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Lemes Dos Santos Sanna P, Bernardes Carvalho L, Cristina Dos Santos Afonso C, de Carvalho K, Aires R, Souza J, Rodrigues Ferreira M, Birbrair A, Martha Bernardi M, Latini A, Foganholi da Silva RA. Adora2A downregulation promotes caffeine neuroprotective effect against LPS-induced neuroinflammation in the hippocampus. Brain Res 2024; 1833:148866. [PMID: 38494098 DOI: 10.1016/j.brainres.2024.148866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 03/19/2024]
Abstract
Caffeine has been extensively studied in the context of CNS pathologies as many researchers have shown that consuming it reduces pro-inflammatory biomarkers, potentially delaying the progression of neurodegenerative pathologies. Several lines of evidence suggest that adenosine receptors, especially A1 and A2A receptors, are the main targets of its neuroprotective action. We found that caffeine pretreatment 15 min before LPS administration reduced the expression of Il1b in the hippocampus and striatum. The harmful modulation of caffeine-induced inflammatory response involved the downregulation of the expression of A2A receptors, especially in the hippocampus. Caffeine treatment alone promoted the downregulation of the adenosinergic receptor Adora2A; however, this promotion effect was reversed by LPS. Although administering caffeine increased the expression of the enzymes DNA methyltransferases 1 and 3A and decreased the expression of the demethylase enzyme Tet1, this effect was reversed by LPS in the hippocampus of mice that were administered Caffeine + LPS, relative to the basal condition; no significant differences were observed in the methylation status of the promoter regions of adenosine receptors. Finally, the bioinformatics analysis of the expanded network demonstrated the following results: the Adora2B gene connects the extended networks of the adenosine receptors Adora1 and Adora2A; the Mapk3 and Esr1 genes connect the extended Adora1 network; the Mapk4 and Arrb2 genes connect the extended Adora2A network with the extended network of the proinflammatory cytokine Il1β. These results indicated that the anti-inflammatory effects of acute caffeine administration in the hippocampus may be mediated by a complex network of interdependencies between the Adora2B and Adora2A genes.
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Affiliation(s)
| | | | | | - Kassia de Carvalho
- Center for Epigenetic Study and Genic Regulation - CEEpiRG, Program in Environmental and Experimental Pathology, Paulista University, São Paulo, São Paulo, Brazil
| | - Rogério Aires
- Center for Epigenetic Study and Genic Regulation - CEEpiRG, Program in Environmental and Experimental Pathology, Paulista University, São Paulo, São Paulo, Brazil
| | - Jennyffer Souza
- Laboratory of Bioenergetics and Oxidative Stress - LABOX, Department of Biochemistry, Center for Biological Sciences, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Marcel Rodrigues Ferreira
- Molecular Genetics and Bioinformatics Laboratory, Experimental Research Unity, Botucatu Medical School, São Paulo State University, Brazil.
| | - Alexander Birbrair
- Department of Dermatology, University of Wisconsin-Madison, Madison, WI, USA
| | - Maria Martha Bernardi
- Center for Epigenetic Study and Genic Regulation - CEEpiRG, Program in Environmental and Experimental Pathology, Paulista University, São Paulo, São Paulo, Brazil
| | - Alexandra Latini
- Laboratory of Bioenergetics and Oxidative Stress - LABOX, Department of Biochemistry, Center for Biological Sciences, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Rodrigo A Foganholi da Silva
- Dentistry, University of Taubaté, Taubaté, São Paulo, São Paulo, Brazil; Center for Epigenetic Study and Genic Regulation - CEEpiRG, Program in Environmental and Experimental Pathology, Paulista University, São Paulo, São Paulo, Brazil.
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Aires R, Galafassi G, Pinho MCV, de Araújo Paz D, Salati T, Marchi C, de Aguiar PHP. Preoperative scale proposal based on clinical outcome for elderly patients with ruptured intracranial aneurysms undergoing microsurgery. Int J Neurosci 2023; 133:1204-1210. [PMID: 35465825 DOI: 10.1080/00207454.2022.2070488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 04/18/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Life expectancy in individuals has increased in recent years. There is no consensus in the literature on the best treatment for a ruptured aneurysm in the elderly (> 60 years), but some places only have microsurgery as a therapeutic strategy. This work aims to develop a prognostic scale for ruptured intracranial aneurysms in the elderly. MATERIAL AND METHODS Two thousand five hundred thirty patients with subarachnoid hemorrhage were retrospectively evaluated in the last ten years, and 550 of them were elderly. We developed a prognostic scale from the analysis of medical records, clinical and tomographic features that had statistical significance. Glasgow Coma Outcome (GOS) was the outcome of interest and p value < 0,05 was considered statistically significant. RESULTS Five hundred fifty patients were evaluated, and the comorbidities that were independent variables for poor prognosis were smoking and arterial hypertension; clinical variables were Hunt-Hess, modified Rankin and Glasgow Coma Scale; tomographic was Fisher scale. Poor outcome was defined as GOS ≤ 3. Poor surgical outcomes were more remarkable in the high-risk factor categories, being 6.41 times higher among individuals who had 3 to 4 risk factors and 8.80 times higher among individuals with 5 to 6 risk factors. CONCLUSION In some vascular neurosurgery services worldwide, microsurgery is the only therapeutic option. This scale aimed at the elderly patient individualizes the treatment and can predict the clinical outcome in ruptured intracranial aneurysms.
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Affiliation(s)
- Rogério Aires
- Institute of Medical Assistance to the State Public Servant, Leforte Liberty Hospital, Santa Paula Hospital, São Paulo, Brazil
| | | | | | | | | | | | - Paulo Henrique Pires de Aguiar
- Institute of Medical Assistance to the State Public Servant, Santa Paula Hospital, ABC Medical School, São Paulo, Brazil
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Costa MR, Dos Santos AYI, de Miranda TB, Aires R, de Camargo Coque A, Hurtado ECP, Bernardi MM, Pecorari VGA, Andia DC, Birbrair A, Guillemin GJ, Latini A, da Silva RA. Impact of neuroinflammation on epigenetic transcriptional control of Sonic Hedgehog members in the central nervous system. Brain Res 2023; 1799:148180. [PMID: 36463954 DOI: 10.1016/j.brainres.2022.148180] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 08/03/2022] [Revised: 09/14/2022] [Accepted: 11/23/2022] [Indexed: 12/03/2022]
Abstract
Sonic Hedgehog (Shh) signaling plays a critical role during central nervous system (CNS) development, and its dysregulation leads to neurological disorders. Nevertheless, little is known about Shh signaling regulation in the adult brain. Here, we investigated the contribution of DNA methylation on the transcriptional control of Shh signaling pathway members and its basal distribution impact on the brain, as well as its modulation by inflammation. The methylation status of the promoter regions of these members and the transcriptional profile of DNA-modifying enzymes (DNA Methyltransferases - DNMTs and Tet Methylcytosine Dioxygenase - TETs) were investigated in a murine model of neuroinflammation by qPCR. We showed that, in the adult brain, methylation in the CpG promoter regions of the Shh signaling pathway members was critical to determine the endogenous differential transcriptional pattern observed between distinct brain regions. We also found that neuroinflammation differentially modulates gene expression of DNA-modifying enzymes. This study reveals the basal transcriptional profile of DNMTs and TETs enzymes in the CNS and demonstrates the effect of neuroinflammation on the transcriptional control of members of the Shh Signaling pathway in the adult brain.
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Affiliation(s)
| | | | | | - Rogério Aires
- Epigenetic Study Center and Gene Regulation - CEEpiRG, Program in Environmental and Experimental Pathology, Paulista University, São Paulo 04026-002, São Paulo, Brazil
| | - Alex de Camargo Coque
- Epigenetic Study Center and Gene Regulation - CEEpiRG, Program in Environmental and Experimental Pathology, Paulista University, São Paulo 04026-002, São Paulo, Brazil
| | - Elizabeth Cristina Perez Hurtado
- Epigenetic Study Center and Gene Regulation - CEEpiRG, Program in Environmental and Experimental Pathology, Paulista University, São Paulo 04026-002, São Paulo, Brazil.
| | - Maria Martha Bernardi
- Epigenetic Study Center and Gene Regulation - CEEpiRG, Program in Environmental and Experimental Pathology, Paulista University, São Paulo 04026-002, São Paulo, Brazil
| | | | - Denise Carleto Andia
- School of Dentistry, Health Science Institute, Paulista University, São Paulo 04026-002, São Paulo, Brazil.
| | - Alexander Birbrair
- Department of Pathology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Gilles J Guillemin
- Neuroinflammation Group, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia.
| | - Alexandra Latini
- Bioenergetics and Oxidative Stress Lab - LABOX, Department of Biochemistry, Center for Biological Sciences, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Rodrigo A da Silva
- School of Dentistry, University of Taubaté, 12020-3400 Taubaté, São Paulo, Brazil; Epigenetic Study Center and Gene Regulation - CEEpiRG, Program in Environmental and Experimental Pathology, Paulista University, São Paulo 04026-002, São Paulo, Brazil.
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Aires R, Porto ML, de Assis LM, Pereira PAN, Carvalho GR, Côco LZ, Vasquez EC, Pereira TMC, Campagnaro BP, Meyrelles SS. DNA damage and aging on hematopoietic stem cells: Impact of oxidative stress in ApoE -/ - mice. Exp Gerontol 2021; 156:111607. [PMID: 34715304 DOI: 10.1016/j.exger.2021.111607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 05/03/2021] [Revised: 10/18/2021] [Accepted: 10/21/2021] [Indexed: 12/14/2022]
Abstract
The effects of aging on ROS production and DNA damage were assessed in hematopoietic stem cells (HSCs) from apolipoprotein E-deficient (ApoE-/-) mice (2-, 12- and 24-month-old), a traditional experimental model of atherogenic dyslipidemia. HSCs from aged ApoE-/- mice were associated with increased ROS levels, leading to loss quiescence, DNA damage, apoptosis and telomere shortening. The concurrence of lack of ApoE and aging result in exhaustion and senescence of HSCs accompanied by increased oxidative stress and inflammation. Therefore, our data open avenues to a better understanding of age-related changes and genetic factors, which may synergistically compromise the efficacy of aged HSC recovery and/or transplantation.
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Affiliation(s)
- R Aires
- Laboratory of Translational Physiology, Health Sciences Center, Federal University of Espirito Santo (UFES), Vitoria, Brazil.
| | - M L Porto
- Federal Institute of Education, Science and Technology (IFES), Vila Velha, ES, Brazil
| | - L M de Assis
- Federal Institute of Education, Science and Technology (IFES), Vila Velha, ES, Brazil
| | - P A N Pereira
- Federal Institute of Education, Science and Technology (IFES), Vila Velha, ES, Brazil
| | - G R Carvalho
- Laboratory of Translational Physiology and Pharmacology, Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Vila Velha, ES, Brazil
| | - L Z Côco
- Laboratory of Translational Physiology and Pharmacology, Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Vila Velha, ES, Brazil
| | - E C Vasquez
- Laboratory of Translational Physiology and Pharmacology, Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Vila Velha, ES, Brazil
| | - T M C Pereira
- Federal Institute of Education, Science and Technology (IFES), Vila Velha, ES, Brazil; Laboratory of Translational Physiology and Pharmacology, Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Vila Velha, ES, Brazil
| | - B P Campagnaro
- Laboratory of Translational Physiology and Pharmacology, Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Vila Velha, ES, Brazil
| | - S S Meyrelles
- Laboratory of Translational Physiology, Health Sciences Center, Federal University of Espirito Santo (UFES), Vitoria, Brazil
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Marchi C, de Aguiar PHP, Moura AM, Matricardi G, Muniz CU, Aires R, Gehrke F, Santiago N, Simis S. Abducent nerve palsy after microballoon compression of the trigeminal ganglion: Case report. Surg Neurol Int 2017; 8:125. [PMID: 28713629 PMCID: PMC5502296 DOI: 10.4103/sni.sni_375_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 09/19/2016] [Accepted: 03/31/2017] [Indexed: 12/02/2022] Open
Abstract
Background: Trigeminal neuralgia (TN) is the most common type of facial neuralgia with incidence of 26.8/100,000 person year. In general, this scenario is characterized by a lancinating, unilateral, paroxysmal pain in the area of the fifth cranial nerve. Several treatment methods, including the injection of ethyl alcohol or butyl alcohol into the ganglion, the glycerol injection into the trigeminal cistern, peripheral nerve divisions, the radiofrequency thermocoagulation of the preganglionic fibers, and radiosurgery has been used for TN. Case Description: A case of a 74-year-old woman patient who undergone a treatment of TN through a compression of Meckel cave and developed a transient abducent palsy is presented. Complication regarding to a palsy of abducent nerve is discussed as well as the analysis of presumable evolving physiopathology. A critical review of literature was performed. Conclusions: Among the procedures, we mean that percutaneous microballoon compression (PMC) is the best choice for elderly frail patients, because it had a very low associated mortality-morbidity rate and does not damage permanent the Gasserian ganglion.
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Affiliation(s)
- Cassiano Marchi
- Department of Neurosurgery, Hospital Santa Paula, São Paulo, Brazil
| | - Paulo Henrique Pires de Aguiar
- Department of Surgery, Post Graduation Section, Federal University of Rio Grande do Sul, São Paulo, Brazil.,Department of Medicine, Division of Neurology, Catholic Pontifical University of São Paulo, São Paulo, Brazil.,Section of Post Graduation of IAMSPE, São Paulo State Civil Servant Hospital, São Paulo, Brazil
| | - Ana Maria Moura
- Department of Neurosurgery, Hospital Santa Paula, São Paulo, Brazil
| | - Giovanna Matricardi
- Department of Medicine, Division of Neurology, Catholic Pontifical University of São Paulo, São Paulo, Brazil
| | - Carolina Utsunomya Muniz
- Department of Medicine, Division of Neurology, Catholic Pontifical University of São Paulo, São Paulo, Brazil
| | - Rogério Aires
- Section of Post Graduation of IAMSPE, São Paulo State Civil Servant Hospital, São Paulo, Brazil
| | - Flávia Gehrke
- Section of Post Graduation of IAMSPE, São Paulo State Civil Servant Hospital, São Paulo, Brazil
| | - Natally Santiago
- Department of Neurosurgery, Hospital Santa Paula, São Paulo, Brazil
| | - Samuel Simis
- Department of Medicine, Division of Neurology, Catholic Pontifical University of São Paulo, São Paulo, Brazil
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Aires R, Pimentel EB, Forechi L, Dantas EM, Mill JG. Time course of changes in heart rate and blood pressure variability in rats with myocardial infarction. ACTA ACUST UNITED AC 2017; 50:e5511. [PMID: 28076450 PMCID: PMC5264537 DOI: 10.1590/1414-431x20165511] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 05/30/2016] [Accepted: 10/25/2016] [Indexed: 01/01/2023]
Abstract
Our aim was to determine the time course of changes in autonomic balance in the acute
(1 and 3 days), sub-acute (7 days) and chronic (28 days) phases of myocardial
infarction (MI) in rats. Autonomic balance was assessed by temporal and spectral
analyses of blood pressure variability (BPV) and heart rate variability (HRV).
Pulsatile blood pressure (BP) recordings (30 min) were obtained in awake and
unrestrained male Wistar rats (N = 77; 8-10 weeks old) with MI (coronary ligature) or
sham operation (SO). Data are reported as means±SE. The high frequency (HF) component
(n.u.) of HRV was significantly lower in MI-1- (P<0.01) and MI-3-day rats
(P<0.05) than in their time-control groups (SO-1=68±4 vs
MI-1=35.3±4.3; SO-3=71±5.8 vs MI-3=45.2±3.8), without differences
thereafter (SO-7=69.2±4.8 vs MI-7=56±5.8; SO-28=73±4
vs MI-28=66±6.6). A sharp reduction (P<0.05) of BPV
(mmHg2) was observed in the first week after MI (SO-1=8.55±0.80;
SO-3=9.11±1.08; SO-7=7.92±1.10 vs MI-1=5.63±0.73; MI-3=5.93±0.30;
MI-7=5.30±0.25). Normal BPV, however, was observed 4 weeks after MI (SO-28=8.60±0.66
vs MI-28=8.43±0.56 mmHg2; P>0.05). This reduction
was mainly due to attenuation of the low frequency (LF) band of BPV in absolute and
normalized units (SO-1=39.3±7%; SO-3=55±4.5%; SO-7=46.8±4.5%; SO-28=45.7±5%;
MI-1=13±3.5%; MI-3=35±4.7%; MI-7=25±2.8%; MI-28=21.4±2.8%). The results suggest that
the reduction in HRV was associated with decrease of the HF component of HRV
suggesting recovery of the vagal control of heartbeats along the post-infarction
healing period. The depression of BPV was more dependent on the attenuation of the LF
component, which is linked to the baroreflex modulation of the autonomic balance.
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Affiliation(s)
- R Aires
- Departmento de Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | - E B Pimentel
- Departmento de Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | - L Forechi
- Departmento de Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | - E M Dantas
- Colegiado de Ciências Biológicas, Universidade Federal do Vale do São Francisco, Petrolina, PE, Brasil
| | - J G Mill
- Departmento de Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
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de Aguiar PHP, Zicarelli CAM, Isolan G, Antunes A, Aires R, Georgeto SM, Tahara A, Haddad F. Brainstem cavernomas: a surgical challenge. Einstein (Sao Paulo) 2012; 10:67-73. [PMID: 23045829 DOI: 10.1590/s1679-45082012000100014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The authors show their experience with brainstem cavernomas, comparing their data with the ones of a literature review. METHODS From 1998 to 2009, 13 patients harboring brainstem cavernomas underwent surgical resection. All plain films, medical records and images were reviewed in order to sample the most important data regarding epidemiology, clinical picture, radiological findings and surgical outcomes, as well as main complications. RESULTS The mean age was 42.4 years (ranging from 19 to 70). No predominant gender: male-to-female ratio, 6:7. Pontine cases were more frequent. Magnetic resonance imaging was used as the imaging method to diagnose cavernomas in all cases. The mean follow-up was 71.3 months (range of 1 to 138 months). Clinical presentation was a single cranial nerve deficit, VIII paresis, tinnitus and hearing loss (69.2%). All 13 patients underwent resection of the symptomatic brainstem cavernoma. Complete removal was accomplished in 11 patients. Morbidity and mortality were 15.3 and 7.6%, respectively. CONCLUSIONS Cavernomas can be resected safely with optimal surgical approach (feasible entry zone) and microsurgical techniques, and the goal is to remove all lesions with no cranial nerves impairment.
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Pires de Aguiar P, Aires R, Maldaun M, Panagopoulos A, Souza Filho A, Zicarelli C, Lehmann M, Marques R, Simm R. Paraclinoid Aneurysms: Surgical Management. Skull Base 2011. [DOI: 10.1055/s-2011-1274206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Pires de Aguiar PH, Aires R, Maldaun MVC, Tahara A, de Souza Filho AM, Zicarelli CA, Ramina R. Is sagittal sinus resection in falcine meningiomas a factor of bad surgical outcome? Surg Neurol Int 2010; 1:64. [PMID: 21125007 PMCID: PMC2980903 DOI: 10.4103/2152-7806.71983] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [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: 04/30/2010] [Accepted: 09/14/2010] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Meningiomas arising purely from the falx below the longitudinal sinus represents a surgical challenge for the neurosurgeon. The authors discuss the new aspects of surgical details that may avoid complications and determine the prognosis. MATERIALS AND METHODS We retrospectively evaluated our surgical experience from June 2004 to January 2010. Seventy patients harboring falcine meningiomas were included and submitted for surgical resection. All historical records, office charts and images were reviewed in order to sample the most important data regarding epidemiology, clinical pictures, radiological findings and surgical results, as well as the main complications. The patients were divided into three main groups: anterior third 32 patients (Group A), middle third 15 patients (Group B), 23 patients in the posterior third of falx (Group C). RESULTS In Group A, total macroscopic resection was achieved in 31 out of 32 cases (96.87%). Twenty five patients had Rankin 0, five patients had Rankin 1-2, two patients had Rankin 6. In Group B (15 patients), 10 patients had gross resection and Rankin 0, four patients had Rankin 1-2 and one patient had Rankin 6. In Group C (23 patients), 20 patients were absolutely able, Rankin score 0, after six months postoperative period (83.3% had excellent results) and no mortality. Four cases had Rankin score 1 - 2 (16.6%). Ten cases (43.47%) had Simpson I resection and ten cases (43.47%) had Simpson II. CONCLUSION Despite larger lesion volumes, Group A meningiomas had a better outcome due to the position they were in, the tumor and surrounding structures. The preoperative preparation and surgical planning can preserve sagittal sinus; but in some cases, this is not possible. Sagittal sinus resection, as proven by this paper, is still a factor of bad surgical outcome. In the middle and posterior third, resection of sagittal sinus is a factor of a bad outcome, due to cerebral infartion.
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Affiliation(s)
- Paulo Henrique Pires de Aguiar
- Department of Neurology - São Paulo Medical School, University of Sao Paulo, São Paulo; Division of Neurosurgery of Santa Paula Hospital, São Paulo; Division of Neurosurgery of Brigadeiro, Unic Brazilian Health System- (SUS-UBHS), São Paulo; Division of Neurosurgery of São Camilo Hospital, São Paulo; Department of Surgery, Catholic Pontific University, Curitiba, Brazil
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de Aguiar PHP, Aires R, Laws ER, Isolan GR, Logullo A, Patil C, Katznelson L. Labeling index in pituitary adenomas evaluated by means of MIB-1: is there a prognostic role? A critical review. Neurol Res 2010; 32:1060-71. [PMID: 20483025 DOI: 10.1179/016164110x12670144737855] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The present article presents an overview of the literature, and analyses the methods and the primary questions related to assessment of proliferation index using the Ki-67/MIB-1 labeling index in pituitary adenomas. Although atypical adenomas are characterized by their atypical morphological features by an elevated mitotic index, a Ki-67 (MIB-1) labeling index greater than 3% and extensive nuclear staining for p53, use of the proliferation index (LI) of pituitary adenomas in assessing the degree of tumor aggressiveness is a controversial topic in the literature, and there are disparate results involving many studies. METHODS A review of literature was carried out to correlate the role of Ki-67 LI and its correlation with clinical findings, tumor size, invasiveness, recurrence, adenoma subtype, adenoma doubling time, and pituitary carcinomas is addressed. RESULTS The prognosis cannot be predicted on the basis of the Ki-67 LI alone. Although there is no direct relation between Ki-67 LI and some of these variables and controversial data were found regarding some topics, our review justify the use of Ki-67 in the analysis of pituitary adenomas as an additional information for clinical decision. CONCLUSION Although assessment of proliferative may be helpful in predicting subsequent tumor recurrence or invasiveness, there are many other important and as yet unidentified factors pituitary tumors. It is clear that further research is needed to clarify these molecular mechanisms to predict those with a potentially poor clinical outcome.
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