1
|
Virupakshaiah A, Ladakis DC, Nourbakhsh B, Bhargava P, Dilwali S, Schoeps V, Borkowski K, Newman JW, Waubant E. Several serum lipid metabolites are associated with relapse risk in pediatric-onset multiple sclerosis. Mult Scler 2023; 29:936-944. [PMID: 37199529 PMCID: PMC10524330 DOI: 10.1177/13524585231171517] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
BACKGROUND The circulating metabolome is altered in multiple sclerosis (MS), but its prognostic capabilities have not been extensively explored. Lipid metabolites might be of particular interest due to their multiple roles in the brain, as they can serve as structural components, energy sources, and bioactive molecules. Gaining a deeper understanding of the disease may be possible by examining the lipid metabolism in the periphery, which serves as the primary source of lipids for the brain. OBJECTIVE To determine if altered serum lipid metabolites are associated with the risk of relapse and disability in children with MS. METHODS We collected serum samples from 61 participants with pediatric-onset MS within 4 years of disease onset. Prospective longitudinal relapse data and cross-sectional disability measures (Expanded Disability Status Scale [EDSS]) were collected. Serum metabolomics was performed using untargeted liquid chromatography and mass spectrometry. Individual lipid metabolites were clustered into pre-defined pathways. The associations between clusters of metabolites and relapse rate and EDSS score were estimated utilizing negative binomial and linear regression models, respectively. RESULTS We found that serum acylcarnitines (relapse rate: normalized enrichment score [NES] = 2.1, q = 1.03E-04; EDSS: NES = 1.7, q = 0.02) and poly-unsaturated fatty acids (relapse rate: NES = 1.6, q = 0.047; EDSS: NES = 1.9, q = 0.005) were associated with higher relapse rates and EDSS, while serum phosphatidylethanolamines (relapse rate: NES = -2.3, q = 0.002; EDSS: NES = -2.1, q = 0.004), plasmalogens (relapse rate: NES = -2.5, q = 5.81E-04; EDSS: NES = -2.1, q = 0.004), and primary bile acid metabolites (relapse rate: NES = -2.0, q = 0.02; EDSS: NES = -1.9, q = 0.02) were associated with lower relapse rates and lower EDSS. CONCLUSION This study supports the role of some lipid metabolites in pediatric MS relapses and disability.
Collapse
Affiliation(s)
- Akash Virupakshaiah
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Dimitrios C Ladakis
- Division of Neuroimmunology, Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Bardia Nourbakhsh
- Division of Neuroimmunology, Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Pavan Bhargava
- Division of Neuroimmunology, Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Sonam Dilwali
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Vinicius Schoeps
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Kamil Borkowski
- West Coast Metabolomics Center, University of California Davis, Davis, CA, USA
| | - John W Newman
- West Coast Metabolomics Center, University of California Davis, Davis, CA, USA United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA, USA Department of Nutrition, University of California Davis, Davis, CA, USA
| | - Emmanuelle Waubant
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
2
|
Dilwali S, Mark I, Waubant E. MRI lesions can often precede trigeminal neuralgia symptoms by years in multiple sclerosis. J Neurol Neurosurg Psychiatry 2023; 94:189-192. [PMID: 36396446 DOI: 10.1136/jnnp-2022-330172] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/25/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Understanding when multiple sclerosis (MS) lesions become clinically symptomatic may provide insight into disease pathophysiology. Our objective was to temporally associate lesion formation and trigeminal neuralgia (TN) symptom onset in MS. METHODS This is a retrospective case series of patients with MS, analysing time difference between TN symptom onset and oldest MRI showing a correlative lesion. RESULTS For the 26 patients with MS, a correlative lesion was noted on MRI on average 5±4 years prior to TN symptom onset; 57% had primary or secondary progressive MS. CONCLUSIONS TN lesions can be present years prior to symptom onset, suggestive of alternative explanations than typical relapses. This phenomenon may hint at alternative pathophysiology of progressive MS in comparison to relapsing-remitting MS.
Collapse
Affiliation(s)
- Sonam Dilwali
- Department of Neuroimmunology, University of California System, San Francisco, California, USA
| | - Ian Mark
- Department of Neuroradiology, University of California San Francisco, San Francisco, California, USA
| | - Emmanuelle Waubant
- Department of Neuroimmunology, University of California System, San Francisco, California, USA
| |
Collapse
|
3
|
Dilwali S, Harroud A, Rasool N, Green A. The Eye as a Window to the Brain: Prominent Retinal Vasculopathy Points to Neuro-Behcet Diagnosis for an Undifferentiated Solitary Brain Lesion. Neurology 2022. [DOI: 10.1212/01.wnl.0000903484.13341.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
ObjectiveTo report a perplexing case of Behcet disease (BD) presenting as a focal parenchymal lesion that reached a diagnosis after noting a prominent retinal vasculopathy, highlighting the importance of ophthalmologic evaluation in undifferentiated CNS disease.BackgroundBD can have variable systemic manifestations driven by a vasculitis, including oral or genital ulcers, pulmonary aneurysms, and uveitis. Neurologic involvement is present in less than 10% of patients, most commonly as a meningoencephalitis.Design/MethodsWe present the case of a woman who developed asymmetric sub-acute sensorineural hearing loss at age 31 followed by transient right facial weakness at age 40, and most recently presented with right facial numbness and arm weakness at age 47. Brain MRI revealed a left frontal enhancing lesion with associated T2/FLAIR hyperintensity extending from the periventricular to the juxtacortical area with a thin rim of a reduced diffusion. CSF and serum studies were negative for inflammation, infection and malignancy except for elevated ESR and CRP. Brain biopsy revealed non-specific gliosis. Persistent enhancement on MRI was noted over 3 months, with spontaneous clinical improvement. Patient endorsed insidious vision changes over recent years, and visual testing was performed.ResultsDilated ophthalmic examination demonstrated striking peripheral attenuation and sclerosis of retinal vasculature, with evidence of nonperfusion and skip lesions on retinal fluorescein angiography (FA). Findings of occlusive retinal peripheral vasculopathy suggested an underlying vasculitis as the etiology of the brain lesion and prior deficits, raising the likelihood of BD. Patient was homozygous for HLA-B*51, further supporting this diagnosis even with lack of mucosal ulcers and negative history of pathergy.ConclusionsNeurologic manifestations of BD can be diverse including retinal occlusive vasculopathy; ulcers are not universally present. Ophthalmologic examination, even when minimally symptomatic, can inform the diagnosis of CNS lesions. Patient was started on Prednisone, Infliximab and Methotrexate, achieving disease remission.
Collapse
|
4
|
Peris Sempere V, Muñiz-Castrillo S, Ambati A, Binks S, Pinto AL, Rogemond V, Pittock SJ, Dubey D, Geschwind MD, Gelfand JM, Dilwali S, Lee ST, Knight J, Elliott KS, Irani S, Honnorat J, Mignot E. Human Leukocyte Antigen Association Study Reveals DRB1*04:02 Effects Additional to DRB1*07:01 in Anti-LGI1 Encephalitis. Neurol Neuroimmunol Neuroinflamm 2022; 9:e1140. [PMID: 35115410 PMCID: PMC8815287 DOI: 10.1212/nxi.0000000000001140] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/27/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVES To study human leukocyte antigen (HLA) allele associations in anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitis. METHODS A multiethnic cohort of 269 patients with anti-LGI1 encephalitis and 1,359 controls was included. Four-digit HLA sequencing and genome wide association single-nucleotide polymorphism typing imputation (0.99 concordance) were used for HLA typing. Significance of primary and secondary associations was tested using χ2, Fisher exact tests, or logistic regression with the control of population stratification covariates when applicable. RESULTS DRB1*07:01 and DQA1*02:01, 2 alleles in strong linkage disequilibrium, were associated with the disease (90% vs 24%, OR = 27.8, p < 10e-50) across ethnicity independent of variation at DRB3 and DQB1, 2 flanking HLA loci. DRB1*07:01 homozygosity was associated with a doubling of risk (OR = 2.1, p = 0.010), suggesting causality. DRB1*07:01 negative subjects were younger (p = 0.003) and more frequently female (p = 0.015). Three patients with malignant thymomas did not carry DRB1*07:01, whereas patients with other tumors had high DRB1*07:01 frequency, suggesting that the presence of tumors other than thymomas may be coincidental and not causal. In both DRB1*07:01 heterozygous individuals and DRB1*07:01 negative subjects, DRB1*04:02 was associated with anti-LGI1 encephalitis, indicating an independent effect of this allele (OR = 6.85, p = 4.57 × 10-6 and OR = 8.93, p = 2.50 × 10-3, respectively). DRB1*04:02 was also independently associated with younger age at onset (β = -6.68, p = 9.78 × 10-3). Major histocompatibility complex peptide-binding predictions using LGI1-derived peptides revealed divergent binding propensities for DRB1*04:02 and DRB1*07:01 alleles, suggesting independent pathogenic mechanisms. DISCUSSION In addition to the established primary DRB1*07:01 association in anti-LGI1 encephalitis, we observe a secondary effect of DRB1*04:02 with lower age at onset. Our study provides evidence for secondary effects within HLA locus that correlate with clinical phenotypes in anti-LGI1 encephalitis.
Collapse
Affiliation(s)
| | | | - Aditya Ambati
- From the Stanford University Center for Sleep Sciences (V.P.S., A.A., and E.M.), Stanford University School of Medicine, Palo Alto, CA; French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (S.M.-C., A.-L.P., V.R., and J.H.), Hospices Civils de Lyon, Hôpital Neurologique; Synatac Team (S.M.-C., A.-L.P., V.R., and J.H.), NeuroMyoGene Institute, INSERM U1217/CNRS UMR5310, Université Claude Bernard Lyon 1, Université de Lyon, France; Oxford Autoimmune Neurology Group (S.B. and S.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Neurology (S.B. and S.I.), John Radcliffe Hospital, Oxford, United Kingdom; Department of Laboratory Medicine and Pathology (S.J.P. and D.D.), and Department of Neurology (S.J.P. and D.D.), Mayo Clinic, Rochester, MN; Department of Neurology (M.D.G., J.M.G., and S.D.), University of California, San Francisco; Department of Neurology (S.-T.L.), Seoul National University Hospital, South Korea; and Wellcome Centre for Human Genetics (J.K. and K.S.E.), Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - Sophie Binks
- From the Stanford University Center for Sleep Sciences (V.P.S., A.A., and E.M.), Stanford University School of Medicine, Palo Alto, CA; French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (S.M.-C., A.-L.P., V.R., and J.H.), Hospices Civils de Lyon, Hôpital Neurologique; Synatac Team (S.M.-C., A.-L.P., V.R., and J.H.), NeuroMyoGene Institute, INSERM U1217/CNRS UMR5310, Université Claude Bernard Lyon 1, Université de Lyon, France; Oxford Autoimmune Neurology Group (S.B. and S.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Neurology (S.B. and S.I.), John Radcliffe Hospital, Oxford, United Kingdom; Department of Laboratory Medicine and Pathology (S.J.P. and D.D.), and Department of Neurology (S.J.P. and D.D.), Mayo Clinic, Rochester, MN; Department of Neurology (M.D.G., J.M.G., and S.D.), University of California, San Francisco; Department of Neurology (S.-T.L.), Seoul National University Hospital, South Korea; and Wellcome Centre for Human Genetics (J.K. and K.S.E.), Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - Anne-Laurie Pinto
- From the Stanford University Center for Sleep Sciences (V.P.S., A.A., and E.M.), Stanford University School of Medicine, Palo Alto, CA; French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (S.M.-C., A.-L.P., V.R., and J.H.), Hospices Civils de Lyon, Hôpital Neurologique; Synatac Team (S.M.-C., A.-L.P., V.R., and J.H.), NeuroMyoGene Institute, INSERM U1217/CNRS UMR5310, Université Claude Bernard Lyon 1, Université de Lyon, France; Oxford Autoimmune Neurology Group (S.B. and S.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Neurology (S.B. and S.I.), John Radcliffe Hospital, Oxford, United Kingdom; Department of Laboratory Medicine and Pathology (S.J.P. and D.D.), and Department of Neurology (S.J.P. and D.D.), Mayo Clinic, Rochester, MN; Department of Neurology (M.D.G., J.M.G., and S.D.), University of California, San Francisco; Department of Neurology (S.-T.L.), Seoul National University Hospital, South Korea; and Wellcome Centre for Human Genetics (J.K. and K.S.E.), Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - Veronique Rogemond
- From the Stanford University Center for Sleep Sciences (V.P.S., A.A., and E.M.), Stanford University School of Medicine, Palo Alto, CA; French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (S.M.-C., A.-L.P., V.R., and J.H.), Hospices Civils de Lyon, Hôpital Neurologique; Synatac Team (S.M.-C., A.-L.P., V.R., and J.H.), NeuroMyoGene Institute, INSERM U1217/CNRS UMR5310, Université Claude Bernard Lyon 1, Université de Lyon, France; Oxford Autoimmune Neurology Group (S.B. and S.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Neurology (S.B. and S.I.), John Radcliffe Hospital, Oxford, United Kingdom; Department of Laboratory Medicine and Pathology (S.J.P. and D.D.), and Department of Neurology (S.J.P. and D.D.), Mayo Clinic, Rochester, MN; Department of Neurology (M.D.G., J.M.G., and S.D.), University of California, San Francisco; Department of Neurology (S.-T.L.), Seoul National University Hospital, South Korea; and Wellcome Centre for Human Genetics (J.K. and K.S.E.), Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - Sean J. Pittock
- From the Stanford University Center for Sleep Sciences (V.P.S., A.A., and E.M.), Stanford University School of Medicine, Palo Alto, CA; French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (S.M.-C., A.-L.P., V.R., and J.H.), Hospices Civils de Lyon, Hôpital Neurologique; Synatac Team (S.M.-C., A.-L.P., V.R., and J.H.), NeuroMyoGene Institute, INSERM U1217/CNRS UMR5310, Université Claude Bernard Lyon 1, Université de Lyon, France; Oxford Autoimmune Neurology Group (S.B. and S.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Neurology (S.B. and S.I.), John Radcliffe Hospital, Oxford, United Kingdom; Department of Laboratory Medicine and Pathology (S.J.P. and D.D.), and Department of Neurology (S.J.P. and D.D.), Mayo Clinic, Rochester, MN; Department of Neurology (M.D.G., J.M.G., and S.D.), University of California, San Francisco; Department of Neurology (S.-T.L.), Seoul National University Hospital, South Korea; and Wellcome Centre for Human Genetics (J.K. and K.S.E.), Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - Divyanshu Dubey
- From the Stanford University Center for Sleep Sciences (V.P.S., A.A., and E.M.), Stanford University School of Medicine, Palo Alto, CA; French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (S.M.-C., A.-L.P., V.R., and J.H.), Hospices Civils de Lyon, Hôpital Neurologique; Synatac Team (S.M.-C., A.-L.P., V.R., and J.H.), NeuroMyoGene Institute, INSERM U1217/CNRS UMR5310, Université Claude Bernard Lyon 1, Université de Lyon, France; Oxford Autoimmune Neurology Group (S.B. and S.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Neurology (S.B. and S.I.), John Radcliffe Hospital, Oxford, United Kingdom; Department of Laboratory Medicine and Pathology (S.J.P. and D.D.), and Department of Neurology (S.J.P. and D.D.), Mayo Clinic, Rochester, MN; Department of Neurology (M.D.G., J.M.G., and S.D.), University of California, San Francisco; Department of Neurology (S.-T.L.), Seoul National University Hospital, South Korea; and Wellcome Centre for Human Genetics (J.K. and K.S.E.), Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - Michael D. Geschwind
- From the Stanford University Center for Sleep Sciences (V.P.S., A.A., and E.M.), Stanford University School of Medicine, Palo Alto, CA; French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (S.M.-C., A.-L.P., V.R., and J.H.), Hospices Civils de Lyon, Hôpital Neurologique; Synatac Team (S.M.-C., A.-L.P., V.R., and J.H.), NeuroMyoGene Institute, INSERM U1217/CNRS UMR5310, Université Claude Bernard Lyon 1, Université de Lyon, France; Oxford Autoimmune Neurology Group (S.B. and S.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Neurology (S.B. and S.I.), John Radcliffe Hospital, Oxford, United Kingdom; Department of Laboratory Medicine and Pathology (S.J.P. and D.D.), and Department of Neurology (S.J.P. and D.D.), Mayo Clinic, Rochester, MN; Department of Neurology (M.D.G., J.M.G., and S.D.), University of California, San Francisco; Department of Neurology (S.-T.L.), Seoul National University Hospital, South Korea; and Wellcome Centre for Human Genetics (J.K. and K.S.E.), Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - Jeffrey Marc Gelfand
- From the Stanford University Center for Sleep Sciences (V.P.S., A.A., and E.M.), Stanford University School of Medicine, Palo Alto, CA; French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (S.M.-C., A.-L.P., V.R., and J.H.), Hospices Civils de Lyon, Hôpital Neurologique; Synatac Team (S.M.-C., A.-L.P., V.R., and J.H.), NeuroMyoGene Institute, INSERM U1217/CNRS UMR5310, Université Claude Bernard Lyon 1, Université de Lyon, France; Oxford Autoimmune Neurology Group (S.B. and S.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Neurology (S.B. and S.I.), John Radcliffe Hospital, Oxford, United Kingdom; Department of Laboratory Medicine and Pathology (S.J.P. and D.D.), and Department of Neurology (S.J.P. and D.D.), Mayo Clinic, Rochester, MN; Department of Neurology (M.D.G., J.M.G., and S.D.), University of California, San Francisco; Department of Neurology (S.-T.L.), Seoul National University Hospital, South Korea; and Wellcome Centre for Human Genetics (J.K. and K.S.E.), Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - Sonam Dilwali
- From the Stanford University Center for Sleep Sciences (V.P.S., A.A., and E.M.), Stanford University School of Medicine, Palo Alto, CA; French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (S.M.-C., A.-L.P., V.R., and J.H.), Hospices Civils de Lyon, Hôpital Neurologique; Synatac Team (S.M.-C., A.-L.P., V.R., and J.H.), NeuroMyoGene Institute, INSERM U1217/CNRS UMR5310, Université Claude Bernard Lyon 1, Université de Lyon, France; Oxford Autoimmune Neurology Group (S.B. and S.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Neurology (S.B. and S.I.), John Radcliffe Hospital, Oxford, United Kingdom; Department of Laboratory Medicine and Pathology (S.J.P. and D.D.), and Department of Neurology (S.J.P. and D.D.), Mayo Clinic, Rochester, MN; Department of Neurology (M.D.G., J.M.G., and S.D.), University of California, San Francisco; Department of Neurology (S.-T.L.), Seoul National University Hospital, South Korea; and Wellcome Centre for Human Genetics (J.K. and K.S.E.), Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - Soon-Tae Lee
- From the Stanford University Center for Sleep Sciences (V.P.S., A.A., and E.M.), Stanford University School of Medicine, Palo Alto, CA; French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (S.M.-C., A.-L.P., V.R., and J.H.), Hospices Civils de Lyon, Hôpital Neurologique; Synatac Team (S.M.-C., A.-L.P., V.R., and J.H.), NeuroMyoGene Institute, INSERM U1217/CNRS UMR5310, Université Claude Bernard Lyon 1, Université de Lyon, France; Oxford Autoimmune Neurology Group (S.B. and S.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Neurology (S.B. and S.I.), John Radcliffe Hospital, Oxford, United Kingdom; Department of Laboratory Medicine and Pathology (S.J.P. and D.D.), and Department of Neurology (S.J.P. and D.D.), Mayo Clinic, Rochester, MN; Department of Neurology (M.D.G., J.M.G., and S.D.), University of California, San Francisco; Department of Neurology (S.-T.L.), Seoul National University Hospital, South Korea; and Wellcome Centre for Human Genetics (J.K. and K.S.E.), Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - Julian Knight
- From the Stanford University Center for Sleep Sciences (V.P.S., A.A., and E.M.), Stanford University School of Medicine, Palo Alto, CA; French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (S.M.-C., A.-L.P., V.R., and J.H.), Hospices Civils de Lyon, Hôpital Neurologique; Synatac Team (S.M.-C., A.-L.P., V.R., and J.H.), NeuroMyoGene Institute, INSERM U1217/CNRS UMR5310, Université Claude Bernard Lyon 1, Université de Lyon, France; Oxford Autoimmune Neurology Group (S.B. and S.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Neurology (S.B. and S.I.), John Radcliffe Hospital, Oxford, United Kingdom; Department of Laboratory Medicine and Pathology (S.J.P. and D.D.), and Department of Neurology (S.J.P. and D.D.), Mayo Clinic, Rochester, MN; Department of Neurology (M.D.G., J.M.G., and S.D.), University of California, San Francisco; Department of Neurology (S.-T.L.), Seoul National University Hospital, South Korea; and Wellcome Centre for Human Genetics (J.K. and K.S.E.), Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - Katherine S. Elliott
- From the Stanford University Center for Sleep Sciences (V.P.S., A.A., and E.M.), Stanford University School of Medicine, Palo Alto, CA; French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (S.M.-C., A.-L.P., V.R., and J.H.), Hospices Civils de Lyon, Hôpital Neurologique; Synatac Team (S.M.-C., A.-L.P., V.R., and J.H.), NeuroMyoGene Institute, INSERM U1217/CNRS UMR5310, Université Claude Bernard Lyon 1, Université de Lyon, France; Oxford Autoimmune Neurology Group (S.B. and S.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Neurology (S.B. and S.I.), John Radcliffe Hospital, Oxford, United Kingdom; Department of Laboratory Medicine and Pathology (S.J.P. and D.D.), and Department of Neurology (S.J.P. and D.D.), Mayo Clinic, Rochester, MN; Department of Neurology (M.D.G., J.M.G., and S.D.), University of California, San Francisco; Department of Neurology (S.-T.L.), Seoul National University Hospital, South Korea; and Wellcome Centre for Human Genetics (J.K. and K.S.E.), Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - Sarosh Irani
- From the Stanford University Center for Sleep Sciences (V.P.S., A.A., and E.M.), Stanford University School of Medicine, Palo Alto, CA; French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (S.M.-C., A.-L.P., V.R., and J.H.), Hospices Civils de Lyon, Hôpital Neurologique; Synatac Team (S.M.-C., A.-L.P., V.R., and J.H.), NeuroMyoGene Institute, INSERM U1217/CNRS UMR5310, Université Claude Bernard Lyon 1, Université de Lyon, France; Oxford Autoimmune Neurology Group (S.B. and S.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Neurology (S.B. and S.I.), John Radcliffe Hospital, Oxford, United Kingdom; Department of Laboratory Medicine and Pathology (S.J.P. and D.D.), and Department of Neurology (S.J.P. and D.D.), Mayo Clinic, Rochester, MN; Department of Neurology (M.D.G., J.M.G., and S.D.), University of California, San Francisco; Department of Neurology (S.-T.L.), Seoul National University Hospital, South Korea; and Wellcome Centre for Human Genetics (J.K. and K.S.E.), Nuffield Department of Medicine, University of Oxford, United Kingdom
| | | | | |
Collapse
|
5
|
Abstract
The original version of this article contains an error in the title. The title should be: Migraine Aura Without Headache. The title is corrected in this correction article.
Collapse
Affiliation(s)
- Divya R Shah
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, MC 9322, Dallas, TX, 75390-9322, USA
| | - Sonam Dilwali
- University of Texas Southwestern, Dallas, TX, USA.,Massachusetts General Hospital, Boston, MA, USA
| | - Deborah I Friedman
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, MC 9322, Dallas, TX, 75390-9322, USA. .,Department of Ophthalmology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
| |
Collapse
|
6
|
Landegger LD, Sagers JE, Dilwali S, Fujita T, Sahin MI, Stankovic KM. A Unified Methodological Framework for Vestibular Schwannoma Research. J Vis Exp 2017. [PMID: 28654042 DOI: 10.3791/55827] [Citation(s) in RCA: 7] [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: 01/12/2023] Open
Abstract
Vestibular schwannomas are the most common neoplasms of the cerebellopontine angle, making up 6-8% percent of all intracranial growths. Though these tumors cause sensorineural hearing loss in up to 95% of affected individuals, the molecular mechanisms underlying this hearing loss remain elusive. This article outlines the steps established in our laboratory to facilitate the collection and processing of various primary human tissue samples for downstream research applications integral to the study of vestibular schwannomas. Specifically, this work describes a unified methodological framework for the collection, processing, and culture of Schwann and schwannoma cells from surgical samples. This is integrated with parallel processing steps now considered essential for current research: the collection of tumor and nerve secretions, the preservation of RNA and the extraction of protein from collected tissues, the fixation of tissue for the preparation of sections, and the exposure of primary human cells to adeno-associated viruses for application to gene therapy. Additionally, this work highlights the translabyrinthine surgical approach to collect this tumor as a unique opportunity to obtain human sensory epithelium from the inner ear and perilymph. Tips to improve experimental quality are provided and common pitfalls highlighted.
Collapse
Affiliation(s)
- Lukas D Landegger
- Eaton Peabody Laboratories, Department of Otolaryngology, Massachusetts Eye and Ear; Department of Otolaryngology, Harvard Medical School; Department of Otolaryngology, Vienna General Hospital, Medical University of Vienna
| | - Jessica E Sagers
- Eaton Peabody Laboratories, Department of Otolaryngology, Massachusetts Eye and Ear; Program in Speech and Hearing Bioscience and Technology, Harvard Medical School
| | - Sonam Dilwali
- Eaton Peabody Laboratories, Department of Otolaryngology, Massachusetts Eye and Ear; Program in Speech and Hearing Bioscience and Technology, Harvard Medical School
| | - Takeshi Fujita
- Eaton Peabody Laboratories, Department of Otolaryngology, Massachusetts Eye and Ear; Department of Otolaryngology, Harvard Medical School
| | - Mehmet I Sahin
- Eaton Peabody Laboratories, Department of Otolaryngology, Massachusetts Eye and Ear; Department of Otolaryngology, Harvard Medical School
| | - Konstantina M Stankovic
- Eaton Peabody Laboratories, Department of Otolaryngology, Massachusetts Eye and Ear; Department of Otolaryngology, Harvard Medical School; Program in Speech and Hearing Bioscience and Technology, Harvard Medical School;
| |
Collapse
|
7
|
Abstract
While there have been remarkable advances in hearing research over the past few decades, there is still no cure for Sensorineural Hearing Loss (SNHL), a condition that typically involves damage to or loss of the delicate mechanosensory structures of the inner ear. Sophisticated in vitro and ex vivo assays have emerged in recent years, enabling the screening of an increasing number of potentially therapeutic compounds while minimizing resources and accelerating efforts to develop cures for SNHL. Though homogenous cultures of certain cell types continue to play an important role in current research, many scientists now rely on more complex organotypic cultures of murine inner ears, also known as cochlear explants. The preservation of organized cellular structures within the inner ear facilitates the in situ evaluation of various components of the cochlear infrastructure, including inner and outer hair cells, spiral ganglion neurons, neurites, and supporting cells. Here we present the preparation, culture, treatment, and immunostaining of neonatal murine cochlear explants. The careful preparation of these explants facilitates the identification of mechanisms that contribute to SNHL and constitutes a valuable tool for the hearing research community.
Collapse
Affiliation(s)
- Lukas D Landegger
- Eaton Peabody Laboratories, Department of Otolaryngology, Massachusetts Eye and Ear; Department of Otolaryngology, Harvard Medical School; Department of Otolaryngology, Vienna General Hospital, Medical University of Vienna
| | - Sonam Dilwali
- Eaton Peabody Laboratories, Department of Otolaryngology, Massachusetts Eye and Ear; Harvard Program in Speech and Hearing Bioscience and Technology
| | - Konstantina M Stankovic
- Eaton Peabody Laboratories, Department of Otolaryngology, Massachusetts Eye and Ear; Department of Otolaryngology, Harvard Medical School; Harvard Program in Speech and Hearing Bioscience and Technology;
| |
Collapse
|
8
|
Soares VYR, Atai NA, Fujita T, Dilwali S, Sivaraman S, Landegger LD, Hochberg FH, Oliveira CAPC, Bahmad F, Breakefield XO, Stankovic KM. Extracellular vesicles derived from human vestibular schwannomas associated with poor hearing damage cochlear cells. Neuro Oncol 2016; 18:1498-1507. [PMID: 27194145 DOI: 10.1093/neuonc/now099] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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: 10/20/2015] [Accepted: 04/13/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Vestibular schwannoma (VS) is a tumor of the vestibular nerve that transmits balance information from the inner ear to the brain. Sensorineural hearing loss occurs in 95% of patients with these tumors, but the cause of this loss is not well understood. We posit a role of VS-secreted extracellular vesicles (EVs) as a major contributing factor in cochlear nerve damage. METHODS Using differential centrifugation, we isolated EVs from VS cell line HEI-193 and primary cultured human VS cells from patients with good hearing or poor hearing. The EVs were characterized using a Nanosight device and transmission electron microscopy and by extracting their RNA content. The EVs' effects on cultured murine spiral ganglion cells and organotypic cochlear cultures were studied using a transwell dual-culture system and by direct labeling of EVs with PKH-67 dye. EV-induced changes in cochlear cells were quantified using confocal immunohistochemistry. Transfection of VS cells with a green fluorescent protein-containing plasmid was confirmed with reverse transcription PCR. RESULTS Human VS cells, from patients with poor hearing, produced EVs that could damage both cultured murine cochlear sensory cells and neurons. In contrast, EVs derived from VS cells from patients with good hearing did not damage the cultured cochlear cells. CONCLUSIONS This is the first report on EVs derived from VSs and on the capacity of EVs from VSs from patients with hearing loss to selectively damage cochlear cells, thereby identifying a potential novel mechanism of VS-associated sensorineural hearing loss.
Collapse
Affiliation(s)
- Vitor Y R Soares
- Department of Otolaryngology, Eaton Peabody Laboratories, Massachusetts Eye and Ear, Boston, Massachusetts (V.Y.R.S., T.F., S.D., L.D.L., K.M.S.); Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts (V.Y.R.S., T.F., L.D.L., K.M.S.); Health Science Program and Department of Otolaryngology, University of Brasilia, Brasília, Distrito Federal, Brazil (V.Y.R.S., C.A.P.C.O., F.B.); University of Amsterdam, Amsterdam, the Netherlands (N.A.A.); Department of Neurology and Radiology, Massachusetts General Hospital and Program in Neuroscience, Harvard Medical School, Charlestown, Massachusetts (N.A.A., S.S., X.O.B.); Harvard-MIT Program in Speech and Hearing Bioscience and Technology, Boston, Massachusetts (S.D., K.M.S); Department of Neurosurgery, University of California at San Diego, San Diego, California (F.H.H.)
| | - Nadia A Atai
- Department of Otolaryngology, Eaton Peabody Laboratories, Massachusetts Eye and Ear, Boston, Massachusetts (V.Y.R.S., T.F., S.D., L.D.L., K.M.S.); Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts (V.Y.R.S., T.F., L.D.L., K.M.S.); Health Science Program and Department of Otolaryngology, University of Brasilia, Brasília, Distrito Federal, Brazil (V.Y.R.S., C.A.P.C.O., F.B.); University of Amsterdam, Amsterdam, the Netherlands (N.A.A.); Department of Neurology and Radiology, Massachusetts General Hospital and Program in Neuroscience, Harvard Medical School, Charlestown, Massachusetts (N.A.A., S.S., X.O.B.); Harvard-MIT Program in Speech and Hearing Bioscience and Technology, Boston, Massachusetts (S.D., K.M.S); Department of Neurosurgery, University of California at San Diego, San Diego, California (F.H.H.)
| | - Takeshi Fujita
- Department of Otolaryngology, Eaton Peabody Laboratories, Massachusetts Eye and Ear, Boston, Massachusetts (V.Y.R.S., T.F., S.D., L.D.L., K.M.S.); Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts (V.Y.R.S., T.F., L.D.L., K.M.S.); Health Science Program and Department of Otolaryngology, University of Brasilia, Brasília, Distrito Federal, Brazil (V.Y.R.S., C.A.P.C.O., F.B.); University of Amsterdam, Amsterdam, the Netherlands (N.A.A.); Department of Neurology and Radiology, Massachusetts General Hospital and Program in Neuroscience, Harvard Medical School, Charlestown, Massachusetts (N.A.A., S.S., X.O.B.); Harvard-MIT Program in Speech and Hearing Bioscience and Technology, Boston, Massachusetts (S.D., K.M.S); Department of Neurosurgery, University of California at San Diego, San Diego, California (F.H.H.)
| | - Sonam Dilwali
- Department of Otolaryngology, Eaton Peabody Laboratories, Massachusetts Eye and Ear, Boston, Massachusetts (V.Y.R.S., T.F., S.D., L.D.L., K.M.S.); Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts (V.Y.R.S., T.F., L.D.L., K.M.S.); Health Science Program and Department of Otolaryngology, University of Brasilia, Brasília, Distrito Federal, Brazil (V.Y.R.S., C.A.P.C.O., F.B.); University of Amsterdam, Amsterdam, the Netherlands (N.A.A.); Department of Neurology and Radiology, Massachusetts General Hospital and Program in Neuroscience, Harvard Medical School, Charlestown, Massachusetts (N.A.A., S.S., X.O.B.); Harvard-MIT Program in Speech and Hearing Bioscience and Technology, Boston, Massachusetts (S.D., K.M.S); Department of Neurosurgery, University of California at San Diego, San Diego, California (F.H.H.)
| | - Sarada Sivaraman
- Department of Otolaryngology, Eaton Peabody Laboratories, Massachusetts Eye and Ear, Boston, Massachusetts (V.Y.R.S., T.F., S.D., L.D.L., K.M.S.); Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts (V.Y.R.S., T.F., L.D.L., K.M.S.); Health Science Program and Department of Otolaryngology, University of Brasilia, Brasília, Distrito Federal, Brazil (V.Y.R.S., C.A.P.C.O., F.B.); University of Amsterdam, Amsterdam, the Netherlands (N.A.A.); Department of Neurology and Radiology, Massachusetts General Hospital and Program in Neuroscience, Harvard Medical School, Charlestown, Massachusetts (N.A.A., S.S., X.O.B.); Harvard-MIT Program in Speech and Hearing Bioscience and Technology, Boston, Massachusetts (S.D., K.M.S); Department of Neurosurgery, University of California at San Diego, San Diego, California (F.H.H.)
| | - Lukas D Landegger
- Department of Otolaryngology, Eaton Peabody Laboratories, Massachusetts Eye and Ear, Boston, Massachusetts (V.Y.R.S., T.F., S.D., L.D.L., K.M.S.); Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts (V.Y.R.S., T.F., L.D.L., K.M.S.); Health Science Program and Department of Otolaryngology, University of Brasilia, Brasília, Distrito Federal, Brazil (V.Y.R.S., C.A.P.C.O., F.B.); University of Amsterdam, Amsterdam, the Netherlands (N.A.A.); Department of Neurology and Radiology, Massachusetts General Hospital and Program in Neuroscience, Harvard Medical School, Charlestown, Massachusetts (N.A.A., S.S., X.O.B.); Harvard-MIT Program in Speech and Hearing Bioscience and Technology, Boston, Massachusetts (S.D., K.M.S); Department of Neurosurgery, University of California at San Diego, San Diego, California (F.H.H.)
| | - Fred H Hochberg
- Department of Otolaryngology, Eaton Peabody Laboratories, Massachusetts Eye and Ear, Boston, Massachusetts (V.Y.R.S., T.F., S.D., L.D.L., K.M.S.); Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts (V.Y.R.S., T.F., L.D.L., K.M.S.); Health Science Program and Department of Otolaryngology, University of Brasilia, Brasília, Distrito Federal, Brazil (V.Y.R.S., C.A.P.C.O., F.B.); University of Amsterdam, Amsterdam, the Netherlands (N.A.A.); Department of Neurology and Radiology, Massachusetts General Hospital and Program in Neuroscience, Harvard Medical School, Charlestown, Massachusetts (N.A.A., S.S., X.O.B.); Harvard-MIT Program in Speech and Hearing Bioscience and Technology, Boston, Massachusetts (S.D., K.M.S); Department of Neurosurgery, University of California at San Diego, San Diego, California (F.H.H.)
| | - Carlos A P C Oliveira
- Department of Otolaryngology, Eaton Peabody Laboratories, Massachusetts Eye and Ear, Boston, Massachusetts (V.Y.R.S., T.F., S.D., L.D.L., K.M.S.); Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts (V.Y.R.S., T.F., L.D.L., K.M.S.); Health Science Program and Department of Otolaryngology, University of Brasilia, Brasília, Distrito Federal, Brazil (V.Y.R.S., C.A.P.C.O., F.B.); University of Amsterdam, Amsterdam, the Netherlands (N.A.A.); Department of Neurology and Radiology, Massachusetts General Hospital and Program in Neuroscience, Harvard Medical School, Charlestown, Massachusetts (N.A.A., S.S., X.O.B.); Harvard-MIT Program in Speech and Hearing Bioscience and Technology, Boston, Massachusetts (S.D., K.M.S); Department of Neurosurgery, University of California at San Diego, San Diego, California (F.H.H.)
| | - Fayez Bahmad
- Department of Otolaryngology, Eaton Peabody Laboratories, Massachusetts Eye and Ear, Boston, Massachusetts (V.Y.R.S., T.F., S.D., L.D.L., K.M.S.); Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts (V.Y.R.S., T.F., L.D.L., K.M.S.); Health Science Program and Department of Otolaryngology, University of Brasilia, Brasília, Distrito Federal, Brazil (V.Y.R.S., C.A.P.C.O., F.B.); University of Amsterdam, Amsterdam, the Netherlands (N.A.A.); Department of Neurology and Radiology, Massachusetts General Hospital and Program in Neuroscience, Harvard Medical School, Charlestown, Massachusetts (N.A.A., S.S., X.O.B.); Harvard-MIT Program in Speech and Hearing Bioscience and Technology, Boston, Massachusetts (S.D., K.M.S); Department of Neurosurgery, University of California at San Diego, San Diego, California (F.H.H.)
| | - Xandra O Breakefield
- Department of Otolaryngology, Eaton Peabody Laboratories, Massachusetts Eye and Ear, Boston, Massachusetts (V.Y.R.S., T.F., S.D., L.D.L., K.M.S.); Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts (V.Y.R.S., T.F., L.D.L., K.M.S.); Health Science Program and Department of Otolaryngology, University of Brasilia, Brasília, Distrito Federal, Brazil (V.Y.R.S., C.A.P.C.O., F.B.); University of Amsterdam, Amsterdam, the Netherlands (N.A.A.); Department of Neurology and Radiology, Massachusetts General Hospital and Program in Neuroscience, Harvard Medical School, Charlestown, Massachusetts (N.A.A., S.S., X.O.B.); Harvard-MIT Program in Speech and Hearing Bioscience and Technology, Boston, Massachusetts (S.D., K.M.S); Department of Neurosurgery, University of California at San Diego, San Diego, California (F.H.H.)
| | - Konstantina M Stankovic
- Department of Otolaryngology, Eaton Peabody Laboratories, Massachusetts Eye and Ear, Boston, Massachusetts (V.Y.R.S., T.F., S.D., L.D.L., K.M.S.); Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts (V.Y.R.S., T.F., L.D.L., K.M.S.); Health Science Program and Department of Otolaryngology, University of Brasilia, Brasília, Distrito Federal, Brazil (V.Y.R.S., C.A.P.C.O., F.B.); University of Amsterdam, Amsterdam, the Netherlands (N.A.A.); Department of Neurology and Radiology, Massachusetts General Hospital and Program in Neuroscience, Harvard Medical School, Charlestown, Massachusetts (N.A.A., S.S., X.O.B.); Harvard-MIT Program in Speech and Hearing Bioscience and Technology, Boston, Massachusetts (S.D., K.M.S); Department of Neurosurgery, University of California at San Diego, San Diego, California (F.H.H.)
| |
Collapse
|
9
|
Dilwali S, Landegger LD, Soares VYR, Deschler DG, Stankovic KM. Secreted Factors from Human Vestibular Schwannomas Can Cause Cochlear Damage. Sci Rep 2015; 5:18599. [PMID: 26690506 PMCID: PMC4686978 DOI: 10.1038/srep18599] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [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: 05/29/2015] [Accepted: 10/26/2015] [Indexed: 12/25/2022] Open
Abstract
Vestibular schwannomas (VSs) are the most common tumours of the cerebellopontine angle. Ninety-five percent of people with VS present with sensorineural hearing loss (SNHL); the mechanism of this SNHL is currently unknown. To establish the first model to study the role of VS-secreted factors in causing SNHL, murine cochlear explant cultures were treated with human tumour secretions from thirteen different unilateral, sporadic VSs of subjects demonstrating varied degrees of ipsilateral SNHL. The extent of cochlear explant damage due to secretion application roughly correlated with the subjects' degree of SNHL. Secretions from tumours associated with most substantial SNHL resulted in most significant hair cell loss and neuronal fibre disorganization. Secretions from VSs associated with good hearing or from healthy human nerves led to either no effect or solely fibre disorganization. Our results are the first to demonstrate that secreted factors from VSs can lead to cochlear damage. Further, we identified tumour necrosis factor alpha (TNFα) as an ototoxic molecule and fibroblast growth factor 2 (FGF2) as an otoprotective molecule in VS secretions. Antibody-mediated TNFα neutralization in VS secretions partially prevented hair cell loss due to the secretions. Taken together, we have identified a new mechanism responsible for SNHL due to VSs.
Collapse
Affiliation(s)
- Sonam Dilwali
- Eaton Peabody Laboratories, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA.,Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA.,Harvard-MIT Program in Health, Science and Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Lukas D Landegger
- Eaton Peabody Laboratories, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA.,Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.,Department of Otology and Laryngology, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Vitor Y R Soares
- Eaton Peabody Laboratories, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA.,Department of Otology and Laryngology, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA.,Department of Otorhinolaryngology-Head and Neck Surgery, Health Science Faculty, University of Brasilia, SGAN, Via L2 Norte, Quadra 604/605, 70840-050, Asa Norte, DF, Brazil
| | - Daniel G Deschler
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA.,Department of Otology and Laryngology, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Konstantina M Stankovic
- Eaton Peabody Laboratories, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA.,Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA.,Harvard-MIT Program in Health, Science and Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA.,Department of Otology and Laryngology, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| |
Collapse
|
10
|
Abstract
Vestibular schwannoma (VS), the fourth most common intracranial tumor, arises from the Schwann cells of the vestibular nerve. Although several pathways have been independently implicated in VS pathobiology, interactions among these pathways have not been explored in depth. We have investigated the potential cross-talk between hepatocyte growth factor (HGF) and vascular endothelial growth factor-A (VEGF-A) in human VS, an interaction that has been described in other physiological and pathological cell types. We affirmed previous findings that VEGF-A signaling is aberrantly upregulated in VS, and established that expression of HGF and its receptor cMET is also significantly higher in sporadic VS than in healthy nerves. In primary human VS and Schwann cell cultures, we found that VEGF-A and HGF signaling pathways modulate each other. siRNAs targeting cMET decreased both cMET and VEGF-A protein levels, and siRNAs targeting VEGF-A reduced cMET expression. Additionally, siRNA-mediated knockdown of VEGF-A or cMET and pharmacologic inhibition of cMET decreased cellular proliferation in primary human VS cultures. Our data suggest cross-talk between these 2 prominent pathways in VS and highlight the HGF/cMET pathway as an additional important therapeutic target in VS.
Collapse
Key Words
- BrdU, 5-Bromo-2'-Deoxyuridine
- DMSO, Dimethyl sulfoxide
- GAN, Great auricular nerve
- HCl, Hydrochloric acid
- HGF, Gene encoding HGF protein
- HGF, Hepatocyte growth factor
- HRP, Horse-radish peroxidase
- KDR, Gene encoding vascular endothelial growth factor receptor 2
- MET, Gene encoding cMET protein
- NF2, Neurofibromatosis type 2
- PBS, Phosphate buffered saline
- S100, Schwann cell/schwannoma cell marker
- SD, Standard deviation
- SEM, Standard error of mean
- Schwann cells
- VEGF-A, Vascular endothelial growth factor-A
- VEGFA, Gene encoding VEGF-A protein
- VEGFR2, Vascular endothelial growth factor receptor 2
- VS, Vestibular schwannoma
- cMET, MNNG HOS transforming gene, hepatocyte growth factor receptor
- cross-talk
- hepatocyte growth factor
- mRNA, Messenger ribonucleic acid
- siRNA
- siRNA, Small interfering ribonucleic acid
- vascular endothelial growth factor
- vestibular schwannoma
Collapse
Affiliation(s)
- Sonam Dilwali
- a Eaton Peabody Laboratories and Department of Otolaryngology; Massachusetts Eye & Ear Infirmary ; Boston , MA USA
| | | | | |
Collapse
|
11
|
Dilwali S, Briët MC, Kao SY, Fujita T, Landegger LD, Platt MP, Stankovic KM. Preclinical validation of anti-nuclear factor-kappa B therapy to inhibit human vestibular schwannoma growth. Mol Oncol 2015; 9:1359-70. [PMID: 25891780 DOI: 10.1016/j.molonc.2015.03.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [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: 08/12/2014] [Revised: 02/22/2015] [Accepted: 03/23/2015] [Indexed: 01/25/2023] Open
Abstract
Vestibular schwannomas (VSs), the most common tumors of the cerebellopontine angle, arise from Schwann cells lining the vestibular nerve. Pharmacotherapies against VS are almost non-existent. Although the therapeutic inhibition of inflammatory modulators has been established for other neoplasms, it has not been explored in VS. A bioinformatic network analysis of all genes reported to be differentially expressed in human VS revealed a pro-inflammatory transcription factor nuclear factor-kappa B (NF-κB) as a central molecule in VS pathobiology. Assessed at the transcriptional and translational level, canonical NF-κB complex was aberrantly activated in human VS and derived VS cultures in comparison to control nerves and Schwann cells, respectively. Cultured primary VS cells and VS-derived human cell line HEI-193 were treated with specific NF-κB siRNAs, experimental NF-κB inhibitor BAY11-7082 (BAY11) and clinically relevant NF-κB inhibitor curcumin. Healthy human control Schwann cells from the great auricular nerve were also treated with BAY11 and curcumin to assess toxicity. All three treatments significantly reduced proliferation in primary VS cultures and HEI-193 cells, with siRNA, 5 μM BAY11 and 50 μM curcumin reducing average proliferation (±standard error of mean) to 62.33% ± 10.59%, 14.3 ± 9.7%, and 23.0 ± 20.9% of control primary VS cells, respectively. These treatments also induced substantial cell death. Curcumin, unlike BAY11, also affected primary Schwann cells. This work highlights NF-κB as a key modulator in VS cell proliferation and survival and demonstrates therapeutic efficacy of directly targeting NF-κB in VS.
Collapse
Affiliation(s)
- Sonam Dilwali
- Eaton Peabody Laboratories, Department of Otolaryngology, 243 Charles Street, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA; Harvard-MIT Program in Speech and Hearing Bioscience and Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA.
| | - Martijn C Briët
- Eaton Peabody Laboratories, Department of Otolaryngology, 243 Charles Street, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA; Department of Otorhinolaryngology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
| | - Shyan-Yuan Kao
- Eaton Peabody Laboratories, Department of Otolaryngology, 243 Charles Street, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA.
| | - Takeshi Fujita
- Eaton Peabody Laboratories, Department of Otolaryngology, 243 Charles Street, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA; Department of Otology and Laryngology, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
| | - Lukas D Landegger
- Eaton Peabody Laboratories, Department of Otolaryngology, 243 Charles Street, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA; Department of Otology and Laryngology, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
| | - Michael P Platt
- Department of Otology and Laryngology, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Department of Otolaryngology-Head and Neck Surgery, Boston University, 72 E Concord Street, Boston, MA 02118, USA.
| | - Konstantina M Stankovic
- Eaton Peabody Laboratories, Department of Otolaryngology, 243 Charles Street, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA; Harvard-MIT Program in Speech and Hearing Bioscience and Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA; Department of Otology and Laryngology, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
| |
Collapse
|
12
|
Dilwali S, Patel PB, Roberts DS, Basinsky GM, Harris GJ, Emerick KS, Stankovic KM. Primary culture of human Schwann and schwannoma cells: improved and simplified protocol. Hear Res 2014; 315:25-33. [PMID: 24910344 PMCID: PMC4164296 DOI: 10.1016/j.heares.2014.05.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 04/30/2014] [Accepted: 05/29/2014] [Indexed: 11/27/2022]
Abstract
Primary culture of human Schwann cells (SCs) and vestibular schwannoma (VS) cells are invaluable tools to investigate SC physiology and VS pathobiology, and to devise effective pharmacotherapies against VS, which are sorely needed. However, existing culture protocols, in aiming to create robust, pure cultures, employ methods that can lead to loss of biological characteristics of the original cells, potentially resulting in misleading biological findings. We have developed a minimally manipulative method to culture primary human SC and VS cells, without the use of selective mitogens, toxins, or time-consuming and potentially transformative laboratory techniques. Schwann cell purity was quantified longitudinally using S100 staining in SC cultures derived from the great auricular nerve and VS cultures followed for 7 and 12 weeks, respectively. SC cultures retained approximately ≥85% purity for 2 weeks. VS cultures retained approximately ≥80% purity for the majority of the span of 12 weeks, with maximal purity of 87% at 2 weeks. The VS cultures showed high level of biological similarity (68% on average) to their respective parent tumors, as assessed using a protein array featuring 41 growth factors and receptors. Apoptosis rate in vitro negatively correlated with tumor volume. Our results, obtained using a faster, simplified culturing method than previously utilized, indicate that highly pure, primary human SC and VS cultures can be established with minimal manipulation, reaching maximal purity at 2 weeks of culture. The VS cultures recapitulate the parent tumors' biology to a great degree, making them relevant models to investigate VS pathobiology.
Collapse
Affiliation(s)
- Sonam Dilwali
- Speech and Hearing Bioscience and Technology Program, Harvard - Massachusetts Institute of Technology, Division of Health Sciences and Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA; Eaton Peabody Laboratories and Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA, 02114, USA
| | - Pratik B Patel
- Department of Otology and Laryngology, Harvard Medical School, 651 Huntington Avenue, Boston, MA 02115, USA; Eaton Peabody Laboratories and Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA, 02114, USA
| | - Daniel S Roberts
- Department of Otology and Laryngology, Harvard Medical School, 651 Huntington Avenue, Boston, MA 02115, USA; Eaton Peabody Laboratories and Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA, 02114, USA
| | - Gina M Basinsky
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Gordon J Harris
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Kevin S Emerick
- Department of Otology and Laryngology, Harvard Medical School, 651 Huntington Avenue, Boston, MA 02115, USA; Eaton Peabody Laboratories and Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA, 02114, USA
| | - Konstantina M Stankovic
- Speech and Hearing Bioscience and Technology Program, Harvard - Massachusetts Institute of Technology, Division of Health Sciences and Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA; Department of Otology and Laryngology, Harvard Medical School, 651 Huntington Avenue, Boston, MA 02115, USA; Eaton Peabody Laboratories and Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA, 02114, USA.
| |
Collapse
|
13
|
Abstract
Etiologies for many inner ear disorders, including autoimmune inner ear disease, sudden sensorineural hearing loss, and Meniere’s disease, remain unknown. Indirect evidence suggests an immune-mediated process involving an allergic or autoimmune mechanism. We examined whether known immunogenic proteins share sequence similarity with inner ear proteins, which may lead to cross-reactivity and detrimental immune activation. Comprehensive bioinformatic analyses of primary sequences of intact and mutated proteins associated with human hearing loss and all proteins known to be expressed in the human inner ear were compared with all immune epitopes in the Immune Epitope Database. The exact match and basic local alignment search tool computational algorithms identified 3036 and 106 unique epitope matches, respectively, the majority of which were infectious epitopes. If validated in future clinical trials, these candidate immune epitopes in the inner ear would be potential novel targets for diagnosis and treatment of some inner ear disorders and the resulting hearing loss.
Collapse
Affiliation(s)
- Michael Platt
- Department of Otolaryngology–Head and Neck Surgery, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Sonam Dilwali
- Eaton Peabody Laboratory and Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Program in Speech and Hearing Bioscience and Technology, Harvard/Massachusetts Institute of Technology Joint Division of Health Sciences and Technology, Cambridge, Massachusetts, USA
| | - Alphi Elackattu
- Department of Otolaryngology–Head and Neck Surgery, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jignesh R. Parikh
- Department of Engineering, Boston University, Boston, Massachusetts, USA
| | - Konstantina M. Stankovic
- Eaton Peabody Laboratory and Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Program in Speech and Hearing Bioscience and Technology, Harvard/Massachusetts Institute of Technology Joint Division of Health Sciences and Technology, Cambridge, Massachusetts, USA
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
14
|
Platt MP, Elackattu AP, Dilwali S, Parikh J, Stankovic KM. Mining Immune Epitopes in Ménière’s Disease and Sudden Sensorineural Hearing Loss. Otolaryngol Head Neck Surg 2012. [DOI: 10.1177/0194599812451438a166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: Etiologies for Ménière’s disease and sudden sensorineural hearing loss remain unknown. Indirect evidence exists for allergy-mediated or autoimmune process. The purpose of this study is to determine whether immunogenic proteins share similar sequences with inner ear proteins, which may lead to cross-reactivity and immune activation in inner ear disorders. Method: Comprehensive bioinformatic primary sequence analyses of intact and mutated proteins associated with human syndromic and nonsyndromic hearing loss and proteins expressed in the human inner ear was performed. Comparison of sequences to epitopes in the Immune Epitope Database was performed by exact match, BLAST, and BLOSUM62 score computational algorithms. Results: Computational analysis of primary protein sequence for 81 known inner ear proteins, 102 proteins from genes identified in syndromic and non-syndromic hearing loss, and 438 protein sequences with known mutations that contribute to sensorineural hearing loss was compared to 151,086 epitopes previously implicated in allergic, autoimmune, and infectious disorders within the Immune Epitope Database. The exact match and BLAST algorithms identified 1925 and 97 unique epitope matches, respectively. Top BLOSUM62 score algorithm resulted in a single hit for the 47 kDa membrane antigen. Other epitopes included those seen in allergic rhinitis, infectious diseases, and autoimmune disorders. Conclusion: Abnormal immune activation is suspected in Ménière’s disease and SSNHL. Candidate immune epitopes were identified that may contribute to pathogenesis of these disorders. While these epitopes await clinical validation, they present novel targets for diagnosis and treatment of sensorineural hearing loss.
Collapse
|