.M.K.); Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands (K.E.v.d.V.)
| | - Derek Oakley
- Departments of Neurology and Radiology, Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, Massachusetts (K.E.v.d.V., E.R.A., X.Z., C.L., S.P., O.M., M.H.W.C., J.S., X.O.B.); Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, Massachusetts (E.C., T.R.M., J.E.K., S.E.H.); Neuropathology Service, Massachusetts General Hospital and Department of Pathology, Harvard Medical School, Boston, Massachusetts (D.O., A.S-R.); Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (A.M.K.); Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands (K.E.v.d.V.)
| | - Shilpa Prabhakar
- Departments of Neurology and Radiology, Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, Massachusetts (K.E.v.d.V., E.R.A., X.Z., C.L., S.P., O.M., M.H.W.C., J.S., X.O.B.); Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, Massachusetts (E.C., T.R.M., J.E.K., S.E.H.); Neuropathology Service, Massachusetts General Hospital and Department of Pathology, Harvard Medical School, Boston, Massachusetts (D.O., A.S-R.); Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (A.M.K.); Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands (K.E.v.d.V.)
| | - Osama Mardini
- Departments of Neurology and Radiology, Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, Massachusetts (K.E.v.d.V., E.R.A., X.Z., C.L., S.P., O.M., M.H.W.C., J.S., X.O.B.); Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, Massachusetts (E.C., T.R.M., J.E.K., S.E.H.); Neuropathology Service, Massachusetts General Hospital and Department of Pathology, Harvard Medical School, Boston, Massachusetts (D.O., A.S-R.); Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (A.M.K.); Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands (K.E.v.d.V.)
| | - Matheus H W Crommentuijn
- Departments of Neurology and Radiology, Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, Massachusetts (K.E.v.d.V., E.R.A., X.Z., C.L., S.P., O.M., M.H.W.C., J.S., X.O.B.); Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, Massachusetts (E.C., T.R.M., J.E.K., S.E.H.); Neuropathology Service, Massachusetts General Hospital and Department of Pathology, Harvard Medical School, Boston, Massachusetts (D.O., A.S-R.); Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (A.M.K.); Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands (K.E.v.d.V.)
| | - Johan Skog
- Departments of Neurology and Radiology, Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, Massachusetts (K.E.v.d.V., E.R.A., X.Z., C.L., S.P., O.M., M.H.W.C., J.S., X.O.B.); Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, Massachusetts (E.C., T.R.M., J.E.K., S.E.H.); Neuropathology Service, Massachusetts General Hospital and Department of Pathology, Harvard Medical School, Boston, Massachusetts (D.O., A.S-R.); Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (A.M.K.); Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands (K.E.v.d.V.)
| | - Anna M Krichevsky
- Departments of Neurology and Radiology, Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, Massachusetts (K.E.v.d.V., E.R.A., X.Z., C.L., S.P., O.M., M.H.W.C., J.S., X.O.B.); Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, Massachusetts (E.C., T.R.M., J.E.K., S.E.H.); Neuropathology Service, Massachusetts General Hospital and Department of Pathology, Harvard Medical School, Boston, Massachusetts (D.O., A.S-R.); Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (A.M.K.); Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands (K.E.v.d.V.)
| | - Anat Stemmer-Rachamimov
- Departments of Neurology and Radiology, Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, Massachusetts (K.E.v.d.V., E.R.A., X.Z., C.L., S.P., O.M., M.H.W.C., J.S., X.O.B.); Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, Massachusetts (E.C., T.R.M., J.E.K., S.E.H.); Neuropathology Service, Massachusetts General Hospital and Department of Pathology, Harvard Medical School, Boston, Massachusetts (D.O., A.S-R.); Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (A.M.K.); Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands (K.E.v.d.V.)
| | - Thorsten R Mempel
- Departments of Neurology and Radiology, Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, Massachusetts (K.E.v.d.V., E.R.A., X.Z., C.L., S.P., O.M., M.H.W.C., J.S., X.O.B.); Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, Massachusetts (E.C., T.R.M., J.E.K., S.E.H.); Neuropathology Service, Massachusetts General Hospital and Department of Pathology, Harvard Medical School, Boston, Massachusetts (D.O., A.S-R.); Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (A.M.K.); Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands (K.E.v.d.V.)
| | - Joseph El Khoury
- Departments of Neurology and Radiology, Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, Massachusetts (K.E.v.d.V., E.R.A., X.Z., C.L., S.P., O.M., M.H.W.C., J.S., X.O.B.); Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, Massachusetts (E.C., T.R.M., J.E.K., S.E.H.); Neuropathology Service, Massachusetts General Hospital and Department of Pathology, Harvard Medical School, Boston, Massachusetts (D.O., A.S-R.); Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (A.M.K.); Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands (K.E.v.d.V.)
| | - Suzanne E Hickman
- Departments of Neurology and Radiology, Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, Massachusetts (K.E.v.d.V., E.R.A., X.Z., C.L., S.P., O.M., M.H.W.C., J.S., X.O.B.); Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, Massachusetts (E.C., T.R.M., J.E.K., S.E.H.); Neuropathology Service, Massachusetts General Hospital and Department of Pathology, Harvard Medical School, Boston, Massachusetts (D.O., A.S-R.); Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (A.M.K.); Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands (K.E.v.d.V.)
| | - Xandra O Breakefield
- Departments of Neurology and Radiology, Massachusetts General Hospital and NeuroDiscovery Center, Harvard Medical School, Boston, Massachusetts (K.E.v.d.V., E.R.A., X.Z., C.L., S.P., O.M., M.H.W.C., J.S., X.O.B.); Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, Massachusetts (E.C., T.R.M., J.E.K., S.E.H.); Neuropathology Service, Massachusetts General Hospital and Department of Pathology, Harvard Medical School, Boston, Massachusetts (D.O., A.S-R.); Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (A.M.K.); Division of Molecular Carcinogenesis, The Netherlands Cancer Institute, Amsterdam, the Netherlands (K.E.v.d.V.)
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